Anterior Süperior Palatal Alveolar Arterin Morfolojik Detaylarının Dijital Subtraksiyon Anjiyografi Tekniği ile Tespiti ve Gömülü Kanin Diş Varlığı ile İlişkisinin Belirlenmesi

Abstract

By the increase in number of surgical procedures in the intraoral region, the evaluation of the anatomical structures gains importance. The frequency of surgical applications and the need of increasing the success rate made it necessary to evaluate the anatomy of the region. In order to achieve a safer working environment, injury to major vascular and nerve branches should be avoided. The widespread use of cone beam computed tomography (CBCT) offers successful results in evaluating the anatomical features of the jaws, especially in relation to neurovascularization and possible anatomical variations. However, even if the bone canal of the neurovascular structures is displayed, it cannot show the presence of the artery. Angiography technique is required to evaluate vascular structures. The aim of this study is to identify the anterior superior palatal alveolar artery (ASPAA), which is not included in the anatomy books, in the maxillary anterior region, by digital subtraction angiography (DSA) technique and evaluating its morphology and eliminating the deficiency in this subject in the literature. As a result of these examinations, it is aimed to inform the dentist before the surgical intervention to be performed in the area where the ASPAA is located for preventing possible complications and failures. In our study DSA images of 110 patients age range of 18-80 were examined by two different observers and inter-observer agreement was evaluated. The presence of impacted canine teeth was evaluated in computed tomography (CT) image of the same patients. In our study, while the presence of ASPAA resulted in perfect agreement between the observers, no significant relationship was found between the presence of ASPAA and the presence of impacted canine teeth. In the evaluation of DSA images of 110 patients, it was observed that 40 patients did not have ASPAA, 19 patients had ASPAA on the right side, 21 patients on the left side, and 30 patients had bilateral ASPAA.