Retrospective cone beam computerized tomography study of the infraorbital foramen in relation to the maxillary sinus

Abstract

Objectives: As cone beam computerized tomography is used more widely for initial data collection and treatment planning, more valuable anatomic information is at the disposal of clinicians. The scans provide a very accurate display of the patient’s anatomy and these beneficial findings can be used to prevent surgical complications as well as advancing anatomical knowledge. This study aims to expand the current knowledge on the location of the infraorbital nerve in relation to the maxillary sinus in a group of patients who had CBCT scans taken for diagnosis and treatment planning. The study also aims to determine if age, gender or ethnicity have a relationship with the location of the nerve in relation to the sinus. Materials and Methods: 821 CBCT scans were take at Temple University Kornberg School of Dentistry Department of Oral and Maxillofacial Radiology from January 1, 2009 to July 31, 2013. These scans were evaluated using i-CAT computer imaging software. Patients under 18, patients without posterior or maxillary dentitions and patients who’s scans did not include the infraorbital nerve were excluded from the study. A total of four hundred three (403) CBCT scans were included in the study. Patients with visible infraorbital nerves were selected and location, age, gender and ethnicity were recorded. Individual scans had infraorbital nerves identified and examined for relationship superior to a specific tooth, and distance above the floor of the sinus. Results: After reviewing 680 scans, only 403 were included in the study due to exclusions. Scans were subdivided into age, gender, ethnicity and location of the nerve in relation to tooth position. The total average distance from the infraorbital foramen to the floor of the maxillary sinus was 23.94 mm on the right side and 22.84 mm on the left side. The average distance of males was 25.3 mm on the right and 24.27 mm on the left. The females’ average distance was 22.77 mm on the right and 21.62 mm on the left. The distance increased as the patients aged. The most common maxillary tooth inferior to the foramen was second premolar 46.65% of time, followed by the first molar 41.69% of the time. The difference between genders, right and left sides, and age groups all showed statistical significance. The differences between the ethnicities were not statistically significant. Conclusion: Based on the data collected and analyzed in the present study, the infraorbital foramen appeared to be located above the second premolar or first molar 88% of the time. The distance of the foramen from the floor of the sinus was larger in men than women. The right and left side can be different, and the distance tends to increase with the age of the patient. This information can be applied to better achieve local anesthetic delivery success, and avoid complications and nerve damage when performing procedures.