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Contemporary CBCT diagnostics—discovery of a new artery with possible impact on surgical planning: the anterior superior palatal alveolar artery

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Abstract

Purpose

An ongoing clinical trial regarding intra- and post-surgical morbidity in maxillary apicoectomies showed significant higher morbidity for upper canines and palatal roots of upper 1st premolars. Analysis of available presurgical cone beam computed tomography (CBCT)-scans revealed the existence of an unknown bone-canal branching off from the bone-canal or groove of the anterior superior alveolar artery (asaa). Aim of the study was the determination of the contents of this newly found bone canal in human cadaver heads, its prevalence as possible standard anatomical structure and its automatized detection with a contemporary high-resolution TRIUM-CBCT-device in vivo.

Methods

35 human cadaver heads were dissected, the prevalence of the bone-canal determined and its contents analyzed by histology. 835 consecutive routine high-resolution TRIUM-CBCT-scans from routine patients were analyzed by an automatized detection- and tracing-algorithm for in vivo-determination of prevalence of this bone canal. Automatized detection and additional manual tracing were statistically evaluated by SSPS 20.0 software.

Results

The bone-canal was found in 96% of the anatomical specimens, its content identified as artery not described until now and named after the first finder “Arteria Kurrekii”. Automatized tracing of TRIUM-CBCT-scans with additional manual tracing revealed an in vivo prevalence of this newly found artery of 95% (p ≤ 0.05).

Conclusions

The newly found anterior superior palatal alveolar artery (aspaa—“Arteria Kurrekii”) might have the same clinical impact for surgical procedures in the maxilla as the posterior superior alveolar artery (psaa). Its first detection was enabled by high-resolution TRIUM-CBCT devices and prevalence as standard anatomical structure proven in vivo by automatized CBCT-scan analysis.

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Acknowledgements

The authors cordially thank Univ.Prof.emer. Dr. Juergen K. Mai, Professor of Neuroanatomy, former Director of the Institute of Anatomy I, H.-Heine-University Duesseldorf, for his advices and support at all stages of the study, his search and professional international inquiries among his colleagues regarding any knowledge of the supposedly newly found artery, provisioning of human cadaver heads, neural network IT-resources and computing time and adaptation of experimental detection algorithms developed, tested and used at his institution without remuneration.

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Authors and Affiliations

  1. Implantology Clinic Oberkassel, Dominikanerstr.10, 40545, Düsseldorf, Germany

    Andreas Kurrek

  2. Institute of Anatomy I, Heinrich-Heine-University Dusseldorf, Universitätsstraße 1, 40225, Düsseldorf, Germany

    Andreas Kurrek

  3. Institute for Maxillofacial Surgery and Dentistry, General Hospital of the City of Vienna “Hietzing”, Wolkersbergenstrasse 1, 1130, Vienna, Austria

    Angelo Troedhan

  4. Division of Clinical and Functional Anatomy, Department of Anatomy, Histology and Embryology, Medical University of Innsbruck, Muellerstraße 59, 6020, Innsbruck, Austria

    Marko Konschake

Authors
  1. Andreas Kurrek
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  2. Angelo Troedhan
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  3. Marko Konschake
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Contributions

AK: Project development, Data collection, Data management, Data analysis, Manuscript editing, Anatomy lab work, CBCT lab work. AT: Protocol development, Data collection, Data management, Data analysis, Manuscript writing, CBCT lab work. MK: Data collection, Data management, Data analysis, Manuscript editing, Anatomy lab work.

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Correspondence to Angelo Troedhan.

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The authors declare that they have no conflict of interest.

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Kurrek, A., Troedhan, A. & Konschake, M. Contemporary CBCT diagnostics—discovery of a new artery with possible impact on surgical planning: the anterior superior palatal alveolar artery. Surg Radiol Anat 40, 1147–1158 (2018). https://doi.org/10.1007/s00276-018-2062-9

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  • DOI: https://doi.org/10.1007/s00276-018-2062-9

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