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Distance of the alveolar crest to infraorbital foramen in dentulous and total edentulous maxillae: a reference to the anterior superior alveolar nerve anesthesia

ABSTRACT: Introduction: The technique of dental anesthesia of the anterior superior alveolar nerve (ASAN) is complex and may become more difficult in total edentulous patients, since the reabsorption of the alveolar process and subsequent decrease in face height alters the local morphology and topography, including the anatomical accidents of reference for this technique. The aim of this study is to determine if there is a statistically significant difference between the vestibular alveolar crest of the first upper premolar to the center of the infraorbital foramen (IOF) in skulls with dentulous and edentulous maxillae. Material and Methods: 30 adult skulls, divided into 15 dentulous skulls and 15 senile edentulous skulls, were collectedfrom the human Anatomy Laboratory of the Federal University of Uberlandia. The distance between the alveolar bone crest of the first upper premolar from the center of the IOF in the maxilla was measured with a digital caliper. Results: Measurements between these distances revealed that the averages between dentulous and edentulous maxillae presented differences of 4.0 mm (right side) and 4.2 mm (left side) in distance. In the dentulous maxillae, the sides had a mean difference of 0.4 mm and, and the sides of the edentulous maxillae showed an average difference of 0.2 mm. The differences were statistically significant between the dentulous and edentulous skulls, but not within their respective antimeres. Conclusion: We concluded that for a safe clinical performance of the ASAN anesthesia technique in the IOF region, the penetration of the needle should be 4 mm smaller in the edentulous patients when compared with the total dentulous, providing safety for the technique and comfort for the patient.

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