10/11/2016

3D REVIEW
OF THE Maxillary Anatomy
MICRORADIOGRAPHICAL
Alexandre Khairallah DDS. HSSD. PGD.DEADMFR.MBAIRD
Post Graduate Diploma in Oral Biology
High Specialized Studies Diploma in Oral Surgery
ANATOMY
Post Graduate Diploma in Oral & Maxillo-Facial Imaging
Diplomat of the European Academy of Dento-Maxillo-Facial Radiologist
Member of the Implant Council -BAIRD- British Academy of Implant &
Restorative Dentistry
Partner/Opinion Leader Kavo Dental GmBH - Radiology division
Partner/Opinion Leader Carestream health - dental division
Training Director CBCT program Carestream health – Middle East
International speaker/ Consultant Leader implant - Italy
Chef de Service Oral & Maxillo-Facial Imaging Dpt / Dental School – LU
Founder & manager of CLIR "Centre de Lecture et d’Interprétation
Radiologique “
http://clir-3d.blogspot.com

Nasal Fossa Nasal Fossa Anterior nasal spine

Private collection Private collection

Courtesy S. Jade Property of CLIR Property of CLIR

Nasal septum

Private collection Private collection

Property of CLIR Property of CLIR

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Private collection Private collection

Property of CLIR Property of CLIR

Private collection Courtesy W. Richter

Property of CLIR Private collection
Property of CLIR

Private collection
Property of CLIR

2
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Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Private collection Private collection

Private collection Property of CLIR Property of CLIR
Property of CLIR

Nasopalatine foramen

Private collection
Private collection Private collection Property of CLIR
Property of CLIR Property of CLIR

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Nasopalatine foramen
Stenson & Scarpa
foramia

1.5 mm ≤ Φ ≤ 9.2 mm (≥1cm :Cyst)

2.9 mm ≤ BP bone ≤ 13.6 mm
Anastomoses of the
descending palatine and the
sphenopalatine artery
Private collection Nasopalatine nerve Private collection
Property of CLIR Property of CLIR

Private collection Private collection

Property of CLIR Property of CLIR Private collection
Property of CLIR

Courtesy
H. Maghairy

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Maxillary sinus Maxillary sinus

Inferior &
middle concha

Nose
Sinus

Sinus

Courtesy S. Jade

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

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Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Schneiderian membrane Antral teeth

Goblet Ciliated
cells cells

*The cilia beat approximately 1000 times/min and move mucous toward
the ostium at a flow rate of 6 mm/min. Private collection
Private collection Property of CLIR
Property of CLIR

Sinus pneumatisation

Private collection
Property of CLIR

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Private collection Private collection

Property of CLIR Property of CLIR

Roots Membrane Roots

Private collection Private collection

Property of CLIR Property of CLIR

The ostium

Courtesy of UNC

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The ostium The ostium

Courtesy of W. Richter Private collection

Property of CLIR

Private collection Private collection

Property of CLIR Private collection Property of CLIR
Property of CLIR

Schneiderian membrane lifting

Lifted Shneiderian
membrane

Private collection
Property of CLIR
Platelet rich fibrin
Bone graft
Private collection Private collection
Oral surgeon
membrane
Property of CLIR Property of CLIR
N. Barakat

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Membrane perforation Septum Septum

Anterior

Lateral
Private collection
Private collection
Courtesy S. Jade
Property of CLIR
Property of CLIR

Mucous retention Implant placement

Private collection Private collection

Property of CLIR Property of CLIR Private collection
Property of CLIR

Vascularization anastomosis Vascularization anastomosis

Animation performed by A. Khairallah Animation performed by A. Khairallah

Private collection
Property of CLIR
Posterior superior alveolar artery & Infra orbital arteries

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Vascularization anastomosis Vascularization anastomosis Vascularization anastomosis

Animation performed by A. Khairallah Animation performed by A. Khairallah

Posterior superior alveolar artery & Infra orbital arteries Posterior superior alveolar artery & Infra orbital arteries

Vascularization anastomosis

19mm

Animation performed by A. Khairallah

Private collection
Courtesy W. Richter
Posterior superior alveolar artery & Infra orbital arteries Property of CLIR

Private collection Private collection

Property of CLIR Property of CLIR Private collection
Property of CLIR

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Maxillary tuberosity

Private collection Private collection

Property of CLIR Property of CLIR

MANDIBULAR
ANATOMY

Private collection
Property of CLIR
Nakuru Reserve
Kenia

Mental symphysis /Mental fossa

Implantology Implantology

Private collection Private collection

Property of CLIR Property of CLIR

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Implantology Implantology Bone harvesting

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Bone harvesting Bone harvesting Bone harvesting

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Cyst enucleation Cyst enucleation Cyst enucleation

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

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Cyst enucleation

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Private collection Private collection

Property of CLIR Property of CLIR
Private collection
Property of CLIR

L B

Private collection Private collection

Property of CLIR Property of CLIR

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Genial tubercles

Private collection
Property of CLIR

Private collection Private collection

Property of CLIR Property of CLIR

Lingual foramen

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10.3 mm
L B

L B

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Courtesy S. Jad

Sub lingual arteries anastomose and

give a 1-2 mm branch
0.7mm ≤ Ø ≤ 1.8mm
Blood flow of 0.7-3.7 ml/min

Fluoroscopy of the Sublingual arteries

Courtesy N. Barakat

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Anatomy aberration Anatomy aberration

Private collection Private collection

Property of CLIR Property of CLIR

Anatomy aberration Anatomy aberration Anatomy aberration

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

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Inferior Lingual canal

Inferior lingual canal houses a lower

Private collection division of the sub lingual artery Private collection Private collection
Property of CLIR Property of CLIR Property of CLIR

Mandibular canal

Private collection
Property of CLIR

Neurovascular bundle Neurovascular bundle Neurovascular bundle

NVB
B L

Private collection
Property of CLIR Courtesy S. Jade Courtesy S. Jade

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Inferior alveolar nerve Inferior alveolar nerve Inferior alveolar nerve

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Inferior alveolar nerve

Tooth NO of Risk assessment for Tooth NO of Risk assessment for
analyzed analyzed
type teeth
Inferior alveolar nerve type teeth
Inferior alveolar nerve
injury injury
PM2 40 26/40 65% PM2 40 26/40 65%

M1 47 25/47 53% M1 47 25/47 53%

M2 48 35/48 73% M2 48 35/48 73%

Froum S, Casanova L, Byrne S, Cho SC. Risk Assessment Prior to Extraction for Immediate Implant Placement in the Froum S, Casanova L, Byrne S, Cho SC. Risk Assessment Prior to Extraction for Immediate Implant Placement in the
Private collection Posterior Mandible - A Computerized Tomographic Scan Study. J Periodontol. 2010 Sep Posterior Mandible - A Computerized Tomographic Scan Study. J Periodontol. 2010 Sep
Property of CLIR

Private collection Private collection

Property of CLIR Property of CLIR

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Lingual path Buccal path

B L

Private collection
Property of CLIR

Anatomy aberration

Private collection Private collection

Property of CLIR Property of CLIR Private collectio
Property of CLIR

Mental foramen

Private collection Private collection

Property of CLIR Property of CLIR

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Premolar-canine region

Private collection
Property of CLIR

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Variation of position

Private collection
Female 49 years old Property of CLIR

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Variation of position Variation of size Variation of number

Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR

Incisif canal

Private collection
Property of CLIR Miller R. Edwards W, Boudet C. Revised maxillofacial anatomy: The mandibular symphysis in 3d, International journal of
dental implants & biomaterials titanium 2009 1(2): 1-6

Incisif canal

0.48 mm < Ф > 2.9 mm

Private collection Private collection

Property of CLIR Property of CLIR

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Dysesthesia following placement of an Dysesthesia following placement of an

implant implant 10 mm anterior to the mental
foramen.

Private collection
Property of CLIR Private collection
42 years old female Property of CLIR

Submandibular Fossa
*Neurosensory dysfunction
Private collection may be partly due to the large
diameter of the incisive canal.
Property of CLIR

*Dysesthesia may be caused by injury to the

incisive nerve. *Incisive bundle may cause
*Patient may not exhibit parasthesia of the lip or
chin because the injury is anterior to the sensory implant osteointegration
division.
*Wallerian degeneration of the nerve may result in
failure, by migrating of soft
pain or a burning sensation following transection or tissue.
compression.
Kohavi D, Bar-Ziv J. Atypical incisive nerve: clinical report. Implant Dent.1996;5:281-3. Rosenquist B. Is there an anterior loop of the inferior alveolar nerve?. Int J Periodontics Restorative Dent.
1996;16:40-5. Private collection
Miller R. Edwards W, Boudet C. Revised maxillofacial anatomy: The mandibular symphysis in 3d, International Property of CLIR
journal of dental implants & biomaterials titanium 2009 1(2): 1-6

Submandibular Gland

L L L

Private collection Private collection

Property of CLIR Property of CLIR

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Tooth NO of Risk assessment for Tooth NO of Risk assessment for

analyzed analyzed
type teeth
lingual plate perforation type teeth
lingual plate perforation

PM2 14 1/14 7% PM2 14 1/14 7%

M1 12 2/22 9% M1 12 2/22 9%

M2 22 4/13 31% M2 22 4/13 31%

Private collection
Froum S, Casanova L, Byrne S, Cho SC. Risk Assessment Prior to Extraction for Immediate Implant Placement in the Froum S, Casanova L, Byrne S, Cho SC. Risk Assessment Prior to Extraction for Immediate Implant Placement in the Property of CLIR
Posterior Mandible - A Computerized Tomographic Scan Study. J Periodontol. 2010 Sep Posterior Mandible - A Computerized Tomographic Scan Study. J Periodontol. 2010 Sep

Private collection Private collection

Property of CLIR Property of CLIR

Private collection
13 month later Private collection Private collection
Property of CLIR Property of CLIR Property of CLIR

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Great people don’t

do different
things, they do
the same things
differently

3D
IMAGING
Carestream
CBCT

Alexandrekhairallah@hotmail.com Alexandrekhairallah@hotmail.com
Alexandrekhairallah@Gmail.com Alexandrekhairallah@Gmail.com
http://clir-3d.blogspot.com http://clir-3d.blogspot.com

Mobile: +961 3 264332 Mobile: +961 3 264332

Wind mill
Mykonos Greece
2013

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