Extremely rare bilateral variation of the posterior superior alveolar artery on the maxillary sinus floor observed using CBCT: A case report

The posterior maxilla is particularly susceptible to bone resorption and poses significant anatomical challenges for surgical interventions, including sinus augmentation and dental implant placement. The Posterior Superior Alveolar Artery (PSAA), which usually courses along the lateral wall of the maxillary sinus, is essential for supplying blood to this area. Nonetheless, variations in the PSAA's position and diameter can increase the risk of complications during and after surgery. We here report the case of a 36-year-old male patient presented for implant treatment in the posterior maxilla. A Cone Beam Computed Tomography (CBCT) scan revealed a rare anatomical variation of the large PSAA, observed bilaterally on the floor of the maxillary sinus instead of its typical lateral wall position. This unusual finding was considered in preoperative planning to prevent potential complications during implant placement. Preoperative CBCT imaging is essential in identifying uncommon anatomical variations of the PSAA to ensure safe and effective surgical outcomes in the posterior maxilla. Early identification of such variations can guide surgical planning, prevent complications, and enhance patient safety.