THE PTERYGOMAXILLARY JUNCTION AS A TARGET POINT IN DENTAL IMPLANT PLACEMENT: PECULIARITIES OF THE ANATOMICAL STRUCTURE

• Published in: Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії Vol. 25; no. 2; pp. 148 - 151
• Main Authors: Vares, Y.Y., Vares, Y.E.
• Format: Journal Article
• Language: English
• Published: 29.05.2025
• ISSN: 2077-1096; 2077-1126; 2077-1126
• DOI: 10.31718/2077-1096.25.2.148

Introduction. Tuberosity-wing implants are becoming an increasingly favored option among implantologists for the rehabilitation of edentulous areas in the distal maxilla. Objective. The purpose of this study was to investigate the anatomical structure of the pterygo-maxillary junction as a prerequisite for tubero-pterygoid implant placement. Materials and methods. A literature review covering the past 20 years was conducted using scientometric medical databases, including SciVerse, PubMed-NCBI, MEDLINE, Cochrane Library, EMBASE, and ResearchGate. The search employed the following Keywords: “Pterygomaxillary junction”, “Morphometric analyses”, and “Cone-beam computed tomography”. A total of 65 sources in English and Ukrainian were identified and analyzed, with a focus on studies involving radiological and cadaveric examinations of the pterygomaxillary junction. Additionally, data were obtained from the information database of the Center for Medical 3D Diagnostics (Lviv), from which 30 cone-beam computed tomography (CBCT) scans of the maxilla were randomly selected. The sample included 18 women and 12 men aged between 34 and 72 years, who underwent imaging between 2020 and 2024. Scanning was performed using a Vatech Pax-i3D Green CBCT scanner (South Korea), in 9×12 cm mode with a voxel size of 0.2 mm, enabling high-resolution visualization of small anatomical structures in the maxilla and adjacent regions. Image processing and analysis were carried out using Ez3D2009 and Xelis Dental software (South Korea). Results and conclusions. The pterygomaxillary junction is a subject of study for anatomists and clinicians of implantology because it is a potential target for the so-called tubero-pterygoid implant placement, which allows for high primary stability of implants and their immediate loading. The analysis of available sources of professional literature indicates that there are ethnic, age, and gender peculiarities of the structure of the pterygo-maxillary junction. Studies by foreign experts indicate quite significant differences in the length and width of the pterygo-maxillary junction in representatives of different populations, including European and Asians. At the same time, the thickness of the junction was not characterized by statistically significant differences. Some scientists point to the presence of sex differences in the structure of the pterygo-maxillary junction, as well as the difference between the right and left junctions in one individual. A significant difference was also found when analyzing the angle of the pterygo-maxillary junction to the mid-sagittal plane. In our own study of 30 CCTs of patients of different sexes and ages, it was found that the length, width, and thickness of the pterygo-maxillary junction were 12,9±1,24 mm, 10,0±0,9 mm, and 3,4±0,6 mm, respectively, and the angulation index to the mid-sagittal line was 103,0±5,4°, which is consistent with the reports of some researchers and significantly different from others. The existing differences in the length, width, thickness, and angulation of the pterygo-maxillary junction associated with ethnic, age, and gender characteristics of the anatomical structure indicate the expediency of further research in this area, in particular with a larger sample.