Evaluation of inferior alveolar artery and its variations using three-dimensional rotational angiography

Abstract

Purpose This study aims to evaluate the morphological features and branching patterns of the inferior alveolar artery (IAA) in living individuals using three-dimensional rotational angiography (3D-RA) and to propose a novel radiological classification based on its shape and branching pattern. Methods A total of 101 hemifaces (53 right, 34 males/34 females) underwent 3D-RA imaging (slice thickness:0.10-0.20 mm). Morphological assessments of the maxillary artery (MA) and the IAA were performed on maximum intensity projection images. Statistical analysis used IBM SPSS Statistics 22.0 (p < 0.05). Results Mean diameters of the internal carotid artery (ICA), external carotid artery (ECA), and MA were 4.62 +/- 0.58 mm, 3.60 +/- 0.87 mm, and 2.35 +/- 0.41 mm, respectively. Females exhibited significantly smaller ICA, ECA, and MA diameters (p = 0.036, 0.001, 0.001), while IAA diameter (0.95 +/- 0.19 mm) showed no sex difference. The IAA originated predominantly from the MA (96%), rarely from the ECA (4%), or was not observed (1%). Duplicated IAAs were detected in two cases. Branching patterns included a single vessel (71%) or a shared trunk with the posterior deep temporal artery (29%), showing significant correlation with MA course (superficial/deep) (p < 0.05). IAA shapes were categorized as straight, curved, or looped, addressing a literature gap. Conclusions This is the first in vivo study to radiologically classify variations of the IAA using 3D-RA. The technique enables high-resolution visualization of submillimeter vessels, offering valuable anatomical insights for maxillofacial surgeries. Further studies are warranted to validate these findings and explore clinical correlations.