Assessment of infraorbital foramen location based on skeletal malocclusion, maxillary sinus pneumatization and infraorbital canal morphology using 3D CBCT scans

Abstract

Introduction

Understanding the infraorbital foramen (IOF) location is crucial in terms of regional anaesthesia as well as facial filler injection and radiofrequency neurotomy. We aimed to define a safe infraorbital foramen (IOF) location zone using three dimensional (3D) cone beam computed tomography (CBCT) scans and to evaluate the influence of skeletal malocclusion (SM), maxillary sinus pneumatization (MSP), and infraorbital canal (IOC) morphology on IOF position.

Materials and methods

3D models of 300 (170 female, 130 male, range 18–50 years) CBCT scans were used to identify the SM, MSP, and IOC types, and to measure the distances from IOF to infraorbital margin, pyriform aperture, and zygion to determine IOF position. Using combined distances the IOF location zone was formed and divided into nine zones.

Results

The IOF was predominantly located in the superocentral zones (Zones 1–6) in Class II patients, mostly associated with hypoplastic MS, Type I and IV IOCs. Conversely, in Class III patients mostly linked to hyperplastic MS, Type II and III IOCs, the likelihood of IOF was mainly observed in the inferocentral zones (Zones 4–9). Also, we observed a significant increase in the prevalence of Class I, hypoplastic MS, Type I and IV IOCs with age.

Conclusion

Our results suggest that prediction of a safe IOF zone is possible based on SM, MSP, and IOC types in relation to gender and age within the studied population using 3D CBCT technology. This is essential for improved treatment planning and avoidance of iatrogenic injury during midface procedures.