CTA morphometryDiagnostics2026Open Access

Maxillary artery morphometry in relation to mandibular landmarks

A bilateral CTA study of 164 patients introducing a three-type patient-level MA–lateral pterygoid relationship, population-level looping data, normative gonial-angle and lingula distances, and a strong link between non-retrotuberosity loops and dangerous lingular proximity.

Viviana Dincă · Mugurel Constantin Rusu · Răzvan Costin Tudose · Adela Gabriela Stănescu · Adelina Maria Jianu · George Triantafyllou · Maria Piagkou · Iulian Brezean

Explore the bilateral types ↓Full article ↗

The risk association

Non-retrotuberosity looping strongly predicts close MA–lingula proximity.

Loop-positive superficial sides had shorter MA–lingula distances, and looping was associated with nearly a tenfold increase in the odds of a distance below 5 mm.

OR 9.95for MA–lingula distance <5 mm in non-retrotuberosity loop-positive sides

01 · Cohort

Normative bilateral CTA anatomy

The study analysed both maxillary arteries in 164 adults and measured several mandibular relationships.

164

Patients

328 arterial sides.

61%

Superficial course

Relative to the inferior head of the lateral pterygoid muscle.

34.8%

Any loop

At least one looped side per patient.

8.03 mm

MA–lingula

Mean distance on eligible superficial non-retrotuberosity sides.

02 · Interactive bilateral classification

Three patient-level course types

Select a type to see how the maxillary arteries course relative to the lateral pterygoid muscles.

03 · Loop × lingula risk

Looping is common enough to matter

The study separates loops into interpterygoid-triangle and retrotuberosity patterns because they threaten different operative corridors.

Looped sides

Any loop morphology.

13.6%

<5 mm

Eligible superficial sides with close MA–lingula proximity.

2.10 mm

Minimum

Closest recorded MA–lingula distance.

Loop-positive mean

6.86 mm

Loop-negative mean

8.64 mm

Clinical meaning: when an interpterygoid/non-retrotuberosity loop is present, the maxillary artery is much more likely to approach the lingula closely—relevant to inferior alveolar nerve block, sagittal split ramus osteotomy, and related medial-ramus procedures.

04 · Landmark morphometry

Three mandibular relationships

The study establishes new normative or directional reference data.

34.53 mm

MA–gonial angle

First normative population dataset; marked sex dimorphism: males 36.74 mm, females 31.35 mm.

83.4%

Above the notch

The MA was superior to the mandibular-notch plane in most superficial sides.

24.4%

Asymmetric patients

Type 3 had one superficial and one deep side, perfectly balanced by side.

Take-home message: bilateral course type, loop morphology, and landmark proximity together offer more useful surgical risk information than isolated side-based description.