Location Of Greater Palatine Foramen Research Articles

Morphological and Morphometric Study of Greater Palatine Foramen in Dry Skulls of Eastern Indian Population

Abstract Background: Greater palatine foramen (GPF) transmits important neurovascular structures which may get injured during different operative procedures such as intraoral maxillary nerve block, cleft palate repair, and operative procedures involving maxillary sinus and maxillary molars. Hence, proper knowledge about the GPF is very essential. The aim of this study was to study the shape of GPF and its location in relation to molar tooth, measure the diameters of GPF, and measure the distances of GPF from different landmarks of palate. Methodology: A dry bone-based study was conducted on dry human skulls of Eastern Indian population using digital Vernier caliper. At first location of GPF in relation to maxillary molars was noted, followed by anteroposterior (AP) and transverse diameter of GPF and distance of GPF from incisive fossa, posterior border of hard palate (PBHP) and interpalatine suture was measured. Results: In 69.64% of cases, GPF was present medial to the maxillary molar tooth and most common shape is oval type which is found in 44.64% of cases. AP diameter was almost same in both the sides which is 5.13 mm in average and transverse diameter is 2.91 mm. The mean distance of GPF from incisive fossa, PBHP, and interpalatine suture (IPS) is as follows in sequence, 37.24 mm, 3.21 mm, and 13.68 mm. Conclusion: The findings from the present study can be used as a guide for locating GPF during different operative procedures such as palatal reconstruction in cleft palate, maxillary surgeries, and intraoral maxillary nerve block. GPF is located about 3 mm in front of PBHP, most commonly medial to the third maxillary molar, about 15 mm lateral to IPS in the present study among Eastern Indian population.

CBCT as a novel pre-op non-invasive method to determine the location of Greater Palatine Foramen

Aim: To determine the greater palatine foramen position with reference to Maxillary molar teeth among patients presenting in a tertiary care hospital in Lahore by using cone beam computed (CBCT). Method: In this cross sectional studywhich was conducted at Fatima Memorial Hospital located in Lahore, in which a total of 80 patients were included. Informed consents and demographic details were noted. Cone beam computed tomography was taken in Planmeca Promax 3D Mid (60-120 kV; 9-33 s; 200 um voxel size) of all subjects. As per operational definitions, linear measurements for location of greater palatine foramen were measured. All the information was recorded in a specifically designed form. Results: Onaveragethe age ofpatients in this study was 39.35±11.19 years, 38(47.50%) patients were male. On left and right side the most common position was between middle and mesial face of third molar noted in 45(56.25%) and 43(53.75%) patients respectively. Conclusion: The most common position both sides was the position between middle and mesial face of third molar followed by position between distal face and middle of third molar in patients reporting in a tertiary care hospital located in Lahore by using cone beam computed tomography (CBCT) Keywords: Greater palatine foramen, cone beam, CT,

The Anatomical Position and Size of Greater Palatine Foramen and Canal in an Iranian Sample Using Cone Beam Computed Tomography.

Detection of location of greater palatine foramen (GPF) and its anatomical variations are vital prior to posterior maxillary surgeries. The aim of this study is to determine the anatomical position and size of the greater palatine canal and GPF using cone beam computed tomography (CBCT) scan. To determine the anatomical foramen position, the posterior maxilla area was divided into five regions on the axial view (A to E from the mesial surface of the second molar to distal surface of third molar). The length of the canal was investigated on both coronal and sagittal views. Independent t-test was used to analyze the data. Among 80 females and 68 males, the anatomical position of the GPF was mainly located in region E on the left (55%) and the right (50%), and then, respectively, in region D and region C. The mean diameter of GPF was 4/48 mm on the left and 4/63 mm on the right side (P = 0/01). The average length of the canal on the coronal view was 29.46 mm on the left side and 29.75 mm on the right (P = 0.005). The average length of the canal on the sagittal view was 29.62 mm on the left and 30.02 mm on the right (P = 0.001). The anatomical position of the GPF was primarily located distal to the third maxillary molar. CBCT is a valuable diagnostic tool for evaluation of vital anatomic landmarks in the maxillofacial region prior to surgeries.

Evaluation of hard palate asymmetry in turkish population

Aim: In a sample of the Turkish population, we aimed to evaluate differences in hard palate asymmetry by sex, the direction of right-left dominance, and how hard palate asymmetry and morphometric measurements are shaped with age.Materials and Methods: The present study was conducted on 3-dimensional computed tomography images of the head and neck region belonging to 172 (88 males, 84 females) individuals aged between 20-89 years. In this study, the distances between the Incisive foramen-Greater palatine foramen, Greater palatine foramen-Posterior nasal spine on the right and left sides with regard to the hard palate were measured. The asymmetry ratio was determined as a percentage using the asymmetry index. Furthermore, the angle values between the Incisive foramen-Posterior nasal spine-Greater palatine foramen on the right and left sides were measured on the lines between the measured points and compared with each other.Results: The measured parameters were compared between sexes, higher linear measurement parameters were found in males; angular values and the asymmetry index were close to each other, and no difference was found between them. When a comparison was made between the sides, the difference was revealed only in the measurement of the Greater palatine foramen-Posterior nasal spine, and the right side was larger. In all cases, the right side was larger in 79 cases in the Incisive foramen-Greater palatine foramen asymmetry index, and in 93 cases, the asymmetry was to the left. In the Greater palatine foramen-Posterior nasal spine asymmetry index, it was found that the asymmetry was to the right in 61 cases, and the asymmetry was to the left in 111 cases. Conclusion: This study provided important data on the hard palate morphology of the Turkish population. It also presented anthropological references for hard palate measurements of the Turkish population. Using 3-dimensional computed tomography images, we determined the greater palatine foramen's location according to the posterior nasal spine and incisive foramen. Determining the greater palatine foramen's location according to anatomical structures will contribute to determining the location of the greater palatine foramen in surgical interventions to be performed in this region.

Greater palatine foramen- morphometry, sexual dimorphism and clinical perspective

Abstract Background and aims: Maxillary nerve block via greater palatine foramen (GPF) is most commonly followed procedure for many dental, oral and maxillofacial surgeries. Many standard textbooks mention location of GPF in a general way. Location of GPF with respect to fixed bony landmarks has been studied by many authors in different population groups. The results of those studies showed lot of variability in location of GPF. The data regarding possible existence of sexual dimorphism are sparse. The present study was aimed at contributing further data regarding morphometry of the GPF. Ao attempt has also been made to look for sexual dimorphism. Material and Methods: One hundred and twenty three adult dry skulls of known sex (male- 55 & female - 68) were studied for GPF with regards to- morphometry, shape, relation to molars, fixed bony landmarks- Median maxillary suture(MMS), Incisive fossa(IF), Posterior border of hard palate(PBHP), Aogle between line joiniog GPF with IF & MMS, direction of opening of GPF into oral cavity. Results: Aotero-posterior diameter on left side (p-0.006), transverse diameter on both sides (p-0.000 on left & right side) distance between GPF to IF on both sides (p- 0.013 right side, p-0.02 left side, GPF-PBHP distance on both sides (p-0.001 left side, p-0.002 on right side) showed statistical significance when compared male with female skulls. In both male and female skulls, Oval shape predominated followed by round and slit variety of GPF. Both on right and left side GPF found to be predominantly related to anterior half of 3rd molar. Direction of opening of GPF into oral cavity was predominantly antero-medial on both sides in male and female skulls. Conclusion: Our study provides a valuable addition to the available literature on location of GPF and also gives an insight to the possible existence of sexual dimorphism.

Cone-beam computed tomography evaluation of the soft tissue thickness and greater palatine foramen location in the palate.

The aim of this study was to evaluate the palatal mucosa thickness and greater palatine foramen location using cone-beam computerized tomography (CBCT). Cone-beam computerized tomography images of 345 patients were measured. The relationship between palate vault depth and angle between the alveolar bone and palatal plane (PA) was evaluated. Differences in the palatal mucosal thickness according to age, gender and tooth site were evaluated. The mean palatal mucosal thickness from the second molar to the canine teeth were 3.7, 3.3, 3.7, 3 and 3mm, respectively. The palatal mucosal thickness at the second molar and second premolar was statistically different from those at other zones. There was no correlation between the palatal junction angle and the palatal depth. Greater palatine foramen was observed at the level of third molar tooth, between third and second molar, second molar 63%, 31% and 6% in men and 56%, 36% and 8% in women respectively. The second premolar to second molar zone was considered a suitable graft site based on the mean palatal mucosal thickness.

Analysis of the greater palatine foramen in a Lebanese population using cone-beam computed tomography technology.

Objective:The aim of this study was to describe the diameter and the position of the greater palatine foramen (GPF) in relation to adjacent anatomical landmarks in the maxilla in a Lebanese population using cone-beam computed tomography (CBCT) technology.Materials and Methods:CBCT images of 58 Lebanese adult patients were included in this study and a total of 116 GPF were evaluated bilaterally. The diameter of the GPF and its position relative to the maxillary molars, and distances to the midline maxillary suture and to the anterior nasal spine were analyzed.Results:Of all foramina assessed, 41.38% were located opposite to the third molar, 29.31% were distal to it, 27.59% were between the second and the third, and only 1.72% were opposite to the second. The average diameter was 5.633 mm on the right and 5.723 mm on the left, and the average distances to midline maxillary suture and anterior nasal spine were 16.228 mm and 48.294 mm on the right and 14.907 mm and 48.122 mm on the left, respectively.Conclusion:Within the limits of this study, we conclude that in Lebanese patients, the GPF location is variable, very rarely opposite to the second molar, and more closely related to the third, but may present mesial or distal to it in one-fourth of patients.

Analysis of position of greater palatine foramen in central Indian adult skulls: a consideration for maxillary nerve block

To anaesthetize posterior part of soft palate for various surgical procedures, knowledge of the position of the greater palatine foramen (GPF) is very important. Blocking of maxillary division of trigeminal nerve or its branches for local anaesthesia is common practice for maxillofacial surgeries. Objective: this study was aimed to determine the morphology of greater palatine foramen in relation to certain fixed points. Methodology: this study was conducted on 86 dry adult Indian skulls. All the measurements were done with vernier caliper accurate to 0.1 mm. Using flexible stainless steel wire direction of opening of GPF into oral cavity was noted. Results: In 73.26% cases, GPF is located opposite third maxillary molar tooth. Mean distance from GPF to the incisive fossa (IF) was found to be 35.9 mm. The mean distance between posterior margins of GPF to posterior border of hard palate was 3.4 mm. The distance between the GPF to the midline maxillary suture was 15.3 mm. In 74.42% cases, direction of opening of GPF was located antero-laterally. Arched palatal vault was found in 66.28% skulls. Conclusion: The location of greater palatine foramen is variable still in most of the cases it is located opposite third molar tooth and is directed antero-later.

Anatomic and anaesthetic considerations of greater palatine nerve block in Indian population

Background: Greater palatine nerve block holds its importance for anaesthesia and analgesia in different maxillofacial surgical procedures. Accuracy in localization of greater palatine foramen is required for its successful implication in regional block, although racial variations exist in various population groups. Aims: To study the morphometry of greater palatine foramen and its location with nearby anatomical landmarks in Indian population. Material and Methods: A total of one hundred dry skulls (60 males and 40 females) were collected and observed for the study. Various parameters were noted from greater palatine foramen on both sides, together with its location with respect to maxillary molar tooth. Along with that the angle between midline maxillary suture and Incisive foramen-Greater palatine foramen is measured. Results: 198 sides were measured and the most common location of greater palatine foramen was found to be medial to third molar tooth (71.21%). The mean distance from greater palatine foramen to midline maxillary suture on right and left sides were 14.82 ± 1.34 mm and 14.79 ± 1.57 mm, statistically insignificant. The angle between midline maxillary suture and incisive foramen-greater palatine foramen was 20.81° ± 2.47°on right side and 20.58° ± 2.69°on left side.The direction of the opening of greater palatine canal onto the hard palate was observed to be antero-medial in 60.10% of cases. Conclusions: Our study reveals the importance of usage of various anatomical parameters for precise location of greater palatine foramen, establishment of specific measurements in each population group and thereby applying such measurements for successful greater palatine nerve block.

Palatal Mucosal Measurements in a Japanese Population Using Cone‐Beam Computed Tomography

Although assessment of entire palatal mucosal thickness is important in many dental procedures, available data are mostly limited to the lateral aspect of the palate. The objective of this study was to use cone-beam computed tomography (CBCT) to perform a comprehensive analysis of the palatal mucosal thickness from the gingival margin to the mid-palatine suture in a Japanese population. Associations of palatal mucosal thickness with the palatal vault depth were also examined. Measurements on the coronal plane were obtained from 44 adults with 3-mm interval in the canine (Ca), first premolar (P1), second premolar (P2), midpoint between first and second molars (M1d), first molar (M1), and second molar (M2). Furthermore, the location of greater palatine foramen (GPF) and palatine groove (PG) were also investigated. Canine region did not show a significant difference throughout measured points. P1, P2, and all molar regions were thickest at 9, 12, and 12 mm from the gingival margin, respectively. At 3 and 6 mm, Ca, P1, and P2 showed significantly greater thickness than the molar region. At 9 mm, P1 demonstrated a greater thickness than M1d, and P2 was greater than M1 and Mi. At 12 and 15 mm, P1 was thinner than P2, M1, and M2, whereas P2 was thinner than M2. M1 was thinner than M2. The high-vault group showed a significantly greater thickness than the low-vault group. In majority of subjects, GPF and PG were identified in second molar and first premolar to first molar, respectively. Palatal mucosa in a Japanese population was the thickest in canine to premolar regions at 9 to 12 mm from the gingival margin. Identification of GPF and PG using CBCT can assist diagnosis of palate seems to minimize surgical complications. This study evaluated the thickness of palatal mucosa in a Japanese population using cone-beam computed tomography, covering a wide range. Canine to second premolar regions are the most suitable in harvesting palatal mucosa for the purpose of soft tissue grafts.

Position of the greater palatine foramen: an anatomical study through cone beam computed tomography images

The block anesthesia of the greater palatine foramen (GPF) is largely used in minor oral surgeries, periodontics and general dentistry. Furthermore, the area of the GPF serves as a donor of soft tissue graft. So, the aim of this study was to evaluate the position and characteristics of the GPF in Brazilian patients using cone beam computed tomography (CBCT) providing anatomical information for the greater palatine nerve block anesthesia and indicate site to collect palatal donor tissue. Fifty CBCT exams of Brazilian patients with a mean age of 35.8years (27 male/23 female) were evaluated. All patients had erupted first, second and third upper molars. A total of 100 GPF were evaluated bilaterally. The GPFs were assessed regarding position, diameter and distances to the midline maxillary suture (MMS) and to alveolar ridge (AR). Guidelines were drawn in the CBCT axial image depicting all molar interproximal surfaces, bilaterally. The guidelines were located between first, second and third molar and in the center of the second and third, performing five guidelines in each side. These guidelines and the molars were landmarks to assess the GPF anatomic position. From the 100 GPF analyzed, 92 were located in the third molar region (24 male/22 female). The 92 GPF were distributed as 47 in the left side and 45 in the right side. The average GPF diameter and the distance to both the AR and the MMS were 3.1mm; 7.9 and 15.3mm, respectively. Within the limits of this study, we concluded that the in Brazilian patients studied, the GPF location was more closely related to third molar. Therefore, whenever the third molar is erupted, it could be used as landmark for successful GPN block anesthesia. Moreover, harvesting palatal mucosa graft around the third molar should be done cautiously to prevent damage to the GPF vascular-nerve complex.

Anatomical study of the greater palatine artery and related structures of the palatal vault: considerations for palate as the subepithelial connective tissue graft donor site

Palate is considered as a tissue graft donor site for dental surgical procedures. Therefore, the aim of this study was to investigate the anatomy of palatal structures, such as greater palatine artery, greater palatine foramen, and incisive fossa, in order to consider their topography at planning the graft dimensions and reduce the potential risk of injury of greater palatine artery. Direct inspection of 41 Thai cadavers was performed. The results showed the statistically significant differences as for the length of female and male palates (p = 0.017); however, vertical measurements were equally distributed in examined population. Main location of greater palatine foramen was palatal to the second molar (35.7%), as well as, interproximal to the second and third molars (35.7%) in women, and palatal to the second molar in men (65%). GPA was branching most frequently at the level of first premolar (38%) and at first and second molars together (43%) in women. In men, the branching on the alveolar process side was commonly observed at the level of first and second premolars together (56%), and at the level of second and third molars together (32%). In the area between maxillary first premolar and second molar, it appeared possible to harvest a connective tissue graft measuring at least 5 mm in height. The results of this research will provide the useful data for other comparative studies and for assisting periodontologists in planning the dimensions and harvesting the subepithelial connective tissue grafts from palate.