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

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Abstract

Purpose

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.

Methods

Fifty CBCT exams of Brazilian patients with a mean age of 35.8 years (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.

Results

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 3.1 mm; 7.9 and 15.3 mm, respectively.

Conclusions

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.

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Acknowledgments

The authors would like to thank FAPESP for providing a scholarship supporting this study (FAPESP: 2010/14922-9).

Ethical standard

It was granted by the Institutional review board of University of São Paulo (Process: 081/2010).

Conflict of interest

We declare none conflict of interest.

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Authors and Affiliations

  1. Department of Oral Medicine, Bauru School of Dentistry, University of São Paulo, Al Otávio P Brisola 9-75, Bauru, SP, 17012-901, Brazil

    Carla Renata Sanomiya Ikuta & Izabel Regina Fischer Rubira-Bullen

  2. Department of Stomatology, Santa Catarina Hospital, Av Paulista 200, Sao Paulo, SP, 01310-000, Brazil

    Camila Lopes Cardoso

  3. Department of Oral Surgery, Bauru School of Dentistry, University of São Paulo, Al Otávio P Brisola 9-75, Bauru, SP, 17012-901, Brazil

    Osny Ferreira-Júnior

  4. Department of Public Health, Bauru Dental School, University of São Paulo, Al Otávio P Brisola 9-75, Bauru, SP, 17012-901, Brazil

    José Roberto Pereira Lauris

  5. Department of Radiology, School of Health and Biosciences, PUC-Curitiba School of Dentistry, Pontifical Catholic University of Paraná, Rua Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil

    Paulo Henrique Couto Souza

Authors
  1. Carla Renata Sanomiya Ikuta
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  2. Camila Lopes Cardoso
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  3. Osny Ferreira-Júnior
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  4. José Roberto Pereira Lauris
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  5. Paulo Henrique Couto Souza
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  6. Izabel Regina Fischer Rubira-Bullen
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Corresponding author

Correspondence to Carla Renata Sanomiya Ikuta.

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Ikuta, C.R.S., Cardoso, C.L., Ferreira-Júnior, O. et al. Position of the greater palatine foramen: an anatomical study through cone beam computed tomography images. Surg Radiol Anat 35, 837–842 (2013). https://doi.org/10.1007/s00276-013-1151-z

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  • DOI: https://doi.org/10.1007/s00276-013-1151-z

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