Journal of Mazandaran University of Medical Sciences (Jun 2024)
Assessment of Morphology and Situation Variations of Greater Palatine Foramen and Canal by Cone Beam Computed Tomography Imaging Technique
Abstract
Background and purpose: The anatomy of the great palatine canal is important for dentists and maxillofacial surgeons in terms of performing various surgical procedures such as local anesthesia, dental implant placement, and paranasal sinus surgery. In the axial view, the great palatal foramen (GPF) is usually seen in the alignment of the second molar and is hidden by the thick mucosa, which is important to determine its clinical position according to the anatomical signs. The present study aimed to investigate and evaluate the anatomical variations of the large palatine foramen and canal, the large and small palatine foramen, and the location of the large palatine foramen by CBCT technique. Materials and methods: In this retrospective cross-sectional study, 316 CBCT images related to the maxilla were analyzed to identify the large and small palatal foramen and the palatal canal and their positions. In this cross-sectional study, CBCT images obtained from patients were evaluated in terms of morphology and diameter of the large palatal foramen and large palatal canal. The anatomical shape of the large palatal canal in the sagittal plane and the position of the large palatal foramen in the axial plane relative to the second molar tooth in the upper jaw were investigated. The required information was collected in the checklist prepared for this purpose. With the help of two observers specializing in maxillofacial radiology, the CBCT images were examined and gave their opinion, and 20% of the data were repeated for the observer's error. In this study, the samples were divided into three age groups for statistical analysis. The relationship between age groups, GPF, and large palatal canal was investigated. After collecting the data and information, it was analyzed by SPSS V.23 software, and the data was described using number and percentage indicators and central and dispersion indicators. The significance level was considered to be P<0.05. Results: Results showed that large palatal holes are seen in 63.9% of the distal second molar and 36.1% flush with the second molar in CBCT images. In terms of foramen morphology, the most common shape was oval in 107 patients (33.9%). Also, according to the surveys, the most common morphology of the large palatal canal was cascade in 120 people (38%). Additionally, the results showed that there is a significant relationship between the morphology of the large palatal foramen and gender, so that the round and oval shapes are more common in men, and the round, split, and teardrop shapes are more common in women. The number of small palatal foramen was less than 3 in 88.8% of cases. According to statistical tests, there is a significant relationship between the diameter of the small palatal foramen with sex, age, and jaw direction (P=0.046). Conclusion: Considering that the large palatal foramen is located in the distal second molar in most cases a significant relationship was found between the shape of the GPF and its position. Therefore, to avoid surgical problems, it is necessary to evaluate the anatomical variations of the hole and the large palatal canal, especially before the maxillary wisdom tooth surgery.
