Abstract
Purpose
The greater and lesser palatine nerves and vessels supply the hard and soft palates, and the roots of these vessels and nerves run through a bony structure. However, the arrangement of blood vessels in the maxilla requires attention during clinical treatments, but detailed morphological information about changes in the greater and lesser palatine arteries and nerves during aging is unavailable. We therefore need detailed investigations of the morphology of the donor cadaver palatine using cone-beam computed tomography (CBCT) and macroscopic observations.
Methods
We investigated 72 donor cadavers using macroscopic segmentation and CBCT. The results’ analysis examined differences in skull measurement parameters and differences between dentate and edentulous cases.
Results
The greater palatine artery and nerve showed different macroscopic arrangements in dentate and edentulous cadavers. We also classified three types of bony structures of the nerve and vessel roots in the molar regions of the palatine using CBCT images: the shallow groove, deep groove, and flat groove. The deep groove is the deepest of the three and is remarkable in edentulous elderly cadavers.
Conclusion
This study of macroscopic and CBCT data provides information useful for planning dental implant surgeries and autogenous bone harvesting.
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References
Agur AM, Dalley AF (2009) Grant’s atlas of anatomy. Lippincott Williams & Wilkins, Philadelphia
Ajmani ML (1994) Anatomical variation in position of the greater palatine foramen in the adult human skull. J Anat 184:635–637
Aoun G, Zaarour I, Sokhn S, Nasseh I (2015) Maxillary nerve block via the greater palatine canal: an old technique revisited. J Int Soc Prev Community Dent 5:359–364. https://doi.org/10.4103/2231-0762.165930
Bornstein MM, Lauber R, Sendi P, von Arx T (2011) Comparison of periapical radiography and limited cone-beam computed tomography in mandibular molars for analysis of anatomical landmarks before apical surgery. J Endod 37:151–157. https://doi.org/10.1016/j.joen
Cagimni P, Govsa F, Ozer MA, Kazak Z (2017) Computerized analysis of the greater palatine foramen to gain the palatine neurovascular bundle during palatal surgery. Surg Radiol Anat 39:177–184. https://doi.org/10.1007/s00276-016-1691-0
Chrcanovic BR, Custódio AL (2011) Optic, oculomotor, abducens, and facial nerve palsies after combined maxillary and mandibular osteotomy: case report. J Oral Maxillofac Surg 69:e234–e241. https://doi.org/10.1016/j.joms.2011.01.001
El Nahass H, Naiem SN (2015) Analysis of the dimensions of the labial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res 26:e57–e61. https://doi.org/10.1111/clr.12332
Gibelli D, Borlando A, Dolci C, Pucciarelli V, Cattaneo C, Sforza C (2017) Anatomical characteristics of greater palatine foramen: a novel point of view. Surg Radiol Anat. https://doi.org/10.1007/s00276-017-1899-7
Hafeez NS, Ganapathy S, Sondekoppam R, Johnson M, Merrifield P, Galil KA (2015) Anatomical variation of the greater palatine nerve in the greater palatine canal. J Can Dent Assoc 81:f14
Harnet JC, Feki A, Maillot C (1994) The greater palatine canal. Radio-anatomical study and clinical value. J Radiol 75:287–293
Hochstetter F (1948) Toldts Anatomischer Atlas, Band 1, Wien, Urban & Schwarzenberg, 21 Auflage
Jeyaseelan N, Gupta M (1988) Canals for the greater palatine nerve and vessels in the hard palate. J Anat 156:231–233
Klosek SK, Rungruang T (2009) 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. Surg Radiol Anat 31:245–250. https://doi.org/10.1007/s00276-008-0432-4
Kopsch F (1922) Lehrbuch und Atlas der Anatomie des Menschen. Georg Thieme, Leipzig, pp 294–325
Monnet-Corti V, Santini A, Glise JM, Fouque-Deruelle C, Dillier FL, Liébart MF, Borghetti A (2006) Connective tissue graft for gingival recession treatment: assessment of the maximum graft dimensions at the palatal vault as a donor site. J Periodontol 77:899–902
Nishi S (1974) Topographical atlas of human anatomy. Kanehara Shuppan, Tokyo
Ozcan G, Sekerci AE, Cantekin K, Aydinbelge M, Dogan S (2016) Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature. Acta Odontol Scand 74:250–258. https://doi.org/10.3109/00016357
Pandharbale AA, Gadgil RM, Bhoosreddy AR, Kunte VR, Ahire BS, Shinde MR, Joshi SS (2016) Evaluation of the posterior superior alveolar artery using cone beam computed tomography. Pol J Radiol 19:606–610. https://doi.org/10.4317/jced.53213
Piagkou M, Xanthos T, Anagnostopoulou S, Demesticha T, Kotsiomitis E, Piagkos G, Protogerou V, Lappas D, Skandalakis P, Johnson EO (2012) Anatomical variation and morphology in the position of the palatine foramina in adult human skulls from Greece. J Craniomaxillofac Surg 40:e206–e210. https://doi.org/10.1016/j.jcms.2011.10.011
Sato I, Kawai T, Yoshida S, Miwa Y, Imura K, Asaumi R, Sunohara M, Yosue T (2010) Observing the bony canal structure of the human maxillary sinus in Japanese cadavers using cone beam CT. Okajimas Folia Anat Jpn 87:123–128
Spalteholz W (1939) Hand Atlas der Anatomie des Menschen, Band 1, Leipzig, 14 Auflage
Sujatha N, Manjunath KY, Balasubramanyam V (2005) Variations of the location of the greater palatine foramina in dry human skulls. Indian J Dent Res 16:99–102
Taylor TD (ed) (2000) Clinical maxillofacial prosthetics. Quintessence Publishing Co Inc., Chicago, pp 155–170
Tomaszewska IM, Kmiotek EK, Pena IZ, Średniawa M, Czyżowska K, Chrzan R, Nowakowski M, Walocha JA (2014) Computed tomography morphometric analysis of the greater palatine canal: a study of 1500 head CT scans and a systematic review of literature. Anat Sci Int 2015 90:287–297. https://doi.org/10.1007/s12565-014-0263-9
Wong JD, Sved AM (1991) Wong via the greater palatine canal: a modified technique and case reports. Aust Dent J 36:15–21
Zivanović S (1980) Longitudinal grooves and canals of the human hard palate. Anat Anz 147:161–167
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Protocol/project development: IS, YM. Data collection and management: RA, TK. Data analysis: YM, YM. Manuscript writing/editing IS, YM.
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Miwa, Y., Asaumi, R., Kawai, T. et al. Morphological observation and CBCT of the bony canal structure of the groove and the location of blood vessels and nerves in the palatine of elderly human cadavers. Surg Radiol Anat 40, 199–206 (2018). https://doi.org/10.1007/s00276-017-1952-6
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DOI: https://doi.org/10.1007/s00276-017-1952-6