Morphometric study of incisive, greater and lesser palatine foramina: a novel point of maxillary nerve block in a Thai population / Estudio morfométrico del foramen palatino incisivo, mayor y menor: un punto novedoso de bloqueo del nervio maxilar en una población tailandesa

SUMMARY: To study the morphometric location of the incisive, greater, and lesser palatine foramina for maxillary nerve block. Two hundred Thai dry skulls were randomly organized from the Forensic Osteology Research Center. The distances of the parameters were measured via Vernier caliper.: Thedistances from the incisive foramen to the incisive margin of the premaxilla were 10.93?2.42 mm in males and 10.98?2.06 mm in females. From the left side, the incisive foramen to the greater palatine foramen (GPF) was39.07?2.23mm in males and 38.57?2.41 mm in females, and from the right side were 39.81?2.37 mm in males and 38.62?2.53mm in females. From the left side, the incisive foramen to the lesser palatine foramen (LPF) was 43.16?2.23 mm in males and 41.84?2.42mm in females and from the right side were 42.93?2.14 mm in males and 41.76?2.61 mm in females. The GPF found at medial to the maxillary third molar were 94-95 % in males and 84 % in females. These findings suggest that the medial position to the third molar teeth be used as a landmark for a palatine nerve block in Thais. These findings will help dentists to perform local anesthetic procedures, especially the nasopalatine and greater palatine nerve blocks, more effectively.

RESUMEN: El objetivo de este trabajo fue estudiar la localización morfométrica de los forámenes palatinos incisivos, mayores y menores para el bloqueo del nervio maxilar. Se organizaron al azar doscientos cráneos secos tailandeses del Centro de Investigación de Osteología Forense. Las distancias de los parámetros se midieron mediante un calibre Vernier. Las distancias desde el foramen incisivo hasta el margen incisivo de la premaxila fueron 10,93 ? 2,42 mm en hombres y 10,98 ? 2,06 mm en mujeres. Desde el lado izquierdo, el foramen incisivo al foramen palatino mayor (FPM) fue de 39,07 ? 2,23 mm en los hombres y 38,57 ? 2,41 mm en las mujeres, y del lado derecho fue de 39,81 ? 2,37 mm en los hombres y 38,62 ? 2,53 mm en las mujeres. Del lado izquierdo, el foramen incisivo al foramen palatino menor (LPF) fue de 43,16 ? 2,23 mm en hombres y 41,84 ? 2,42 mm en mujeres y del lado derecho 42,93 ? 2,14 mm en hombres y 41,76 ? 2,61 mm en mujeres. El FPM encontrado medial al tercer molar maxilar fue 94-95 % en hombres y 84 % en mujeres. Estos hallazgos sugieren que la posición medial de los terceros molares se utilice como punto de referencia para un bloqueo del nervio palatino en individuos tailandeses. Estos hallazgos ayudarán, de manera más eficaz, a los dentistas a realizar procedimientos anestésicos locales, especialmente los bloqueos nasopalatinos y del nervio palatino mayor.

Anatomical Study On Location Of Greater Palatine Foramen In Dried Adult Human Skull: Key To Successful Maxillary Nerve Block

Background: The greater palatine foramen (GPF) conducts greater palatine nerve, responsible for the innervationof posterior part of the hard palate. Anaesthetic block for greater palatine nerve is highly recommended forsurgical practices involving upper molar, maxillary sinus and nasal region. But the practical problem associatedwith anaesthesia is difficulty in locating the exact position of greater palatine foramen, leading to deliveringinsufficient anaesthetic solution. The greater palatine neurovascular structures enter the oral cavity through thegreater palatine foramen so this foramen should be approached carefully during any surgical procedures toavoid damage to these neurovascular structure.Materials and methods: 126 dried adult skull bones of unknown sex, obtained from the department of anatomy,MVJ Medical College and Research Hospital were used to locate the exact position of greater palatine foramen inrelation to bony landmarks. On both side, the distance of greater palatine foramen from midline maxillarysuture, posterior border of hardpalate, incisive fossa and lesser palatine foramen were measured with digitalvernier caliper. Location of GPF in relation to molar or premolar tooth was also noted. The data obtained wereanalyzed statistically by calculating mean and standard deviation. The percentage was calculated for the locationof GPF in relation to molar or premolar tooth.Result: In the present study of anthropometric analysis of greater palatine foramen of 126 dried skulls, it wasobserved that the most common location of greater palatine foramen was opposite to the third molar tooth. Themean distance between greater palatine foramen to mid maxillary suture was 13.71mm on right side and13.72mm on left side and posterior border of hard palate on right side was 4.62mm and 4.49mm on left side. Themean distance between greater palatine foramen and incisive fossa was 36.73mm and 36.66mm on the right andleft side respectively. The mean distance between greater palatine foramen and lesser palatine foramen was1.47mm on right side and 1.49 mm on left side.Conclusion: Results of present study may contribute greatly to the successful outcome of maxillofacial and oralsurgeries regional anaesthesia.

A Study Of Palatal Indices And Foramina In The Hard Palate Of Adult Human Skulls In Central India Region

Aim of study: Aim of study: The aim of the study is to determine morphometric indices of hard palate, positionand location of greater palatine foramen (GPF) in relation to maxillary molars and number of lesser palatineforamen (LPF).Materials and methods: 100 adult skulls (65 males and 35 females) were obtained from the Department ofAnatomy. The parameters of hard palate like length, breadth and height were measured and palatine indiceswere calculated. Observations were made on the position and relation of GPF with maxillary molar and numberof LPF. There were highly significant differences between both the sexes in Palatal length, breadth and height. Thepalatine index indicated that majority (61%)of skulls had narrow palate (Leptostaphyline).The palatine heightindex showed that majority (69%) of skulls had high arched or deep palate.(Hypsistaphyline). The greater palatineforamen was at the level of third molar in 50%, in between second and third molar in 35.5%, and at the level ofsecond molar in 14% . In majority of skulls (71%) one lesser palatine foramen was observed and about (35%) ofskulls had two LPF and (2.5%) of skulls had three LPF, and in about (5.5%) absence of LPF was observed.Conclusion: Thorough anatomical study of hard palate is useful in ethnic and racial classification of crania,anthropological studies, fabricating complete maxillary dentures for edentulous patients and performing certainsurgical procedures in hard palate and soft palate. Knowledge of palatal indices would be helpful to the anatomists,anthropologists, and forensic experts and surgeons during repair of the cleft palate and lip.