ANALYSIS OF THE GREATER PALATINE FORAMEN USING CONE BEAM COMPUTED-TOMOGRAPHY TECHNOLOGY

Abstract

Background: The greater palatine foramen (GPF) is an essential anatomical landmark of the hard palate, frequently used in maxillofacial interventions such as palatal anesthesia, periodontal surgeries, cleft palate repair, and nerve block procedures. Precise knowledge of its morphometry and spatial orientation is critical for reducing complications such as hemorrhage, mucosal necrosis, and failed anesthesia. Despite its importance, limited research has explored the morphometric characteristics of the GPF in South Asian populations, particularly in Pakistan, creating a gap in region-specific anatomical data.

Objective: To assess the morphometric dimensions and spatial relationships of the GPF in a Karachi population using cone-beam computed tomography (CBCT).

Methods: A prospective observational study was conducted at the Department of Dental and Maxillofacial Surgery, Dow University of Health Sciences, Karachi, over three months (March–June 2025). A total of 212 participants, equally distributed by gender (106 males, 106 females), were enrolled through non-probability convenience sampling. Inclusion criteria comprised ethnic Karachiite individuals aged ≥18 years with intact permanent dentition and no maxillofacial pathology. CBCT scans were analyzed in sagittal, axial, coronal, and panoramic views. Measurements included the distance from the GPF to the median palatine suture (MMS), distance to the anterior nasal spine (ANS), GPF diameter, and positional relationship to molars based on Ajmani’s classification. Data were analyzed using SPSS v26, with independent t-tests applied at a significance threshold of p < 0.05.

Results: The mean age of the cohort was 44.71 ± 15.62 years. The mean GPF–MMS distance was 15.5 ± 1.72 mm, while the mean GPF–ANS distance measured 26.31 ± 2.29 mm. The GPF diameter averaged 5.22 ± 0.30 mm. Positional analysis revealed the highest frequency in Classification B (10.4%), followed by D (9.9%), C (9.4%), A (9.0%), and E (8.5%). Independent t-tests confirmed significant gender- and quadrant-based differences across all morphometric parameters (p < 0.05).

Conclusion: The study highlights significant variability in the morphometry and position of the GPF among the Karachi population. These findings provide valuable normative data, improving the precision of maxillofacial procedures and minimizing risks of iatrogenic injury. The results contribute to filling the regional knowledge gap and underscore the need for further multicenter studies to validate these observations.