Morphological Variations in the Greater Palatine Canal and Foramen Assessed using Cone Beam Computed Tomography: A Retrospective Observational Study

Introduction: The Greater Palatine Foramen (GPF), a key structure in the hard palate, serves as a critical anatomical landmark connecting the Pterygopalatine Fossa (PF) to the oral cavity via the Greater Palatine Canal (GPC). The PF contains essential structures, including the maxillary nerve, its branches, the pterygopalatine ganglion and maxillary artery. Aim: To assess the morphological and morphometric variations of GPF and canal by using Cone Beam Computed Tomography (CBCT). Materials and Methods: This retrospective observational study was conducted in the Department of Oral Medicine and Radiology, at Vishnu Dental College, Vishnupur, Bhimavaram, Andhra Pradesh, India in a time of six months, data collection from May 2024 to September 2024 and analysis in October 2024. A total of 100 scans of maxillary arch were analysed. CBCT images covering the full arch maxilla within the age range of 20 to 70 years were included. Parameters such as the shape of the foramen and distance from GPF centre to Mid-Maxillary Suture (MMS) and Anterior Nasal Spine (ANS) in axial sections and shape of the canal in sagittal sections were evaluated on both right and left-sides and compared between genders. Results: A statistically significant differences were observed in the mean distance from the GPF to the MMS on the rightside for both genders p-value=0.001. The most common shape of the GPC was straight with frequency of 22% on both right and left-sides in males and 14%, 17% on right and left-sides respectively in females in the sagittal plane and oval with a frequency of 17%- right, 18%- left-side in males and 13%- right, 11%- left in females in the axial plane. Regarding the location of the GPF in relation to molars, the most prevalent position was E, with a frequency of 24%- right and left-sides in males, 23%- on both right and left-sides in females, where the GPF is distal to the upper third molar. Conclusion: The study emphasises the importance of morphometric variations in dental procedures, using CBCT for accurate assessment and improved surgical precision. CBCT, which offers precise three-dimensional imaging that improves surgical planning, patient safety and diagnostic accuracy, is essential for precisely evaluating these variances.