Morphological analysis of the greater palatine foramen in babies and children: anesthetic and surgical approach

The greater palatine foramen position during growth concerning deciduous dentition is extremely scarce. Knowledge of the anatomical variation of greater palatine foramen in infants and children is important to local anesthesia and to prevent injuries to the vascular-nervous bundle during surgeries. This study was conducted at Federal University of São Paulo (UNIFESP). Eighteen dry skulls of babies and children between 9 months to 7 years old were selected. The skulls were divided into two groups as follows: group 1: skulls with erupted first primary molars (N = 9) and group 2: skulls with erupted second primary molars (N = 9). To assess the shape and area of the greater palatine foramen, its antero-posterior and latero-lateral diameters (LL) were measured. After that, a formula was applied to determine its area. To assess the position of the foramen, a straight line was drawn and measured from it to the midpalatal suture and laterally to the margin of alveolar crest. In addition, a straight line was drawn between the midpalatal suture and the most convex region of the distal surface of the last molar. The distance between this reference line to the foramen was measured. Data were tabulated, analyzed using the Kolmogorov-Smirnov normality test and subsequently T-test was used to compare data between groups. The greater palatine foramen shifted significantly to lateral and posterior. The results show a change in the form and position of the foramen using the deciduous last molar as a reference, which is important for anesthetic techniques and surgical procedures performed in the region.