Radiomorphometric Analysis of the Greater Palatine Canal and the Pterygopalatine Fossa Using Cone Beam Computed Tomography: A Retrospective Study.

Background & objectives: The Greater Palatine Foramen (GPF), is a vital anatomical landmark for palatal nerve blocks. Hence imaging of this structure to understand its anatomy is important. Our study aimed to explore the radiomorphometric parameters of the greater palatine canal and pterygopalatine fossa using CBCT images in different age groups and gender.

Subjects materials and methods: 100 CBCT images showing both right and left maxillary sinus region were analysed for length of the greater palatine canal, the upper and lower opening diameters, and the intra-canal curvature. The recorded values were statistically analysed.

Results: The right greater palatine canal length was significantly shorter in individuals >25 years (Mean = 31.72 mm, SD = 4.30 mm, p-value = 0.021). The left upper opening diameter increased significantly with age (Mean = 5.90 mm, SD = 1.47 mm, p-value = 0.006). Males exhibited longer canals (Avg. length mean = 33.23 mm, SD = 4.19 mm, p-value = 0.095). And larger lower opening diameters (Avg. mean = 5.69 mm, SD = 1.18 mm, p-value = 0.073) than females. Canal curvature was predominantly curved across both the age groups, but age group 18-25 years showed a significantly higher prevalence of curved canals on both sides.

Conclusion: The present study showed significant variations in the morphology of the greater palatine foramen and canal curvature with respect to age and sex. Variations in GPC length, diameter, and curvature can influence the success of palatal nerve blocks, that reduce the risk of injury to the greater palatine nerve. Recognizing these differences through preoperative CBCT enables accurate anesthesia delivery, safer flap design, and precise osteotomy planning.