title: The accuracy of identifying the greater palatine neurovascular bundle: a cadaver study.
abstract: BACKGROUND
  The palate is a common site for harvesting subepithelial connective tissue grafts (SCTG). The size of SCTG that can be harvested is dictated by the position of the greater palatine neurovascular bundle (GPB). The aims of this cadaver study are to assess the accuracy of predicting the location of the GPB on study models and to evaluate anatomic factors that might influence the predictability.
  
  
  METHODS
  Eleven fully dentate or partially edentulous maxillary cadavers were used. Study models were fabricated after the greater palatine foramen was identified. The GPB was recognized after dissection, from which the distance to the cemento-enamel junction of the first molar and premolar was measured. Eight periodontists and twelve periodontal residents were asked to estimate the location of the GPB on the study models and the same measurements were taken. Comparisons of the estimated and true GPB position were performed. The correlation between the palatal vault height and the variability of detecting the GPB was investigated.
  
  
  RESULTS
  The most frequent greater palatine foramen location was between the second and third molars (66.6%). For most cases, there was an underestimation of the location of the GPB up to 4 mm. The interexaminer variability was positively correlated with the vault height.
  
  
  CONCLUSIONS
  The estimated location of the GPB was commonly closer to the cemento-enamel junction of posterior teeth. Agreement on the location of the GPB was lowered with the presence of high palatal vaults. The results of this study could assist clinicians in planning the location for harvesting SCTG on the hard palate.
authors.affiliation: Graduate Periodontics, School of Dentistry, University of Michigan, Ann Arbor, MI.
authors.forename: Jia-Hui
authors.initials: JH
authors.lastname: Fu
authors.forename: Dawlat G
authors.initials: DG
authors.lastname: Hasso
authors.forename: Chu-Yuan
authors.initials: CY
authors.lastname: Yeh
authors.forename: Daylene J M
authors.initials: DJ
authors.lastname: Leong
authors.forename: Hsun-Liang
authors.initials: HL
authors.lastname: Chan
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001641:Bicuspid / Q000098:blood supply / Q000294:innervation; D002102:Cadaver; D002508:Cephalometry; D003724:Dental Arch / Q000098:blood supply / Q000294:innervation; D004210:Dissection; D005544:Forecasting; D006801:Humans; D008297:Male; D008437:Maxilla / Q000098:blood supply / Q000294:innervation; D008875:Middle Aged; D008963:Molar / Q000098:blood supply / Q000294:innervation; D008964:Molar, Third / Q000098:blood supply / Q000294:innervation; D021362:Palate, Hard / Q000033:anatomy & histology* / Q000098:blood supply / Q000294:innervation; D019237:Tooth Cervix / Q000098:blood supply / Q000294:innervation