title: Neurovascular anatomical variations in the anterior palate observed on CBCT images.
abstract: OBJECTIVE
  This study aimed to assess the presence of additional foramina and canals in the anterior palate region, through cone beam computed tomography (CBCT) images, describing their location, direction, and diameter.
  
  
  METHODS
  CBCT exams of 178 subjects displaying the anterior maxilla were included and the following parameters were registered: gender; age group; presence of additional foramina in the anterior palate (AFP) with at least 1 mm in diameter; location and diameter of AFP; and direction of bony canals associated with AFP.
  
  
  RESULTS
  Twenty-eight patients (15.7%) presented AFP and in total 34 additional foramina were registered. No statistical differences between patients with or without AFP were found for gender or age. The average diameter of AFP was 1.4 mm (range from 1 to 1.9 mm). Their location was variable, with most of the cases occurring in the alveolar process near the incisors or canines (n = 27). In 18 cases, AFP was associated with bony canals with upward or oblique direction toward the anterior nasal cavity floor. In 14 cases, the canal presented as a direct extension of the canalis sinuosus, in an upward direction laterally to the nasal cavity aperture. In two cases, the canal was observed adjacent to the incisive and joined the nasopalatine canal superiorly.
  
  
  CONCLUSIONS
  CBCT images have a crucial role in the recognition of anatomical variations by allowing detailed tridimensional evaluations. Additional foramina and canals in the anterior region of the upper jaw are relatively frequent. Practitioners should be aware and trained to identify these variations.
  
  
  CONCLUSIONS
  Over 15% of the population studied had additional foramina in the anterior palate, between 1 mm and 1.9 mm wide, with variable locations. In most cases the canals associated with these foramina either presented as a direct extension of the canalis sinuosus, or coursed towards the nasal cavity floor.
authors.affiliation: Department of Morphology, Stomatology and Physiology, University of São Paulo-Ribeirão Preto School of Dentistry, Ribeirão Preto, Brazil. oliveirach@forp.usp.br
authors.forename: Christiano
authors.initials: C
authors.lastname: de Oliveira-Santos
authors.forename: Izabel R F
authors.initials: IR
authors.lastname: Rubira-Bullen
authors.forename: Solange A C
authors.initials: SA
authors.lastname: Monteiro
authors.forename: Jorge E
authors.initials: JE
authors.lastname: León
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D021362:Palate, Hard / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000294:innervation*