title: New supplemental landmark for the greater palatine foramen as found deep to soft tissue: application for the greater palatine nerve block.
abstract: OBJECTIVE
  Many researches have investigated the morphology of the greater palatine foramina using dry skulls and cone-beam computed tomography. In most studies, some structures in the hard tissue have been measured and statistically analyzed. However, none of the studies has analyzed this foramen in regard to its location with overlying soft tissues, which is so clinically relevant. Therefore, this study was performed to provide the knowledge about relationship between the greater palatine foramen and foveola palatina for a better understanding of dental procedures such as greater palatine nerve block.
  
  
  METHODS
  Thirty sides, from fifteen fresh cadaveric heads, were used in this study. The specimens were derived from eight males and seven females. A 27-gauge needle was inserted into the fossa, which was palpated at the edge of a dental mirror at a 45° angle to the occlusal plane and parallel to the sagittal plane. The anteroposterior distance, which was parallel to the midline, between the penetration site and foveola palatina was measured.
  
  
  RESULTS
  All the penetrations advanced to the greater palatine foramen. The distances ranged from 2.0 to 8.3 mm on right sides, and 1.1 to 8.2 mm on left sides, respectively.
  
  
  CONCLUSIONS
  The results of this study could help dentists identify the correct location of the greater palatine foramen with a supplemental landmark.
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA. joei@seattlesciencefoundation.org.|Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan. joei@seattlesciencefoundation.org.|Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan. joei@seattlesciencefoundation.org.
authors.forename: Joe
authors.initials: J
authors.lastname: Iwanaga
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA.
authors.forename: Vlad
authors.initials: V
authors.lastname: Voin
authors.affiliation: Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, MA, USA.
authors.forename: Allen Ali
authors.initials: AA
authors.lastname: Nasseh
authors.affiliation: Tsukiyama Dental Clinic, Fukuoka, Japan.
authors.forename: Junta
authors.initials: J
authors.lastname: Kido
authors.affiliation: Tsukiyama Dental Clinic, Fukuoka, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Tsukiyama
authors.affiliation: Tsukiyama Dental Clinic, Fukuoka, Japan.|Division of Endodontics, Columbia University College of Dental Medicine, New York, USA.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kamura
authors.affiliation: Advanced Education in General Dentistry, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA.|Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Fisahn
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alonso
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA.|Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Oskouian
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA.|Department of Anatomical Sciences, St. George's University, West Indies, Grenada.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D000766:Anesthesia, Dental / Q000379:methods*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D021362:Palate, Hard / Q000033:anatomy & histology*
keywords: Anatomic landmark; Anatomy; Cadaver; Hard palate; Nerve block