What is the Safety Zone for palatal soft tissue graft harvesting based upon the locations of the Greater Palatine Artery and Foramen? A systematic review

Publication date: Available online 11 October 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Lorenzo Tavelli, Shayan Barootchi, Andrea Ravidà, Tae-Ju Oh, Hom-Lay Wang

ABSTRACT

Objective

Palatal soft tissue graft harvesting is a common procedure in periodontal and implant dentistry. However, most of the complications following this procedure are associated with the underestimation of anatomical structures, such as the greater palatine artery (GPA). Therefore, the aim of the present study was to provide guidelines for a safety palatal harvesting.

Material and Methods

A systematic searching was conducted to identify cadaver and CBCT/CT studies assessing the location of the greater palatine foramen (GPF) and the path of the GPA in relation to the maxillary teeth. The effect of age, sex, cadaver or CBCT/CT studies on the location of the GPF and on the course of GPA was also assessed.

Results

Twenty-six studies, investigating 5768 hemipalates were included in the present systematic review. The most common location of the GPF was in the mid-palatal aspect of the third molar (57.08%). As it traverses the palate anteriorly, the distance from the GPA to the maxillary teeth gradually decreases, except in the second premolar region where it has the tendency to increase (13.8 ± 2.1 mm). The least distance from the GPA to the teeth was found in the canine area (9.9 ± 2.9 mm), while the greatest distance was in the second molar region (13.9 ± 1 mm). A safety zone for palatal harvesting was proposed based on the anatomical findings.

Conclusions

The present study provides guidelines for identifying the position of the GPF and defines a safety zone for harvesting an FGG/CTG, minimizing the risk of GPA injury.

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