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<title xml:lang="en">Anatomical landmarks for the localization of the greater palatine foramen – a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis</title>
<author>
<name sortKey="Tomaszewska, Iwona M" sort="Tomaszewska, Iwona M" uniqKey="Tomaszewska I" first="Iwona M" last="Tomaszewska">Iwona M. Tomaszewska</name>
<affiliation>
<nlm:aff id="au1">
<institution>Department of Medical Education, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Tomaszewski, Krzysztof A" sort="Tomaszewski, Krzysztof A" uniqKey="Tomaszewski K" first="Krzysztof A" last="Tomaszewski">Krzysztof A. Tomaszewski</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kmiotek, Elizabeth K" sort="Kmiotek, Elizabeth K" uniqKey="Kmiotek E" first="Elizabeth K" last="Kmiotek">Elizabeth K. Kmiotek</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
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<author>
<name sortKey="Pena, Iwona Z" sort="Pena, Iwona Z" uniqKey="Pena I" first="Iwona Z" last="Pena">Iwona Z. Pena</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
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<name sortKey="Urbanik, Andrzej" sort="Urbanik, Andrzej" uniqKey="Urbanik A" first="Andrzej" last="Urbanik">Andrzej Urbanik</name>
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<institution>Department of Radiology, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
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<author>
<name sortKey="Nowakowski, Michal" sort="Nowakowski, Michal" uniqKey="Nowakowski M" first="Michał" last="Nowakowski">Michał Nowakowski</name>
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<institution>Department of Medical Education, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
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<name sortKey="Walocha, Jerzy A" sort="Walocha, Jerzy A" uniqKey="Walocha J" first="Jerzy A" last="Walocha">Jerzy A. Walocha</name>
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<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
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<idno type="RBID">PMC:4174025</idno>
<idno type="doi">10.1111/joa.12221</idno>
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<title xml:lang="en" level="a" type="main">Anatomical landmarks for the localization of the greater palatine foramen – a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis</title>
<author>
<name sortKey="Tomaszewska, Iwona M" sort="Tomaszewska, Iwona M" uniqKey="Tomaszewska I" first="Iwona M" last="Tomaszewska">Iwona M. Tomaszewska</name>
<affiliation>
<nlm:aff id="au1">
<institution>Department of Medical Education, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Tomaszewski, Krzysztof A" sort="Tomaszewski, Krzysztof A" uniqKey="Tomaszewski K" first="Krzysztof A" last="Tomaszewski">Krzysztof A. Tomaszewski</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kmiotek, Elizabeth K" sort="Kmiotek, Elizabeth K" uniqKey="Kmiotek E" first="Elizabeth K" last="Kmiotek">Elizabeth K. Kmiotek</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Pena, Iwona Z" sort="Pena, Iwona Z" uniqKey="Pena I" first="Iwona Z" last="Pena">Iwona Z. Pena</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Urbanik, Andrzej" sort="Urbanik, Andrzej" uniqKey="Urbanik A" first="Andrzej" last="Urbanik">Andrzej Urbanik</name>
<affiliation>
<nlm:aff id="au3">
<institution>Department of Radiology, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nowakowski, Michal" sort="Nowakowski, Michal" uniqKey="Nowakowski M" first="Michał" last="Nowakowski">Michał Nowakowski</name>
<affiliation>
<nlm:aff id="au1">
<institution>Department of Medical Education, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Walocha, Jerzy A" sort="Walocha, Jerzy A" uniqKey="Walocha J" first="Jerzy A" last="Walocha">Jerzy A. Walocha</name>
<affiliation>
<nlm:aff id="au2">
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Journal of Anatomy</title>
<idno type="ISSN">0021-8782</idno>
<idno type="eISSN">1469-7580</idno>
<imprint>
<date when="2014">2014</date>
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<div type="abstract" xml:lang="en">
<p>Accurate knowledge of greater palatine foramen (GPF) anatomy is necessary when performing a variety of anaesthesiological, dental or surgical procedures. The first aim of this study was to localize the GPF in relation to multiple anatomical landmarks. The second aim was to perform a systematic review of literature, and to conduct a meta-analysis on the subject of GPF position to aid clinicians in their practice. One-hundred and fifty dry, adult, human skulls and 1200 archived head computed tomography scans were assessed and measured in terms of GPF relation to other anatomical reference points. A systematic literature search was performed using the PubMed, Embase and Web of Science databases, and a meta-analysis on the subject of GPF relation to the maxillary molars was conducted. On average, in the Polish population, the GPF was positioned 15.9 ± 1.5 mm from the midline maxillary suture (MMS), 3.0 ± 1.2 mm from the alveolar ridge (AR) and 17.0 ± 1.5 mm from the posterior nasal spine (PNS); 74.7% of GPF were positioned opposite the third maxillary molar (M3). Twenty-seven studies were included in the systematic review and 23 in the meta-analysis (
<italic>n</italic>
= 6927 GPF). The pooled prevalence of the GPF being positioned opposite the M3 was 63.9% (95% confidence interval = 56.6–70.9%). Concluding, the GPF is most often located opposite the M3 in the majority of the world's populations. The maxillary molars are the best landmarks for locating the GPF. In edentulous patients the most useful points for approximating the position of the GPF are the AR, MMS and PNS. This study introduces an easy and repeatable classification to reference the GPF to the maxillary molars.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Anat</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Anat</journal-id>
<journal-id journal-id-type="publisher-id">joa</journal-id>
<journal-title-group>
<journal-title>Journal of Anatomy</journal-title>
</journal-title-group>
<issn pub-type="ppub">0021-8782</issn>
<issn pub-type="epub">1469-7580</issn>
<publisher>
<publisher-name>Blackwell Science Inc</publisher-name>
<publisher-loc>Oxford, UK</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25131842</article-id>
<article-id pub-id-type="pmc">4174025</article-id>
<article-id pub-id-type="doi">10.1111/joa.12221</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Anatomical landmarks for the localization of the greater palatine foramen – a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Tomaszewska</surname>
<given-names>Iwona M</given-names>
</name>
<xref ref-type="aff" rid="au1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tomaszewski</surname>
<given-names>Krzysztof A</given-names>
</name>
<xref ref-type="aff" rid="au2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kmiotek</surname>
<given-names>Elizabeth K</given-names>
</name>
<xref ref-type="aff" rid="au2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pena</surname>
<given-names>Iwona Z</given-names>
</name>
<xref ref-type="aff" rid="au2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Urbanik</surname>
<given-names>Andrzej</given-names>
</name>
<xref ref-type="aff" rid="au3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nowakowski</surname>
<given-names>Michał</given-names>
</name>
<xref ref-type="aff" rid="au1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Walocha</surname>
<given-names>Jerzy A</given-names>
</name>
<xref ref-type="aff" rid="au2">2</xref>
</contrib>
<aff id="au1">
<label>1</label>
<institution>Department of Medical Education, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</aff>
<aff id="au2">
<label>2</label>
<institution>Department of Anatomy, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</aff>
<aff id="au3">
<label>3</label>
<institution>Department of Radiology, Jagiellonian University Medical College</institution>
<addr-line>Krakow, Poland</addr-line>
</aff>
</contrib-group>
<author-notes>
<corresp id="cor1">Iwona M. Tomaszewska, DDS, Department of Medical Education, Jagiellonian University Medical College, 16 Lazarza Street, 31-530 Kraków, Poland. T: +48-666-666-987; E:
<email>im.tomaszewska@gmail.com</email>
</corresp>
<fn>
<p>This work has been partially presented at the I Congress of the Polish Anatomical Society, Dolina Charlotty, 27–30.06.2013, and received the Congress ‘Young Investigator’ award.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<month>10</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>05</day>
<month>8</month>
<year>2014</year>
</pub-date>
<volume>225</volume>
<issue>4</issue>
<fpage>419</fpage>
<lpage>435</lpage>
<history>
<date date-type="accepted">
<day>30</day>
<month>6</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>© 2014 Anatomical Society</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract>
<p>Accurate knowledge of greater palatine foramen (GPF) anatomy is necessary when performing a variety of anaesthesiological, dental or surgical procedures. The first aim of this study was to localize the GPF in relation to multiple anatomical landmarks. The second aim was to perform a systematic review of literature, and to conduct a meta-analysis on the subject of GPF position to aid clinicians in their practice. One-hundred and fifty dry, adult, human skulls and 1200 archived head computed tomography scans were assessed and measured in terms of GPF relation to other anatomical reference points. A systematic literature search was performed using the PubMed, Embase and Web of Science databases, and a meta-analysis on the subject of GPF relation to the maxillary molars was conducted. On average, in the Polish population, the GPF was positioned 15.9 ± 1.5 mm from the midline maxillary suture (MMS), 3.0 ± 1.2 mm from the alveolar ridge (AR) and 17.0 ± 1.5 mm from the posterior nasal spine (PNS); 74.7% of GPF were positioned opposite the third maxillary molar (M3). Twenty-seven studies were included in the systematic review and 23 in the meta-analysis (
<italic>n</italic>
= 6927 GPF). The pooled prevalence of the GPF being positioned opposite the M3 was 63.9% (95% confidence interval = 56.6–70.9%). Concluding, the GPF is most often located opposite the M3 in the majority of the world's populations. The maxillary molars are the best landmarks for locating the GPF. In edentulous patients the most useful points for approximating the position of the GPF are the AR, MMS and PNS. This study introduces an easy and repeatable classification to reference the GPF to the maxillary molars.</p>
</abstract>
<kwd-group>
<kwd>anatomy</kwd>
<kwd>greater palatine foramen</kwd>
<kwd>meta-analysis</kwd>
<kwd>position</kwd>
<kwd>systematic review</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
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