Evaluation of the neurovascular bundle position at the palate with cone beam computed tomography: an observational study

Abstract

BackgroundThe aim of this study was to investigate the neurovascular bundle (NVB) position with cone-beam computerized tomography (CBCT).MethodsCBCT images of 345 patients were evaluated. The distance from the neurovascular bundle to the cemento-enamel junction (CEJ) was measured (DNB). The distance from mid-palatal suture to the alveolar crest was used to determine the palatal depth. Palatal junction angle (PA) was measured using the junction angle between the hard palate and alveolar crest. The relationships between the DNB and the palatal depth and between these two parameters and the PA were evaluated. Student’s t-test was used to analyze the differences in DNB related to gender, and the correlation between the DNB while Pearson correlation analysis was used to determine the correlation between the DNB and age (p = 0.05). The relationship between the DNB and the palatal depth, and the relationship between these two parameters and the PA were also evaluated using Pearson correlation analysis.ResultsExcept at the canine and first premolar areas the DNB was positively correlated with the palatal depth. No significant relationship between the PA and DNB or with PVD was observed. The highest DNB was 14 mm at the first molar, and the lowest was 10.8 mm at the canine.ConclusionsCare is needed while rotating flap and harvesting the subepithelial connective tissue graft at the canine area because the neurovascular bundle passes approximately 11 mm apically to CEJ at the canine region.

High‐resolution dental magnetic resonance imaging for planning palatal graft surgery—a clinical pilot study

“…Yilmaz et al. () evaluated use of CBCT for detection of the position of the neurovascular bundle in 345 patients. The authors did not, however, report intra‐ and inter‐reader agreement for vessel identification.…”

A novel clinical protocol for the greater palatine compression suture: A case report

“…[ 3 ] reported that the GPB was located 13.1 ± 2 mm from the CEJ of the first molar and 12.2 ± 2 mm from the CEJ of the premolar teeth. Yilmaz and Ayali,[ 10 ] used cone beam computerized tomography to locate the GPB and reported that the GPB was located at a distance of 14 mm from the CEJ of the first molars and 10.8 mm from the CEJ of the canine teeth. The CEJ can be used as a clinical guide to assess the location of the greater palatine foramen.…”

Preliminary evaluation of near-infrared vein visualization technology in the screening of palatal blood vessels

“…The average distances between palatal NVB and the nearest teeth are documented by numerous studies to suggest a safe distance which may aid the clinicians in the determination of surgical borders during the graft harvesting ( 3 , 8 - 11 ). However, there are some discrepancies in these reported measurements.…”

“…Considering the above mentioned complications, prevention from this injury is a crucial concern in palatal graft harvesting surgery. Numerous cadaver and radiological studies suggested “safe” distances from the adjacent teeth to palatal vessels to guide clinicians for the determination of surgical borders of palatal donor sites during the graft harvesting ( 3 , 8 - 11 ). However, considering the anatomical variations use of these morphometric reference distances is not valid for each individual ( 4 ) .…”