Palate is considered as a tissue graft donor site for dental surgical procedures. Therefore, the aim of this study was to investigate the anatomy of palatal structures, such as greater palatine artery, greater palatine foramen, and incisive fossa, in order to consider their topography at planning the graft dimensions and reduce the potential risk of injury of greater palatine artery. Direct inspection of 41 Thai cadavers was performed. The results showed the statistically significant differences as for the length of female and male palates (p = 0.017); however, vertical measurements were equally distributed in examined population. Main location of greater palatine foramen was palatal to the second molar (35.7%), as well as, interproximal to the second and third molars (35.7%) in women, and palatal to the second molar in men (65%). GPA was branching most frequently at the level of first premolar (38%) and at first and second molars together (43%) in women. In men, the branching on the alveolar process side was commonly observed at the level of first and second premolars together (56%), and at the level of second and third molars together (32%). In the area between maxillary first premolar and second molar, it appeared possible to harvest a connective tissue graft measuring at least 5 mm in height. The results of this research will provide the useful data for other comparative studies and for assisting periodontologists in planning the dimensions and harvesting the subepithelial connective tissue grafts from palate.
Clinical examination and surgical procedures require the knowledge of anatomical structures of such a complex area as neck, especially the developmental anomalies in vascular drainage may occur. The aim of this study was to describe the common carotid artery bifurcation to its surrounding structures to locate it properly by using external and internal landmarks. Measurements were performed on 43 Thai cadavers by the direct inspection method. Carotid bifurcation level was compared to the level of cervical vertebra, isthmus of thyroid cartilage, angle of mandible and origins of superior thyroid artery, and lingual artery. Most of carotid bifurcations were found at the level of C3, between C3 and C4, and C4 vertebra, as well as the tendency to lower position in men was noted. Measurements to the angle of mandible on the left sides were significantly different in studied groups (P = 0.02), also with lower position of bifurcation in men. The mean level of carotid bifurcation was approximately 6 mm above ITC, which literally is at the level of the superior border of thyroid cartilage. Moreover, in four cases, common carotid artery did not bifurcate bilaterally, and in four cases, no bifurcations were found at the right side of neck. Further, many superior thyroid arteries originated from common carotid artery. To sum up, during the clinical procedures, the level of thyroid cartilage is mostly advised to follow to locate the carotid sinus. Further, the described variations in topography of carotid bifurcation and arteries origins may have important clinical implications.
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