Morphometric assessment of the greater palatine foramen in a Saudi patient sample: a CBCT study

The greater palatine foramen (GPF) is a critical anatomical landmark for palatal nerve block anesthesia, periodontal surgery, and soft tissue graft harvesting. Population-specific morphometric data are needed for safe clinical practice. However, standardized CBCT-based GPF morphometric data with reliability analysis are lacking for the Saudi population. This retrospective cross-sectional study evaluated 68 CBCT scans of adult Saudi patients (18-65 years) from King Saud Dental University Hospital. Three primary variables were measured using Planmeca Romexis software: the distance from the GPF to the midline maxillary suture (GPF-MMS), the anteroposterior (AP) diameter, and the lateromedial (LM) diameter. Data were analyzed using R (version 4.5.3). Descriptive statistics, normality testing, and sex-based comparisons were performed. The mean GPF-MMS distance was 15.25 ± 1.26 mm (95% CI: 14.95-15.56). The mean AP diameter was 5.34 ± 0.97 mm (95% CI: 5.11-5.58), and the mean LM diameter was 2.43 ± 0.54 mm (95% CI: 2.30-2.56). All three measurements were significantly larger in males than females (GPF-MMS: p=0.003, d=0.820; AP: p=0.006, d=0.742; LM: p=0.005, r=0.341). Inter-rater reliability was excellent for GPF-MMS (ICC=0.920) and good for AP and LM diameters (ICC=0.808 and 0.873, respectively). GPF-MMS distance, AP diameter, and LM diameter in Saudi adults were 15.25 mm, 5.34 mm, and 2.43 mm, respectively. Males had significantly larger measurements across all three variables. Population-specific and sex-adjusted reference values should be applied when planning palatal nerve block anesthesia and soft tissue graft harvesting in Saudi patients.