Morphometric Analysis of Greater Palatine Foramen and the Adjacent Structures: Forensic Odontology Study using CBCT

Introduction: Sexual dimorphism plays a pivotal role in many instances, including solving medicolegal problems, anthropological studies, sorting out victims of natural calamities and man-made calamities. Among various parameters available for sexual dimorphism, structures of the oral cavity play an important role. The use of Cone Beam Computed Tomography (CBCT) is convenient and provides accurate measurements with the help of digital software.

Aim: To determine the role of Greater Palatine Foramen (GPF), its Greater Palatine Canal (GPC) and relation with the adjacent structures like Naso-Palatine Foramen (NPF) and Lesser Palatine Foramen (LPF) in elucidating the level of sexual dimorphism using CBCT images, while enhancing the information on anatomy of Greater Palatine Foramen (GPF).

Materials and Methods: This cross-sectional forensic odontology study was conducted in the Department of Oral Medicine and Radiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India, and was performed using 50 males and 50 females CBCT images of patients between age 18 to 45. The CBCT data were collected from January 2021 till January 2022, and the obtained data were analysed from March 2022 till April 15, 2022. These were analysed using Planmeca imaging software. Measurements of GPF length, angulation with respect to Hard Palate (HP), relation between NPC and GPF, distance between GPC and Mid Maxillary Suture (MMS). Its relation to LPF and dimensions of GPF at opening of oral cavity were done. Finally, all measures were subjected to statistical analysis using IBM Statistical Package for the Social Sciences (SPSS), version 28.0. Independent t-test was used for analysis of difference between male and female measurements.

Results: The GPC length on right (male:13.2570, female:12.3628) and left (male:12.8089, female:12.2780), angulation of GPC left (male: 61.1379, female: 57.4964), angle between GPF and NPC left (male: 28.6208, female: 26.5024), distance between GPC and MMS left (male: 15.1625, female: 14.5350) and Anteroposterior (AP) dimensions of GPF on right (male: 5.5402, female: 4.2314) and left-side (5.4934, female: 4.4576), Transverse (TR) dimension of GPF on right (male: 2.6752, female: 2.0528) and left (male: 5.4943, female: 4.4576) showed statistically significant difference between male and female CBCT images, while the measures were significantly higher in males.

Conclusion: The CBCT images provided reliable measurements of the areas of interest. The present study results highlight a statistically significant difference between male and female, where males showed higher measurements in most instances. A more precise morphological measurement of GPF in relation to adjacent structures such as NPC, MMS proves to have sexual dimorphism in humans.