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Analysis of blood supply in the hard palate and maxillary tuberosity—clinical implications for flap design and soft tissue graft harvesting (a human cadaver study)

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Abstract

Objectives

The aim of the present study is to provide a detailed macroscopic mapping of the palatal and tuberal blood supply applying anatomical methods and studying specific anastomoses to bridge the gap between basic structural and empirical clinical knowledge.

Materials and methods

Ten cadavers (three dentate, seven edentulous) have been prepared for this study in the Department of Anatomy, Semmelweis University, Budapest, Hungary, and in the Department of Anatomy of the Medical University of Graz. All cadavers were fixed with Thiel’s solution. For the macroscopic analysis of the blood vessels supplying the palatal mucosa, corrosion casting in four cadavers and latex milk injection in other six cadavers were performed.

Results

We recorded major- and secondary branches of the greater palatine artery (GPA) and its relation to the palatine spine, different anastomoses with the nasopalatine artery (NPA), and lesser palatal artery (LPA) as well as with contralateral branches of the GPA. Penetrating intraosseous branches at the premolar-canine area were also detected. In edentulous patients, the GPA developed a curvy pathway in the premolar area. The blood supply around the maxillary tuberosity was also presented.

Conclusion

The combination of different staining methods has shed light to findings with relevance to palatal blood supply, offering a powerful tool for the design and execution of surgical interventions involving the hard palate.

Clinical relevance

The present study provides clinicians with a good basis to understand the anatomical background of palatal and tuberal blood supply. This might enable clinicians to design optimized incision- and flap designs. As a result, the risk of intraoperative bleeding and postoperative wound healing complications related to impaired blood supply can be minimized.

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Acknowledgements

The authors would like to express their gratitude to Dr. Gábor Baksa from the Department of Anatomy, Histology and Embryology, Semmelweis University for his precious support. The authors also would like to thank all other co-workers of the Department of Anatomy, Histology and Embryology, and Dr. Ferenc Bartha and Dr. Dániel Palkovics from the Department of Periodontology, Semmelweis University and the Department of Macroscopical and Clinical Anatomy of Graz University for their work and support.

Funding

The work was supported by the Department of Periodontology, Semmelweis University, Budapest, Hungary; Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary; Department of Macroscopical and Clinical Anatomy, Medical University of Graz, Graz, Austria.

Author information

Author notes

  1. Bálint Molnár and Péter Windisch contributed equally to this work.

Authors and Affiliations

  1. Department of Periodontology, Semmelweis University, Budapest, Hungary

    Arvin Shahbazi, Bálint Molnár & Péter Windisch

  2. Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary

    Arvin Shahbazi, András Grimm, Gábor Gerber & Andrea Dorottya Székely

  3. Department of Macroscopical and Clinical Anatomy, Medical University of Graz, Graz, Austria

    Georg Feigl

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  1. Arvin Shahbazi
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  2. András Grimm
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  3. Georg Feigl
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  4. Gábor Gerber
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  5. Andrea Dorottya Székely
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  6. Bálint Molnár
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  7. Péter Windisch
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Correspondence to Péter Windisch.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required. Informed consent was obtained from all individual participants included in the study.

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Shahbazi, A., Grimm, A., Feigl, G. et al. Analysis of blood supply in the hard palate and maxillary tuberosity—clinical implications for flap design and soft tissue graft harvesting (a human cadaver study). Clin Oral Invest 23, 1153–1160 (2019). https://doi.org/10.1007/s00784-018-2538-3

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  • DOI: https://doi.org/10.1007/s00784-018-2538-3

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