Utility of CBCT for the measurement of palatal bone thickness

Evaluation of Palatal Thickness for the Placement of MARPE Device among a Cohort of Iraqi-Kurdish Population: A Retrospective CBCT Study

Objectives

This study aimed to evaluate and compare palatal thickness in adults for the placement of mini-implants for miniscrew-assisted rapid palatal expansion (MARPE) appliances using cone-beam computed tomography (CBCT) in a sample of Iraqi-Kurdish people.

Materials and Methods

CBCT scans from 68 Kurdish patients, aged between 18 and 30 years, were assessed retrospectively. Of these, 37 were males and 31 were females. The measurements were performed at 3 mm from the mid-palatal suture. T-zone was selected for the anterior points, at the level of the palatal cusps of 2nd premolars, and the posterior point at the level of mesio-palatal cusps of 1st molars bilaterally. Palatal thickness of males and females bilaterally, as well as anterior and posterior areas, were measured and compared. An independent t-test was applied for comparison for normally distributed data, and the Mann-Whitney test was utilized for nonnormally distributed data. Additionally, Bonferroni correction was implemented for p-value adjustment.

Results

The mean palatal thickness at the anterior area was 6.06 mm for males, 6.17 mm for females on the right side, 5.94 mm for males, and 5.99 mm for females on the left side. The mean palatal thickness at the posterior area was almost the same for both genders (4.40 mm for males and 4.44 mm for females) on the right side, 4.35 mm for males, and 4.54 mm for females on the left side. Statistically, no significant difference was recorded between males and females, as well as right and left sides in both anterior and posterior regions; however, a very highly statistically significant difference (p  < 0.001) was recorded when comparing total thickness, including both hard and soft tissue, between anterior and posterior regions.

Conclusions

CBCT proves a highly effective modality in assessing palatal thickness and suggesting ideal locations for orthodontic mini-screw placement. Our examination of palatal thickness in a sample of Iraqi-Kurdish individuals revealed no statistical difference between genders or sides, but significant variations were noted between anterior and posterior thicknesses. Comprehensive clinical and pre-expansion CBCT evaluations are crucial for precisely determining the optimal placement of MARPE devices in each patient, ensuring successful outcomes.

Palatal bone thickness for mini-implant insertion in different vertical growth patterns: a systematic review

Introduction

The purpose of this systematic review was to identify, evaluate, and provide information about palatal bone thickness in different vertical growth patterns for the placement of orthodontic anchorage devices.

Methods

We performed a systematic review of the published data in Medline via PubMed, Web of Science, Cochrane Library, and Scopus from January 2000 to August 2022 using eligibility criteria. Data collection analysis and data extraction were performed independently by three reviewers. Sensitivity analyses were performed with the Cochrane risk of bias tool and the ROBINS-I tool was used for non-randomized studies.

Results

A total of 343 articles were identified. The inclusion criteria included palatal bone thickness and vertical facial growth. However, both variables were found in 4 studies and only 2 had a control group. The different studies evaluated palatal bone thickness according to sex (male 14.1 mm; female 9.68 mm) and vertical malocclusion (normal 2.2 -12.6 mm; open bite 1.9 -13.2mm) with heterogeneous results. Likewise, the vertical growth pattern with a low angle (9.39 mm) was greater than the normal (8.55 mm) and high angle (7.53 mm).

Conclusions

Palatal bone thickness varies according tp different vertical growth patterns, with the greatest thickness being found near the incisive foramen in hypodivergent individuals.

Analysis of factors associated with the success of microimplant-assisted rapid palatal expansion

INTRODUCTION

Success-related factors of microimplant-assisted rapid palatal expansion (MARPE) were evaluated, including age, palatal depth, suture, and parassutural bone thickness, suture density and maturation, and the relation to corticopuncture (CP) technique, as well as skeletal and dental effects.

METHODS

Sixty-six cone-beam computed tomography scans were analyzed before and after rapid maxillary expansion procedures in 33 patients aged 18-52 years for both sexes. The scans were generated in digital imaging and communications in medicine file format and analyzed in the multiplanar reconstruction of the regions of interest. Palatal depth, suture thickness, density and maturation, age, and CP were assessed. To evaluate dental and skeletal effects, the sample was divided into 4 groups: successful MARPE (SM), SM + CP technique (SMCP), failure MARPE (FM), and FM + CP (FMCP).

RESULTS

Successful groups presented more skeletal expansion and dental tipping than failure groups (P <0.05). The mean age of the FMCP group was significantly higher than the SM groups; suture and parassutural thickness significantly related to the success, and patients who received CP showed a success rate of 81.2% compared with 33.3% in the no CP group (P <0.05). Suture density and palatal depth did not show a difference between the success and failure groups. Suture maturation was higher in SMCP and FM groups (P <0.05).

CONCLUSIONS

Older age, thin palatal bone, and higher stage of maturation can influence the success of MARPE. CP technique in these patients appears to have a positive impact, increasing the chance of treatment success.

A computed tomography-based analysis of the structure of the mandible according to age and sex

Background

The primary objectives of mandibular surgery are to achieve optimal occlusion, low sensory disturbance, and adequate fixation with early movement. In-depth knowledge of the mandibular structure is required to achieve these goals. This study used computed tomography (CT) to evaluate the mandibular cortical thickness and cancellous space according to age and sex.

Methods

We enrolled 230 consecutive patients, aged 20 to 50 years, who underwent CT scanning. The cortex and cancellous space centered around the inferior alveolar nerve (IAN) canal were measured at two specific locations: the lingula and second molar region. Statistical analysis of differences according to increasing age and sex was performed.

Results

The t-test revealed that the cancellous space and cortical thickness differed significantly with respect to the threshold of 35 years of age. Both cortical thickness and cancellous space in the molar region were negatively correlated with age. Meanwhile, both cortical thickness and cancellous space in the lingula region showed a positive correlation with age. With respect to sex, significant differences in the cancellous space at the molar region and the cortical thickness at the lingula were observed. However, no further statistically significant differences were observed in other variables with respect to sex. The sum of each measurement on the mandibular body reflected the safe distance from the surface of the outer cortex to the IAN canal. The safe distances also showed statistically significant differences between those above and below 35 years of age.

Conclusion

Knowledge of the anatomical structure of the mandible and of changes in bone structure is crucial to ensure optimal surgical outcomes and avoid damage to the IAN. CT examination is useful to identify changes in the bone structure, and these should be taken into account in the planning of surgery for older patients.

Use of Micro-CT Imaging to Assess Ventral Mandibular Cortical Thickness and Volume in an Experimental Rodent Model With Chronic High-Phosphorus Intake

Adverse effects of high dietary phosphorus on bone health have been observed in both animal and human studies. The aim of the investigation was to examine chronic effects of high phosphorus diet on the apical mandibular cortical thickness and volume in a hystricomorph rodent (Octodon degus) using microcomputed tomography. Male degus were randomly divided into two groups fed by different mineral contents from the age of 12 weeks till the age of 17 months. The micro-CT scanning and wall thickness analysis were applied on the region of the mandible exactly under the apices of the 4th premolar tooth, first molar tooth, and second molar tooth in two animals from each group. General overview and mapping of the ventral mandibular bone thickness revealed pronounced bony mandibular protrusions in all the animals fed a high-phosphorus diet with obvious bone thinning apically to the 4th premolar and first and second molar tooth apices. Mandibular bone volume and thickness located apically to the premolar and molars were statistically significantly smaller/thinner in the group fed by a high phosphorus diet. The thinnest bone measured 0.004 mm, where the mandibular 4th premolar tooth almost perforated the mandibular cortex. Similar studies of metabolic bone disease and its influence on alveolar bone were also published in rats and mice. The influence of different environmental, infectious, or metabolic factors on the growing tooth, alveolar bone formation, and bone pathologies must be done experimentally on growing animals. In contrast, degus have continuously growing dentition, and the effect of any of the above listed factors can be studied in this animal model at any age and for longer time periods.

A Modified Procedure for Anterior Maxillary Osteotomy

ABSTRACT

Anterior maxillary osteotomy is a traditional operation in the treatment of maxillary protrusion. Varies fields about operation have been changed or improved in those years to avoid different kinds of complications. In our study, the authors would present 1 kind of improved anterior maxillary osteotomy surgical method. The study was conducted at the Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Guangzhou, Guangdong province. Patients are divided into improved group and general group. Patients after surgery were claimed to have regular return visits. Occlusion, tooth vitalities, postoperative complications would be well evaluated. The operative time, blood losses, complications showed no different at maxillary operation. Our procedure could give much better and direct sight of anterior maxillary bone, and the simplified osteotomy lines could help maxilla move, reduce the times spent on hard tissue cut off or grind. The modified procedure can meet clinical command, improve dentofacial deformities, and gives convenience to surgeon.

Determination of sex dimorphisms of the thickness of the hard palate in adolescence using computed tomography: Pilot study

BACKGROUND

In addition to traditional craniometric techniques, computer craniometry has been used in recent decades, including stereometric methods, which make it possible to determine the microanatomical spatial relationships and dimensional features of various structures of the skull, in particular the thickness of the inert palate of the maxilla.

AIM

Determination of the gender-specific variability of the thickness of the bony palate at the age of 18-20 years using CT.

MATERIAL AND METHODS

The material of the pilot study were 40 computed tomograms of young males and females aged 18-20 years. The method of computer craniometry was used to measure the thickness of the bony palate in sagittal projection taking into account the gender. A graphic raster map was created to identify the palatal areas, then analyze their thickness and determine the safe zones for the mini dental implants.

RESULTS

In young males and females (18-20 years) the thickness of the bony palate decreases at different levels from front to back and from the median suture to the alveolar process. The greatest thickness of the bony palate corresponds to its anterior third and reliably predominates in young males at all levels compared to young females. In the middle and posterior third palate, the averages do not show gender differences and their variation is insignificant.

CONCLUSIONS

The greatest thickness of the bony palate can be used as the most favorable zone for the fixation of orthodontic mini dental implants. The variability in the thickness of the bony palate should be considered when selecting the most optimal zones and depth of mini-implant placement.