scholarly journals Quantitative evaluation of palatal bone thickness to guide miniscrews insertion: a CBCT assessment

HU Revista ◽  
2020 ◽  
Vol 46 ◽  
pp. 1-8
Author(s):  
Rodrigo César Santiago ◽  
Carolina De Sá Werneck ◽  
Fernanda Ramos de Faria ◽  
Robert Willer Farinazzo Vitral ◽  
Marcio José Da Silva Campos

Introduction: The use of mini-implants has become common in orthodontic practice as it has increased the possibility of skeletal anchorage. The palate constitutes a site of choice for the insertion of miniscrews purposes because it is a site with relatively safety with appropriate bone thickness and less suitability for inflammation. Aim: To quantitatively evaluate the thickness of the palatal bone for miniscrews insertion. Material and Methods: Forty-seven sets of cone beam computed tomographic (CBCT) images were selected. The sample consisted of cone beam computed tomography from 47 patients (20 male, 27 female; mean age 22.4 years old/± 3.01 years). Palatal bone thickness (PBT) was measured in millimeters (mm) with 5 regions of interest (ROIs) which were determined used the coronal reconstructions of the patatal area: 4, 6, 8 and 10 mm posterior to the incisive foramen were evaluated. A total of 940 ROIs were evaluated. RESULTS: Significant differences were observed for PBT between various palatal sections (p<.01). The thickest area (6.31-7.03 mm) was found in the anterior part of the palate. The mean bone thicknesses in the 6, 8 and 10 mm sections were significantly less than those observed at 4 mm from the incisive foramen. Conclusions: The thickness of the palatal bone is progressively thinner from the palatine foramen to the posterior region. Transversally, the bone was thicker in the palatine suture than in paramedian areas, mainly in the coronal reconstructions located more laterally.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
P. López-Jarana ◽  
C. M. Díaz-Castro ◽  
A. Falcão ◽  
C. Falcão ◽  
J. V. Ríos-Santos ◽  
...  

Abstract Background The objective of this study was to measure two parameters involved in tri-dimensional implant planning: the position of the buccal and palatal bone wall and the palatal thickness. Methods Cone beam computed tomography (CBCT) images (Planmeca ProMax 3D) of 403 teeth (208 upper teeth and 195 lower teeth) were obtained from 49 patients referred to the Dental School of Seville from January to December 2014. The height difference between the palatal and buccal walls was measured on the most coronal point of both walls. The thickness of the palatal wall was measured 2 mm from the most coronal point of the palatal wall. Results The mean values in the maxilla were 1.7 ± 0.9 mm for central and lateral incisors, 2.2 ± 1.7 mm for canines, 1.6 ± 0.9 mm for premolars and 1.9 ± 1.5 mm for molars. In the lower jaw, the mean values were 1.3 ± 0.8 mm for incisors, 1.7 ± 1.2 mm for canines, 2.3 ± 1.3 mm for premolars, and 2.6 ± 1.7 mm for molars. In the upper jaw, more than 55% of maxillary teeth (excluding second premolars and molars) presented mean height differences greater than 1 mm. In the mandible, more than 60% of incisors showed a buccal bone thickness of 1 mm from the apical to lingual aspect. All teeth except the second premolar presented a buccal wall located more than 1 mm more apically than the lingual bone wall. Conclusions The buccal bone wall is located more apically (greater than 1 mm) than the palatal or lingual table in most of the cases assessed. The thickness of the palatal or lingual table is also less than 2 mm in the maxilla and mandible, except in the upper canines and premolars and the lower molars.


2010 ◽  
Vol 80 (1) ◽  
pp. 137-144 ◽  
Author(s):  
Sung Hee Moon ◽  
Sun Hyung Park ◽  
Won Hee Lim ◽  
Youn Sic Chun

Abstract Objectives: To evaluate palatal bone density to allow for better selection of palatal implant anchorage sites. Materials and Methods: Computed tomographic (CT) images were obtained from 15 males and 15 females (mean age, 27 years; range, 23–35 years). Bone density was measured in Hounsfield units (HU) at 80 coordinates at regular mediolateral and anteroposterior intervals along the midpalatal suture. Results: Bone densities ranged from 805 to 1247 HU. A significant difference between male and female groups was noted, although no difference was found between left and right sides of individual palates. Palatal bone densities showed a tendency to decrease laterally and posteriorly. The midpalatal area within 3 mm of the midsagittal suture had the densest bone in the entire palate. Conclusion: Results suggest that mini-implants for orthodontic anchorage may be effectively placed in most areas with bone density equivalent to the palatal area if they are placed from 3 mm posterior to the incisive foramen and 1 to 5 mm to the paramedian side.


2021 ◽  
Author(s):  
Weiting Chen ◽  
Kaili Zhang ◽  
Dongxu Liu

Abstract Background: Analyze the palatal bone thickness of maxillary skeletal expander (MSE) implantation area in adult patients with skeletal class Ⅲ malocclusion based on Cone-beam computed tomography (CBCT) data, and to provide a reference for the implantation of the miniscrew.Methods: A total of 80 adult patients (40 M, 40 F) with an normal angle before treatment were divided into two groups; skeletal class Ⅲ malocclusion group and skeletal Ⅰ malocclusion group according to sagittal facial type, with 40 patients in each group, with a male to female ratio of 1: 1. CBCT scanner was used to obtain DICOM data from all patients.The palatal bone thickness was measured at 45 sites with MIMICS 21.0 and SPSS 22.0 was employed for statistical analysis. The bone thickness of different regions of the palate in the same group was analyzed by one-way analysis of variance (ANOVA) method; Fisher’s least significant difference (LSD)-t method was used for comparison in pairs, and an independent sample t-test was employed to test the difference of bone thickness in the same area between the two groups.Results: (1) There was no significant difference among the anterior, middle, and posterior regions of the midline area in patients with skeletal class Ⅲ malocclusion (P > 0.05). Palatal bone thickness decreased gradually from front to back in the middle and lateral areas in both groups (P < 0.001). (2) The bone thickness of the anterior, middle, and posterior regions of the two groups gradually decreased from the middle area to the parapalatine region. (3) The palatal bone were significant thinner in the area 9.0 mm before the transverse palatine suture in midline area, 9.0 mm before and after the transverse palatine suture in the middle area, and 9.0 mm after the transverse palatine suture in the lateral area.Conclusion: (1) The palatal bone of patients with class Ⅲ malocclusion was thinner in some areas, so the MSE implant anchorage position could be moved forward appropriately. (2) The thin palatal bone increased the risk of MSE anchorage screw penetrating nasal mucosa and even inferior turbinate. Patients should be given a more precise and personalized implantation scheme based on factors such as palatine bone thickness and palatal morphology.


2017 ◽  
Vol 43 (5) ◽  
pp. 333-336 ◽  
Author(s):  
Maryam Rastegar Moghddam ◽  
Zeinab Davoudmanesh ◽  
Nasim Azizi ◽  
Vahid Rakhshan ◽  
Mahsa Shariati

The anterior loop of the inferior alveolar nerve is a sensitive anatomical feature that should be taken into account during installation of dental implants anterior to the mental foramen. This study was conducted to explore the controversy regarding prevalence and length. A total of 452 mandible quadrants of 234 patients (age: 50.1 ± 13.3 years, 113 males, 121 females) were studied using cone-beam computerized tomography. After reconstructing axial, frontal, and sagittal slices, the region between the most anterior point on the mental foramen and the most anterior part of the mandibular nerve was inspected for signs of anterior loop presence. If positive, the length of the anterior loop was measured in mm as the distance between the anterior border of mental foramen and the anterior border of the loop. Prevalence and length of the anterior loop were compared statistically between sexes and age groups. The anterior loop was observed in 106 quadrants (23.5% of 451 quadrants) of 95 patients (40.6% of 234 patients), of whom 11 had bilateral anterior loops. Prevalences were similar in males (41%) and females (39%, chi-square P =.791). The mean anterior loop length was 2.77 ± 1.56 mm (95% CI: 2.5–3.1 mm), without significant sex (regression beta = −0.159, P = .134) or age (beta = −0.059, P = .578) differences. The anterior loop might exist in about 40% of patients, regardless of their gender. The mean safe anterior distance from the anterior loop is about 3 mm + (2.5–3.1 mm) = 5.5–6.1 mm, regardless of age.


2015 ◽  
Vol 31 (5) ◽  
pp. 265-270 ◽  
Author(s):  
Yi-Ching Poon ◽  
Hong-Po Chang ◽  
Yu-Chuan Tseng ◽  
Szu-Ting Chou ◽  
Jung-Hsuan Cheng ◽  
...  

2021 ◽  
Author(s):  
Krishan Sarna ◽  
Merna Akram Estreed ◽  
Khushboo Jayant Sonigra ◽  
Thomas Amuti ◽  
Florence Opondo ◽  
...  

Abstract Purpose: Surgical procedures revolving around the anterior maxilla are of great interest due to their debilitating facial aesthetics and nerve injury effects if complications arise. Hence, sufficient knowledge concerning the morphology and morphometry of the nasopalatine canal (NPC) and incisive foramen (IF) is necessary to prevent such complications from arising. Materials and Methods: Measurements of the NPC and the IF were carried out on 150 CBCT scans. The maxillary bone thickness anterior to the NPC was measured at 3 levels. Independent t-test and chi-square test were performed to determine the presence of sexual dimorphism. Results: The presence of one Stenson’s foramen was most prevalent. The mean length of NPC was 13.21 ± 3.25 mm with significantly longer canals in males. The most prevalent shape of NPC was cylindrical in sagittal view and a single canal in coronal view. The mean angulation of NPC was 118.42° to the horizontal plane. The average dimensions of the IF were 3.53 mm and 3.07 mm in the anteroposterior and mediolateral diameter respectively while the most common shape was round. The anterior maxillary bone was thicker in males and generally reduced in thickness from the anterior nasal spine superiorly towards the alveolar crest inferiorly. Conclusion: This study highlights the anatomical characteristics of the NPC and IF, with significant sexual dimorphism observed regarding the number of Stenson’s foramina, length of NPC, shapes of the NPC and IF as well as alveolar bone thickness anterior to NPC.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weiting Chen ◽  
Kaili Zhang ◽  
Dongxu Liu

Abstract Background Maxillary skeletal expanders (MSE) is effective for the treatment of maxillary transverse deformity. The purpose of the study was to analyse the palatal bone thickness in the of MSE implantation in patients with skeletal class III malocclusion. Methods A total of 80 adult patients (40 males, 40 females) with an average angle before treatment were divided into two groups, the skeletal class III malocclusion group and the skeletal I malocclusion group, based on sagittal facial type. Each group consisted of 40 patients, with a male to female ratio of 1:1. A cone-beam computed tomography scanner was employed to obtain DICOM data for all patients. The palatal bone thickness was measured at 45 sites with MIMICS 21.0 software, and SPSS 22.0 software was employed for statistical analysis. The bone thickness at different regions of the palate in the same group was analysed with one-way repeated measures ANOVA. Fisher’s least significant difference-t method was used for the comparison of pairs, and independent sample t test was employed to determine the significance of differences in the bone thickness at the same sites between the two groups. Results Palatal bone thickness was greater in the middle region of the midline area (P < 0.01), while the thickness in the middle and lateral areas in both groups was generally lower (P < 0.001). The bone in the anterior, middle, and posterior regions of the two groups became increasingly thin from the middle area toward the parapalatine region. The palatal bone was significantly thinner in the area 9.0 mm before the transverse palatine suture in the midline area, 9.0 mm before and after the transverse palatine suture in the middle area, and 9.0 mm after the transverse palatine suture in the lateral area. Conclusion The palatal bone was thinner in patients with class III malocclusion than in patients with class I malocclusion, with significant differences in some areas. The differences in bone thickness should be considered when MSE miniscrews are implanted. The anterior and middle palatal areas are safer for the implantation of miniscrews, while the thinness of the posterior palatal bone increases the risk of the miniscrews falling off and perforating.


2015 ◽  
Vol 9 (1) ◽  
pp. 287-291 ◽  
Author(s):  
Masume Johari ◽  
Farzaneh Kaviani ◽  
Arman Saeedi

Introduction : Orthodontic mini-implants have been incorporated into orthodontic treatment modalities. Adequate bone at mini-implant placement site can influence the success or failure of anchorage. The present study was to determine the thickness of cortical bone in the maxillary mid-palatal area at predetermined points for the placement of orthodontic mini-implants using Cone Beam CT technique in order to evaluate the relationship of these values with the facial height. Materials and Methods : A total of 161 patients, consisting of 63 males (39.13%) and 98 females (60.87%), were evaluated in the present study; 38% of the subjects had normal facial height, 29% had short face and 33% had long face. In order to determine which patient belongs to which facial height category, i.e. normal, long or short, two angular and linear evaluations were used: the angle between S-N and Go-Me lines and the S-Go/N-Me ratio. Twenty points were evaluated in all the samples. First the incisive foramen was located. The paracoronal cross-sections were prepared at distances of 4, 8, 16 and 24 mm from the distal wall of the incisive foramen and on each cross-section the mid-sagittal and para-sagittal areas were determined bilaterally at 3- and 6-mm distances (a total of 5 points). The thicknesses of the cortical plate of bone were determined at the predetermined points. Results : There was a significant relationship between the mean cortical bone thickness and facial height (p<0.01), with significantly less thickness in long faces compared to short faces. However, the thickness of cortical bone in normal faces was similar to that in long and short faces. Separate evaluation of the points showed that at point a16 subjects with short faces had thicker cortical bone compared to subjects with long and normal faces. At point b8 in long faces, the thickness of the cortical bone was significantly less than that in short and normal faces. At point d8, the thickness of the cortical bone in subjects with short faces was significantly higher than that in subjects with long faces. Conclusion : At the point a16 the cortical bone thickness in short faces was significantly higher than normal and long faces. The lower thickness of the cortical bone in the palatal area at points b8 and d8 in subjects with long faces might indicate a lower anchorage value of these points in these subjects.


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