Objectives The aim of the present study was to measure the thickness of the palatal mucosa in a Jordanian (Middle Eastern) population as well as identify possible factors that may influence the thickness of palatal mucosa. Material and Methods Sixty period on tally healthy subjects (29 males and 31 females) were selected. Fifteen measurement points were defined on the palate. The mucosal thickness in the hard palate was determined by “bone sounding” with a Hu‐Friedy® round periodontal probe. Results The overall mean thickness of the palatal masticatory mucosa was 3.23 ± 0.47 mm.The mean thickness increased from the gingival margin to a more apical position irrespective of the tooth measured or side of the mouth in the following sequence: canine, second molar, first premolar, second premolar and lastly, the first molar. No significant difference between gender, smoking status, gingival phenotype andsides of the mouth with the thickness of palatal masticatory mucosa was determined. A significant difference between palatal shape and palatal gingival thickness was found. Conclusions The most appropriate site for graft harvesting is the canine‐premolar area 8‐13 mm from the mid‐palatal aspect of each respective tooth in a Jordanian population. Except for the palatal shape, the side of the mouth, smoking, gender or gingival phenotype does not affect the graft harvest. Clinical Relevance Scientific Rationale for Study Knowledge on the thickness of the masticatory mucosa is crucialin making decisions for surgical treatment modality and may affect surgical outcome. We measured the thickness of the palatal mucosa in a Jordanian population and identified possible influencing factors. Principal Findings The thickness varied according to the teeth and the canine to premolar region was found to be the appropriate donor site. Practical Implications This information on safe zone for graft harvest can guide the periodontist to make appropriate incisions and choose the appropriate location to obtain a graft of adequate thickness and dimensions.
Background The purpose of the cross sectional study was to investigate the distal extension of the rugae area in a Jordanian (Middle Eastern) population, as an anatomical limitation influencing the surgical decision of harvesting a palatal soft tissue graft. Factors that may influence or predict the extension were also assessed. Methods Sixty periodontally healthy participants (29 males and 31 females) were included. Maxillary alginate impressions were made and casts were poured. The measurements were highlighted from the origin of the rugae (near mid palatine raphe) to the terminal end with a sharp graphite pencil on the cast and a magnification lens was used for identification. The most posterior extension of the rugae were marked on the casts and determined by a standardized periodontal probe. The normal approximation test for binomial distribution was used to determine the proportion of the subjects with rugael extensions beyond the mesial end of the upper second premolar and fisher’s exact test for the purpose of analysis of the association of this extension with other factors. Results In almost half (41.7%) of the sample, the rugae extended distal to the upper second premolar, 23.3% extended to the mid-palatal of the upper second premolar, and 11.7% extended to the mesial of the upper second premolar. The implication is that 90.0% of the rugae reached the upper second premolar and 78.3% extended beyond its mesial aspect. The normal approximation test performed with 95% CI with the "rugael extension proximal to the mesial end of the upper 2nd premolar" considered to be the "success" category revealed that the proportion of the subjects with rugael extensions proximal to the mesial end of the upper second premolar was significantly lower than the proportion beyond the mesial end of the upper second premolar (95% CI of 11.2–32.0%, p = .00001). There was no significant difference between gender, smoking status, gingival phenotype and palatal shape with the posterior extension of palatal rugae. Conclusions Palatal rugae in a sample of a Jordanian population extends beyond the mesial aspect of the upper second premolar which may cause a substantial limitation for graft harvesting from the palate. The hard palate of Jordanian patients may not be a reliable source of soft tissue grafts required for aesthetic mucogingival surgery. No significant association existed between the most posterior extent of palatal rugae and gender, gingival phenotype or palatal shape. Other possible sources should be explored.
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