Treatment of dentoalveolar protrusion with customized lingual appliances and template-guided periodontal surgery

Objective To measure the palatal thickness of soft tissues and the density of cortical bones to determine safe regions for the placement of orthodontic mini-implants and to examine the influence of sex and age on soft-tissue thickness and cortical bone density. Materials and Methods Cone-beam computed tomography images of 42 patients (22 males, 20 females), including 21 adults and 21 adolescents, were examined for this study. The palatal soft-tissue thickness and cortical bone density were measured at the coronal planes between the premolars (P4-5), between the second premolars and first molars (P5-6), and between the first molars and second molars (P6-7). Results Cortical bone density was greatest at P4-5, followed by and P5-6, P6-7 while the thickness of soft tissue was similar among the three planes. Cortical bone density decreased from anterior to posterior and from lateral to median. Soft tissue thickness increased from the median to the lateral and was similar anterior to the posterior. Palatal thickness and cortical bone density are influenced by sex, age, and their interactions. The recommended and optimal sites for palatal orthodontic mini-implants were then mapped. Conclusions Depending on soft tissue thickness and bone density, the preferred implant site tends to be more anterior and closer to the midpalatal suture region. Due to the diversity of palatal morphology among individuals, preferably with cone-beam CT.

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Mapping optimal orthodontic implant sites in the palate using cone-beam computed tomography

Zhu,

Zhong,

Zhao

et al. 2024

Front. Oral. Health

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ObjectiveTo measure the palatal soft tissue thickness and cortical bone density to determine safe regions for the placement of orthodontic mini-implants and to examine the influence of sex and age on soft tissue thickness and cortical bone density.Materials and methodsCone-beam computed tomography images of 42 patients (22 males and 20 females), including 21 adults and 21 adolescents, were examined in this study. The palatal soft tissue thickness and cortical bone density were measured at the coronal planes between the premolars (P4–5), between the second premolars and first molars (P5–6), and between the first molars and second molars (P6–7).ResultsThe thickness of the soft tissue revealed similar coronal planes, but the bone density varied. The mean thickness was 3.8 mm at 0°–60° and 1.5 mm at 60°–90°. P4–5 had the highest bone density (>600 HU), decreasing toward P6–7 (<600 HU). Bone density decreased from 90° to 0° coronally, whereas the soft tissue thickness increased. Age, sex, and their interaction affected bone and soft tissues.ConclusionsIn general, areas with a high bone density tended to have thin soft tissue coronally, thus the preferred implant site tends to be more anterior to the P4–5 plane and closer to 60°–90°. Considering individual variances, mapping of the recommended regions for palatal mini-implants is suggested.

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Treatment of dentoalveolar protrusion with customized lingual appliances and template-guided periodontal surgery

Cited by 3 publications

References 27 publications

Maxillary Palatal Region

Maxillary Palatal Region

Mapping of the recommended and optimal orthodontic implantation sites in the palate by cone-beam computed tomography

Mapping optimal orthodontic implant sites in the palate using cone-beam computed tomography

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