Evaluation of total bone and cortical bone thickness of the palate for temporary anchorage device insertion

Abstract

Background/purpose: The palate has become a popular site for the placement of temporary anchorage devices (TADs) owing to its bone quantity and quality. This study aimed to investigate total and cortical bone thicknesses in the whole palate as well as palatal width using a standard grid system and cone-bean computed tomography (CBCT) images. Materials and methods: The CBCT images of 43 samples were selected. The total bone and cortical bone thicknesses of the palate were surveyed on 64 points per patient. The palatal width was measured. The difference between the age and sex groups was analyzed. Results: The total palatal bone thickness in the adult group ranged from 9.85 ± 2.04 to 1.87 ± 0.79 mm. In the adolescent group, we found one-third of the incisor roots in the area 3 mm distal to the incisive foramen and 8 mm lateral to the mid-palatal suture. The cortical bone thickness in adults was significantly thicker in the posterior paramedian area than that in adolescents. Conclusion: The thickest vertical bone is located in the zone 3 mm distal to the incisive foramen and 4–8 mm lateral to the midpalate. The zone 6 mm posterior to the incisive foramen and 2–8 mm lateral to the midpalate exhibited optimal thickness and was away from the incisor roots. This region could be a safe zone for adolescent patients to place TADs. When TADs are to be inserted at the posterior palate, the 2-mm paramedian area should be the first region of choice.

Keywords

• Adolescent
• Cortical bone
• Cone-bean computed tomography
• Orthodontic appliance
• Palate