Cone-beam Computed Tomography Evaluation of the Soft Tissue Thickness and Neurovascular Bundle's Position at the Palatal Region

Abstract

Avoiding to damaging the neurovascular bundle (NB) while harvesting soft tissue graft (STG) from palatal area which is considered as a donor site for periodontal plastic surgery is important. The size of STG that can be related the position of NB and thickness of palatal mucosa (PMT). The aim of this study was to evaluate PMT and NB morphology from cone-beam computerized tomography (CBCT) images for established the ideal zone for STG. Measurements performed at 122 patients’ CBCT images. PMT evaluated according to age, gender and teeth zone. The relation of the distance among NB to top of maxillary alveolar ridge (NBD) and palate vault depth (PVD) and the angle between the alveolar bone and the palatal plane (PA) were evaluated. The mean PMT from second molar to first premolar teeth were detected as 3.8, 3.2, 3.6 and 3.1 mm respectively. PMT at second molar and second premolar teeth were statistically different from other zones (p< 0.05). The mean PMT was significantly thicker in males. Except for NBD of first premolar zone, NBD showed positive correlation with PVD. No significant relationship among PA with NBD and PVD established. The highest NBD detected 11.2 mm at second molar zone and the lowest was detected 8.05 mm at first premolar zone. The second premolar to second molar teeth zones observed as the suitable graft area considering the mean PMT. It should be careful when the STG harvested from the first premolar zone since NBD decreased to 8mm.