Quantitative cone-beam computed tomography evaluation of palatal bone thickness for orthodontic miniscrew placement

Abstract

The purpose of this study was to evaluate the 3-dimensional thickness of the palate to determine the best location to place miniscrews. We selected digital volumetric tomographs from 162 healthy subjects, aged 10 to 44 years (80 male, 82 female). The sample was divided into 3 groups. Group A included 52 subjects (ages, 10-15 years; 28 boys, 24 girls); group B included 38 subjects (ages, 15-20 years; 18 males, 20 females), and group C had 72 subjects (age, 20-44 years; 34 men, 38 women). Ninety-degree paracoronal views of the palatal region at 4, 8, 16, and 24 mm posterior to the incisive foramen were reconstructed, and bone height was measured laterally from the midline in each reconstruction at 0-, 3-, and 6-mm increments to describe the topography of the palate. Measurements of palatal height in 27 of the 162 patients were made by 2 different investigators. Method error was calculated according to the Dahlberg formula (S(2) = Sigmad(2)/2n), and systematic error was evaluated with the dependent Student t test, with P <0.05 considered significant. The thickest bone (4-8 mm) was found in the anterior part of the palate, at the suture and in the paramedian areas, but the posterior region, despite its reduced thickness, is also suitable for miniscrews. The Kruskal-Wallis test showed no significant differences between the groups in the various palatal sections (median suture, 3 and 6 mm to the right and left of the suture) except between groups A and C in the 16-mm paracoronal section at 6 mm to the right and left of the suture. There were no statistically significant differences due to sex or between the right and left sides of the palate. The anterior region is the thickest part of the palate, but the bone thickness in the posterior region is also suitable for screws of appropriate diameter and length.