Palatal Width Research Articles

Conservative management of canine cleft palate can be a viable treatment option: 65 cases (2006-2023).

To evaluate nonsurgical management outcomes of cleft palate (CP) in dogs and identify any association between cleft size, prevalence of clinical signs, and quality of life (QoL). 65 dogs treated conservatively for CP from January 2006 through December 2023 were retrospectively identified. Diet, activity, medical history, and QoL were recorded for dogs that survived to the transition to solid food. Results were compared to those from 24 control dogs. Measurements of cleft area, width, and percentage of the hard palate occupied by the cleft were made with the use of calibrated photographs. Clefts were divided into 3 types: wide throughout, wide rostrally, and slit throughout. Sneezing was the most frequent clinical sign (43 of 65 over the past month, 34 of 65 when most affected). There was a greater frequency of material lodging in the cleft in the wide-throughout clefts (13 of 16 dogs) compared to the slit-throughout clefts (7 of 19 dogs). Veterinary removal of material was required in 10 of 68 episodes (7 of 31 dogs). There was no correlation between cleft size and prevalence of clinical signs or QoL. Sixty-three percent of dogs had a perfect QoL on a weighted scale, while 83.3% had a perfect score on a visual analog scale. Sixty-four of 65 owners would adopt another dog with a CP. Measures of QoL were favorable among dogs treated conservatively for CP. Conservative management appears to be a viable option for treatment of CPs in some dogs.

Morphometric analysis of the skull base and palatal regions for gender identification using CBCT: a retrospective study.

The objectives of this study were to evaluate the accuracy of morphometry of skull base and palate in gender discrimination using cone beam computed tomography (CBCT) scanning and to assess the accuracy of the results among a sample of the Arab population. Using CBCT scans, a cross-sectional analysis was conducted on 142 consented patients who underwent various dental procedures at the University Dental Hospital, Sharjah (UDHS). Of these patients, 70 were females and 72 were males, with respective means of 38.5 and 36.2 years. Eleven parameters related to skull base and palatal region were measured on the CBCT scans by two expert radiologists followed by statistical analysis. There was significant gender-based difference in the mean palatal width (PW) (p=0.001), mean palatal height (PH) (p=0.005). Among other skull base region parameters that were significant in term of gender-based difference like; the clivus length (CL) (p<0.001), occipital condyle height (OCH) (p<0.001), basal angle (BA) (p=0.006) and transverse diameter of foramen magnum (p=0.003). Only palate variables showed a significant age difference. Discriminant analysis related to gender showed that occipital condyle height was the most accurate and best discriminator among the skull base region parameters. The use of discriminant analysis in CBCT based on skull base and palatal region variables provides an efficient method for determining gender, which is particularly valuable in forensic science and anthropological research. Accurate gender identification is crucial in forensic investigations, and the skull base region, being a stable and sexually dimorphic anatomical feature, can serve as a reliable marker for this purpose.

Presurgical Maxillary Segmented Orthodontics Associated With 3-Piece Le Fort 1 Osteotomy for Palatal Expansion.

The aim of this study is to assess maxillary transverse dimension following presurgical maxillary segmented orthodontics associated with 3-piece Le Fort 1 osteotomy in a cohort of "long face syndrome" patients with palatal constriction. Patients with maxillary transverse insufficiency were retrospectively included. They all underwent maxillary segmented orthodontics followed by a 3-piece Le Fort 1 osteotomy with palatal expansion. Palatal width dimensions were collected preoperatively, postoperatively, and at the time of the final follow-up, the stability of the expansion was analyzed. Nineteen patients were included. There was no complication. The mean postoperative expansion was 6 mm (range: 3.1-8.7mm) in the canine region and 4.3mm (range: 0-9.1mm) in the second molar region. The mean relapse was 0.36mm (range: 0-1.4mm) or 6% (range: 0%-16.1%) in the canine region and 0.17mm (range: 0-1.3mm) or 4% (range: 0%-14%) in the second molar region. Presurgical maxillary segmented orthodontics with 3-piece Le Fort 1 osteotomy has shown high stability of the maxillary transverse dimension in a 1-step surgery without dental tipping. It should be considered as an alternative to rapid palatal expansion.

In utero nicotine exposure affects murine palate development.

Despite data linking smoking to increased risk of fetal morbidity and mortality, 11% of pregnant women continue to smoke or use alternative nicotine products. Studies confirm that nicotine exposure during pregnancy increases the incidence of birth defects; however, little research has focused on specific anatomic areas based on timing of exposure. We aim to determine critical in utero and postnatal periods of nicotine exposure that affect craniofacial development, specifically palate growth. Malformation of the palatal structures can result in numerous complications including facial growth disturbance, or impeding airway function. We hypothesized that both in utero and postnatal nicotine exposure will alter palate development. We administered pregnant C57BL6 mice water supplemented with 100 μg/mL nicotine during early pregnancy, throughout pregnancy, during pregnancy and lactation, or lactation only. Postnatal day 15 pups underwent micro-computed tomography (μCT) analyses specific to the palate. Resultant pups revealed significant differences in body weight from lactation-only nicotine exposure, and μCT investigation revealed several dimensions affected by lactation-only nicotine exposure, including palate width, palate and cranial base lengths, and mid-palatal suture width. These results demonstrate the direct effects of nicotine on the developing palate beyond simple tobacco use. Nicotine exposure through tobacco alternatives, cessation methods, and electronic nicotine delivery systems (ENDS) may disrupt normal growth and development of the palate during development and the postnatal periods of breastfeeding. Due to the recent dramatic increase in the use of ENDS, future research will focus specifically on this nicotine delivery method.

Mll4 regulates postnatal palate growth and midpalatal suture development.

MLL4, also known as KMT2D, is a histone methyltransferase that acts as an important epigenetic regulator during various organogenesis programs. Mutations in the MLL4 gene are the major cause for Kabuki syndrome, a human developmental disorder that involves craniofacial birth defects, including anomalies in the palate. The purpose of this study was to investigate the role of Mll4 and the underlying mechanisms in the development and growth of the palate. We generated a novel conditional knockout (cKO) mouse model with tissue-specific deletion of Mll4 in the palatal mesenchyme. By using micro-computed tomography (CT), histology, cell mechanism assays, and gene expression analysis approaches, we examined the development and growth of the palate in the Mll4 -cKO mice. Gross intra-oral examination at adult stages showed that Mll4 -cKO mice had defects along the midline of the palate, which included disrupted rugae pattern and widened midpalatal suture. Micro-CT-based skeletal analysis in the adult mice revealed that the overall palate width was decreased in the Mll4 -cKO mice. By using whole-mount and histological staining approaches at perinatal stages, we identified that the midline defects started to appear as early as 1 day prior to birth, manifesting initially as a widened midpalatal suture, accompanied by increased cell apoptosis in the suture mesenchyme cells. Genome-wide analysis of mRNA expression in the midpalatal suture tissue showed that Mll4 is essential for timely expression of major genes for cartilage development, such as Col2a1 and Acan , at birth. These results were validated through immunofluorescence staining, confirming that the expression of chondrogenic markers Sox9 and Col2a1 were markedly decreased, whereas that of the osteogenic marker Runx2 remained unchanged, in the midpalatal suture of the Mll4 -cKO mice. Indeed, time-course histological analysis during postnatal palate growth revealed retardation in the development of the suture cartilage in the Mll4 -cKO mice. In parallel, time-course micro-CT analysis during postnatal palatogenesis confirmed a transverse growth deficit in the palate of the Mll4 -cKO mice. Taken together, our results show that Mll4 is essential for timely occurrence of key cellular and molecular events that lead to proper midpalatal suture development and palate growth.

Evaluation of hard palate and cleft morphology in neonates with Pierre Robin Sequence and Cleft Palate Only.

This study aimed to establish a fully digital measurement protocol for standardizing the description of hard palate and cleft morphology in neonates with an isolated cleft palate (CPO) and Pierre Robin sequence (PRS). A total of 20 digitized plaster models of neonates with CPO and 20 digitized plaster models of neonates with PRS were retrospectively investigated. For the control group, the hard palate was segmented from 21 pre-existing 1.5 T MRI datasets of neonates and exported as an STL file. The digital models were marked with predefined reference points by three raters. Distance, angular, and area measurements were performed using Blender and MeshLab. Neonates with CPO (20.20 ± 2.33 mm) and PRS (21.41 ± 1.81 mm) had a significantly shorter hard palate than the control group (23.44 ± 2.24 mm) (CPO vs. control: P < .001; PRS vs. control: P = .014). Notably, neonates with PRS (33.05 ± 1.95 mm) demonstrated a significantly wider intertuberosity distance than those with CPO (30.52 ± 2.28 mm) (P = .012). Furthermore, there were also significant differences measured between the cleft and control groups (25.22 ± 2.50 mm) (P < .001). The data from this study demonstrate the feasibility of using MRI datasets to generate digital models of the hard palate. The presence of a cleft palate leads to pronounced adaptations of the total palatal surface area, dorsal width, and length of the hard palate. Mandibular retrognathia and altered tongue position in PRS, as opposed to CPO, might further impact palatal morphology and intertuberosity distance.

Craniofacial Morphology and Knowledge of the Stability in Class III Malocclusion Growing Subjects

Introduction: to investigate the palatal and craniofacial relationship in Class III growing patients between successful and failed treated groups. Methods: Thirty-one patients treated with RME/FM/BB were enrolled (inclusion criteria: Caucasian ancestry, III Class malocclusion, maturation stage CS1-CS2, mixed dentition). Digital cast and cephalometric analysis were performed on pre-treatment and post-treatment records. Statistical analysis and a discriminant analysis was performed. GMM was used on digital dental casts with Procrustes analysis to assess the covariation between palatal and craniofacial morphology. Two groups (relapse, R, 19 and success S, 12) were identified. Results: R group showed a greater maxillary-anterior transversal width at T0. At T1 R showed a shorter maxillary-anterior length than S. A larger maxillary-anterior and posterior-transversal widths was found in both groups. S had greater maxillary-anterior and posterior-sagittal length. A larger mandibular-anterior and posterior-transversal widths was shown in R, while S showed no differences in mandibula. Maxillary-anterior and maxillary-posterior length were two predictive variables found by discriminant analysis. The PC1 showed significant changes in the palatal morphology and revealed differences for the craniofacial vertical components. Palatal and craniofacial shapes showed a significant covariation, linking the palatal width to skeletal divergence. Discussion: In Class III malocclusion increases in vertical divergence are correlated with a higher palatal vault and narrower width. A wider and shorter maxillary morphology could be a relapse factor for Class III orthopedic treatment, while the lack of mandibular modification could be predisposing for treatment success.

Maxillary Canine Impaction: Assessing the Influence of Maxillary Anatomy Using Cone Beam Computed Tomography.

BACKGROUND The purpose of this study was to evaluate the anatomical characteristics of patients with unilateral impacted canine teeth compared to a control group. Cone beam computed tomography (CBCT) records were retrospectively analyzed. MATERIAL AND METHODS CBCT records of 64 patients with unilateral impacted canine teeth (57.8% female and 42.2% male) and 64 controls (59.4% female and 40.6% male) were retrospectively analyzed. On the CBCT images, intermolar width, arch length, arch perimeter, palatal width in the molar region at cementoenamel junction, palatal width in the molar region at the crest, palatal width in the molar region measured from mid-root level, nasal cavity width, and palatal depth were evaluated. RESULTS In the palatal width measurement from the mid-root variable, the measurement of labially positioned canines was significantly lower than the control group (P<0.05). In terms of intermolar width, the labial positioned impacted canines' values were lower than in the control group. There was a significant difference in terms of the perimeter variable and both palatinally and labially positioned impacted canines were significantly lower than in the control group (P<0.05). All parameters were compared according to sex, and measurements of male patients were significantly higher than in female patients (P<0.05). CONCLUSIONS A labially impacted canine was strongly linked to a decrease in mid-root palatal and intermolar widths. Additionally, impacted canines positioned both palatally and labially were found to result in a reduced arch perimeter. Moreover, male patients with impacted canines exhibited notably greater anatomical measurements compared to female patients.

Palatal Morphology After Treatment of Children With Obstructive Sleep Apnoea Using the Modified Twin-Block Appliance

ObjectiveTo investigate changes in the upper maxillary palates of children with obstructive sleep apnoea (OSA) and mandibular retraction who were treated using modified twin-block appliances (MTBAs). MethodsThirty-five OSA children (age: 6-12 years) with mandibular retraction were included as the experimental group and 35 children who were Angle's class I but without mandibular retraction were included as the control group. The experimental group was treated with MTBA. Plaster models were made before the treatment and at the end of the 6-month treatment period. Plaster models of the control group were made at inclusion and after 6 months. Some plaster models were excluded because of damage or their failure to exhibit sufficiently clear marks, which left 26 pairs each for the experimental and control groups. The gender and age of the experimental group were matched with those of the control group at the end of the treatment. Three-dimensional (3D) digital model information was gathered using the external oral scanning model, and the data were extracted and analysed statistically to clarify the morphologic improvement in the maxillopalatine in OSA children treated using MTBAs. ResultsAfter the OSA children with mandibular retraction were treated with MTBAs, the maxillary intercusp width, intermolar width, anterior palate width, posterior palate width, and surface area and volume of the maxillary palate significantly increased (*P < .05). By contrast, the anterior palatal height–apex level (H3) significantly decreased (*P < .05). ConclusionsCompared with the control group, the narrow maxillary arch and basal bone were significantly enlarged after the OSA children with mandibular retraction were treated using MTBAs. The palatal surface area and volume increased, thereby allowing more space for accommodating the tongue and relieving transverse dissonance of the dentition.

Tongue pressure production and orofacial muscle activities during swallowing are related to palatal morphology in individuals with normal occlusion

ABSTRACT Purpose The relationships between motor function, including the orofacial muscles coordinated with the tongue during swallowing, and palatal morphology are still unclear. This study aimed to identify the relationships between tongue pressure production and orofacial muscle activities during swallowing and palatal morphology. Materials and methods The participants were 20 healthy volunteers with individual normal occlusion (8 men, 12 women; mean age: 25.0 ± 2.9 years). Tongue pressure and masseter, orbicularis oris, mentalis and supra-infrahyoid muscle activities during 4 ml gel swallowing were recorded simultaneously by a sensor sheet system, with five measuring points and surface electromyography, respectively. Onset, offset and duration of each parameter and the maximum magnitude of tongue pressure were analysed. Palatal width and depth were measured using three-dimensional digital images of maxillary dental models and examined for correlations with tongue pressure and orofacial muscle activities. Results The temporal coordination between tongue pressure production and orofacial muscle activities during swallowing was observed. The maximum magnitude of tongue pressure was significantly positively correlated with the palatal width. Palatal depth showed significant correlations with the time sequences of tongue pressure and orbicularis oris and mentalis muscle activities. Conclusion These results suggest that tongue pressure production and orofacial muscle activities during swallowing are related to palatal width and depth.

Investigation of the relatıonshıp of palatal arch morphometry with maxillary sinus volume: CBCT study

Background/Aim: The maxillofacial region is a complex of anatomical structures that are in close proximity and connection with each other. The aim of this study was to determine the shape, depth, width, length and palatal vault angle of the palatal arch on cone beam computed tomography (CBCT) images taken for various reasons and to determine the relationship between these factors and maxillary sinus volume. Material and Methods: CBCT images of a total of 150 male and female patients over the age of 18, taken for different diagnostic purposes, were evaluated by an oral radiologist with two years of experience. The shape of the palatal arch was determined on each image, and palatal depth, width, length and palatal vault angle were measured. ITK-SNAP (version 3.8.0) software was used for maxillary sinus measurement. Statistical analysis of the study was performed using SPSS v.21 software. Results: All of the measured parameters were found to be statistically significant between genders, except for the palatal vault angle. As a result of the correlation analysis, it was shown that palatal length was 0.4% (R2=0.004), palatal depth was 42.3% (R2=0.423), and palatal width was 2%(R2=0.020) effective in explaining the palatal vault angle. A high level of correlation was detected between the right (1) and left (2) sinus maxillaris volumes and total sinus maxillaris volumes (r1=0.959, r2=0.961). Conclusions: There is a significant difference in palatal arch parameters between different genders. In addition, these dimensions also play a role on maxillary sinus volumes.

Impact of different cephalometric skeletal configurations on anatomic midface parameters in adults

ObjectivesSkull morphology and growth patterns are essential for orthodontic treatment, impacting clinical decision making. We aimed to determine the association of different cephalometric skeletal configurations on midface parameters as measured in 3D CT datasets.Materials and methodsAfter sample size calculation, a total of 240 fully dentulous patients between 20 and 79 years of age (mean age: 42 ± 15), who had received a CT of the skull within the scope of trauma diagnosis or intracranial bleeding, were retrospectively selected. On the basis of cephalometric analysis, using MPR reconstructions, patients were subdivided into three different vertical skull configurations (brachyfacial, mesofacial, dolichofacial) and the respective skeletal Class I, II, and III relationships. Anatomic parameters were measured using a three-dimensional post-processing console: the thickness of the maxillary and palatine bones as well as the alveolar crest, maxillary body and sutural length, width and height of the hard palate, maxillary facial wall thickness, and masseter muscle thickness and length.ResultsIndividuals with brachyfacial configurations had a significantly increased palatal and alveolar ridge thicknesses compared to those with dolichofacial- or mesofacial configurations. Brachyfacial configurations presented a significantly increased length and thickness of the masseter muscle (4.599 cm; 1.526 cm) than mesofacial (4.431 cm; 1.466 cm) and dolichofacial configurations (4.405 cm; 1.397 cm) (p < 0.001). Individuals with a skeletal Class III had a significantly shorter palatal length (5.313 cm) than those with Class I (5.406 cm) and Class II (5.404 cm) (p < 0.01). Sutural length was also significantly shorter in Class III (p < 0.05).ConclusionsSkeletal configurations have an impact on parameters of the bony skull. Also, measurable adaptations of the muscular phenotype could result.Clinical relevanceThe association between viscerocranial morphology and midface anatomy might be beneficial for tailoring orthodontic appliances to individual anatomy and planning cortically anchored orthodontic appliances.

A Study on Morphological and Morphometrical Parameters on the Skull of the Konya Merino Sheep

Objective: In this study, it was aimed to determine the craniometric measurements of the skull of the Konya Merino breed and to reveal the differences between it and other sheep breeds. &#x0D; Material-Method: For this study, ten Konya merino heads were used and craniometric measurements were made from 46 points on the skull. &#x0D; Result: In the study, the skull length of the Konya merino was 274.03 ± 5.23, the frontal width (ectorbitale – ectorbitale) which is the widest region of the skull 123.47 ± 2.60, zygomatic width (the distance between two zygomatic arches) 110.30 ± 1.96 and the distance between the foramen supraorbitales 49.06 ± 2.38. has been found to be. It was determined that both the fronto-nasal and palato-maxillar sutures resembled the letter "V" in Konya merino, while the pariato-frontal suture was in the form of a straight line. When the correlation between index values was examined, it was seen that there was a statistically significant strong positive correlation between I1 (Nasal index) and I2 (Facial Index), but the relationship between other examined features was insignificant. When the statistically significant correlation values of the skull measurements are examined, it is seen that there is a strong negative or positive correlation between the features. While the highest positive correlation was between L5 (premolare – prosthion) and L39 (greatest palatal breadth (measured across the outer borders of the alveoli) features (0.943), the highest negative correlation was L33 (greatest neurocranium breadth-greatest breadth of the alveoli)). braincase (euryon - euryon) and L46 (supraorbital foramina distance) features were found to be (-0.908). &#x0D; Conclusion: As a result, in this study, it is thought that the difference in the craniometric values of Konya merino, which is accepted as the native breed of Turkey, with other sheep breeds, depending on the skull morphology, may be caused by the breed of sheep.

Is There a Relationship Between Unilateral/Bilateral Impacted Maxillary Canines and Nasal Septum Deviation?

Introduction A deviated nasal septum may be associated with some dentofacial deformities. The aim of the study was to determine whether there is a relationship between some craniomaxillary features of unilateral and bilateral maxillary impacted canines and nasal septum deviation. Methods This is a retrospective study consisting of cone beam computed tomography (CBCT) images of 51 patients. All patients were divided into three subgroups: unilateral maxillary impacted canines (UMIC) (n=19) bilateral maxillary impacted canines (BMIC) (n=15), and control group (MC) (n=17). The septal deviation angle and some angular and dimensional measurements were performed. Differences in linear and angular measurements between the groups were analyzed using One-way ANOVA and the Kruskal-Wallis test. Pearson's correlation analysis was performed to determine the relationship between the septal deviation angle, septal deviation direction, nasal floor angle, and other parameters, and multivariate linear regression analysis was performed to determine the effect of variables in the septal deviation angle. Results Bilateral or unilateral position of the impacted canines was found to be effective on septal deviation. The septal deviation angle and the nasal floor angle values were found to be significantly higher in the UMIC and BMIC groups (p<0.001) than in the MC group. Maxillary width was found to be significantly lower in the BMIC group compared to the UMIC (p<0.01) and MC group (p<0.001). Septal deviation angle was positively correlated with septal deviation direction and nasal floor angle (p<0.001). Palatal width and nasal floor angle were found to be negatively correlated (p<0.05), and palatal depth and septal deviation direction were found to be positively correlated (p<0.01). Groups and septal deviation angle, septal deviation direction, and nasal floor angle were found to be negatively correlated (p<0.001). The multivariate linear regression analysis revealed an association between septal deviation angle, group (p<0.01), and nasal floor angle (p<0.05). Conclusion Bilateral or unilateral position of the impacted canines was found to be effective on septal deviation.The septal deviation angle values were found to be higher when the maxillary impacted canine was unilateral. Unilateral or bilateral positions of the impacted canine and the nasal floor angle were found to be factors affecting the formation of septal deviation.

Evidences From Systematic Reviews Regarding Miniscrew-Assisted Rapid Palatal Expansion (MARPE) Approach In Orthodontics

Background. Miniscrew-assisted rapid palatal expansion (MARPE) has been considered as relatively novel and effective method of orthodontic treatment, but the discussion is still ongoing regarding effectiveness of MARPE for different age population groups, while also in comparison with surgically assisted rapid palatal expansion or conventional rapid maxillary expansions, since evidences available for MARPE is mostly of insufficient quality.&#x0D; Objective. To collect and represent evidences of MARPE treatment outcomes in orthodontics based on the data available within systematic reviews.&#x0D; Materials and Methods. Search was provided via PubMed Central, Web of Science and Scopus databases, while also within Cochrane Library. Only systematic reviews written in English were considered for analysis. Primary outcomes such as success rate (percentage of cases, where required maxillary width was achieved) and maxillary expansion rate in means of midpalatal split, dental intermolar width, skeletal and dentoalveolar expansion, palatal suture opening, palatal width measured in millimeters or percentage were tabulated and analyzed. Secondary outcomes were presented in descriptive manner &#x0D; Results. Overall 12 systematic reviews were enrolled into study group of targeted publications. Among these 12 systematic reviews primary outcomes were extracted from 8 of them, while rest 4 systematic reviews were used for analysis of secondary outcomes. Succes rate of MARPE varied in the range of 82.8-100%, while intermolar width increase after MARPE treatment – in the range of 4.79-6.55 mm. &#x0D; Conclusion. Considering data available within systematic reviews MARPE approach seems to be reliable orthodontic treatment option, which help to gain significant increase for skeletal and dental intermolar width among patients with maxillary transverse deficiency. Such treatment strategy provides better results than conventional rapid maxillary expansion and lesser periodontal negative consequences compare to surgical-assisted rapid palatal expansion, even though quality of data supporting these statements are insufficient and debatable.

Cephalometric changes associated with MAD therapy

Study objectives: The main objectives of this study were to assess the effect of mandibular advancement device (MAD) therapy on the upper airway morphology, as well as the occurence of dental and skeletal side effects following 1-year MAD therapy in patients with mild to moderate obstructive sleep apnea (OSA). Methods: In this study we included 15 patients with mild to moderate OSA treated with MAD therapy. All subjects underwent sleep study and lateral cephalometric radiography at baseline and at 1-year follow-up. Lateral cephalograms were analyzed with respect to relevant variables. Results: MAD therapy reduced apnea-hypopnea index (AHI) from 22.9±5.9 to 9.7±4.5 events/h (P&amp;lt;0.001) after 1-year of therapy. Oral area enclosure (3697.0±372.4 vs. 3381.5±336.4 mm2, P&amp;lt;0.001), superior airway space width (8.9±2.0 vs. 10.0±2.0 mm2, P=0.039), soft palate width (10.9±1.0 vs. 9.8±1.4, P=0.005) and length (45.4±3.8 vs. 43.9±4.2 mm, P=0.033) were significantly larger with the MAD intra-orally. Additionally, the tongue length decreased (84.1±5.3 vs. 80.7±5.9 mm, P=0.002), while the tongue height increased significantly (27.0±2.4 vs. 29.9±2.5 mm, P=0.003) with the MAD intra-orally. There were no significant changes in skeletal and dental cephalometric variables after 1 year of MAD therapy. Conclusions: Our results show significant enlargement of the upper airway dimensions with the MAD intra-orally in patients with mild to moderate OSA. Although there were no significant changes in skeletal and dental cephalometric variables after 1 year of MAD therapy, close follow-up during MAD therapy is advisable to prevent potentially relevant occlusal changes.

Assessment of palatal mucosal thickness and location of the greater palatine foramen using cone-beam computed tomography: a retrospective study.

This study aimed to measure the palatal mucosal thickness and examine the location of the greater palatine foramen using cone-beam computerized tomography (CBCT). In this study, cone-beam computed tomography (CBCT) images of the maxillary posterior region of 120 subjects were evaluated. The palatal mucosal thickness (PMT), palatal width and depth, and location of the greater palatine foramen (GPF) were determined on CBCT. The differences in the palatal mucosal thickness according to gender and palatal width/palatal depth were analyzed. The location of the GPF related to the maxillary molars was noted. The mean palatal mucosal thicknesses from the canine to the second molar teeth were 3.66, 3.90, 4.06, 3.76, and 3.92mm, respectively. The mean PMT at the second premolar was statistically thicker than at other regions (p < 0,001). There was no relationship between PMT and gender. However, the palatal depth and width of the males were greater than females. (p = 0.004 and p = 0.014, respectively) PMT in the low palatal vault group had statistically higher compared to the high palatal vault group. (p = 0.023) Greater palatine foramen was mostly observed between second and third molar teeth. (48%). According to our results, first and second premolar regions can be preferable in soft tissue grafting procedures for safe and successful treatment outcomes. The measurement of the thickness of the palatal mucosa and the evaluation of the greater palatine foramen location before the surgical procedures are essential steps to harvest from the ideal donor site and to achieve optimal surgical outcomes.

Three-Dimensional Measurements of the Palate and Dental Arch Perimeter as Predictors for Maxillary Palatal Canine Impaction-A Cone-Beam Computed Tomography Image Analysis.

(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal dimensions, and maxillary arch perimeter using digital measurements and determine the factors that could be used as predictors for maxillary palatal canine impaction. (2) Method: A cross-sectional study was conducted on cone-beam computed tomography images of orthodontic patients aged 15 to 25. Palatal dimensions and maxillary arch perimeter were digitally measured using Materialize Interactive Medical Image Control System. (3) Results: A significant difference was found between the case and the study groups regarding palatal depth, length, and arch perimeter, except for the palatal width. A weak correlation was reported in palatal depth and length with canine impaction, whereas the correlation was moderate concerning the arch perimeter. They can be used as predictors for palatal canine impaction. (4) Conclusion: Palatal dimensions and dental arch perimeter affect maxillary palatal canine impaction. Deficient arch perimeter, palatal depth, and length could be helpful in the prediction of maxillary palatal canine impaction.

Correlation of Palatal Index With Pharyngeal Airway in Various Skeletal Patterns.

Introduction This retrospective study aimedto correlate palatal index with pharyngeal airway in class I, class II and class III skeletal patterns. Materials and methods A total of 30 individuals with a mean age of 17.5 years were included in the study. The subjects were categorized on the basis of ANB (A point, nasion, B point) angle into skeletal class I, II, and III patterns (N=10). Using Korkhaus analysis, palatal height, palatal breadth, and palatal height index were calculated from the study models. From the lateral cephalogram, the dimensions of the upper and lower pharyngeal airways were measured using McNamara Airway Analysis. The results were calculated using the ANOVA test. Results A statistically significant difference was found in all three groups of class I, II, and III malocclusions for palatal index and airway dimensions. The skeletal class II malocclusion participants exhibited the highest mean values for the palatal index (P=0.03). Class I had the highest mean value for the upper airway (P=0.041), whereas class III had the highest mean value for the lower airway (P=0.026). Conclusion It was concluded that subjects with the class II skeletal pattern have a high palate and reduced upper and lower airways when compared with class Iand class III skeletal patterns, which showed larger upper and lower airways, respectively.

Palatal shape covariation in extraction versus nonextraction borderline patients: A geometric morphometric study

This study aimed to evaluate changes in palatal shape after orthodontic treatment from a borderline sample of extraction and nonextraction patients with a Class I relationship. A borderline sample regarding premolar extractions was obtained through discriminant analysis and comprised 30 nonextraction and 23 extraction patients. The digital dental casts of these patients were digitized with 3 curves and 239 landmarks placed on the hard palate. Procrustes superimposition and principal component analysis were implemented to assess group shape variability patterns. The success of the discriminant analysis in identifying a borderline sample regarding the extraction modality was validated using geometric morphometrics. Concerning palatal shape, no sexual dimorphism was found (P= 0.78). The first 6 principal components that were statistically significant accounted for 79.2% of the total shape variance. Palatal changes were 61% more pronounced in the extraction group, which exhibited a decrease in palatal length (P= 0.02; 10,000 permutations). In contrast, the nonextraction group showed an increase in the palatal width (P<0.001; 10,000 permutations). Intergroup comparisons indicated that the nonextraction group exhibited longer palates, whereas the extraction group exhibited higher palates (P= 0.02; 10,000 permutations). Considerable changes in palatal shape were seen for the nonextraction and extraction treatment group, with the latter exhibiting more pronounced changes, mainly in terms of palatal length. Further investigations are needed to clarify the clinical significance of the palatal shape changes in borderline patients after extraction and nonextraction treatment.