Measurement Of The Palatal Mucosa Thickness With Cone Beam Computerised Tomography

Abstract

The main techniques for covering denuded tooth surfaces are laterally positioned flaps, coronnally positioned flaps, oblique positioned flaps, double papilla flaps, free gingival grafts, subepithelial connective tissue grafts and gingival unit grafts. The mucosa surrounding the oral space is named palatal mucaosa and is the main donor site for free gingival graft and subepithelial connective tissue graft procedures. There is different ways to determine the thickness of palatal mucosa. Conic Beam Computerised Tomography CBCT has become a handfull technology as it can help making milimetric measurements and obtain highly diagnostic datas. When planning the procedures harvesting grafts from the palatina, CBCT gives datas of the graft dimensions. In this retrospective study, CBCT images of 50 women and 50 men are used. In the crosssection view the thickness of palatal mucosa of 1st premolar, 2nd premolar, 1st molar and 2nd molar teeth were measured. And from the cross-section image of second molar tooth the palatal depth and palatal angle. When measurements were analyzed, statistically no signifficant difference were found regarding between palatal mucosa thickness values for men and women. And the region between first premolar and first molar teeth was found to be the most suitable graft area.

Keywords

• Palatal mucosa, subepithelial connective tissue grafts, CBCT

PALATİNAL MUKOZA KALINLIĞININ KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ İLE ÖLÇÜLMESİ

Abstract

Açığa çıkmış kök yüzeyinin kapatılması için kullanılan tekniklerin başlıcaları laterale pozisyone flep LPF , koronale pozisyone flep KPF , oblik pozisyonlandırılan flep, double papilla flep DPF , serbest dişeti grefti SDG , subepitelyal bağ dokusu grefti SBDG , dişeti ünitesi grefti DÜG ve yönlendirilmiş doku rejenerasyonu olarak sayılabilir. Damak olarak bilinen ağız boşluğu tavanını kaplayan mukoza palatinal mukozadır ve SBDG ve BDG işlemlerinde greft alınması için sıklıkla tercih edilmektedir. Palatinal mukoza kalınlığının ölçülebilmesi amacıyla farklı teknikler kullanılabilmektedir. Konik ışınlı bilgisayarlı tomografi KIBT teknolojisi hekime milimetrik düzeyde inceleme ve yüksek diagnostik kalitede bilgiler sağlaması nedeniyle diş hekimliğinde artık gerekliliği kanıtlanmış bir yöntem haline gelmiştir. Damaktan yumuşak doku grefti alınmasını gerektirecek prosedürlerin planlanması aşamasında uygun miktarda greftin elde edilebilmesi açısından konik ışınlı bilgisayarlı tomografi incelemesi yapılması önemli bilgiler sağlayabilmektedir.

Keywords

• Palatinal mukoza, subepitelyal bağ dokusu grefti, KIBT

References

1. Glossary of Periodontal Terms (1992). The American Academy of Periodontology. 3rd Ed. Chicago: The American Academy of Periodontology.
2. Miller PD (1985a). A classification of marginal tissue recession. Int. J.Peridont. Rest. Dent., 2: 8-13.
3. Miller PD (1993). Root coverage graft- ing for regeneration and aesthetics. Periodon- tology 2000, 1: 118-127.
4. Waerhaug J (1967). De periodontale lidersers klinikse patologi. Nordisk Klinisk Odontologi. 3: 3-4. In Sangnes G (1976). Traumatization of teeth and gingiva related to habitual tooth cleaning procedures. J. Clin. Periodontol. 3: 94-103.
5. Seichter U (1987). Root surface caries. A clinical literature review. JADA, 115: 305- 309
6. Addy M, Mostafa P, Newcombe RG (1987). Dentine hypersensitivity: the distribu- tion of recession, sensitivity an plaque. J. Dent., 15: 242-248.
7. Orchardson M, Collins WJN (1987). Clinical features of hypersensitive teeth. Br. Dent. J., 162: 253-256.
8. Mjör IA, Kvam E (1969). Dental pulp reactions following the exposure of coronal dentine in vivo. ACTA Odontologica Scandi- navica, 27: 145-151.

9. Sandholm L, Niemi ML, Ainamo J (1982). Identification of soft tissue brushing lesions. A clinical and scanning electron mi- croscopic study.J. Clin Periodontol., 9: 397- 401.
10. Maynard JG (1987). The rational for mucogingival therapy in the child and adoles- cent. Int. J.Periodont. Rest. Dent., 1: 36-51.
11. Seibert J, Lindhe J (1989). Esthetics and periodontal therapy. In: Lındhe J (ed.): Textbook of Clinical Periodontology. 2nd. Ed. Copenhagen: Munksgaard, Chapter 19.
12. Sullivan HC, Atkins JH (1968). Free autogenous gingival grafts. ııı. Utilization of grafts in the treatment of gingival recession. Periodontics, 6: 152-160.
13. Scarfe W, Farman A & Sukovic P (2006). Clinical application of cone-beam computed tomography in dental practice. Jour- nal of Canadian Dental Association, 72: 75- 80.
14. Januario AL, Barriviera M & Duarte W (2008). Soft tissue cone-beam computed tomography: a novel method for the measure- ment of gingival tissue and the dimensions of the dentogingival unit. Journal of Esthetic and Restorative Dentistry 20: 366–374.
15. Eger T, Muller,HP & Heinecke A (1996) Ultrasonic determination of gingival thickness.Subject variation and influence of tooth type and clinical features. Journal of Clinical Periodontology 23: 839–845.
16. Kydd WL, Daly CH & Wheeler JB III (1971) The thickness measurement of mastica- tory mucosa in vivo. International Dental Journal 21: 430–441.
17. Muller HP, Schaller N & Eger T (1999) Ultrasonic determination of thickness of masticatory mucosa. A methodological study. Oral Surgery Oral Medicine Oral Pa- thology Oral Radiology and Endodontics 88: 248– 253.
18. Muller HP, Schaller N, Eger T & Hei- necke A (2000) Thickness of masticatory mu- cosa. Journal of Clinical Periodontology 27: 431–436.
19. Song JE, Um YJ, Kim CS, Choi SH, Cho KS, Kim CK, Chai JK & Jung UW (2008) Thickness of posterior palatal masticatory mu- cosa: the use of computerized tomography. Journal of Periodontology 79: 406–412.
20. Studer SP, Allen EP, Rees TC & Kou- ba A (1997) The thickness of masticatory mu- cosa in the human hard palate and tuberosity as potential donor sites for ridge augmentation procedures. Journal of Periodontology 68: 145–151.
21. Wara-aswapati N, Pitiphat W, Chan- drapho N, Rattanayatikul C & Karimbux N (2001) Thickness of palatal masticatory muco- sa associated with Age. Journal of Periodon- tology 72: 1407–1412.
22. Barriviera M, Duarte WR, Janua´rio AL, Faber J, Bezerra ACB (2009). A new method toassess and measure palatal mastica- tory mucosa by cone-beam computerized to- mography. J Clin Periodontol. 36: 564–568.
23. Zucchelli G & De Sanctis M (2000). Treatment of multiple recession-type defects in patients with esthetic demands. Journal of Per- iodontology 71: 1506–1514.
24. Zuhr O, Beaumer D & Heurzeler M (2014). The addition of soft tissue replacement grafts in plastic periodontal and implant sur- gery: critical elements in design and execution. Journal of Clinical Periodontology 41 (Suppl. 15): S123– S142.
25. Yilmaz HG, Boke F, Ayali A (2015). Cone-beam computed tomography evaluation of the soft tissue thickness and greater palatine foramen location in the palate. J Clin Perio- dontol. 42: 458–461.
26. Mosadomi A, Shklar G, Loftus ER & Chauncey HH (1978). Effects of tobacco smoking and age on the keratinization of pala- tal mucosa: a cytologic study. Oral Surgery Oral Medicine Oral Pathology, 46: 413–417.
27. Ueno D, Sekiguchi R, Morita M, Jay- awardena A, Shinpo S, Sato J & Kobayashi K (2014). Palatal mucosal measurements in a Japanese population using cone-beam comput- ed tomography. Journal of Esthetic and Re- storative Dentistry, 26: 48–58.