Comparison of palatal bone thickness between 3D model and lateral cephalometric radiograph

Min-Guk Jang; Jin-Woo Lee; Kyung-Suk Cha; Dong-Hwa Chung; Sang-Min Lee

doi:10.4041/kjod.2011.41.5.312

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Jang, Lee, Cha, Chung, and Lee: Comparison of palatal bone thickness between 3D model and lateral cephalometric radiograph

Original Article

Korean J Orthod 2011;41(5):312-323.

Published online: 21 January 2011

DOI: https://doi.org/10.4041/kjod.2011.41.5.312

Comparison of palatal bone thickness between 3D model and lateral cephalometric radiograph

Min-Guk Jang^a, Jin-Woo Lee^b, Kyung-Suk Cha^b, Dong-Hwa Chung^c, Sang-Min Lee^d

DDS, MSD

DDS, MSD, PhD

^aGraduate Student, Department of Orthodontics, School of Dentistry, Dankook University

^bProfessor, Department of Orthodontics, School of Dentistry, Dankook University

^cAssociate Professor, Department of Orthodontics, School of Dentistry, Dankook University

^dAssistant Professor, Department of Orthodontics, School of Dentistry, Dankook University

Corresponding author: Jin-Woo Lee. Department of Orthodontics, School of Dentistry, Dankook University, San 7-1 Sinbu-dong, Cheonan 330-716, Korea. +82 41 550 1945; e-mail, serail@naver.com.

Received 22 March 201115 July 2011 Accepted 18 July 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

This study compared the bone thickness of the palate between lateral cephalogram and 3D model measurements.

Methods

The subjects consisted of 30 adults (15 men,15 women) with a normal skeletal pattern and occlusion. The CT images were transformed to a 3D model, and were compared with the cephalometric image. Descriptive statistics for each variable were calculated.

Results

In the 3D CT model, the mid-palatal area was the thickest part. It became thinner as the palate tapered laterally. In the male group, the thinnest portion was positioned 6 mm away from the mid-palate, while in the female group the thinnest portion was 8mm away from the mid-palate. Correlation analysis between the lateral cephalometric and 3D CT model revealed a significant correlation except in the mid palatal area and the area 2 mm lateral to the mid-palate in men, whereas there was a significant relationship in every area in the women. In both men and women, the highest correlation appeared in the area 8 mm lateral to the mid palate.

Conclusions

Using regression analysis, an actual prediction of the bone thickness between the measured bone thickness of the lateral cephalometric radiograph and 3D model was made. This will provide useful information for mini-implant length selection when inserting into the palate.

Keywords: Palate, Bone thickness, Lateral cephalometric radiograph, CT

REFERENCES

1.Kyung SH., Lim JK., Park YC. The use of miniscrew as an anchorage for the orthodontic tooth movement. Korean J Orthod. 2001. 31:415–24.

2.Kanomi R. Mini-implant for orthodontic anchorage. J Clin Orthod. 1997. 31:763–7.

3.Costa A., Raffainl M., Melsen B. Miniscrews as orthodontic anchorage: a preliminary report. Int J Adult Orthodon Orthognath Surg. 1998. 13:201–9.

4.Kyung SH. A study on the bone thickness of midpalatal suture area for miniscrew insertion. Korean J Orthod. 2004. 34:63–70.

5.Lim HJ., Eun CS., Cho JH., Lee KH., Hwang HS. Factors associated with initial stability of miniscrews for orthodontic treatment. Am J Orthod Dentofacial Orthop. 2009. 136:236–42.

6.Park YC., Lee JS., Kim DH. Anatomical characteristics of the midpalatal suture area for miniscrew implantation using CT image. Korean J Orthod. 2005. 35:35–42.

7.Henriksen B., Bavitz B., Kelly B., Harn SD. Evaluation of bone thickness in the anterior hard palate relative to midsagittal orthodontic implants. Int J Oral Maxillofac Implants. 2003. 18:578–81.

8.Wehrbein H., Merz BR., Diedrich P. Palatal bone support for orthodontic implant anchorage--a clinical and radiological study. Eur J Orthod. 1999. 21:65–70.

9.Kim HJ., Yun HS., Park HD., Kim DH., Park YC. Soft-tissue and cortical-bone thickness at orthodontic implant sites. Am J Orthod Dentofacial Orthop. 2006. 130:177–82.

10.Waitzman AA., Posnick JC., Armstrong DC., Pron GE. Craniofacial skeleton measurements based on computed tomography: part I. Accuracy and reproducibility. Cleft Palate Craniofac J. 1992. 29:112–7.

11.Masumoto T., Hayashi I., Kawamura A., Tanaka K., Kasai K. Relationships among facial type, buccolingual molar inclination, and cortical bone thickness of the mandible. Eur J Orthod. 2001. 23:15–23.

12.Kim DH., Lee JW., Cha KS., Chung DH. Consideration of maxillary sinus bone thickness when installing miniscrews. Korean J Orthod. 2009. 39:354–61.

13.Bernhart T., Vollgruber A., Gahleitner A., Dörtbudak O., Haas R. Alternative to the median region of the palate for placement of an orthodontic implant. Clin Oral Implants Res. 2000. 11:595–601.

14.Kang S., Lee SJ., Ahn SJ., Heo MS., Kim TW. Bone thickness of the palate for orthodontic mini-implant anchorage in adults. Am J Orthod Dentofacial Orthop. 2007. 131(4 Suppl):S74–81.

15.Gracco A., Lombardo L., Cozzani M., Siciliani G. Quantitative cone-beam computed tomography evaluation of palatal bone thickness for orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop. 2008. 134:361–9.

16.Baumgaertel S. Quantitative investigation of palatal bone depth and cortical bone thickness for mini-implant placement in adults. Am J Orthod Dentofacial Orthop. 2009. 136:104–8.

17.Park HS., Lee YJ., Jeong SH., Kwon TG. Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofacial Orthop. 2008. 133:30–7.

18.Park YC., Lee SY., Kim DH., Jee SH. Intrusion of posterior teeth using mini-screw implants. Am J Orthod Dentofacial Orthop. 2003. 123:690–4.

19.Kyung SH., Hong SG., Park YC. Distalization of maxillary molars with a midpalatal miniscrew. J Clin Orthod. 2003. 37:22–6.

20.Kim SJ., Lim SH. Anatomic study of the incisive canal in relation to midpalatal placement of mini-implant. Korean J Orthod. 2009. 39:146–58.

21.Wehrbein H., Merz BR., Hämmerle CH., Lang NP. Bone-to-implant contact of orthodontic implants in humans subjected to horizontal loading. Clin Oral Implants Res. 1998. 9:348–53.

22.Motoyoshi M., Inaba M., Ono A., Ueno S., Shimizu N. The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone. Int J Oral Maxillofac Surg. 2009. 38:13–8.

23.Harrell WE. 3D orthodontic diagnosis and treatment planning. In: McNamara JA, Kapila S editors. Craniofacial growth series. Vol 43. Digital radiography and three-dimensional imaging. Ann Arbor: The University of Michigan;2006. p. 147–58.

Fig 1.

Set up of common reference plane.

Fig 3.

Measurement of bone thickness on lateral cephalogram.

Fig 2.

Reconstruction procedure of 3D model. A, Cutting the 3-D model at the vertical reference plane; B, mid palatal point of 3D model.

Fig 4.

Measurement of bone thickness in the 3D model. Rt, Right; Lt, left.

Fig 5.

Mean palatal bone thickness left and right of the suture in the male group. Ceph, Cephalogram; CT, computed tomography; Rt, right; Lt, left.

Fig 6.

Mean palatal bone thickness left and right of the suture in the female group. Ceph, Cephalogram; CT, computed tomography; Rt, right; Lt, left.

Fig 7.

Comparison of bone thickness between male and female in the 3D model. CT, Computed tomography; Rt, right; Lt, left. *p ＜ 0.05.

Table 1.

Point registration

	Landmark	Definition
Lateral	Porion	The most superior point of external acoustic meatus
cephalogram	Orbitale	The most inferior point of bony orbit
	Contact point	Contact point between second premolar and first molar in maxilla
	Point upper	Upper intersection point between vertical reference plane and maxilla
	Point lower	Lower intersection point between vertical reference plane and maxilla
	Maxilla	Outer line of maxilla cortical bone
Computed	Contact point (Rt.,	Lt.) Contact point between second premolar and first molar in maxilla
tomography	Porion (Rt., Lt.)	The most superior point of external acoustic meatus
	Orbitale (Lt.)	The most inferior point of bony orbit
	Crista galli	The most superior point of Crista galli
	ANS	Anterior nasal spine
	PNS	Posterior nasal spine
	Mid palatal point	Intersection point between vertical reference plane and mid sagittal plane on the palatal surface of maxilla

Rt., rightå Lt., leftå ANS, anterior nasal spine; PNS, posterior nasal spine.

Table 2.

Plane registration

	Reference plane	Definition
Lateral	FH plane	The plane passing porion and orbitale
cephalogram	Vertical reference plane	The plane perpendicular to FH plane passing through the contact point between upper second premolar and first molar
Computed	FH plane	The plane passing right and left porion and left orbitale
tomography	Vertical reference plane	The plane perpendicular to FH plane passing right and left contact points between upper second premolar and first molar
	Mid sagittal plane	The plane passing crista galli, ANS and PNS

FH, Frankfort; ANS, anterior nasal spine; PNS, posterior nasal spine.

Table 3.

Descriptive statistics of bone thickness

Gender	Thickness (mm)	Lateral cephalogram	Computed tomography
			Rt.	Rt.	Rt.	Rt.	Rt.	M	Lt.	Lt.	Lt.	Lt.	Lt.
			10 mm	8 mm	6 mm	4 mm	2 mm	M	2 mm	4 mm	6 mm	8 mm	10 mm
Male	Mean	4.21	6.18	4.47	4.24	4.80	5.45	7.85	5.56	5.00	4.36	4.38	6.04
	SD	1.03	1.66	1.23	1.16	1.28	1.02	1.41	1.17	1.13	1.22	1.24	1.42
	Max	6.09	10.45	7.21	6.19	6.93	6.75	9.65	6.81	6.41	6.45	7.09	8.98
	Min	2.48	4.44	2.54	2.27	2.49	3.79	5.50	3.45	2.60	2.00	2.10	3.94
Female	Mean	2.71	4.22	2.87	2.97	3.60	4.53	5.84	4.47	3.62	3.06	3.01	4.15
	SD	1.62	1.68	1.30	1.23	1.32	1.31	1.13	1.38	1.37	1.23	1.42	1.77
	Max	6.02	7.22	5.42	5.52	6.19	7.26	8.16	7.63	6.91	5.70	5.70	6.88
	Min	1.18	1.54	1.35	1.05	1.51	2.87	4.23	2.43	2.00	1.54	1.45	2.02

Rt., Right; M, mid palatal point; Lt., left; SD, standard deviation; Max, maximun; Min, minimum.

Table 4.

Bone thickness correlation analysis between lateral cephalogram and 3D model

Gender		Rt.	Rt.	Rt.	Rt.	Rt.	M	Lt.	Lt.	Lt.	Lt.	Lt.
Gender		10 mm	8 mm	6 mm	4 mm	2 mm	M	2 mm	4 mm	6 mm	8 mm	10 mm
Male	R	0.848	0.903	0.879	0.679	0.296	0.540	0.441	0.718	0.847	0.869	0.782
	p—value	^†	^†	^†	*	-	-	-	*	^†	^†	^†
Female	R	0.832	0.927	0.917	0.846	0.806	0.765	0.671	0.840	0.885	0.941	0.884
	p—value	^†	^†	^†	^†	^†	^†	*	^†	^†	^†	^†

Rt., Rightå M, mid palatal pointå Lt., left.

^* p<0.05;

^† p<0.01.

Table 5.

Bone thickness regression analysis between lateral cephalogram and 3D model

Gender		Rt.	Rt.	Rt.	Rt.	Rt.	M	Lt.	Lt.	Lt.	Lt.	Lt.
Gender		10 mm	8 mm	6 mm	4 mm	2 mm	M	2 mm	4 mm	6 mm	8 mm	10 mm
Male	B	1.265	1.042	0.958	0.891	—	—	—	0.747	1.046	1.089	1.174
	Y—int.	0.856	0.089	0.208	1.054				1.858	—0.037	—0.206	1.102
	R²	0.611	0.756	0.718	0.515				0.461	0.773	0.816	0.718
	β	0.782	0.869	0.847	0.718				0.679	0.879	0.903	0.848
Female	B	0.915	0.756	0.669	0.685	0.544	0.535	0.688	0.716	0.694	0.811	0.909
	Y—int.	1.744	0.827	1.157	1.748	3.060	4.387	2.610	1.684	1.179	0.818	1.693
	R²	0.782	0.885	0.784	0.705	0.450	0.585	0.650	0.715	0.841	0.859	0.693
	β	0.884	0.941	0.885	0.840	0.671	0.765	0.806	0.846	0.917	0.927	0.832

Rt., Right; M, mid palatal point; Lt., left; Y—int., Y-intercept.

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