Relationship Between the Thickness of Cortical Bone at Maxillary Mid-palatal Area and Facial Height Using CBCT

Abstract

Introduction : Orthodontic mini-implants have been incorporated into orthodontic treatment modalities. Adequate bone at mini-implant placement site can influence the success or failure of anchorage. The present study was to determine the thickness of cortical bone in the maxillary mid-palatal area at predetermined points for the placement of orthodontic mini-implants using Cone Beam CT technique in order to evaluate the relationship of these values with the facial height. Materials and Methods : A total of 161 patients, consisting of 63 males (39.13%) and 98 females (60.87%), were evaluated in the present study; 38% of the subjects had normal facial height, 29% had short face and 33% had long face. In order to determine which patient belongs to which facial height category, i.e. normal, long or short, two angular and linear evaluations were used: the angle between S-N and Go-Me lines and the S-Go/N-Me ratio. Twenty points were evaluated in all the samples. First the incisive foramen was located. The paracoronal cross-sections were prepared at distances of 4, 8, 16 and 24 mm from the distal wall of the incisive foramen and on each cross-section the mid-sagittal and para-sagittal areas were determined bilaterally at 3- and 6-mm distances (a total of 5 points). The thicknesses of the cortical plate of bone were determined at the predetermined points. Results : There was a significant relationship between the mean cortical bone thickness and facial height (p<0.01), with significantly less thickness in long faces compared to short faces. However, the thickness of cortical bone in normal faces was similar to that in long and short faces. Separate evaluation of the points showed that at point a₁₆ subjects with short faces had thicker cortical bone compared to subjects with long and normal faces. At point b₈ in long faces, the thickness of the cortical bone was significantly less than that in short and normal faces. At point d₈, the thickness of the cortical bone in subjects with short faces was significantly higher than that in subjects with long faces. Conclusion : At the point a₁₆ the cortical bone thickness in short faces was significantly higher than normal and long faces. The lower thickness of the cortical bone in the palatal area at points b₈ and d₈ in subjects with long faces might indicate a lower anchorage value of these points in these subjects.