Measurement of soft tissue thickness on posterior palatal area by using computerized tomography in Korean population

전산화단층촬영법을 통한 한국인의 구개 저작 점막 두께에 대한 연구

  • Song, Ji-Eun (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Chae, Gyung-Joon (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Jung, Ui-Won (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Kim, Chang-Sung (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Choi, Seong-Ho (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Cho, Kyoo-Sung (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Kim, Chong-Kwan (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration) ;
  • Chai, Jung-Kiu (Department of Periodontology, College of Dentistry, Yonsei University, Research Institute for Periodontal Regeneration)
  • 송지은 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 채경준 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 정의원 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 김창성 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 최성호 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 조규성 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 김종관 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소) ;
  • 채중규 (연세대학교 치과대학 치주과학교실, 치주조직 재생연구소)
  • Published : 2007.03.30

Abstract

The purpose of this study was to measure the thickness of masticatory mucosa in the hard palate as a donor site for mucogingival surgery by using computerized tomography(CT), Thickness measurements were performed in 84 adult patients who took CT on maxilla for implant surgery and 24 standard measurement points were defined in the hard palate according to the gingival margin and mid palatal suture. Radiographic measurements were utilized after calibration for standardization. Data were analyzed to determine the differences in mucosal thickness by gender, age, tooth positions and depth of palatal vault. The results of this study were as follows: 1. Mean thickness of palatal masticatory mucosa was $3.93{\pm}0.6mm$ and females had significantly thinner mean masticatory mucosa($3.76{\pm}0.56mm$) than males($4.04{\pm}0.6mm$)(p<0.05). 2. The thickness of palatal masticatory mucosa increased by aging. 3. Depending on position, masticatory mucosa thickness increased from canine to premeolar, but decreased at the first molar, and increased again in the second molar region(p<0.0001). 4. No significant difference in mean thickness of palatal masticatory mucosa were indentified between low palatal vault group and high palatal vault group(p>0.05). The results suggest that canine and premolar area appears to be the most appropriate donor site for soft tissue grafting procedure. The measurement of the thickness of palatal masticatory mucosa by using computerized tomography can offer useful information clinically but further studies in as-sessing the validity and reliability of the method using computerized tomography is needed.

Keywords

References

  1. Friedman N, Mucogingival surgery. Texas Dent J 1957;75:358-362
  2. Miller PD, Jr. Regenerative and reconstructive periodontal plastic surgery. Mucogingival surgery. Dent Clin North Am 1988;32:287-306
  3. Langer L, Langer B. The subepithelial connective tissue graft for treatment of gingival recession. Dent Clin North Am 1993; 37: 243-264
  4. Miller PD, Jr., Allen EP. The development of periodontal plastic surgery. Periodontol 2000 1996;11:7-17
  5. Seibert JS. Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part II. Prosthetic/periodontal interrelationships. Compend Contin Educ Dent 1983;4:549-562
  6. Seibert JS, Salama H. Alveolar ridge preservation and reconstruction. Periodontol 2000 1996;11:69-84
  7. Hall HD, O'Steen AN. Free grafts of palatal mucosa in mandibular vestibuloplasty, J Oral Surg 1970;28:565-574
  8. Azzi R, Takei HH, Etienne D, Carranza FA. Root coverage and papilla reconstruction using autogenous osseous and connective tissue grafts, Int J Periodontics Restorative Dent 2001:21:141-147
  9. Khoury F, Happe A. The palatal sub- epithelial connective tissue flap method for soft tissue management to cover maxillary defects: a clinical report. Int J Oral Maxillofac Implants 2000;15:415-418
  10. Landsberg CJ, Socket seal surgery combined with immediate implant placement: a novel approach for single-tooth replacement. Int J Periodontics Restorative Dent 1997;17:140-149
  11. Rosenquist B. A comparison of various methods of soft tissue management following the immediate placement of implants into extraction sockets. Int J Oral Maxillofac Implants 1997;12:43-51
  12. Tal H, Autogenous masticatory mucosal grafts in extraction socket seal procedures: a comparison between sockets grafted with demineralized freeze-dried bone and deproteinized bovine bone mineral Clin Oral Implants Res 1999;10:289-296 https://doi.org/10.1034/j.1600-0501.1999.100405.x
  13. Harris RJ, A short-term and long-term comparison of root coverage with an acellular dermal matrix and subepithelial graft. J Periodontol 2004;75:734-743 https://doi.org/10.1902/jop.2004.75.5.734
  14. Tal H. Root coverage of advanced gingival recession: a comparative study between acelluar dermal matrix allograft and subepithelial connective tissue graft. J Periodontol 2002; 73: 1405-1411 https://doi.org/10.1902/jop.2002.73.12.1405
  15. Muller H. Root coverage employing an envel ope technique or guided tissue regeneration with a bioabsorbable membrane. J Periodontol 1999;70:743-751 https://doi.org/10.1902/jop.1999.70.7.743
  16. Berlucchi I, Francetti L, Del Fabbro M, Testori T, Weinstein RL. Enamel matrix proteins (Emdogain) in combination with coronally advanced flap or subepithelial connective tissue graft in the treatment of shallow gingival recessions. Int J Periodontics Restorative Dent 2002;22:583-593
  17. McGuire MK, Nunn M, Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue, Part 1: Comparison of clinical parameters, J Periodontol 2003; 74: 1110-1125 https://doi.org/10.1902/jop.2003.74.8.1110
  18. Castellanos A, de la Rosa M, de la Garza M, Caffesse RG, Enamel matrix derivative and coronal flaps to cover marginal tissue recessions, J Periodontol 2006;77:7-14 https://doi.org/10.1902/jop.2006.77.1.7
  19. Hagewald S, Spahr A, Rompola E, Haller B, Heijl L, Comparative study of Emdogain and coronally advanced flap technique in the treatment of human gingival recessions, A prospective controlled clinical study, J Clin Periodontol 2002;29:35-41 https://doi.org/10.1034/j.1600-051x.2002.290106.x
  20. Del Pizzo M, Zucchelli G, Modica F, Villa R, Debernardi C, Coronally advanced flap with or without enamel matrix derivative for root coverage: a 2-year study, J Clin Periodontol 2005;32:1181-1187 https://doi.org/10.1111/j.1600-051X.2005.00831.x
  21. Callan D, Use of accelluar dermal matrix for increasing keratinized tissue around teeth and implants, Pract Periodontics Aesthet Dent 1998; 10: 731-734
  22. Wei P, Acellular dermal matrix allografts to achieve increased attached gingiva, Part 2, A histological comparative study, J Periodontol 2002;73:257-265 https://doi.org/10.1902/jop.2002.73.3.257
  23. Harris RJ, Soft tissue ridge augmentation with an acellular dermal matrix, , Int J Periodontics Restorative Dent 2003;23:87-92
  24. Greenwell H, The deceptive nature of root coverage results, J Periodontol 2000;71: 1327-1337 https://doi.org/10.1902/jop.2000.71.8.1327
  25. Kydd WL, Daly CH, Wheeler JB, 3rd, The thickness measurement of masticatory muco sa in vivo, Int Dent J 1971;21:430-441
  26. Uchida H, Kobayashi K, Nagao M, Measurement in vivo of masticatory mucosal thickness with 20 MHz B-mode ultrasonic diagnostic equipment. J Dent Res 1989;68:95-100 https://doi.org/10.1177/00220345890680021501
  27. Mormann W, Schaer F, Firestone AR. The relationship between success of free gingival grafts and transplant thickness. Revascularization and shrinkage--a one year clinical study. J Periodontol 1981;52: 74-80 https://doi.org/10.1902/jop.1981.52.2.74
  28. Studer SP, Allen EP, Rees TC, Kouba A. The thickness of masticatory mucosa in the human hard palate and tuberosity as potential donor sites for ridge augmentation procedures. J Periodontol 1997;68:145-151 https://doi.org/10.1902/jop.1997.68.2.145
  29. Wara-aswapati N, Pitiphat W, Chandrapho N, Rattanayatikul C, Karimbux N. Thickness of palatal masticatory mucosa associated with age. J Periodontol 2001;72: 1407-1412 https://doi.org/10.1902/jop.2001.72.10.1407
  30. Olsson M. On the relationship between crown form and clinical features of the gingiva in adolescents. J Clin Periodontol 1993;20:570-577 https://doi.org/10.1111/j.1600-051X.1993.tb00773.x
  31. Ostlund SG. The effect of complete dentures on the gum tissue:a histological and histopathological investigation. Acta Odontol Scand 1958;16:1-40 https://doi.org/10.3109/00016355809028181
  32. Kim HJ. Soft-tissue and cortical-bone thickness at orthodontic implant sites. Am J Orthod Dentofacial Orthop 2006:177-182
  33. Lytle RB. The management of abused oral tissues in complete denture construction. J Prosthet Dent 1957;7:27-42 https://doi.org/10.1016/0022-3913(57)90006-9
  34. Muller HP, Schaller, N. & Eger, T. Ultrasonic determination of thickness of masticatory mucosa: a methodologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:243-253
  35. Muller H. Thickness of masticatory mucosa. Journal of Clinical Periodontol 2000;27: 431-436 https://doi.org/10.1034/j.1600-051x.2000.027006431.x
  36. Terakura T. [Non-invasive measurement of the thickness of oral soft tissues]. Nihon Hotetsu Shika Gakkai Zasshi 1986;30: 1402-1411 https://doi.org/10.2186/jjps.30.1402
  37. Renvert S, Badersten A, Nilveus R, Egelberg J. Healing after treatment of periodontal intraosseous defects. I. Comparative study of clinical methods. J Clin Periodontol 1981;8:387-399 https://doi.org/10.1111/j.1600-051X.1981.tb00888.x
  38. Ursell MJ. Relationships between alveolar bone levels measured at surgery, estimated by transgingival probing and clinical attachment level measurements. J Clin Periodontol 1989;16:81-86 https://doi.org/10.1111/j.1600-051X.1989.tb01618.x
  39. Mealey BL, Neubauer MF, Butzin CA, Waldrop TC. Use of furcal bone sounding to improve accuracy of furcation diagnosis. J Periodontol 1994;65:649-657 https://doi.org/10.1902/jop.1994.65.7.649
  40. 김태우, 이재관, 엄흥식, 장범석. 치주탐침과 초음파기구를 이용한 구개 점막 두께 측정치의 비교연구. 대한치주과학회지 2006;36:901-910
  41. Eager T, Muller, H.P. Ultrasonic determination of gingival thickness. Subject variation and influence of tooth type and clinical features. J Clin Periodontol 1996;23: 839-845 https://doi.org/10.1111/j.1600-051X.1996.tb00621.x
  42. Lawson RB, Jones ML. An evaluation of a noninvasive method of assessing alveolar bone levels in an experimental model of cleft lip and palate. Cleft Palate Craniofac J 1998;35:1-8 https://doi.org/10.1597/1545-1569(1998)035<0001:AEOANM>2.3.CO;2
  43. Kim KD, Ruprecht A, Wang G, Lee JB, Dawson DV, Vannier NW. Accuracy of facial soft tissue thickness measurements in personal computer-based multiplanar reconstructed computed tomographic images. Forensic Sci Int 2005;155:28-34
  44. Aulsebrook WA, Becker PJ, Iscan MY. Facial soft-tissue thicknesses in the adult male Zulu. Forensic Sci lnt 1996;79:83-102 https://doi.org/10.1016/0379-0738(96)01893-2
  45. 한광희, 김동진, 채중규, 김종관, 최성호. 구개 저작 점막의 두께에 대한 연구. 대한치주과학회지 2004;34:573-579
  46. Reiser GM, Bruno JF, Mahan PE, Larkin LH. The subepithelial connective tissue graft palatal donor site: anatomic considerations for surgeons. Int J Periodontics Restorative Dent 1996;16:130-137
  47. Richardson ER, Dunn GF, Bryant WJ, Lawrence F. Comparison of human palatal vault height and tooth length. Oral Surg Oral Med Oral Pathol 1971;32:324-331 https://doi.org/10.1016/0030-4220(71)90234-9
  48. Howell MM, Cassingham RJ, Yukna RA. Relationship of maxillary molar root angulation and palatal vault height. J Periodontol 1986;57:25-28 https://doi.org/10.1902/jop.1986.57.1.25
  49. 석화숙, 이만섭, 권영혁, 박준봉. 구개 및 치아 형태와 구개부 저작 점막의 두께와의 연관성. 대한치주과학회지 2003;33:519-530