The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Anatomic study of the incisive canal in relation to midpalatal placement of mini-implant

정중구개부의 미니 임플랜트 식립과 관련된 절치관의 해부학적 연구

  • Kim, Sung-Jin (Department of Orthodontics, School of Dentistry, Chosun University) ;
  • Lim, Sung-Hoon (Department of Orthodontics, School of Dentistry, Chosun University)
  • 김성진 (조선대학교 치과대학 교정학교실) ;
  • 임성훈 (조선대학교 치과대학 교정학교실)
  • Published : 2009.06.30
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Abstract

Objective: The purpose of this study was to reveal the position of the incisive foramen in relation to the incisive papilla and cusp tips. Methods: Plaster models and CT images of 25 adult orthodontic patients were used to measure the width of the incisive canal and positions of the anterior and posterior borders of the incisive foramen in relation to the incisive papilla. Results: The palatal surface distance from the interdental papilla between the maxillary central incisors to the posterior border of the incisive foramen along the palatal surface was 1.7 fold of the distance from the interdental papilla between the central incisors to the posterior border of the incisive papilla. The distance between the posterior border of the incisive papilla and posterior border of the incisive foramen along the palatal surface was 6.15 ${\pm}$ 1.75 mm. The anteroposterior position of the posterior border of the incisive foramen was slightly anterior to the lingual cusp tips of the maxillary 1st premolars. The width of the incisive foramen was 4.03 ${\pm}$ 0.64 mm, therefore it is recommended to position the mini-implant more than 3 mm laterally when placing a mini-implant lateral to the incisive foramen, from the center. Conclusions: These results can be used as a reference in presuming the position of the incisive foramen when placing mini-implant in the anterior palate area.

정중구개봉합부에 교정용 미니 임플랜트를 식립하고자 할 때 절치관의 해부학적 위치를 파악하여 이를 피하여 식립하여야 한다. 본 연구에서는 절치관의 해부학적 위치를 절치유두나 치관의 교두첨 등의 임상적 지표를 이용하여 예측할 수 있는 해부학적 자료를 마련하고자 하였다. 성인 남녀 25명의 진단 모형과 전산화 단층촬영(CT) 자료를 통해 절치관의 해부학적 형태, 절치유두와 절치관의 전후방적인 위치의 관련성 및 치관 교두첨의 전후방 위치에 따른 절치관 후방 정중구개봉합부의 골두께를 계측하였다. 계측 결과 중절치 사이 설측 치간유두에서 절치공 후연까지 구개면상의 거리는 치간유두-절치유두 후연 길이의 약 1.7배에 해당하였으며 절치유두 후연에서 절치공 후연까지의 구개면상의 거리는 평균 6.15 ${\pm}$ 1.75 mm였다. 절치공 후연의 전후방적 위치는 교두첨을 기준으로 평가 시 제1소구치의 설측교두보다 약간 전방에 해당하였으며, 이 부위 직후방에서는 골표면에 수직으로 식립하는 것보다 교합평면에 수직으로 식립할 때 골두께가 더 두꺼웠다. 또한 절치관의 폭경이 구개에서 4.03 ${\pm}$ 0.64 mm인 것을 고려할 때 절치관의 측방에 식립코자 하는 경우 정중에서 3 mm 이상 측방에 식립하는 것이 바람직하다. 교정용 미니 임플랜트를 정중구개부에 식립할 때 본 연구 결과를 절치공의 위치를 짐작하는 데 활용할 수 있을 것이다.

Keywords

References

  1. Lee HA, Park YC. Treatment and posttreatment changes following intrusion of maxillary posterior teeth with miniscrew implants for open bite correction. Korean J Orthod 2008;38:31-40 https://doi.org/10.4041/kjod.2008.38.1.31
  2. Kim SH, Lee KB, Chung KR, Nelson G, Kim TW. Severe bimaxillary protrusion with adult periodontitis treated by corticotomy and compression osteogenesis. Korean J Orthod 2009;39:54-65 https://doi.org/10.4041/kjod.2009.39.1.54
  3. Kyung SH. A study on the bone thickness of midpalatal suture area for miniscrew insertion. Korean J Orthod 2004;34:63-70
  4. 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
  5. Kraut RA, Boyden DK. Location of incisive canal in relation to central incisor implants. Implant Dent 1998;7:221-5 https://doi.org/10.1097/00008505-199807030-00010
  6. Cavalcanti MG, Yang J, Ruprecht A, Vannire MW. Accurate linear measurements in the anterior maxilla using orthoradially reformatted sprial computed tomography. Dentomaxillofac Radiol 1999;28:137-40 https://doi.org/10.1038/sj.dmfr.4600426
  7. Kim GT, Hwang EH, Lee SR. A study of incisive canal using a cone beam computed tomography. Korean J Oral Maxillofac Radiol 2004;34:7-12
  8. Henriksen B, Bavitz B, Kelly B, Harm SD. Evaluation of bone thickness in the anterior palate relative to midsagittal orthodontic implants. Int J Oral Maxillofac Implants 2003;18: 578-81
  9. Mraiwa N, Jacobs R, Van Cleynenbreugel J, Sanderink G, Schutyser F, Suetens P, et al. The nasopalatine canal revisited using 2D and 3D CT imaging. Dentomaxillofac Radiol 2004;33:396-402 https://doi.org/10.1259/dmfr/53801969
  10. 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 https://doi.org/10.1093/ejo/21.1.65
  11. Bernhart T, Vollgruber A, Gahleitner A, D$\ddot{o}$rtbudak 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 https://doi.org/10.1034/j.1600-0501.2000.011006595.x
  12. 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(Suppl):S74-S81 https://doi.org/10.1016/j.ajodo.2005.09.029
  13. King KS, Lam EW, Faulkner MG, Heo G, Major PW. Vertical bone volume in the paramedian palate of adolescents: a computed tomography study. Am J Orthod Dentofacial Orthop 2007;132:783-8 https://doi.org/10.1016/j.ajodo.2005.11.042
  14. Ferner H, Staubesand J. Sobotta atlas of human anatomy Vol. I: head, neck, upper extrimities. Seoul: Il-Joong Sa; 1983. p. 10
  15. Houston WJ. The analysis of errors in orthodontic measurements. Am J Orthod 1983;83:382-90 https://doi.org/10.1016/0002-9416(83)90322-6
  16. Orban BJ. Oral histology and embryology. 3rd ed. St. Louis: The CV Mosby Co; 1953. p. 13-28
  17. Patten BM. Human embryology. New York: The Blakiston Co; 1946. p. 284, 427-34
  18. Sicher H, DuBrul EL. Oral anatomy. 5th ed. St. Louis: The CV Mosby Co; 1970. p. 37-8, 68-9
  19. Langford RJ. The contrubution of the nasopalatine nerve to sensation of the hard palate. Br J Oral Maxillofac Surg 1989; 27:379-86 https://doi.org/10.1016/0266-4356(89)90077-6
  20. Burdi AR. Distribution of midpalatal cysts: a reevaluation of human palatal closure mechanisms. J Oral Surg 1968;26:41-5
  21. Zingeser MR. The nasopalatine ducts and associated structures in the rhesus monkey (Macaca mulatta): topography, prenatal development, function, and phylogeny. Am J Anat 1984;170: 581-95 https://doi.org/10.1002/aja.1001700406
  22. Van der Waal I, Van der Kwast WAM. Oral pathology. Chicago: Quintessence Publishing Co; 1988. p. 145-6
  23. Jacob S, Zelano B, Gungor A, Abbott D, Naclerio R, McClintock MK. Location and gross morphology of the nasopalatine duct in human adults. Arch Otolaryngol Head Neck Surg 2000;126:741-8 https://doi.org/10.1001/archotol.126.6.741
  24. Kim MK. Head and neck applied anatomy. Seoul: Eu-chi-hak Sa; 1985. p. 15
  25. Bodin I, Isacsson G, Julin P. Cysts of the nasopalatine duct. Int J Oral Maxillofac Surg 1986;15:696-706 https://doi.org/10.1016/S0300-9785(86)80110-7
  26. Triaca A, Antonini M, Wintermantel E. Ein neues Titan-Flanchschrauben-Implantat zur orthodontischen Verankerung am anterioren Gaumen. Informationen aus der orthodontischen Kieferorthopadie 1992;24:251-7
  27. Block MS, Hoffman DR. A new device for absolute anchorage for orthodontics. Am J Orthod Dentofacial Orthoped 1995; 107:251-8 https://doi.org/10.1016/S0889-5406(95)70140-0
  28. Wehrbein H, Merz BR, Diedrich P, Glatzmaier J. The use of palatal implants for orthodontic anchorage. Design and clinical application of the orthosystem. Clin Oral Implants Res 1996;7: 410-6 https://doi.org/10.1034/j.1600-0501.1996.070416.x
  29. Wehrbein H, Merz BR. Aspects of the use of endosseous palatal implants in orthodontic therapy. J Esthetic Dent 1998;10: 315-24 https://doi.org/10.1111/j.1708-8240.1998.tb00510.x
  30. Tosun T, Keles A, Erverdi N. Method for the placement of palatal implants. Int J Oral Maxillofac Implants 2002;17: 95-100
  31. Park YC, Kim JG, Lee JS. Atlas of contemparary orthodontics Vol. III. Shin-Hueng International; 2006. p. 168
  32. Wehrbein H, Yildizhan F. The midpalatal suture in young adults. A radiological-histological investigation. Eur J Orthod 2001;23:105-14 https://doi.org/10.1093/ejo/23.2.105
  33. Schlegel KA, Kinner F, Schlegel KD. The anatomic basis for palatal implants in orthodontics. Int J Adult Orthod Orthognath Surg 2002;17:133-9
  34. Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 1977;72:42-5 https://doi.org/10.1016/0002-9416(77)90123-3
  35. Latham RA. The structure and development of the intermaxillary suture. J Anat 1970;106:167
  36. 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 https://doi.org/10.1016/j.ajodo.2004.12.024

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