Digital Measurement,analysis And Application Of Palatal Mucosa Thickness Of Maxillary Anterior Teeth

ObjectiveThe study aims to explore an efficient,economical and accurate method for measuring the thickness of palatal mucosa in the anterior maxillary teeth region and analyze the distribution pattern of palatal mucosa thickness in this area.The findings of this study can provide reference for soft tissue augmentation surgery in the aesthetic zone.Methods1.According to the inclusion and exclusion criteria,10 student volunteers,including 3 males and 7 females,with an average age of 24 years,who were enrolled in Shandong University from December 2020 to August 2021 were selected.Ten volunteers underwent digital Intra-oral scanning(IOS)and Cone Beam Computer Tomography(CBCT)with three different operation methods.The mucosal thickness at the level of 2 mm,4 mm,6 mm,8 mm,10 mm,and 12 mm from the apex of the gingival margin on the palatal side of the maxillary anterior teeth was measured and recorded.The consistency and validity of three CBCT methods were analyzed.2.According to the inclusion and exclusion criteria,a total of 50 patients(20 males and 30 females,with an average age of 38 years)who completed posterior dental implant restoration in the Department of Implantology,Hospital of Stomatology,Shandong University from December 2020 to December 2022 were selected.CBCT and IOS were used to measure and record the mucosal thickness at the level of 2 mm,4 mm,6 mm,8 mm,10 mm,and 12 mm from the apex of the palatal gingival margin,and at the level of 1 mm and 2 mm from the labial gingival margin of the maxillary anterior teeth.IBM SPSS Statistics 26.0 software was used to analyze the overall distribution of palatal mucosal thickness of the maxillary anterior teeth,the distribution of left and right mucosal thickness,and the differences of mucosal thickness in different gender,gingival biotype,and age.ResultsBland-Altman analysis showed that the points where the difference between each two of the maxillary anterior palatal mucosa thickness was less than 5%were outside the 95%distribution range(Lo A),and the mean difference between each two of the three CBCT methods was within 0.2 mm.Clinically,the three methods could be considered as having a good agreement.The inter-and intra-observer ICC values of the palatal mucosa thickness measured by the three CBCT methods were all greater than 0.75(P<0.001),with good repeatability.There were significant differences in the mucosal thickness between different levels of the same tooth position and between different teeth at the same level(P<0.05).There was a significant difference in the mucosal thickness at the point 8 mm from the apex of the palatal gingival margin between the left and right central incisors(P<0.05).There was a significant difference in the mucosal thickness at the point 2 mm from the apex of the palatal gingival margin between the left and right canine(P<0.01),and there was no significant difference in the other points(P>0.05).There were significant differences in mucosal thickness at the point where the central incisor was 4 mm from the apex of palatal gingival margin,and the point where canine was 10 mm and 12 mm from the apex of palatal gingival margin between males and females(P<0.01).There were no significant differences in other points between males and females(P>0.05).There was no significant difference in the mucosal thickness between the thin and thick gingival biotypes(P>0.05).There were significant differences in mucosal thickness at 4 sites between the young group and the middle-aged group(P<0.05),and there were no significant differences in other sites(P>0.05).Pearson correlation analysis showed that there was no significant difference between the labial mucosa thickness at 1 mm from the gingival margin and the palatal mucosa thickness(P>0.05).The mucosal thickness at 2 mm from the gingival margin on the labial side was statistically significant only at the left maxillary central incisor and 6 mm from the palatal gingival margin(P<0.05),and there was no significant difference at the other sites(P>0.05).ConclusionsCBCT combined with IOS method is feasible to measure the palatal mucosa thickness of the maxillary anterior teeth,and it has good repeatability.Under physiological condition,the palatal mucosa thickness of central incisors,lateral incisors,and canines gradually increased.In the same position,the palatal mucosa thickness first thickened and then became thinner with the increase of the distance between the gingival margin.82%of the sites in the maxillary anterior region had palatal mucosa thickness greater than 2 mm.The palatal mucosal thickness of the maxillary anterior teeth was symmetrical between the left and right sides,with no significant gender difference and no significant difference between different gingival biotypes.The mucosal thickness was relatively thick in the elderly,and no significant correlation between lip and palatal mucosal thickness.