Thickness of posterior palatal masticatory mucosa: the use of computerized tomography

Abstract

BACKGROUND: Periodontal plastic surgery is used to fulfill the esthetic and functional demands of patients. The palatal masticatory mucosa is the main donor site for connective tissue, and the thickness of the graft tissue obtained is an important factor for the success of this technique. The aim of this study was to measure the thickness of masticatory mucosa in the posterior palatal area using computerized tomography (CT).

METHODS: The thickness measurements were performed on the images of 100 adult subjects who underwent CT on the maxilla for implant surgery. Twenty-four standard measurement points were defined in the hard palate according to the gingival margin and the middle palatal suture. The radiographic measurements were used after calibration. The data were analyzed to determine the differences in the mucosal thickness according to gender, age, tooth position, and depth of the palatal vault.

RESULTS: The overall mean thickness of the palatal masticatory mucosa was 3.83 +/- 0.58 mm (range: 2.29 to 6.25 mm). Females had significantly thinner mean masticatory mucosa (3.66 +/- 0.52 mm) than males (3.95 +/- 0.60 mm) (P <0.0001). The thickness of the palatal masticatory mucosa increased with age. The mean thickness according to tooth site was 3.46 mm (maxillary canine), 3.66 mm (first premolar), 3.81 mm (second premolar), 3.13 mm (first molar), 3.31 mm (the base of the interproximal papilla of the first and second molars), and 3.39 mm (second molar). There was an overall increase in the thickness of the palatal masticatory mucosa as the distance from the gingival margin to the middle palatine suture increased, with the exception of the Ca-d (a point at 12 mm from the gingival margin of the canine) region. There was no significant difference in the thickness of the palatal masticatory mucosa between the groups with high or low palatal vaults.

CONCLUSIONS: The palatal masticatory mucosa thickness increased from the canine to premolar region but decreased at the first molar region and increased again in the second molar region, with the thinnest area at the first molar region and the thickest at the second premolar region. The canine to premolar region seems to be the most appropriate donor site that contains a uniformly thick mucosa. CT can be considered an alternative method for the measurement of palatal soft tissue thickness.