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Purpose: Pterygoid implants are an alternative approach to avoid sinus-lifting or other grafting procedures. During pterygoid implant placement, dental surgeons risk damaging the greater palatine canal (GPC). However, they do not have sufficient reasons to avoid GPC injury. This study performed a detailed morphological analysis of the GPC to determine susceptibility to damage during pterygoid implant surgery., Methods: To understand the detailed morphology of the GPC, gross anatomical analysis, histological analysis, and bone morphometry via micro-computed tomography were performed., Results: We found that the medial wall of the GPC communicated with the nasal cavity through the bone dehiscence. The dehiscence appeared near the inferior nasal concha in 72.4% of the cadavers. The nerve and artery passed from the GPC to the nasal mucous membrane through the dehiscence. Given that the greater palatine nerve passed medial to the descending palatine artery in the GPC, the descending palatine artery is damaged first rather than the greater palatine nerve during pterygoid implant surgery., Conclusions: Dental surgeons who penetrate the GPC using an implant body may extend the bleeding to the nasal mucosa, which seems to spread the inflammation to the nasal cavity., (© 2024. The Author(s).)

Introduction: The greater palatine canal (GPC) connects the pterygopalatine fossa to the greater palatine foramen and houses vital neurovascular structures, which provide sensory innervation and circulation to the gums, palate, and nasal cavity. The GPC is of great clinical importance to various medical specialties; however, the anatomical variability of the GPC poses a risk of iatrogenic injury and complications. Therefore, understanding the normal anatomy and variations of the GPC is crucial for identifying vital structures and minimizing risks in clinical practice., Purpose: The aim was to fill a gap in the current literature by focusing on the prevalence of GPC medial wall dehiscence, a lesser-known anatomic variation, in radiological scans., Methods: A total of 200 head and neck CT scans were examined, where 71 scans met the inclusion criteria. Statistical significance for incidence of GPC medial wall dehiscence, in reference to sex and side, was measured., Results: The GPC medial wall dehiscence was observed in 69% of scans. Bilateral dehiscence was seen in 57.7% of scans, while right-sided and left-sided unilateral dehiscence were found in 14.1% and 11.3%, respectively. Significant difference was found between the incidence of bilateral dehiscence compared to the absence of dehiscence., Conclusion: Previous studies have highlighted the potential risks associated with invasive procedures involving the GPC. The clinical relevance of GPC medial wall dehiscence lies in the increased risk of transecting the contained neurovascular bundle. The presence of dehiscence emphasizes the need for meticulous preoperative radiologic analysis to tailor surgical approaches to individual patient anatomy., (© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Accurate sex estimation is crucial for comprehensive analysis of the biological profiles of unidentified human skeletal remains. However, there is a notable lack of research specifically addressing the morphometrics of the hard palate. Therefore, this study aimed to derive discriminant equations using the hard palate and assess their applicability for sexing partial skeletal remains in a contemporary Korean population. Statistical analyses were performed for 24 measurements derived from three-dimensional models of the hard palate, generated using computed tomography scans of 301 individuals (156 males, 145 females). Descriptive statistics revealed significant sexual dimorphism in the mean comparison of hard palate sizes between Korean males and females, with males exhibiting larger palates across all measurements (p < 0.05). Discriminant function score equations were generated to aid in sex determination. Univariate analysis yielded an accuracy range of 57.8-75.1%, whereas the stepwise method achieved an accuracy of 80.7% with five selected variables: IF-PNS, GFL-GFR, IF-GFR, Pr-EcL, and Pr-EnR. The results of this metric analysis demonstrate the usefulness of the hard palate for sex estimation in the contemporary Korean population. These findings have potential implications for forensic investigations, archeological studies, and population-specific anatomical research., (© 2024. The Author(s).)

Objectives: This study aims to compare and analyze the biomechanical effect and the displacement trend of RME and MSE on the maxillofacial complex under different palatal shapes by using finite element analysis., Methods: The three-dimensional model of maxillofacial complex was obtained from a computed tomography image of a person with a normal palate. Then, we modified the shape of the palate to obtain the model with a high palate. Additionally, two expander devices were considered. MSE and RME were created and four models were made: Model 1: Normal-palate craniomaxillofacial complex with RME expander; Model 2: Normal-palate craniomaxillofacial complex with MSE expander; Model 3: High-palate craniomaxillofacial complex with RME expander; Model 4: High-palate craniomaxillofacial complex with MSE expander. Then, lateral forced displacement was applied and the analysis results were obtained., Results: The lateral displacement of the palatal suture of Model 3 is greater than that of Model 1, and the maxilla has more rotation. The crown/root ratio of Model 1 is significantly greater than that of the other three groups. Compared with Model 1, Model 3 has greater stress concentration in the superstructure of the craniomaxillofacial complex. Both of them have greater stress in the anchorage area than Model 2 and Model 4., Conclusion: Different shapes of the palate interfere with the effects of RME and MSE, and its influence on the stress distribution and displacement of the craniomaxillary complex when using RME is greater than MSE. The lateral displacement of the palatal suture of MSE is significantly larger than that of RME. It is more prone to tipping movement of the anchor teeth using RME under normal palate, and MSE may manage the vertical control better due to the smaller crown/root ratio than RME and intrusive movement of molars., (© 2024 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

BACKGROUND The greater palatine foramen (GPF) is anatomically located distal to the third maxillary molar tooth, midway between the midline of the palate and the dental arch. The GPF contains the major palatine artery, vein, and nerve, traversing the palatine sulcus. This study aimed to evaluate the anatomical position of the GPF in 93 women and 67 men at a single center in Cyprus using cone beam computed tomography (CBCT). MATERIAL AND METHODS A retrospective analysis was conducted on 160 CBCT scans. Measurements of the GPF's horizontal and vertical diameters, distances from GPF to the incisive foramen, posterior nasal spine, anterior nasal spine, and midaxillary suture, and positional relationships to molars were recorded. Statistical analyses compared these measurements between males and females. RESULTS The study included 93 females and 67 males with an average age of 46.6 (±11.6) years. Significant sex differences were observed in most GPF measurements, with males showing larger dimensions such as the anterior nasal spine, posterior nasal spine, mid-maxillary suture, and incisive foramen to the GPF. The GPF was predominantly located in the third molar region (96.25% on the right, 96.9% on the left). The left GPF showed a significantly larger horizontal diameter than the right (P<0.05). CONCLUSIONS There was a significant difference in the average distances from the anterior nasal spine, posterior nasal spine, mid-maxillary suture, and incisive foramen to the GPF, as well as in the size of the GPF, between males and females. Recognizing these variations enhances clinical planning and reduces the risk of complications.

Objectives: The aim of this study was to evaluate the influence of palatal vault morphology and screw length on the accuracy of miniscrew insertion in dynamic computer-assisted surgery (d-CAS)., Methods: Twenty-four subjects were allocated into three groups, according to their palatal vault morphology (Group A: medium; Group B: steep/high; Group C: low/flat) and the length of miniscrew used. For each subject, two miniscrews were inserted using a dynamic navigation system. To assess the accuracy of insertion, a postoperative CBCT was performed, and the pre- and post-operative scans were superimposed. Five variables were evaluated: Entry-3D, Entry-2D, Apex-3D, Apex-vertical and angular deviation. Descriptive statistics, Shapiro-wilk, Kruskal-Wallis and Dunn's tests were used for the statistical analysis. The level of significance was P ≤ 0.05., Results: The mean angular deviation values revealed strong discrepancies amongst the groups (Group A:7.11°±5.70°; Group B:13.30°±7.76°; Group C:4.92°±3.15°) and significant differences were found regarding the Apex-3D (P = 0.036) and angular deviations (P = 0.008). A Dunn's test revealed differences in angular deviation between the medium and high/steep palate group (P = 0.004), and between low/flat and high/steep palate group (P = 0.01) but did not confirm any significant difference in the Apex-3D parameter (Group A-B P = 0.10; Group B-C, P = 0.053; Group A-C, P = 1.00). No significant differences were found regarding the length of the miniscrews., Conclusions: Palatal vault morphology is a factor that influences the accuracy of miniscrew insertion in d-CAS. In subjects with steep and high palatal vaults, insertion accuracy is lower when considering the angular deviation value. Miniscrew length does not influence accuracy., Clinical Significance: Although computer-guided surgery assists the clinician in preventing damage to nearby anatomical structures, individual anatomical variability is a crucial variable. In subjects with a high/steep palate, greater attention should be paid during the planning phase in order to allow for a wide margin from adjacent anatomical structures to achieve better outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: Rapid maxillary expansion is a common orthodontic procedure to correct maxillary constriction. Assessing the midpalatal suture (MPS) expansion plays a crucial role in treatment planning to determine its effectiveness. The objectives of this preliminary investigation are to demonstrate a proof of concept that the palatal bone underlying the rugae can be clearly imaged by ultrasound (US) and the reconstructed axial view of the US image accurately maps the MPS patency., Methods: An ex-vivo US scanning was conducted on the upper jawbones of two piglet's carcasses before and after the creation of bone defects, which simulated the suture opening. The planar images were processed to enhance bone intensity distribution before being orderly stacked to fuse into a volume. Graph-cut segmentation was applied to delineate the palatal bone to generate a bone volume. The accuracy of the reconstructed bone volume and the suture opening was validated by the micro-computed tomography (µCT) data used as the ground truth and compared with cone beam computed tomography (CBCT) data as the clinical standard. Also included in the comparison is the rugae thickness. Correlation and Bland-Altman plots were used to test the agreement between the two methods: US versus µCT/CBCT., Results: The reconstruction of the US palatal bone volumes was accurate based on surface topography comparison with a mean error of 0.19 mm for pre-defect and 0.15 mm and 0.09 mm for post-defect models of the two samples, respectively when compared with µCT volumes. A strong correlation (R 2 ≥ 0.99) in measuring MPS expansion was found between US and µCT/CBCT with MADs of less than 0.05 mm, 0.11 mm and 0.23 mm for US, µCT and CBCT, respectively., Conclusions: It was possible to axially image the MPS opening and rugae thickness accurately using high-frequency ultrasound., Clinical Significance: This study introduces an ionizing radiation-free, low-cost, and portable technique to accurately image a difficult part of oral cavity anatomy. The advantages of conceivable visualization could promise a successful clinical examination of MPS to support the predictable treatment outcome of maxillary transverse deficiency., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: The superimposition of 3 dimensions (3D) digital models has been increasingly used for evaluating dental changes resulting from orthodontic treatment, and different superimposition techniques have been described. Although the maxilla has areas with greater stability for superimposition, such as the palatal rugae, there is still no reliable method for superimposing models of the lower arch., Objective: Therefore, this article aims to describe a technique for superimposing virtual models., Methods: To evaluate pre- and post-orthodontic treatment changes, the Geomagic Qualify 2013 software (3D Systems®, Rock Hill, South Carolina, USA) was used, with reference points in the maxilla, including the rugae and a reference area in the palate and midpalatal raphe. The lower arch was superimposed using the maximum habitual intercuspation (MHI) model as reference., Results and Conclusion: 3D models superimposition using palatal rugae and MHI occlusion seems to offer satisfactory results in the interpretation of clinical changes at different follow-up moments in terms of development and/or orthodontic treatment.

Background: The morphology of the nasopalatine canal is crucial in the planning of prosthetic restorations in the anterior region of the maxilla, as well as in the placement of orthodontic mini-implants., Objectives: The aim of this study was to assess the morphology of the nasopalatine canal using cone beam computed tomography (CBCT) scans of patients from the University Dental Clinic in Krakow, Poland, to define the position of the canal in relation to common sites of palatal median microimplant placement, and to investigate potential correlations between the anatomy of the canal and age and gender of the patients., Material and Methods: A total of 120 CBCT images were used to assess the anatomy of the nasopalatine canal in 3 planes of space. The bone thickness anterior to the nasopalatine canal and the distance between the distal margin of Stenson's foramen and the predicted midpalatal microimplant position were also measured., Results: The most frequently observed canal type in the coronal plane was the Y-shaped canal, which was present in 60.8% of patients. The nasopalatine canal was classified as cone-shaped in 31.7% of the scans, cylindrical in 28.3%, hourglass-shaped in 27.5%, and banana-shaped in 12.5%. The mean length of the nasopalatine canal was 11.58 mm. The mean width of the canal was 2.89 mm at the nasal fossa level, 1.94 mm in the middle, and 5.09 mm at the palatal level. The mean bone thickness anterior to the nasopalatine canal was 9.07 mm at the level of the nasal opening, 6.84 mm at the level of the oral opening, and 7.32 mm in the middle. The mean distance between the distal margin of Stenson's foramen and the predicted midpalatal microimplant position varied from 0 to 11.94 mm, with a mean of 2.49 mm., Conclusions: Given the variety of nasopalatine canal forms and dimensions, detailed analysis of CBCT scans is essential prior to the placement of implants and microimplants.

Recent advances in imaging technologies, such as intra-oral surface scanning, have rapidly generated large datasets of high-resolution three-dimensional (3D) sample reconstructions. These datasets contain a wealth of phenotypic information that can provide an understanding of morphological variation and evolution. The geometric morphometric method (GMM) with landmarks and the development of sliding and surface semilandmark techniques has greatly enhanced the quantification of shape. This study aimed to determine whether there are significant differences in 3D palatal rugae shape between siblings. Digital casts representing 25 pairs of full siblings from each group, male-male (MM), female-female (FF), and female-male (FM), were digitized and transferred to a GM system. The palatal rugae were determined, quantified, and visualized using GMM computational tools with MorphoJ software (University of Manchester). Principal component analysis (PCA) and canonical variates analysis (CVA) were employed to analyze palatal rugae shape variability and distinguish between sibling groups based on shape. Additionally, regression analysis examined the potential impact of shape on palatal rugae. The study revealed that the palatal rugae shape covered the first nine of the PCA by 71.3%. In addition, the size of the palatal rugae has a negligible impact on its shape. Whilst palatal rugae are known for their individuality, it is noteworthy that three palatal rugae (right first, right second, and left third) can differentiate sibling groups, which may be attributed to genetics. Therefore, it is suggested that palatal rugae morphology can serve as forensic identification for siblings., (© 2023 American Academy of Forensic Sciences.)

Morphometrics of the hard palate is an important aspect of forensic anthropology and odontology. Palatine triangle is a triangular area in the hard palate formed by the palatine processes of the maxillae, which can aid intraoral bone grafts. We present the osteological measurements of the palatine triangle (maxillary palate) based on sex, compare it with other hard palate parameters, and establish the correlation between them. Seventy-seven male skulls and 36 female skulls were examined. Various morphometric measurements of the hard palate and palatine triangle were performed meticulously. Mean and standard deviation of each parameter were computed for groups using SPSS 16.0. Relationships between all parameters were analyzed using Pearson's rank correlation test. The mean palatine length was 38.84 ± 3.75 mm in males and 37.22 ± 4.12 mm in females; the mean palatine breadth was 31.36 ± 2.61 mm in males and 29.78 ± 3.07 mm in females. The mean area of the palatine triangle was 600.88 ± 80.16 mm 2 in male skulls and 547.96 ± 94.28 mm 2 in the female skulls. Statistically significant difference in various measurements of the palatine triangle and hard palate between the male and female skulls was noted. Leptostaphyline (narrow palate) was the most prominent type of palate. The area of the palatine triangle showed a strong positive correlation between the total length and breadth of the palate for both male and female skulls. A strong positive correlation was also observed between the palate length and the palatine triangle length. Palatine index and palate breadth had a statistically significant moderate linear relationship. The maxillary palate length, breadth, and area of the palatine triangle were higher in males when compared to females in South Indian origin skulls. Most of the skulls had a narrow palate. The results of this metric analysis of the palatine triangle may lead to a new concept of anatomical research into studying the hard palate, which can be used for sexual dimorphism., (© 2023. The Author(s).)

Purpose: Anatomical characteristics of the greater palatine foramen (GPF) are essential during the greater palatine nerve block application to anesthetize maxillary teeth, gums, midface, and nasal cavities. The position of GPF is usually described in relation to adjacent anatomical structures. This investigation aims to examine the morphometric relationships of GPF and closely determine its position., Methods: The study included 87 skulls (174 foramina). They were photographed in a horizontal position with bases facing up. The digital data were processed in the ImageJ 1.53n software., Results: The average distance of the GPF from the median palatine suture was 15.94 mm. In relation to the posterior border of the bony palate, the distance was 2.05 mm. Statistical significance was found in comparing the angle between the GPF, incisive fossa, and the median palatine suture between the sides of the skulls (p = 0.02). Comparing tested parameters between males and females showed significant differences in GPF-MPS (p = 0.003) and GPF-pb (p = 0.012), with lower values in females. The most significant percentage of skulls (77.01%) had the GPF located at the level of the third molar. The most significant number of bony palates had one lesser opening (60.91%) on the left side., Conclusion: GPF is located at the level of the maxillary third molar in most of the examined palates. Knowledge of the anatomical position of the greater palatine foramen and its variations is the basis for successfully implementing anesthesia and various surgical interventions., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Purpose: The palatine bone (PAL) rides over the maxilla (MX) without an end-to-end suture in the bony palate of fetuses. However, changes in the topographical relationship among bones was unknown at and along the pterygopalatomaxillary suture, including the palatine canals., Methods: Using sagittal, frontal, and horizontal histological sections of the head from 15 midterm fetuses to 12 near-term fetuses, we depicted the changes in the topographical anatomy of the MX, PAL, and greater palatine nerve (GPN)., Results: In the bony greater palatine canal of these fetuses, the medial and posterior walls facing the GPN were consistently made up of the PAL. At midterm, the entire course of the GPN was embedded in the PAL (six fetuses), or the MX contributed to the lateral wall of the nerve canal (nine). At near-term, the anterior and lateral walls showed individual variations: an MX in the anterior and lateral walls (three fetuses), an anterior MX and a lateral PAL (five), an anterior PAL and a lateral MX (two), and a PAL surrounding the GPN (four)., Conclusion: These increasing variations suggested that the pterygopalatomaxillary suture was actually growing and that the PAL transiently expanded anteriorly and/or laterally to push the MX in fetuses. The "usual" morphology in which the GPN is sandwiched by the MX and PAL is likely established after birth, possibly during adolescence. The driving force of this change may not be produced by the masticatory apparatus. Rather, it might be triggered by the growing maxillary sinus., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Purpose: Accurate knowledge of greater palatine foramen (GPF) and greater palatine canal (GPC) anatomy is necessary to avoid injury to the greater palatine artery (GPA) when performing a variety of anesthesiologic, dental or surgical procedures. The aim of this paper was to perform a systematic review and meta-analysis of literature on the anatomy and localization of bony structures associated with the GPA, namely the GPF and GPC., Methods: A systematic literature search was performed using PubMed, Embase, ScienceDirect, and Web of Science databases. Seventy-five studies were included in the meta-analysis (n = 22,202 subjects)., Results: The meta-analysis showed that the GPF is positioned 17.21 mm (95% CI = 16.34-18.09 mm) from the posterior nasal spine, 2.56 mm (95% CI = 1.90-3.22 mm) from the posterior border of the hard palate, 46.24 mm (95% CI = 44.30-48.18 mm) from the anterior nasal spine, 15.22 mm (95% CI = 15.00-15.43 mm) from the midline maxillary suture, 37.32 mm (95% CI = 36.19-38.45 mm) from the incisive foramen, and opposite the third maxillary molar (M3) in 64.9% (58.7-70.7%) of the total population., Conclusion: An up-to-date, comprehensive analysis of GPF and GPC clinical anatomy is presented. The results from this evidence-based anatomical study provides a unified set of data to aid clinicians in their practice., (© 2023. The Author(s).)

Objective: The hard palate participates in the construction of the oral and nasal cavities and represents the bony barrier between them. Morphological differences of the hard palate are important for forensic medicine, anthropology, anatomy, as well as scientific branches dealing with the study of evolutionary development, populations differences. The aim of this study was to determine sexual dimorphism of hard palate on three-dimensional (3D) models of human skulls using geometric morphometry., Materials and Methods: The research was conducted on 3D models of 209 human skulls from Bosnian population (139 male, 70 female). On the obtained 3D models, we marked landmarks on the palate using Landmark editor program. Using MorphoJ program we analyzed sex differences of shape and size on hard palate., Results: The principal component analysis showed that the first two components (PC1 and PC2) described 55.503% of the total morphological variability of the hard palate. The results of the discriminant analysis showed predictive power for male with 66.91% accuracy and for female with 58.57% accuracy based on the shape and size of the hard palate. The influence of size of the hard palate on its shape was statistically significant (p<0.0001). The results of discriminant analysis based on shape of hard palate showed predictive power for male with 68.34% accuracy and for female with 64.29% accuracy., Conclusions: Sex differences of hard palate are statistically significant and can be used for sex determination in skeletal remains. The percentage of accuracy for determining sex based on the hard palate was higher for men in this study.

Objective: This study aimed to assess the morphology and location of the great palatine foramen (GPF) of different facial types using cone beam computed tomography (CBCT) scans., Methods: Sixty CBCT scans were divided into: brachyfacial (n = 20), dolichofacial (n = 20) and mesofacial (n = 20) using Ricketts' VERT index for the determination of cephalometric facial type and imported into ImageJ software. GPF shape was characterized as: round, elongated in the anteroposterior direction (EAP), or elongated in the latero-medial direction (ELM). The distances between the GPF and the palatine suture (PS), the center of the GPF and the center incisive foramen (IF), the GPF and the palatine alveolar ridge (PAR), right side GPF (GPFr) and left side (GPFl) GPFs; and the angles formed from the intersection of the GPF, IF and PS were assessed. The position of the GPF was evaluated in relation to the molars., Results: GPFr and GPFl mean distances from PAR presented higher values for dolichofacial patients (p < 0.05). GPFr and GPFl location distally to the third molar (3 M) was higher for brachyfacial type, while their location distally to the second molar was higher for mesofacial and between the mesial and distal surfaces of the 3 M for dolichofacial (p < 0.05)., Conclusions: The GPF was more distant from the PAR in the dolichofacial-type group. The location of the GPF in relation to the molars varied according to the facial type. However, the morphology of the GPF was similar in the three facial types, and the elongated in the anteroposterior direction morphology was more frequent., (© 2021. The Author(s), under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd.)

This study investigated, if genetic variants in BMP2, BMP4 and SMAD6 are associated with variations in the palatal rugae pattern in humans. Dental casts and genomic DNA from 75 patients were evaluated. Each patient was classified as follows: total amount of rugae; bilateral symmetry in the amount, length and shape of the palatal rugae; presence of secondary or fragmentary palatal rugae; presence of unifications; predominant shape; and predominant direction of the palatal rugae. The genetic variants in BMP2 (rs1005464 and rs235768), BMP4 (rs17563) and SMAD6 (rs2119261 and rs3934908) were genotyped. Genotype distribution was compared between palatal rugae patterns using the chi-square test (alpha = 0.05). The allele A was associated with the presence of secondary or fragmentary rugae for rs1005464 (OR = 2.5, 95%CI 1.1-6.3; p = 0.014). Secondary or fragmentary rugae were associated with the G allele in rs17563 (OR = 2.1, 95%CI 1.1-3.9; p = 0.017). rs17563 was also associated with rugae unification (p = 0.017 in the additive model). The predominant shape (wavy) was associated with rs2119261 (p = 0.023 in the additive model). The left-right symmetry of the length of primary rugae was associated with rs3934908 in the recessive model (OR = 3.6, 95%CI 1.2-11.7; p = 0.025). In conclusion, genetic variants in the BMP pathway impacted on palatal rugae pattern.

Purpose: The purpose of this study was to determine the palatal bone and soft tissue thicknesses using a miniscrew-supported maxillary skeletal expander (MSE) in Class III malocclusion., Methods: The thicknesses of the palatal bone and soft tissue were measured in cone-beam computed tomography images obtained from 58 patients. All 20 points were crossing points between five levels, which were defined at 3 mm intervals relative to the line connecting the central fossae of the first molar (Level 0), and 2 mm and 4 mm lateral to the anteroposterior reference line (AP line)., Results: The palatal bone was significantly thicker in males than females in the anterior palate up to Level 0, while there was no significant sex-related difference in the posterior palate. There was a tendency for the thickness to decrease in the posterior direction, except in females at 2 mm lateral to the AP line. The palatal soft tissue was significantly thicker in males than females in all positions. At 2 mm lateral to the AP line, the palatal soft tissue thickness decreased in the posterior direction. A 4 mm lateral to the AP line, it initially decreased in the posterior direction, and then increasing again at Level - 6 (6 mm posterior of Level 0). As the lateral distance from the AP line increased, the palatal bone thickness decreased while the palatal soft tissue thickness increased., Conclusions: These findings provide quantitative data on the palatal bone and soft tissue thicknesses for the miniscrew-supported MSE in the posterior palate.

Background: The endoscopic endonasal approach (EEA) has been accepted as an alternative option for diseases at the craniovertebral junction. However, the inferior destination through the endoscopic endonasal approach is anatomically higher than that of the transoral approach. Therefore, preoperative assessment of accessibility is mandatory for appropriate selection of indication. Using a navigation system, we examined the inferior limit through the endonasal route and evaluated the relationships between surrounding anatomicl structures and the lowest point., Methods: This study included patients who underwent endoscopic transsphenoidal surgery for intrasellar lesions at our hospital (N = 23). At the start of surgery, the lowest point (target point [TP]) was marked with a straight probe under guidance of the navigation system. We measured 4 parameters on preoperative computed tomography: nasal length, hard palate length, anterior-posterior diameter of the nasopharynx, and nasopalatine angle. Patients were classified into groups depending on whether the TP was at or above (group A) or below (group B) the hard palatine line., Results: TPs were above the hard palatine line in 15 patients (group A) and below the hard palatine line in 8 patients (group B). No TPs reached the nasopalatine line. Nasal length (P = 0.03) and nasopalatine angle (P = 0.01) were larger in group B than in group A. There were no significant differences in anterior-posterior diameter of the nasopharynx or hard palate length., Conclusions: The hard palatine line is a reliable parameter for assessing the inferior limit of the endoscopic endonasal approach. Nostril size affects accessibility with surgical instruments., (Copyright © 2020 Elsevier Inc. All rights reserved.)

This observational study compared palatal rugae morphology in adolescent subjects with normal tooth number and tooth agenesis. Maxillary dental study casts were used to compare rugae number, length and shape. Each study group contained 60 subjects (30 females and 30 males) mean age 13.4 (SD, 1.55) in control and 13.56 (SD, 1.54) years in tooth agenesis groups (p = 0.576). Mean number of missing tooth units in the tooth agenesis group was 2.1. Mean number of primary rugae in the whole sample was 4.35 (SD, 0.98) on the right and 4.33 (SD, 0.92) on the left with no significant differences (p = 0.236 and p = 0.404, respectively). However, the number of secondary rugae on the left (p = 0.006) and fragmentary rugae on the right (p = 0.004) was significantly increased in the tooth agenesis group. The shape of left primary rugae 2 and 3 also differed between groups, tending towards a wavy pattern in the control group and curved in the tooth agenesis group (p = 0.012 and p = 0.004, respectively). In addition, primary rugae 3 was more convergent (p = 0.008) whilst left primary rugae 3 and 5 were orientated in an antero-posterior direction (p = 0.04 for both rugae) in the tooth agenesis group. Subgroup analysis also identified significant associations between patterns of tooth agenesis and rugae number, in addition to shape of primary rugae. The identification of significant differences in rugae pattern between subjects with normal tooth number and agenesis suggests potential commonality in signal pathway disruption during establishment of these structures.

Although there is clinical applicability of the palatal rugae as an identification tool in forensic odontology, controversy exists whether the palatal rugae patterns are stable or variable. The greater the genetic component, the higher the probability that palatal rugae patterns are stable. The aim of this study was to compare the palatal rugae morphology between full siblings and the proportion of variability due to genetic component. This cross-sectional study was conducted on digital models of 162 siblings aged 15-30 years old. The palatal rugae patterns were assessed with Thomas and Kotze (1983) classification using Geomagic Studio software (3D Systems, Rock Hill, SC). The palatal rugae morphology between siblings showed significantly similar characteristics for total number of left rugae (p = 0.001), left primary rugae (p = 0.017), secondary rugae for right (p = 0.024) and left sides (p = 0.001), right straight rugae (p = 0.010), and right convergent rugae (p = 0.005) accounting for at least 6.25%-12.8% of the variability due to heredity. Despite the similarities found, the palatal rugae patterns showed significant differences between siblings of at least 46.9% (p = 0.001). Zero heritability was found in 9 of the 14 rugae patterns. Meanwhile, total number of rugae, primary, backward, and convergent rugae showed moderate heritability (h 2  > 0.3) and total number of secondary rugae showed high heritability (h 2  > 0.6). In conclusion, despite the individuality characteristics, an appreciable hereditary component is observed with significant similarities found between sibling pairs and the palatal rugae patterns were both environmentally and genetically influenced., (© 2020 American Academy of Forensic Sciences.)

The Modified Mallampati Classification stratifies predicted difficulty of endotracheal intubation based on anatomic features.

Palatal suture fusion has seen little testing and/or application due in part to an inadequately described relationship to formal age ranges. This study presents a modified scoring method that examines fusion on samples of modern documented adult males and compares two Bayesian approaches to age estimation. In the first analysis, American and Portuguese collections were used to derive univariate and multivariate transition analysis (TA) parameters, which combined with an informative prior, estimated age in a sample of modern Americans and Portuguese. For the second analysis, a Bayesian multiple linear regression (BMLR) used indicator statuses as the independent variables with age as the dependent variable. Highest posterior density regions (HPDRs) and highest posterior density intervals (HDI) were calculated for a holdout sample. Final age estimates for the methods were tested for accuracy using cumulative binomial tests at 75% and 90% coverages. The HPDRs from multivariate TA captured age better for younger individuals, but consistently underaged. The cumulative binomial tests on the BMLR results indicated the prediction intervals performed as expected, and we show they are narrower (more precise) and/or more accurate than the corresponding HPDR. The modified method presented here formally links palatal suture obliteration to age using two different approaches, one of which (BMLR) is new to the aging literature. The BMLR provided results free from bias and more reasonable age ranges while maintaining accuracy. We present a look-up table and a free, simple R file for users to download and run their own estimates with BMLR., (© 2020 American Academy of Forensic Sciences.)

Objectives: The aim of the present study was to measure the thickness of the palatal mucosa in a Jordanian (Middle Eastern) population as well as identify possible factors that may influence the thickness of palatal mucosa., Material and Methods: Sixty period on tally healthy subjects (29 males and 31 females) were selected. Fifteen measurement points were defined on the palate. The mucosal thickness in the hard palate was determined by "bone sounding" with a Hu-Friedy® round periodontal probe., Results: The overall mean thickness of the palatal masticatory mucosa was 3.23 ± 0.47 mm.The mean thickness increased from the gingival margin to a more apical position irrespective of the tooth measured or side of the mouth in the following sequence: canine, second molar, first premolar, second premolar and lastly, the first molar. No significant difference between gender, smoking status, gingival phenotype andsides of the mouth with the thickness of palatal masticatory mucosa was determined. A significant difference between palatal shape and palatal gingival thickness was found., Conclusions: The most appropriate site for graft harvesting is the canine-premolar area 8-13 mm from the mid-palatal aspect of each respective tooth in a Jordanian population. Except for the palatal shape, the side of the mouth, smoking, gender or gingival phenotype does not affect the graft harvest., Clinical Relevance: SCIENTIFIC RATIONALE FOR STUDY: Knowledge on the thickness of the masticatory mucosa is crucialin making decisions for surgical treatment modality and may affect surgical outcome. We measured the thickness of the palatal mucosa in a Jordanian population and identified possible influencing factors., Principal Findings: The thickness varied according to the teeth and the canine to premolar region was found to be the appropriate donor site., Practical Implications: This information on safe zone for graft harvest can guide the periodontist to make appropriate incisions and choose the appropriate location to obtain a graft of adequate thickness and dimensions., (© 2020 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Postmortem dental examinations play an important role in individual identification. In forensic odontology, individual identification is based on a traditional visual comparison of the antemortem dental record and dental radiographs with those obtained by postmortem examinations. Digitization in forensic odontology has recently started. The aim of this systematic review was to reveal the progress in forensic odontology by using ante/postmortem information obtained by digital technologies. Thirty-six eligible studies were included. No methods with digital technology have been accepted worldwide because of various factors such as expensive special equipment and the cost of other components. Further research should be conducted and progress should be made in the field of forensic odontology along with the progression of general digital technology., (Copyright © 2020 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Objective: The present study evaluated the association between genetic variants in WNT3A and WNT11, and palatal rugae phenotypes., Design: Eighty-five biological unrelated orthodontic patients were included. Dental casts were assessed and data regarding the length, shape, direction and unification of rugae were recorded. The individuals were subsequently classified for each of the following rugae traits: total amount of rugae; bilateral symmetry in the amount, length and shape of the rugae; presence of secondary or fragmentary rugae; presence of unifications; predominant shape; and, direction of the rugae. Genetic variants in WNT3A (rs708111) and WNT11 (rs1533767) were genotyped by real-time PCR. Genotype and allele distributions were compared with an established alpha of 5 %., Results: The wavy and curve rugae were the most common. Genotype/phenotype analyses identified that the presence of the rs708111 A allele (OR = 2.2, 95 % CI: 1.1-4.4, p = 0.01) and the rs1533767 G allele (OR = 2.3, 95 % CI: 1.0-5.3, p = 0.05) increased in more than two times the chance of having bilateral asymmetry in the amount of the rugae. In the recessive model, individuals carrying two risk alleles (AA) of WNT3A rs708111 had a higher risk of presenting this phenotype. SNP-SNP interaction analysis revealed that individuals carrying one rs708111 A allele and rs1533767 G allele showed even a higher chance of having bilateral asymmetry in the amount of rugae (OR = 5.6, 95 % CI: 1.1-28.8, p = 0.03). No associations were identified for other rugae phenotype (p > 0.05)., Conclusion: Genetic variants in WNT3A and WNT11 were associated with the left-right asymmetry in the amount of palatal rugae., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Linguistic diversity is affected by multiple factors, but it is usually assumed that variation in the anatomy of our speech organs plays no explanatory role. Here we use realistic computer models of the human speech organs to test whether inter-individual and inter-group variation in the shape of the hard palate (the bony roof of the mouth) affects acoustics of speech sounds. Based on 107 midsagittal MRI scans of the hard palate of human participants, we modelled with high accuracy the articulation of a set of five cross-linguistically representative vowels by agents learning to produce speech sounds. We found that different hard palate shapes result in subtle differences in the acoustics and articulatory strategies of the produced vowels, and that these individual-level speech idiosyncrasies are amplified by the repeated transmission of language across generations. Therefore, we suggest that, besides culture and environment, quantitative biological variation can be amplified, also influencing language.

The aim of the research was to investigate the morphological and histological structure of the Anatolian bobcat (Lynx lynx) hard palate using light and scanning electron microscopy, in addition to gross examination. The Republic of Turkey Ministry of Agriculture and Forestry Work (Sivas Branch) provided three female Anatolian bobcat cadavers. The Anatolian bobcat hard palate consists of a narrow, rough part in the rostral region (including the incisive papilla, palatine ridges, and palatine raphe) and a wide, smooth part in the caudal part region. The gross examination revealed that the incisive papilla is small and shaped like a carboy icon, the primary and secondary palatine ridges have a serrated appearance, and the palatine raphe forms a single longitudinal row of conical papillae and a single transverse row of conical papillae (in the transverse groove that separates the two palatine ridges). In addition, the microscopy examination revealed microplicae in the epithelium, as well as abundant connective-tissue bundles running in various directions in the lamina propria and submucosa layer. These adaptations of the hard palate structures may increase efficiency during ingestion and help direct food backwards. This is the first study to provide detailed morphological and histological descriptions of the Anatolian bobcat hard palate., (© 2019 Blackwell Verlag GmbH.)

Introduction: To find the association between the morphological characteristics of palatal rugae and sagittal skeletal patterns., Methods: The retrospective charts review was conducted at the Aga Khan University Hospital from April to June 2016, and comprised data obtained from the pretreatment dental cast of orthodontic patients visiting the dental clinics over 5 years from 2011 to 2015. The sample was divided equally in three malocclusion groups based on sagittal skeletal relationship Class I, Class II and Class III. The number of palatal rugae was recorded for both right and left sides. Morphological features of the three anterior most primary rugae were recorded for the length, pattern and orientation bilaterally. SPSS 20 was used to compare the number and lengths as well as the pattern and orientation of palatal rugae among the groups., Results: Of the 165 subjects, there were 55(33.3%) in each of the three groups. Significant differences were recorded in rugae lengths among the groups at ruga 1 on both sides and rugae 2 and 3 on the left side (p<0.05 each). There were significant differences in the palatal rugae patterns among the groups (p<0.05) except at rugae 2 and 3 on the left side (p>0.05). Orientation showed significant differences at ruga 2 on the right side (p=0.02)., Conclusions: No specific pattern was associated with any skeletal pattern. Further studies are required to evaluate three-dimensional characteristics of rugae to assess the association between palatal rugae and sagittal skeletal patterns.

The hard palate and mid-palatal suture are highly important for orthodontic treatment. In cases of transverse maxillary deficiency, palatal expansion is the treatment of choice. As nowadays a growing number of adult patients receive orthodontic treatment, an understanding of suture development throughout life is important to derive tailored orthodontic treatment techniques for each age group. Histological, histochemical and immunohistochemical stains (haematoxylin & eosin, Azan, Movat pentachrome, Masson-Goldner trichrome, Sirius Red, CD 31, osteopontin and TRAP) and histomorphometric analyses were re-established to detect the structural conditions of the mid-palatal suture in human cadavers of three different age groups (20-39, 40-59 and 60-80 years). The mid-palatal suture of the selected age groups (total of n = 12; n = 4 in every group m = f) exhibited marked differences in sutural morphology and metabolism. A wide, interdigitated and well-vascularized suture was observed in younger specimens compared with straighter and smaller sutures with fewer vessels and lower bone density in the 60-80 year group. The fibre composition within the sutural gap differed between the three age groups. Delicate fibres were found in the 20-39 year group, and a tightly interwoven 3D fibre-network was observed in the 40-59 year group. Atrophy primarily characterized the fibres in the 60-80 year group. This evidence demonstrates differences between the evaluated groups. These results suggest that the staining methods used are suitable for the description and evaluation of the morphology and metabolism of mid-palatal sutures. Further investigation is necessary to provide an in-depth description of sutural maturation over a lifetime., (© 2019 Anatomical Society.)

Introduction: The pterygopalatine fossa (PPF) infiltration is performed to reduce blood flow during endoscopic sinus surgery and septorhinoplasty, as well as to control posterior epistaxis and provide regional anesthesia in dental procedures. PPF infiltration performed with consideration of the morphometrics of greater palatine foramen (GPF), greater palatine canal (GPC) and PPF would increase the success of the procedure and reduce the risk of complications. The aim of this study is to investigate the GPF, GPC, lesser palatine foramen (LPF), lesser palatine canal (LPC) and PPF morphology via the images obtained by CBCT, to provide information for interventional procedures., Materials and Methods: GPF, GPC, LPF, LPC and PPF were morphometrically evaluated retrospectively in CBCT images of 75 female and 75 male cases by Planmeca Romexis program. The 19 parameters were measured on these images., Results: These parameters were evaluated statistically. The comparison of these parameters by genders revealed significant differences in distances between GPC-PC, PC-IOF, LPC-GPF, GPF-MS in the coronal and transverse planes, the distance between GPF and the occlusal plane of the teeth, GPF-PNS, GPF-IF and TD-GPF, and in the area of GPF. The number of LPF was found ranging from 1 to 5., Conclusion: Our results may help to insert to needle properly for application of maxillary nerve block with a high success rate and minimal complication. We recommend that the needle should be inserted 14-15 mm lateral to the midsagittal plane, 19-20 mm over the occlusal plane of the teeth and on the same line with the third molar teeth. For PPF infiltration through the GPF, the needle should be pushed forward 28 mm upward at 66° angle on the transverse plane and 14°-15° angle on the vertical plane.

Background: The goal of this study is to evaluate the morphologic characteristics of the posterior palatine region among the Chinese population, more specifically, the greater palatine grooves, crests, bridges, and torus palatinus structures and make comparisons between different ethnic groups and minorities., Methods: A total of 323 cone-beam computed tomography (CBCT) scans were collected for analysis on the presence of grooves, crests, bridges, or torus palatinus (TP). Data were collected through recognizing the grooves, crests, bridges, and TPs and calculating the number of those anatomy structures. The statistics index, including average, standard deviation, were adopted to describe the subjects and Wilcoxon test, Mann-Whitney test, and Chi-squared test were all carried out by SPSS., Results: Three different morphologic manifestations of the greater palatine groove (GPG) found in the upper 1st and 2nd molar regions are as follows: no groove, 1 groove, and 2 grooves. The number of crests ranged from 0 to 3. And the incidence of torus palatines was 29%. Moreover, a positive correlation was found between the presence of crests/GPGs and age in the 2nd molar region., Conclusion: The results in this study reveal that GPGs in the upper 1st and 2nd molar regions have 3 different morphologic manifestations among Chinese people and the number of crests can vary from 0 to 3 crests. Although the proportion of GPG or crest and the incidence of TP are different from the proportions of other studies, this may be due to the fact that different ethnic groups and sample sizes were used in the course of this study. Information about the anatomy structures of the posterior region in hard palate directly contributed to a decrease in potential complications during palatal implant surgery and periodontal surgery.

Purpose: To evaluate the influence of facial profile and age on the morphology of the nasopalatine canal., Materials and Methods: One hundred thirty-two cone-beam computed tomograms were classified according to facial profile-mesofacial, brachyfacial, and dolichofacial-and divided into the following age groups: 21 to 30, 31 to 40, 41 to 50, and 51 to 60 years. Measurements were obtained for openings of the incisive and nasopalatine foramina, alveolar bone thickness, and the full length, most constricted region, and volume of the nasopalatine canal. Intra- and inter-examiner agreements were calculated using the intraclass correlation coefficient. After exploratory and descriptive analysis, data were subjected to 2-way analysis of variance and Tukey test for comparisons between facial profiles and age groups. The significance level was 5% (α = 0.05)., Results: Intra- and inter-examiner reproducibilities were excellent for all measurements. Patients older than 50 years presented a significantly larger nasopalatine canal than patients 21 to 30 years old for all facial profiles (P ≤ .05). Linear measurements obtained from the nasopalatine canal showed no significant difference between facial profiles and age groups (P > .05)., Conclusions: The nasopalatine canal was not influenced by facial profile but did exhibit an increased volume with aging, particularly after 50 years of age., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Tongue plays an important part in oral and maxillofacial system. Measurement of tongue pressure helps to evaluate the performance of tongue movement., Objectives: To establish a system for measuring tongue pressure against hard palate and to preliminarily explore pressure distribution of individual normal occlusions and the relationship with dental arch form., Methods: A total of 19 volunteers of individual normal occlusions out of 189 dental students met inclusion criteria (nine males, ten females, aged 25.53 ± 0.96 years). A force-sensing resistor device was used to measure tongue pressure at rest and functional state (swallowing). We observed tongue pressure of four channel (anterior, posterior and lateral sides of hard palate) in sitting, supine position and swallowing. We analysed pressure differences according to gender and explored correlation relationship between tongue pressure and dental arch width and length using 3D digital maxillary image., Results: In rest, tongue pressure against hard palate increased from front to back in both sitting and supine position, without gender differences. When swallowing saliva, the pressure at lateral sides of females was found significantly higher than that of males. Bivariate correlation analysis revealed duration of swallowing was positively correlated with BMI and weight at posterior region and positively correlated with palatal length at anterior palate. The greater the dental arch width, the smaller the pressure of swallowing in the anterior and lateral region., Conclusion: In rest, there was consistent pressure of tongue against hard palate. The pressure increased significantly during swallowing, especially in females. Tongue pressure was related to dental arch length, width, BMI and weight., (© 2018 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.)

Background: Analysis of the bones and bone fragments of the cranium may be a useful tool for sex diagnosis in the identification of human remains which have been exposed to adverse conditions. The object of the present study was to evaluate sex prediction through metric and non-metric analysis of the hard palate (HP) and the pyriform aperture (PA), using macerated skulls of adult individuals., Materials and Methods: We analysed 312 dry skulls of adult individuals of both sexes, studying the metric and non-metric characteristics of the HP and PA. The accuracy, sensitivity, specificity and positive and negative predictive values were evaluated. A binary logistic regression and a linear regression were performed. The receiver operating characteristic curve was constructed to analyse the perfor- mance of sex diagnosis. Measurements of the HP and the PA were analysed by ANOVA and Tukey's test. The SPSS v. 20.0 software was used, with a significance threshold of 5%., Results: The shape of the PA presented 61.9% accuracy, 54.4% sensitivity and 65.7% specificity. The shape of the HP presented 51.5% accuracy, 65.6% sen- sitivity and 44.7% specificity. Only the height of the PA functioned as a good predictor of sex., Conclusions: The height of the PA produced good diagnostic performance (area under curve = 0.764). The height of the PA was the most reliable indicator for sex prediction, and could be used by forensic scientists to identify sex.

Objective: This study aimed to assess the validity of palatal rugoscopy for sexual dimorphism in the casework routine of forensic dentistry., Design: A systematic literature reviews was established following the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) and Cochrane guidelines. Six electronic databases were searched as the primary source of information. "Grey literature" was included to avoid selection and publication bias. As a secondary source of information, the reference lists of the eligible studies were also consulted to increase the search spectrum. Methodological quality and risk of bias were assessed with Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. Statistic tests, namely the meta-analysis of diagnostic accuracy, Cochran Q test, and I2 test, were performed to verify the heterogeneity between the eligible studies., Results: The systematic search resulted in 263 studies, out of each 8 fulfilled the inclusion criteria. An additional eligible article was included after the search in reference lists. From the 9 studies that underwent qualitative data extraction, six were selected for quantitative analysis. The meta-analysis of grouped sex estimates showed sensitivity and specificity rates of 89% and 83%, respectively. The Area Under the Curve reached 0.93. High heterogeneity and important methodological limitations were detected among the studies., Conclusion: Palatal rugoscopy seems to have discriminant power for sexual dimorphism. However, the limitations found specifically in each study and the strong heterogeneity across studies suggest that palatal rugoscopy lacks evidence-based confirmation for reliable application as a sole tool for sexual dimorphism in practice., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Introduction: Palatal rugae complete its development during early intrauterine life, whereas dental malocclusions in permanent dentition establishes several years into the post-natal life., Objective: The objective of present study was to determine if there is an association between the palatal rugae pattern and Angle's classes of malocclusion., Methods: A cross-sectional study was conducted on pretreatment dental casts of 184 patients. The sample was divided into the following groups: Class I, Class II div. 1, Class II div. 2, and Class III. The number of palatal rugae was recorded, bilaterally. The length, pattern and orientation of three anterior-most primary rugae on both sides were recorded., Results: The mean age of the study sample was 17.8 ± 5.4 years. The mean number of the palatal rugae was 11.18 ± 2.5, with significant differences among different malocclusion groups. The length of the first rugae on left side and third rugae on both sides varied significantly among the groups (p< 0.05). Similarly, the pattern of palatal rugae was also found to be significantly different among the malocclusion groups. The right sided rugae did not have any significant difference in the orientation in different malocclusion groups; however, the left sided rugae showed significant differences among the four malocclusion groups (p< 0.001)., Conclusions: The current study showed subtle differences in the palatal rugae pattern among the Angle's classes of malocclusion. Similarly, the length and orientation of some rugae were also found to be significantly different between malocclusion groups.

Purpose: The aim of this study was to provide basis for future design and selection of cleft palate surgery through establishing finite element model of pharyngeal cavity which was suitable for biomechanical analysis., Methods: One patient with isolated cleft palate and 1 normal child underwent multilayer head CT examination. The scanned data of pharyngeal cavity were imported into Mimics software for a 3-D geometric model reconstruction. The model was divided into a grid, so it can be further processed for subsequent finite element analysis., Results: After applying 5cm water column pressure load of 0.0005 MPa at the back edge of the soft palate in the two models respectively, the results showed that the maximum stress of the abnormal nasopharyngeal cavity model was 0.025 MPa, greater than the normal model (0.017 MPa). The same pressure loading was applied to different parts of the two models, the stress change area in the posterior margin of the soft palate and the middle of the palate was the same, and the stress in the front of the hard palate was smaller., Conclusions: Finite element model has good biomechanical characteristics and geometric similarity. It can be used in isolated cleft palate with preoperative biomechanical analysis, for repairing and functional reconstructive surgery to provide ideal biomechanical model predicts.

Age estimation is guided by the evaluation of events that happen during the processes of bone and dental development. The purpose of this study was to validate the method of age estimation proposed by Lajolo et al. (2013) through oro-cervical radiographic indices in Brazilians. The study aimed to verify the effectiveness of age estimation equations through dental and cervical vertebrae examinations, in addition to including dental and cervical vertebrae data in new age estimation equations. The sample consisted of panoramic radiographs and teleradiographs from 510 subjects (8-24.9 years). Age estimation methods were applied by assessing the development of seven mandibular teeth, cervical vertebrae and third molars. Techniques used previously have been combinations of radiographic indices: Oro-Cervical Radiographic Simplified Score (OCRSS) and Oro-Cervical Radiographic Simplified Score without Wisdom Teeth (OCRSSWWT). In the second phase of the study, dental maturation, vertebral measurements, and real age were estimated by regression equations. OCRSS and OCRSSWWT had success rates of 67.4% (R2=0.64) and 70.8% (R2=0.62), respectively. When age estimation equations for tooth evaluations were applied, the average error was 1.3 years, and for cervical vertebrae measurements, the error was 1.9 years. When dental variables and the measurements of cervical vertebrae were included, the average error of equations was 1.0 year. Radiographic indices were easy to perform, and after adequate training, are reliable and can be used in forensic practice. The use of the new equations presented in this study is recommended because including cervical vertebrae and dental data provides greater accuracy for age estimation.

Background: The objective was to compare the palatal bone thickness (PBT) and palatal bone density (PBD) in the anterior, middle, and posterior part of the palate in males and females., Methods: This retrospective study reviewed cone beam computed tomography scans of 359 patients. The scans were divided into 99 growing males, 105 growing females, 74 non-growing males, and 81 non-growing females. The measurements of PBT and PBD were made in between the canine and first premolar, the first premolar and second premolar, the second premolar and first molar, and the first molar and second molar. The measurements were made in the center of the palate and 4 mm away from the center. ANOVA was used to analyze the PBT and PBD in different areas between four different groups., Results: The PBT was lower (P <  0.0001) as we moved from the anterior to the posterior palate. The PBT was more (P <  0.001) in the center of the palate than 4 mm away from the center, except in between the canine and first premolar. The growing male and non-growing male had higher (P <  0.0001) PBT than the growing female and non-growing female in between the canine and first premolar and the first premolar and second premolar both in the center and 4 mm away from it. The PBD was higher (P <  0.05) in between the canine and first premolar area at the center of the palate and between the second premolar and first molar 4 mm away from the center in all the experimental groups., Conclusions: There exists a definite gender and growth variation in the PBT and PBD in different parts of the palate. Palatal bone thickness between the males and females revealed that the males had significantly higher PBT than the females.

Purpose: Analyze the influence of gender and age on hard palate dimensions and verify the reference parameters available in the literature., Research Strategies: Two reviewers independently performed a search at the Cochrane Library, PubMed-Medline and Web of Knowledge databases using descriptors according to the syntax rules of each database., Selection Criteria: Observational or experimental human studies evaluating the dimensions of the hard palate or maxillary dental arch, with at least one transverse, vertical or sagittal plane measurement, in normal occlusions or class I malocclusions, and comparisons of the dimensions between genders and/or ages., Data Analysis: Descriptive analysis with the following subdivisions: design, sample, evaluation instruments, measurements in millimeters, and statistical analysis. Quality of the included studies was verified by the Newcastle - Ottawa Quality scale., Results: Eighteen studies were selected and 11 presented results for hard palate or maxillary dental arch dimensions according to gender, six in age and gender and one in age only., Conclusion: The dimensions were larger in males and progressive increase in the measurements was observed from birth to the permanent dentition period.

Introduction: Cleft palate is one of the most common congenital anomalies, yet surgical repair remains challenging and can lead to significant complications in the hands of inexperienced surgeons. There is a great need for the development of a simulation model that will allow surgeons worldwide to learn and practice the intricate skills needed for cleft palate surgery., Objectives: 1. To develop a low-cost incomplete cleft palate simulation model using additive manufacturing technology (3D printing). 2. To evaluate its validity and utility to teach palatoplasty in a global health care setting., Methods: Three-dimensional models of a soft palate cleft and an incomplete hard and soft palate cleft were developed using 3D printing and silicone casting. The cost and time of assembly of the 3D printed models were calculated. The models were then assessed for validity by cleft surgeons and trainees during a cleft mission in Ecuador. 3D models were assessed for resemblance to anatomy and tissue characteristics, the ability to incise the soft tissue, dissect and reposition the palatal flaps, and the ease of suture placement. Models were rated using the Likeness to Human Tissue Scale., Results: Cleft palate simulators were successfully developed using 3D printing and silicone casting. Participants reported that models provided a realistic representation of human anatomy and were adequate for novice surgeons to practice the procedure. The models were portable, low cost, and easily assembled., Conclusion: The use of 3D printed haptic simulation models for teaching and learning cleft palate repair techniques could enhance skill acquisition and possibly improve surgical outcomes. In outreach settings, it could help achieve local, sustainable comprehensive care for cleft palate patients., (Copyright © 2018. Published by Elsevier B.V.)

The aim of this study was to investigate the morphology of the goat hard palate by light and scanning electron microscopy (SEM), in addition to gross and morphometric analysis. A total of twelve goat heads, from normal adult and apparently healthy goats of both sexes, were collected from local slaughterhouses in Qena province, Egypt. Samples were subjected to gross examination, morphometric analysis, light microscopy and SEM. The hard palate in the goats was long and could be divided into a rostral narrow part and a caudal wide part with about 12-15 transverse palatine ridges from which the rostral palatine ridges were serrated on their free caudal edges. The dental pad replaced the upper incisors; its caudal border had a serrated appearance. At higher magnification, the epithelial surface of the palatine rugae and incisive papilla revealed a variety in the shape of the microplicae and the pattern of the micropits. These adaptations of the goat's hard palate might increase its efficiency during ingestion and mastication of coarse roughages and in directing the food backwards. To our knowledge, this is the first study showed the detailed anatomical description of the hard palate of the goat with SEM., (© 2018 Blackwell Verlag GmbH.)

Background: To investigate the relationship between the morphological maturation stages of the midpalatal suture and its bone densities., Methods: The sample consisted of 91 subjects aged 8-18 years who underwent cone beam computed tomography. All images were examined to classify morphological maturation of the midpalatal suture to five groups according to Angelieri et al. Bone density of the midpalatal suture was measured at the maxillary and palatal regions. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the difference between groups., Results: Bone density of the midpalatal suture was significantly higher in the palatal region in E stage and in the maxillary region in D and E stages., Conclusions: It is concluded that the change in bone density of the midpalatal suture between the morphological maturation stages supports their reliability in clinical application.

The physiological mechanisms underlying Stage II transport (STII), during which comminuted solid food is transported from the oral cavity into the meso-pharynx for aggregation into a pre-swallow bolus, have yet to be clarified. The purpose of the present study was to investigate relationships between tongue-palate contact during mastication and incidence of STII by synchronised analysis of tongue pressure production on a hard palate and video-endoscopic (VE) images during mastication. Tongue pressure at 5 measuring points with an ultra-thin sensor sheet attached to the hard palate and trans-nasal VE images while masticating corned beef was recorded for 12 healthy subjects. All recordings were divided into 2 groups: mastication with STII and without STII. Tongue pressure duration was longer at the anterior-median part in the group with STII than in the group without STII. Integrated values of tongue pressure were greater at the anterior-median parts and posterior circumferential part in the group with STII. Integrated values of tongue pressure per second were greater in late-stage mastication than in early-stage mastication in the group with STII. These results suggest that the tongue-palate contacting at the anterior-median and post-circumferential parts of the hard palate is related with the incidence of STII., (© 2018 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.)

Palatal rugae are known in literature as individualizing anatomical structures with a strong potential for personal identification. However, a 3D assessment of their uniqueness has not yet been performed. The present study aims at verifying the uniqueness of 3D models of the palate. Twenty-six subjects were recruited among the orthodontic patients of a private dental office; from every patient, at least two dental casts were taken in different time periods, for a total of 62 casts. Dental casts were digitized by a 3D laser scanner (iSeries, Dental Wings©, Montreal, Canada). The palatal area was identified, and a series of 250 superimpositions was then performed automatically through VAM©software in order to reach the minimum point-to point distance between two models. In 36 matches the models belonged to the same individual, whereas in 214 mismatches they came from different subjects. The RMS (root mean square) of point-to-point distances was then calculated by 3D software. Possible statistically significant differences were assessed through Mann-Whitney test (p < 0.05). Results showed a statistically significant difference in RMS mean point-to-point distance between matches (mean 0.26 mm; SD 0.12) and mismatches (mean 1.30; SD 0.44) (p < 0.0001).All matches reached an RMS value below 0.50 mm. This study first provided an assessment of uniqueness of palatal rugae, based on their anatomical 3D conformations, with consequent applications to personal identification.

Background: Identification of unknown dead bodies' especially bony remains is done by different methods like DNA typing, Finger printing, Dental and other skeletal data, facial reconstruction and rugae pattern study. Palatal rugae pattern study or Ruguscopy gives a unique method of identification in cases of skeletal remains due to its uniqueness, resistance to heat, and stability throughout life., Methods: This simple random sampling was carried out on 102 study models (casts of palate) of patients having 880 rugae patterns above 20 years of age in Khan Dental Clinic near Ayub Medical College, Abbottabad. The study is based on classification given by Thomas et al. Casts were taken from palate and then individual casts studied for rugae pattern. They were classified and variations studied for uniqueness., Results: Each individual had different set of palatal rugae which are not same, in all its dimensions like size shape number etc., Conclusions: With the help of this study we can conclude that Palatal rugae pattern give unique method for individual identification.

Purpose: To determine differences between open bite and normal vertical overbite regarding distribution, size and clinical appearance of palatal rugae, depth and length of the palate, intercanine and intermolar widths and arch perimeter., Methods: A cross-sectional study was performed in 264 superior models were studied with a 3D analysis system. A total of 132 individuals with AOB and 132 individuals with normal vertical overbite were evaluated, chosen from public schools with ages between 8 and 16 years. Palatal anthropometric features were evaluated. Qualitative analysis of palatal rugae was performed, exploring the shape, direction, unification and sensitivity of the palate. The Mann Whitney and Chi Square tests were used for statistical analyses., Results: The average age was 11.37 ± 2.27 years for normal overbite and 11.87 for anterior open bite, with 54.9% of women. No significant differences were found between subjects with AOB and subjects with normal vertical overbite regarding intermolar or intercanine width. The maxillary length and depth and the height and width of palatal rugae were lower in the AOB group. The most common rugae shapes were curved and wavy, predominating in the horizontal direction with a parallel distribution., Conclusion: Qualitative evaluation demonstrated asymmetry in the shape, direction and unification of rugae in both groups. Most arch measurements were greater in individuals with AOB.

The mechanical properties of the midpalatal suture and their relationship with anatomical parameters are relevant for both tissue engineering and clinical treatments, such as in sutural distraction osteogenesis. Soft tissues were dissected from ten swine heads and the hard palate was sliced perpendicularly to the midpalatal suture. Thirteen specimens were collected from each animal and analysed with micro-computed tomography and 4-point-bending for sutural width (Sw), interdigitation (LII), obliteration (LOI), failure stress (σ f ), elastic modulus (E), and bone mineral density (BMD). Values of the premaxillary, maxillary, and palatine region were compared with Kruskal-Wallis one-way ANOVA and Spearman's rank coefficient was used to analyse the correlation between parameters and their position along the suture (α = 0.05). LII had values of 1.0, 2.9, and 4.3, LOI had values of 0.0%, 2.5%, and 4.5%, and E had values of 12.5 MPa, 31.3 MPa, and 98.5 MPa, in the premaxillary, maxillary, and palatine region, respectively (p < 0.05). Failure stress and rigidity of the midpalatal suture increased from rostral to caudal, due to greater interdigitation and obliteration. These anatomical and mechanical findings contribute to characterise maxillary growth, and may help to understand its mechanical reaction during loading, and in virtual simulations.