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    Computer-guided technique evaluation of the bony palate for planning individual implant placement
    (Springer France, 2017) Cagimni, Pinar; Govsa, Figen; Ozer, Mehmet Asim; Kazak, Zuhal
    Objective Different clinical problems may require a surgical approach to the dental arch, such as dentofacial orthopedics, implant-supported dental prothesis, maxillary orthodontics protraction, removable appliances, and post-traumatic dental reconstruction. The aim of this study is to analyze the dental arch size and type for supporting individual dental protheses. Materials and methods In this study, the reference measurements on the length of the bony palate, maxillary intercanine width, maxillary intermolar width, and the ratio of the maxillary to the palatinal surface were studied in 120 bony palates using a computer software program. Results The average length of the bony palate, maxilla, and palatine was measured as 104.4 +/- 30.3, 40.05 +/- 4.05, and 15.00 +/- 3.03 mm, respectively. The right and left sides of average width of intermaxillary distances were measured as 13.75 +/- 1.50 and 12.51 +/- 1.50 mm, respectively. The average width of intermolar distance was calculated as 19.82 +/- 1.61 mm (right side) and 18.89 +/- 1.69 mm (left side), respectively. The maxillary dentitions were classified as square (17%), round-square (63.5%), round (14.4%), and round V-shaped arches (5.1%). The round-square ones showed no prominent principal component. Among the maxillary arches, the round arches were characterized by small values and round V-shaped ones with the largest values. Asymmetry between the right and the left bony palate was observed. The areas with equal bony palate on both sides were present in 64.4% of the cases, and in 33.1% of the cases, bony palate was dominant on the right. Conclusions The primary principle in reconstructive treatment should be describing geometrical forms and mathematical details of the bony palate. Three-dimensional reference values relative to the dental arch may increase the success of individual treatment of surgical procedures and reduce possible complications. With the help of certain software, this research has made possible to investigate the variability of the dental arch and calculate the variety in measurements and thereby determining the most appropriate implant position, optimizing the implant axis and defining the best surgical and prosthetic solution for the patient.
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    Computerized analysis of the greater palatine foramen to gain the palatine neurovascular bundle during palatal surgery
    (Springer France, 2017) Cagimni, Pinar; Govsa, Figen; Ozer, Mehmet Asim; Kazak, Zuhal
    Investigation of the computerized dimensional anatomic location of the greater palatine foramen (GPF) and lesser palatine foramens (LPF) is important indicating site to collect palatal donor tissue, reconstructioning the orofacial area of the oncology patient and applying the greater palatine nerve block anesthesia. The aim of this study is to determine a patient-friendly landmark and to specify the precise location of the GPF in order to standardise certain anatomical marks of safe neurovascular bundle. 120 bony palates were examined to detect the position of the GPF and the LPF related to adjacent anatomical landmarks using a computer software program. The GPF was assessed regarding the position, the diameter and the distances between each foramen and the midline maxillary suture (MMS), the inner border of alveolar ridge (AR), posterior palatal border (PBB), and incisive foramen (IF). The GPF was identified as single in 81 %, double in 16 %, triple in 2 % and absent in 2 % of the specimens. The mean distances between the GPF and the MSS, the GPF and the AR, the GPF and the PPB, the GPF and the IF were 16, 4, 4, and 40 mm, respectively. In majority of the cases, the GPF was seen between the distal surfaces of the third maxillary molar (78 %). Single LPF was observed in 53.45 % of the skulls, two LPF were observed in 31 % of the skulls bilaterally and five LPF were rare in 2.1 % of the specimens. The LPF was most commonly at the junction of the palatine bone and the inner lamella of the pterygoid plate (71.9 %). This study made possible to investigate the variability of the GPF and the feasibility of the greater palatine neurovascular bundle, and to calculate the lengths of some parameters with the help of certain software. To collect the donor tissue of the neurovascular greater palatine network, each distance among the AR-GPF-PPB were equal to 4 mm. To estimate the possible length of the graft, the incision was made along the third and the second molar to the IF as 4 cm. The data we obtained within this study have been presented to help the surgeons avoid unexpected hemorrhage during the palatinal procedures such as posttraumatic dental reconstruction, maxillofacial tumor resections, palatal micro-implants, and dentofacial orthopedic surgery.