Computer-guided technique evaluation of the bony palate for planning individual implant placement

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 posttraumatic dental reconstruction. The aim of this study is to analyze the dental arch size and type for supporting individual dental protheses.

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.

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.

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.