Classification and Morphological Analysis of the Hard Palate in Cone-Beam Computed Tomography Scans: A Retrospective Study

Murilo Miranda-Viana; Deborah Queiroz Freitas; Amanda Farias Gomes; Felippe Bevilacqua Prado; Yuri Nejaim

doi:10.1016/j.joms.2020.11.024

Classification and Morphological Analysis of the Hard Palate in Cone-Beam Computed Tomography Scans: A Retrospective Study

J Oral Maxillofac Surg. 2021 Mar;79(3):695.e1-695.e13. doi: 10.1016/j.joms.2020.11.024. Epub 2020 Nov 30.

Authors

Murilo Miranda-Viana¹, Deborah Queiroz Freitas², Amanda Farias Gomes², Felippe Bevilacqua Prado³, Yuri Nejaim⁴

Affiliations

¹ Student, Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil. Electronic address: muriloomiranda@gmail.com.
² Professor, Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
³ Professor, Department of Morphology - Anatomy Area, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
⁴ Professor, Oral Radiology Area, Dental School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.

PMID: 33358709
DOI: 10.1016/j.joms.2020.11.024

Abstract

Purpose: As the hard palate is a central structure of the skull and is involved in orthodontic and surgical procedures, it would be of interest to study the morphological aspects of this bone and its possible variations as per different patterns of skeletal development. Thus, this study aimed to develop a classification for the different morphological characteristics of the hard palate and to evaluate the relationship between these characteristics and the different skeletal patterns, using cone-beam computed tomography (CBCT).

Materials and methods: This retrospective and cross-sectional study used CBCT scans of patients seen from January 2014 to December 2016. Carestream Dental 3D Imaging software was applied to classify each patient according to vertical and sagittal skeletal patterns, and to evaluate the 3 morphological characteristics of the hard palate: depth (flat, regular, or deep), inclination (superior, parallel, or inferior), and presence of a bony projection (S-shaped). χ² and Fisher's exact tests evaluated the relationship between the hard palate characteristics and the different skeletal patterns.

Results: A total of 298 CBCT scans (144 males and 154 females) were evaluated. The depth of the hard palate was significantly related to both skeletal patterns in males (P < .05), with Class II and dolichocephalics presenting a greater amount of deep palates, while classes I and III and brachycephalics had a greater amount of regular palates. The inclination of the hard palate was significantly associated with the facial type in females (P < .05), with brachycephalics and mesocephalics presenting a greater amount of parallel palates, whereas dolichocephalics had a greater number of inferiorly inclined palates. Regarding the presence of the S-shape in the hard palate, there was a greater number of this projection in Class II males and brachycephalic females.

Conclusions: A morphological classification for the hard palate was developed. The morphology of the hard palate varied among the different skeletal patterns.

MeSH terms

Cone-Beam Computed Tomography*
Cross-Sectional Studies
Female
Humans
Male
Palate
Palate, Hard* / diagnostic imaging
Retrospective Studies
Skull