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Could the median-palate accommodate wide-bodied implants in order to support maxillary over-dentures? A radiomorphometric study of human cadavers

Authors

  • Allauddin Siddiqi,

    Corresponding author
    1. Oral Implantology Research Group, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
    • Corresponding author:

      Allauddin Siddiqi

      Sir John Walsh Research Institute, Faculty of Dentistry

      University of Otago

      PO Box 647, Dunedin 9054, New Zealand

      Tel.: +64 3 479 5664

      Fax: +64 3 479 5661

      e-mail: siddiqidr@gmail.com

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  • Jules A. Kieser,

    1. Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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  • Rohana K. De Silva,

    1. Department of Oral Diagnostic & Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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  • Andrew McNaughton,

    1. Department of Anatomy and Structural Biology, School of Medical Sciences, Otago Centre for Confocal Microscopy, University of Otago, Dunedin, New Zealand
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  • Warwick J. Duncan

    1. Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Abstract

Introduction

Atrophy of the alveolar bone is an irreversible multifactorial phenomenon, the rate of which varies between individuals and between the jaws. This atrophy of the alveolar ridges presents severe limitations for the oral rehabilitation of the edentulous patients and poses a clinical challenge to the prosthodontists and implant surgeons. The present research aimed to investigate whether the median-palate of elderly edentulous subjects is anatomically suitable for implant placement.

Materials and methods

A total of 32 samples were harvested from the maxillae of 16 human cadavers. One dentate male subject was included for contrast. Bone quality and quantity were analysed at two regions: the median-palate and the edentulous maxillary alveolar ridge. Samples were scanned through micro-CT, and the region of analysis (ROA) identified and dissected. Bone volume to tissue volume ratio (%BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp) and trabecular bone pattern factor (Tb.Pf) were evaluated for the two regions using Skyscan CTAn®.

Results

The results of bone volume fraction obtained from CTAn® of the median-palatal region show higher values than the respective premolar sites in 12 of 15 (80%) edentulous samples. However, this difference was statistically non-significant (= 0.06). Similarly, the trabecular number for 10 of 15 samples (66.6%) from the median-palate shows greater values than the respective premolar site (= 0.07). Trabecular thickness of 10 of 15 (66.6%) premolar samples is larger than in the median-palatal region. However, these differences were also statistically non-significant (= 0.25). Statistically significant difference (= 0.04) was found between the Tb.Sp values of the two regions.

Conclusion

The results indicate that the anterior median-palate is structurally better than their respective maxillary premolar region in elderly edentulous persons, and an implant can be placed to anchor an overdenture. The best site for a wide-body implant was established to be 6–8 mm posterior to the incisive foramen in elderly edentulous patients.

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