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3D palatal soft tissue volumes : pilot study
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Abstract(s)
INTRODUÇÃO: A Periodontologia dedica-se à prevenção, diagnóstico e tratamento das doenças dos tecidos de suporte dentário. A recessão gengival, frequente em periodontite avançada, compromete a estética, provoca desconforto e expõe as raízes dentárias. Para corrigir esta situação recorre-se a enxertos gengivais, cuja eficácia depende da quantidade e qualidade do tecido conjuntivo disponível. Conhecer previamente a espessura e o volume da mucosa palatina é essencial para otimizar o planeamento cirúrgico, melhorar resultados e reduzir complicações. MATERIAIS E MÉTODOS: Foram avaliados 80 pacientes (45 do sexo feminino e 35 do masculino). Obtiveram-se ficheiros STL (estereolitografia) e DICOM (Digital Imaging and Communications in Medicine), que foram integrados no software CoDiagnostiX, garantindo a sobreposição entre modelos ósseo e gengival. Posteriormente, no Geomagic Control X definiram-se cinco pontos na margem gengival desde o canino até ao 2.º molar, traçando-se linhas horizontais (0mm, 3mm e 8mm) e verticais que delimitaram oito regiões de interesse (ROI) por hemiarcada. Os dados recolhidos foram organizados no Excel e analisados estatisticamente no software SPSS®. RESULTADOS: A maior espessura média da mucosa palatina verificou-se no ROI entre o 1.º e o 2.º pré-molar, com 3,23±0,53 mm à esquerda e 3,22±0,60 mm à direita. O maior volume foi registado no ROI entre o 1.º e o 2.º molar. Globalmente, os homens apresentaram valores superiores e os pacientes mais jovens valores mais baixos. Observou-se ainda um aumento progressivo da espessura com a idade. CONCLUSÃO: Foi desenvolvida uma metodologia digital para avaliar com precisão os tecidos moles palatinos. O palato é uma estrutura simétrica, cuja mucosa palatina apresenta variações de espessura e volume conforme a região anatómica, o sexo e a idade. A área entre o primeiro e o segundo pré-molares é a mais indicada para colheita de enxertos, devido à sua espessura e acessibilidade. Apesar do maior volume disponível na região dos molares, a sua menor espessura e proximidade a estruturas nobres limitam a sua aplicação clínica rotineira.
INTRODUCTION: Periodontology is dedicated to the prevention, diagnosis, and treatment of diseases affecting the supporting tissues of the teeth. Gingival recession, common in advanced periodontitis, compromises aesthetics, causes discomfort, and exposes the tooth roots. To address this condition, gingival grafts are used, and their effectiveness depends on the quantity and quality of the available connective tissue. Knowing the thickness and volume of the palatal mucosa in advance is essential to optimise surgical planning, improve outcomes, and reduce complications. MATERIALS AND METHODS: A total of 80 patients were evaluated (45 female and 35 male). STL files (stereolithography) and DICOM files (Digital Imaging and Communications in Medicine) were obtained and integrated into the CoDiagnostiX software, ensuring the alignment between bone and gingival models. Subsequently, in Geomagic Control X, five points were defined on the gingival margin from the canine to the second molar, and horizontal (0 mm, 3 mm, and 8 mm) and vertical lines were drawn to delimit eight regions of interest (ROI) per arch. The collected data were organized in Excel and statistically analyzed using SPSS® software. RESULTS: The greatest mean palatal mucosal thickness was recorded in the ROI between the first and second premolars, with 3.23±0.53 mm on the left and 3.22±0.60 mm on the right. The largest volume was registered in the ROI between the first and second molars. Overall, male patients showed higher values, while younger patients exhibited lower measurements. A progressive increase in thickness with age was also observed. CONCLUSION: A digital methodology was developed to accurately assess palatal soft tissues. The palate is a symmetrical structure, and its mucosa presents variations in thickness and volume depending on the anatomical region, sex, and age. The area between the first and second premolars is the most suitable for graft harvesting due to its thickness and accessibility. Although the molar region offers greater tissue volume, its reduced thickness and proximity to vital anatomical structures limit its routine clinical use.
INTRODUCTION: Periodontology is dedicated to the prevention, diagnosis, and treatment of diseases affecting the supporting tissues of the teeth. Gingival recession, common in advanced periodontitis, compromises aesthetics, causes discomfort, and exposes the tooth roots. To address this condition, gingival grafts are used, and their effectiveness depends on the quantity and quality of the available connective tissue. Knowing the thickness and volume of the palatal mucosa in advance is essential to optimise surgical planning, improve outcomes, and reduce complications. MATERIALS AND METHODS: A total of 80 patients were evaluated (45 female and 35 male). STL files (stereolithography) and DICOM files (Digital Imaging and Communications in Medicine) were obtained and integrated into the CoDiagnostiX software, ensuring the alignment between bone and gingival models. Subsequently, in Geomagic Control X, five points were defined on the gingival margin from the canine to the second molar, and horizontal (0 mm, 3 mm, and 8 mm) and vertical lines were drawn to delimit eight regions of interest (ROI) per arch. The collected data were organized in Excel and statistically analyzed using SPSS® software. RESULTS: The greatest mean palatal mucosal thickness was recorded in the ROI between the first and second premolars, with 3.23±0.53 mm on the left and 3.22±0.60 mm on the right. The largest volume was registered in the ROI between the first and second molars. Overall, male patients showed higher values, while younger patients exhibited lower measurements. A progressive increase in thickness with age was also observed. CONCLUSION: A digital methodology was developed to accurately assess palatal soft tissues. The palate is a symmetrical structure, and its mucosa presents variations in thickness and volume depending on the anatomical region, sex, and age. The area between the first and second premolars is the most suitable for graft harvesting due to its thickness and accessibility. Although the molar region offers greater tissue volume, its reduced thickness and proximity to vital anatomical structures limit its routine clinical use.
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Keywords
Palato Recessão gengival Tecido conjuntivo Imagem tridimensional Periodontite Palate Gingival recession Connective tissue Three-dimensional imaging Periodontitis
Pedagogical Context
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