Assessment of Palatal Hard and Soft Tissue Thickness for Miniscrew Placement in Patients With Unilateral Cleft Lip and Palate

Abstract

Objective

To identify a safe zones in the palate for placement of temporary anchorage devices (TADs) based on hard tissue (HT) and soft tissue thickness (ST) in patients with unilateral cleft lip and palate (UCLP).

Design

Retrospective, observational.

Setting

Tertiary care dental teaching hospital.

Patients, Participants

Forty patients with non-syndromic UCLP, including 20 left-sided (LUCLP) and 20 right-sided (RUCLP) groups, where 26 were males and 14 were females.

Materials and Methods

Cone beam computed tomography (CBCT) scans were analyzed using a uniform grid mapping comprising of 15 palatal zones. The HT and ST were measured at each zone. Comparisons between the genders within the groups were performed using the Mann–Whitney U-test. Comparison of the HT and ST values across the zones was done using the Kruskal–Wallis test followed by post Dunn post hoc test. The HT/ST ratio was calculated to identify optimal sites for TAD placement.

Results

Statistically significant gender-based variations and inter-zonal variations in HT and ST were observed in both LUCLP and RUCLP groups. Based on HT/ST ratios, the anterior paramedian region on the non-cleft side (zones 4 and 5 in LUCLP; zone 13 in RUCLP) demonstrated the most favorable soft-tissue to bone relationship for TAD placement.

Conclusions

Patients with UCLP exhibit site-specific and gender-related variations in palatal HT and ST. The anterior paramedian region on the non-cleft side represents the most favorable location for palatal TAD placement.