COMPARISON OF PALATAL BONE HEIGHT IN DIFFERENT FACIAL MORPHOLOGICAL PATTERNS BY CONE BEAM COMPUTED TOMOGRAPHY – A PROSPECTIVE STUDY

Abstract

Background:
Orthodontic mini-implants require adequate palatal bone support to achieve primary stability and successful
skeletal anchorage. Variations in palatal bone height associated with different vertical facial growth patterns may
influence the selection of safe and optimal insertion sites. CBCT provides a reliable three-dimensional assessment
of palatal bone morphology and can aid in treatment planning.
Objective:
To evaluate the relationship between facial growth pattern and palatal bone height using CBCT and to identify
regions of adequate bone availability for orthodontic mini-implant placement.
Materials and Methods:
A prospective CBCT-based study was conducted on 90 subjects (45 males and 45 females) aged 18–30 years.
Participants were equally divided into three groups according to facial growth pattern: average (n=30), horizontal
(n=30), and vertical (n=30). Palatal bone height was measured at standardized locations 3, 6, and 9 mm lateral to
the midpalatal suture and at 4-mm intervals posteriorly from the distal margin of the incisive foramen. A total of
18 measurement points were evaluated using Carestream CS 9600 CBCT software. Statistical analysis was
performed using SPSS version 26.0. Comparisons among groups were made using one-way ANOVA with post
hoc testing, while gender and side-wise comparisons were analyzed using independent and paired t-tests,
respectively. Statistical significance was set at p < 0.05.
Results:
No significant difference was observed between right and left palatal bone height measurements (p > 0.05). Males
demonstrated significantly greater composite palatal bone height than females overall (6.89 ± 2.33 mm vs. 6.15
± 2.21 mm; p = 0.031). Mean composite palatal bone height differed significantly among facial growth patterns,
with the highest values observed in the horizontal group (7.31 ± 2.14 mm), followed by the vertical group (6.58
± 2.01 mm) and the average group (5.66 ± 1.84 mm) (p = 0.011). Post hoc analysis revealed significant differences
between average and vertical groups (p = 0.041) and between average and horizontal groups (p = 0.004). At most
measurement sites, palatal bone height was greatest in the horizontal growth pattern and progressively decreased
in posterior regions. Bone height increased significantly with lateral movement from 3 mm to 9 mm from the
midpalatal suture in anterior and middle palatal regions (p < 0.05), while posterior regions demonstrated lower
values and less variation.
Conclusion:
Palatal bone height is significantly influenced by facial growth pattern, with horizontal growers exhibiting the
greatest bone availability and average growers the least. The anterior and paramedian regions of the palate provide
the most favorable bone support for orthodontic mini-implant placement. CBCT-based individualized assessment
is recommended for accurate identification of safe insertion sites and optimal screw length selection in skeletal
anchorage procedures.