Studer S P, Allen E P, Rees T C, Kouba A
Department of Fixed and Removable Prosthodontics and Dental Materials, School of Dental Medicine, Zurich University, Switzerland.
J Periodontol. 1997 Feb;68(2):145-51. doi: 10.1902/jop.1997.68.2.145.
The aim of the present investigation was to clinically determine the thickness of masticatory mucosa in the hard palate and tuberosity as potential donor sites for ridge augmentation procedures. In 31 periodontally healthy, fully dentate subjects the masticatory mucosa thickness was assessed by bone sounding with a periodontal probe. Eighteen standard measurement points were defined in the hard palate, located on 3 lines which ran at different distances parallel to the gingival margin. Six positions were designated on each of these 3 lines between the level of the canine and the second molar. In the tuberosity, 6 standard measurement points were defined, located on 2 lines running parallel to the gingival margin at 2 different distances from the distal aspect of the second molar. Three positions were designated on each line. The hard palate and tuberosity were anesthetized by a spray followed by carticain injection with an epinephrine vasoconstrictor of 1:100,000. Data were analyzed to determine differences in gender, between different positions, and between lines, using an analysis of variance and Wilcoxon test. The mucosa of the tuberosity was significantly thicker than in the hard palate region. Gender did not influence the thickness of masticatory mucosa, either in the hard palate or the tuberosity with the exception of the most distant line in the palate. The mucosa was thickest at the mid-distal position of the tuberosity. In the hard palate, mucosa thickness increased with greater distances from the marginal gingiva. The mucosa over the palatal root of the maxillary first molar was significantly thinner than at all other positions in the hard palate. This represents an anatomical barrier in graft harvesting. It was concluded that two different regions may be defined for soft tissue graft harvesting from an anatomic point of view: 1) In the canine-premolar region rather wide and shallow grafts may be harvested. This region extends distally to the first palatal molar root with a significantly thinner mucosa. 2) The tuberosity revealed a significantly more soft tissue thickness in comparison to the hard palate. This region allows the harvesting of deeper grafts, but graft size is limited by the width of keratinized tissue.
本研究的目的是临床确定硬腭和结节处咀嚼黏膜的厚度，作为牙槽嵴增高术的潜在供区。在31名牙周健康、牙齿完整的受试者中，使用牙周探针通过骨探测法评估咀嚼黏膜的厚度。在硬腭上定义了18个标准测量点，位于与牙龈缘平行的3条不同距离的线上。在犬牙和第二磨牙水平之间的这3条线上，每条线指定6个位置。在结节处，定义了6个标准测量点，位于与牙龈缘平行的2条线上，距第二磨牙远中面有2个不同距离。每条线上指定3个位置。硬腭和结节处先用喷雾麻醉，然后注射含1:100,000肾上腺素血管收缩剂的卡替卡因。使用方差分析和威尔科克森检验分析数据，以确定性别、不同位置和不同线之间的差异。结节处的黏膜明显比硬腭区域厚。性别对咀嚼黏膜的厚度没有影响，硬腭或结节处均如此，但硬腭最远端的线除外。黏膜在结节的中远端位置最厚。在硬腭中，黏膜厚度随着距边缘龈距离的增加而增加。上颌第一磨牙腭根上方的黏膜明显比硬腭的所有其他位置薄。这是移植取材中的一个解剖学屏障。得出的结论是，从解剖学角度来看，可定义两个不同的软组织移植取材区域：1）在尖牙-前磨牙区域，可以获取较宽且较浅的移植物。该区域向远中延伸至第一腭磨牙牙根，此处黏膜明显较薄。2）与硬腭相比，结节处显示出明显更厚的软组织。该区域可以获取更深的移植物，但移植物大小受角化组织宽度的限制。
