Comparative quantitative analysis of palatal masticatory mucosal thickness between Han and Uygur in Xinjiang area

doi:10.19439/j.sjos.2025.03.017

Abstract

Abstract: PURPOSE: To measure and compare the palatal masticatory mucosal thickness from maxillary canine to the second molar region of Han and Uygur periodontally healthy people in Xinjiang area by using CBCT, and to analyze the related factors. METHODS: CBCT images of 48 periodontally healthy subjects in each nationality were selected from the Dental Clinic of the First Affiliated Hospital of Xinjiang Medical University according to the inclusion and exclusion criteria. The thickness of the palatal masticatory mucosa, the height and width of the palatine fornices, and the location of the greater palatine foramen were measured at the distance of 3, 6, 9 and 12 mm from the gingival margin. RESULTS: There were significant differences in the average palatal mucosal thickness at the distance of 3, 6, 9 and 12 mm from the gingival margin, different anatomical shapes of the palatine fornices and different age groups between Han and Uygur(P<0.05). There was no significant difference in the distribution of the greater palatine foramen between Han and Uygur(P>0.05). However, the correlation between mucosal thickness and related factors in Han population was closer. The general trend was similar between the two groups: ①from 3mm to 12mm from the gingival margin, the mucosal thickness first increased and then decreased from the canine to the second premolar, decreased first and then increased from the first molar, and continued to increase from the second molar; ②the mucosal thickness of canine, first premolar and first molar was affected by age and the anatomical morphology of palatine fornix. The mucosal thickness of second premolar was affected by age, and the mucosal thickness of second molar was affected by the anatomical morphology of palatine fornix; ③the greater palatal foramen was mostly located in the distal region of the second molar, and the distance from the greater palatal foramen to the midpalatal suture was smaller in the HFT group than in the LFT group(P<0.05). CONCLUSIONS: The most suitable donor site for autologous connective tissue transplantation in both nationalities is the palatal masticatory mucosa when the distance between the gingival margin of the maxillary first and second premolars is 3-9 mm.

Key words: CBCT, Palatal masticatory mucosa, Mucosal thickness, Autologous soft tissue graft

CLC Number:

R781

Yipalamu·Tulajiang, Ma Ting, Maimaiti·Yasen. Comparative quantitative analysis of palatal masticatory mucosal thickness between Han and Uygur in Xinjiang area[J]. Shanghai Journal of Stomatology, 2025, 34(3): 318-325.

References

[1] Stefanini M, Rendon A, Zucchelli G.Porcine-derived acellular dermal matrix for buccal soft tissue augmentation at single implant sites: a 1-year follow-up case series[J]. Int J Periodontics Restorative Dent, 2020, 40(1): 121-128.
[2] Tavelli L, Barootchi S, Di Gianfilippo R, et al.Acellular dermal matrix and coronally advanced flap or tunnel technique in the treatment of multiple adjacent gingival recessions. a 12-year follow-up from a randomized clinical trial[J]. J Clin Periodontol, 2019, 46(9): 937-948.
[3] Hu S, Kirsner RS, Falanga V, et al.Evaluation of Apligraf persistence and basement membrane restoration in donor site wounds: a pilot study[J]. Wound Repair Regen, 2006,14(4): 427-433.
[4] Ragazzo M, Val M, Montagner G, et al.Human amniotic membrane: an improvement in the treatment of medication-related osteonecrosis of the jaw (MRONJ)? a case-control study[J]. Cell Tissue Bank, 2022, 23(1): 129-141.
[5] Tatarakis N, Gkranias N, Darbar U, et al.Blood flow changes using a 3D xenogeneic collagen matrix or a subepithelial connective tissue graft for root coverage procedures: a pilot study[J]. Clin Oral Investig, 2018, 22(4): 1697-1705.
[6] Barootchi S, Tavelli L, Di Gianfilippo R, et al.Soft tissue phenotype modification predicts gingival margin long-term (10-year) stability: longitudinal analysis of six randomized clinical trials[J]. J Clin Periodontol, 2022, 49(7): 672-683.
[7] Thoma DS, Gasser TJW, Hämmerle CHF, et al.Soft tissue augmentation with a volume-stable collagen matrix or an autogenous connective tissue graft at implant sites: 5-year results of a randomized controlled trial post implant loading[J]. J Periodontol, 2023, 94(2): 230-243.
[8] 德吉, 杨刚, 胡文杰, 等. 自体软组织替代材料在天然牙牙龈增量中的应用和研究进展[J]. 中华口腔医学杂志, 2023, 58(4): 367-373.
[9] Chambrone L, Tatakis DN.Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop[J]. J Periodontol, 2015, 86(2 Suppl): S8-S51.
[10] Harris RJ.Histologic evaluation of connective tissue grafts in humans[J]. Int J Periodontics Restorative Dent, 2003, 23(6): 575-583.
[11] García-Caballero L, Gándara M, Cepeda-Emiliani A, et al.Histological and histomorphometric study of human palatal mucosa: implications for connective tissue graft harvesting[J]. J Clin Periodontol, 2023, 50(6): 784-795.
[12] Larjava H, Wiebe C, Gallant-Behm C, et al.Exploring scarless healing of oral soft tissues[J]. J Can Dent Assoc, 2011, 77: b18.
[13] Asparuhova MB, Song X, Riedwyl D, et al.Differential molecular profiles and associated functionalities characterize connective tissue grafts obtained at different locations and depths in the human palate[J]. Int J Oral Sci, 2023,15(1): 57-73.
[14] Waasdorp M, Krom BP, Bikker FJ, et al.The bigger picture: why oral mucosa heals better than skin[J]. Biomolecules, 2021, 11(8): 1165.
[15] Kim DW, Tempski J, Surma J, et al.Anatomy of the greater palatine foramen and canal and their clinical significance in relation to the greater palatine artery: a systematic review and meta-analysis[J]. Surg Radiol Anat, 2023, 45(2): 101-119.
[16] Yaman D, Aksu S, Disci R, et al.Thickness of palatal masticatory mucosa and its relationship with different parameters in Turkish subjects[J]. Int J Med Sci, 2014, 11(10): 1009-1014.
[17] Zuhr O, B?umer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution[J]. J Clin Periodontol, 2014, 41(Suppl 15): S123-S142.
[18] Barriviera M, Duarte WR, Januário AL, et al.A new method to assess and measure palatal masticatory mucosa by cone-beam computerized tomography[J]. J Clin Periodontol, 2009, 36(7): 564-568.
[19] 刘玲玲, 刘树泰.上颌腭侧软组织厚度的测量方法及影响因素[J].国际口腔医学杂志, 2019, 46(2): 234-237.
[20] Said KN, Abu Khalid AS, Farook FF.Anatomic factors influencing dimensions of soft tissue graft from the hard palate. a clinical study[J]. Clin Exp Dent Res, 2020, 6(4): 462-469.
[21] Müller HP, Schaller N, Eger T, et al.Thickness of masticatory mucosa[J]. J Clin Periodontol, 2000, 27(6): 431-436.
[22] Hilgenfeld T, Kästel T, Heil A, et al.High-resolution dental magnetic resonance imaging for planning palatal graft surgery-a clinical pilot study[J]. J Clin Periodontol, 2018, 45(4): 462-470.
[23] 师苏萌, 施生根, 白忠诚, 等. CBCT测量上颌中切牙区软组织厚度的1例重复性研究[J].中华老年口腔医学杂志, 2013, 11(6): 348-351.
[24] Kuriakose A, Raju S.Assessment of thickness of palatal mucosal donor site and its association with age and gender[J]. J Indian Soc Periodontol, 2012, 16(3): 370-374.
[25] 程筱番, 朱洁, 胡小娅, 等. 汉族青年人上颌腭侧咀嚼黏膜厚度的CBCT研究[J].口腔医学, 2020, 40(10): 910-915.
[26] Yilmaz HG, Boke F, Ayali A.Cone-beam computed tomography evaluation of the soft tissue thickness and greater palatine foramen location in the palate[J]. J Clin Periodontol, 2015, 42(5): 458-461.
[27] 张建忠, 陈志方, 刘堃, 等. 上颌前牙区腭侧黏膜厚度的CBCT分析[J].齐齐哈尔医学院学报, 2020, 41(11): 1349-1353.
[28] Reiser GM, Bruno JF, Mahan PE, et al.The subepithelial connective tissue graft palatal donor site: anatomic considerations for surgeons[J]. Int J Periodontics Restorative Dent, 1996, 16(2): 130-137.
[29] Ueno D, Sekiguchi R, Morita M, et al.Palatal mucosal measurements in a Japanese population using cone-beam computed tomography[J]. J Esthet Restor Dent, 2014, 26(1): 48-58.
[30] 沈晨露, 高碧聪, 吕柯佳, 等. 浙江地区人群上颌腭侧咀嚼黏膜厚度与腭穹隆解剖形态的量化分析[J]. 浙江大学学报(医学版), 2022, 51(1): 87-94.
[31] Heil A, Schwindling FS, Jelinek C, et al.Determination of the palatal masticatory mucosa thickness by dental MRI: a prospective study analysing age and gender effects[J]. Dentomaxillofac Radiol, 2018, 47(2): 20170282.
[32] Ogawa M, Katagiri S, Koyanagi T, et al.Accuracy of cone beam computed tomography in evaluation of palatal mucosa thickness[J]. J Clin Periodontol, 2020, 47(4): 479-488.
[33] 吴洁林. 锥形束CT测量汉族20-69岁成人硬腭黏膜厚度的临床研究[D].太原: 山西医科大学, 2020.
[34] Kolliyavar B, Setty S, Thakur SL.Determination of thickness of palatal mucosa[J]. J Indian Soc Periodontol, 2012, 16(1): 80-83.
[35] Wara-aswapati N, Pitiphat W, Chandrapho N, et al. Thickness of palatal masticatory mucosa associated with age[J]. J Periodontol, 2001, 72(10): 1407-1412.
[36] 薛绯, 段晋瑜, 张瑞. 汉族人群腭大孔解剖位置及其与腭穹隆形态关系的CBCT研究[J]. 实用口腔医学杂志, 2018, 34(3): 364-367.
[37] Tomaszewska IM, Tomaszewski KA, Kmiotek EK, et al.Anatomical landmarks for the localization of the greater palatine foramen-a study of 1 200 head CTs,150 dry skulls, systematic review of literature and meta-analysis[J]. J Anat, 2014, 225(4): 419-435.
[38] Cagimni P, Govsa F, Ozar MA, et al.Computerized analysis of the greater palatine foramen to gain the palatine neurovascular bundle during palatal surgery[J]. Surg Radiol Anat, 2017, 39(2): 177-184.
[39] 杨佳文, 普启宏, 肖剑峰, 等. 成人腭大孔解剖与腭穹隆形态相关性的CBCT影像研究[J]. 昆明医科大学学报, 2022, 43(11): 71-76.