Palatal bone thickness in adult patients with different facial patterns: A retrospective cross-sectional CBCT study for orthodontic miniscrew planning

Introduction

Effective orthodontic anchorage control plays a crucial role in achieving successful treatment outcomes, particularly in cases involving significant tooth movements. Temporary anchorage devices (TADs) placed in the midpalatal region have become widely used due to their ability to provide absolute skeletal anchorage without depending on patient compliance. However, anatomical variables such as palatal bone thickness and possible variations according to facial pattern are essential considerations during treatment planning.

Objective

To evaluate and compare palatal bone thickness in adult patients with different facial patterns, using cone-beam computed tomography (CBCT), with the aim of identifying possible anatomical differences that may influence TAD placement.

Material and methods

This retrospective, cross-sectional, observational study analyzed 90 CBCT scans obtained between 2022 and 2025 from patients aged 18 to 45 years. The sample was evenly divided into three groups according to facial pattern (30 mesofacial, 30 brachyfacial, and 30 dolichofacial), with equal distribution between sexes and comparable ages. Linear measurements of palatal bone thickness were performed at multiple anteroposterior and lateral reference points using the 3D Slicer 5.8.1 software. Intergroup comparison was performed with Kruskal-Wallis test.

Results

A progressive decrease in palatal bone thickness was observed from anterior to posterior regions across all facial types. No statistically significant differences were found between the groups at any measured location (P > 0.05).

Conclusion

The results suggest that facial pattern does not significantly influence palatal bone thickness in the evaluated regions. Therefore, clinical decisions regarding TAD placement should prioritize individual anatomical characteristics over facial patterns.