Three-dimensional Digital Analysis as a Minimally Invasive Diagnostic Tool for Palatal Mucosal Harvest: Cross-sectional Analysis

Aim: To evaluate the accuracy of assessment of palatal mucosal thickness (PMT) and determination of anatomical location of greater palatine foramen (GPF) using a minimally invasive superimposed digital technique (SDT). Materials and Methods: This cross-sectional observational single-blinded study included 32 periodontally healthy participants in the age range of 20–50 years. A single calibrated examiner performed all the measurements. PMT was evaluated at 3.8 and 13 mm from the palatal mucosal margin of 5 teeth, that is, canine (C), 2 premolars (P1, P2) and 2 molars (M1, M2) in each participant. The PMT was determined by ‘bone sounding’ using endodontic files and digital vernier calliper in direct technique (DT) and superimposition of Digital Imaging and Communications in Medicine (DICOM) and Stereolithography (STL) files in SDT. Anatomical position of GPF relative to maxillary molars was assessed using SDT. Results: PMT varied by tooth region, with the least thickness at the canine region and highest at the first molar region. The agreement between DT and SDT was excellent, with high intraclass correlation coefficients (ICC) (0.876–0.934) and consistent results in the Bland-Altman plot. The location of the GPF was most commonly found in the third molar region. Conclusion: The safety zone determined by using SDT could be a potential, minimally invasive alternative for assessment of PMT and anatomical position of GPF relative to maxillary molars prior to periodontal plastic surgery, which may be beneficial in the success of surgical procedures.