Three‐Dimensional CBCT Assessment of Potential Orthodontic Mini‐Implant Sites in the Pterygomaxillary Region and Pyramidal Process

ABSTRACT Objective This study aimed to evaluate the anatomical dimensions and voxel intensity values of the pterygomaxillary and pyramidal regions using cone‐beam computed tomography (CBCT) and to assess their suitability as alternative insertion sites for orthodontic mini‐implants. Methods This study analysed CBCT scans of 50 patients. The width and height of the pterygomaxillary suture and the pyramidal process were measured in axial and coronal sections. Virtual placement of mini‐implants was performed in both regions using dedicated software while maintaining at least a 1 mm safety distance from vital structures. Mini‐implant length, angulation relative to the occlusal and palatal planes, and voxel intensity values around the mini‐implants were recorded. Results The width of the pterygomaxillary suture was significantly greater in males ( p < 0.001), whereas pyramidal region dimensions showed no significant gender differences. Virtual placement demonstrated that all 2 mm diameter mini‐implants were completely surrounded by bone in both regions. Conclusions The pterygomaxillary and pyramidal regions present sufficient bone dimensions and density for orthodontic mini‐implant placement. These areas may serve as safe and biomechanically favorable alternative anchorage sites, particularly for maxillary molar or total arch distalization.