The anatomic basis for palatal implants in orthodontics.

Orthodontic anchorage without negative reciprocal influences on tooth position can be achieved by the use of immobile implants. An existing dentition permits placement of endosseous implants in only a few regions. These are the edentulous parts of the ridge due to previous extractions, the ascending ramus of the mandible, and the os palatinum. A precondition for successful implant osseointegration is a satisfactory bone base. The midline of the os palatinum is of particular anatomic interest due to the increasing use of anchorage implants in this area. Even though most implants are incorporated uneventfully, in some cases, the osseointegration of these implants fails. Therefore, anatomic data characterizing the palatal midline region are of clinical importance. In this study, trephine bur biopsies provided the material for histologic facings. The donor age covered a span from 12 to 53 years and illustrated that complete ossification of the suture palatina mediana (SPM) is rare before the age of 23 years. Therefore, especially in adult orthodontic treatment, the use of palatal implants should be considered. The anterior SPM is less often ossified than the posterior region. Implant placement should take this into account and consider that a bone bed more favorable to osseointegration might be found posterior to the interconnecting line of the first premolars.