Individual scoring and mapping of hard and soft tissues of the anterior hard palate for orthodontic miniscrew insertion.

AIM: The aim of the present study was to introduce a scoring system to select optimal sites to insert a miniscrew in a hard palate. METHODS: The present study consisted of 37 adult patients (21 females and 16 males) aged between 20 and 50 years, with a mean age of 34.81 (+/-9.52) years. Hard and soft tissues of the anterior hard palate were assessed using cone-beam computed tomography. The scoring system was as follows: mucosal thickness: 0-2 mm (2 points), 2-4 mm (1 point), and 4-6 mm (0 points); total bone vertical height: >/=5 mm (1 point) and <5 mm (0 points); and palatal cortical thickness: >/=1 mm (1 point) and <1 mm (0 points). RESULTS: Significant variability was found between the individuals. Total vertical bone height decreased posteriorly and laterally. Mucosal thickness decreased posteriorly, but increased laterally. Palatal cortical thicknesses were higher than the nasal cortical thicknesses. The most balanced sites (highest point) were the midpalatal suture, followed by paramedian points located 3 mm lateral to the midline and 4 mm posterior to the incisive canal. CONCLUSIONS: Considering that both hard and soft tissue parameters are crucial to obtain the best possible success rates, careful investigation is recommended prior to clinical decisions being made.