MyMedR

Morphological patterns of the palatal rugae: A review

Chong JA, Mohamed AMFS, Pau A

J Oral Biosci, 2020 09;62(3):249-259.

PMID: 32619633 DOI: 10.1016/j.job.2020.06.003

BACKGROUND: Palatal rugae are asymmetric ridges of connective tissue located behind the incisive papilla over the anterior hard palate. They serve as stable superimposition landmarks to assess tooth movement in orthodontics and as identification aids in forensic odontology. However, the stability of palatal rugae remains controversial. This review aimed to describe the genetic, growth, and environmental factors that may influence the palatal rugae patterns. A broad search of PubMed and ScienceDirect databases was conducted. A total of 193 articles were identified, of which 73 met the selection criteria. Data were extracted into a table that presented the details of the study, sample description, and changes in the palatal rugae patterns.

HIGHLIGHT: There were conflicting results regarding sexual dimorphism and population characterization of the palatal rugae patterns. All rugae showed positional changes, increased lengths, and lower numbers, but no significant shape changes with growth. The lengths, numbers, and positions of the rugae were affected by orthodontic treatment, especially their lateral points, but their individual characteristics did not change.

CONCLUSION: The diversity in rugae patterns and their potential for sex discrimination among different populations showed differing results due to individual variations and the complex influence of genetic, growth, and environmental factors on their morphology.

Matched MeSH terms: Palate, Hard*

Torus Mandibularis

Chaubal TV, Bapat R, Poonja K

Am J Med, 2017 10;130(10):e451.

PMID: 28528920 DOI: 10.1016/j.amjmed.2017.04.026

Matched MeSH terms: Palate, Hard/abnormalities*; Palate, Hard/pathology

Ice-cream stick injury resembling torus palatinus

Khajotia R, Kew ST

Ear Nose Throat J, 2013 Sep;92(9):E33.

PMID: 24057915

Matched MeSH terms: Palate, Hard*

Fulltext The technology of tongue and hard palate contact detection: a review

Mat Zin S, Md Rasib SZ, Suhaimi FM, Mariatti M

Biomed Eng Online, 2021 Feb 06;20(1):17.

PMID: 33549118 DOI: 10.1186/s12938-021-00854-y

The tongue and hard palate play an essential role in the production of sound during continuous speech. Appropriate tongue and hard palate contacts will ensure proper sound production. Electropalatography, also known as EPG, is a device that can be used to identify the location of the tongue and hard palate contact. It can also be used by a speech therapist to help patients who have a speech disorder. Among the group with the disease are cleft palate, Down syndrome, glossectomy, and autism patients. Besides identifying the contact location, EPG is a useful medical device that has been continuously developed based on the patient's needs and treatment advancement. This article reviews the technology of electropalatography since the early introduction of the device. It also discusses the development process and the drawbacks of the previous EPG systems, resulting in the EPG's upgraded system and technology. This review suggests additional features that can be useful for the future development of the EPG. The latest technology can be incorporated into the EPG system to provide a more convenient method. There are some elements to be considered in the development of EPG's new technology that were discussed in this study. The elements are essential to provide more convenience for the patient during speech therapy. New technology can accelerate the growth of medical devices, particularly on the development of speech therapy equipment that should be based on the latest technological advancements available. Thus, the advanced EPG system suggested in this article may expand the usage of the EPG and serve as a tool to provide speech therapy treatment services and not limited to monitoring only.

Matched MeSH terms: Palate, Hard/physiology*

Fulltext Angioleiomyoma (Vascular Leiomyoma) of the Oral Cavity

Rawal SY, Rawal YB

Head Neck Pathol, 2018 Mar;12(1):123-126.

PMID: 28589436 DOI: 10.1007/s12105-017-0827-9

A 70-year-old male presented with a slow growing, dome shaped and painless mass of the hard palate. The mass was excised. Histopathological examination confirmed the diagnosis of a angioleiomyoma (vascular leiomyoma). A leiomyoma is an uncommon benign tumor of smooth muscle differentiation. True leiomyomas of the oral cavity are rare and most oral tumors are derived from the smooth muscle of walls of blood vessels. Therefore, they are called vascular leiomyomas or angioleiomyomas. Clinically, they may resemble a myriad other conditions both benign and malignant. A definitive diagnosis depends upon histopathological examination of the biopsied tissue in correlation with the tumor cell immunohistochemistry. Tumors are excised and recurrence is rare. The histopathological findings and differential diagnosis of a case of a palatal angioleiomyoma are discussed.

Matched MeSH terms: Palate, Hard/pathology

Mysterious Case of Drooling Infant - Hidden Foreign Body over Hard Palate

Gan BC

Kathmandu Univ Med J (KUMJ), 2023;21(82):235-237.

PMID: 38628021

Foreign body over the hard palate is a rare clinical entity that happen almost exclusively in young pediatric age group with only about 40 odd cases ever reported. Most cases in the literature are described as incidental findings of hard palate mass causing heightened anxiety to parents and clinicians alike during routine oral cavity examination. Owing to its rarity and lackluster presenting symptoms, this simple condition are often overlooked but has high propensity to develop into life threatening condition if dislodged into the airway.

Matched MeSH terms: Palate, Hard

Modified palatal flap--a simpler approach for removal of palatal tori

Chacko JP, Joseph C

J Oral Maxillofac Surg, 2010 Apr;68(4):943-4.

PMID: 20307780 DOI: 10.1016/j.joms.2009.04.009

Matched MeSH terms: Palate, Hard/surgery*

Fulltext The incidence of tori in Malaysians- a retrospective analysis

Shareif Alan, Mohammed Subhi

International Medical Journal Malaysia, 2017;16(21):15-15.

MyJurnal

The aim of this study was to determine the incidence of torus palatinus and torus
mandibularis in Malaysians. The objectives are to evaluate the incidence of tori according to
ethnicity, to assess the incidence of tori according to gender and to determine the incidence of
torus palatinus vs torus mandibularis. (Copied from article).

Matched MeSH terms: Palate, Hard

The Impact of Facial Growth in Unilateral Cleft Lip and Palate Treated With 2 Different Protocols

Wong LS, Lu TC, Hang DTD, Chen PK

Ann Plast Surg, 2020 05;84(5):541-544.

PMID: 32091442 DOI: 10.1097/SAP.0000000000002232

BACKGROUND AND AIM: It is well known that palatoplasty can often cause disturbances in maxillary growth. The use of a single-layer vomer flap for the early closure of the hard palate is controversy among surgeons. The aim of this study is to compare the 10-year facial growth of 2 surgical protocols in the treatment of patients with unilateral cleft lip and palate performed by a single surgeon.

METHODS: This retrospective analysis includes 43 nonsyndromic patients with complete unilateral cleft lip with or without a vomer flap for the closure of the hard palate during cleft-lip repair. Lateral cephalograms were obtained at the age of 5, 7, and 9 years old, and angular measurements were used to assess patient's facial growth. The Mann-Whitney U test was used to compare 2 treatment protocol groups.

RESULT: A total of 23 patients in protocol 1 group (16 male, 7 female) and 20 patients in protocol 2 group (10 male, 10 female) were included. At the age of 5 and 7, there was no significant difference of maxillary and mandibular growth in both groups. At the age of 9 years, all the angular measurement revealed statistical significance with SNA (P = 0.02), SNB (P = 0.05), ANB (P < 0.01), and SNPg (P = 0.05).

CONCLUSIONS: The present study has shown that early anterior palate repair for 3-month-old cleft patients have better maxillary growth and less mandibular prognathism.

Matched MeSH terms: Palate, Hard

Fulltext Is it as dangerous as it looks?

Che Ibrahim NH, Md Shukri N

Malays Fam Physician, 2017;12(1):35-36.

PMID: 28503274 MyJurnal

A common bony protrusion that occurs over the hard palate is sometimes mistaken for a malignancy especially when it is large. This bony growth is a torus palatinus (TP), which is a benign bony prominence over the hard palate. It occurs most commonly in bilateral multiple form, and is often located at the canine to premolar area. A basic knowledge of the assessment and management of TP is important, particularly for the first-line family physician to ensure that the correct information is given to the patient.

Matched MeSH terms: Palate, Hard

Fulltext Neurothekeoma palpebrae in association with multiple superficial angiomyxomas: Tegumental Angiomyxoma-Neurothekeoma syndrome (TAN syndrome)

Kah TA, Yong KC, Annuar FH

Clin Pract, 2011 Jul 01;1(3):e67.

PMID: 24765328 DOI: 10.4081/cp.2011.e67

We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left upper limb, chest, right axilla, hard palate) and epidermal cyst (chin). The histopathological specimens were negative to S-100 protein antibody. Systemic review and family history was unremarkable. Excision biopsy and upper lid reconstruction were performed. Intraoperatively the tumor was multilobulated, firm, well encapsulated and did not invade the underlying tarsal plate. Histopathological features of the upperlid tumor were consistent with nerves sheath myxoma (neurothekeoma). To the best of the authors' knowledge, this is the first reported case of neurothekeoma in association with multiple superficial angiomyxoma.

Matched MeSH terms: Palate, Hard

The Heritability of Palatal Rugae Morphology Among Siblings*, †

Chong JA, Syed Mohamed AMF, Marizan Nor M, Pau A

J Forensic Sci, 2020 Nov;65(6):2000-2007.

PMID: 32692413 DOI: 10.1111/1556-4029.14507

Although there is clinical applicability of the palatal rugae as an identification tool in forensic odontology, controversy exists whether the palatal rugae patterns are stable or variable. The greater the genetic component, the higher the probability that palatal rugae patterns are stable. The aim of this study was to compare the palatal rugae morphology between full siblings and the proportion of variability due to genetic component. This cross-sectional study was conducted on digital models of 162 siblings aged 15-30 years old. The palatal rugae patterns were assessed with Thomas and Kotze (1983) classification using Geomagic Studio software (3D Systems, Rock Hill, SC). The palatal rugae morphology between siblings showed significantly similar characteristics for total number of left rugae (p = 0.001), left primary rugae (p = 0.017), secondary rugae for right (p = 0.024) and left sides (p = 0.001), right straight rugae (p = 0.010), and right convergent rugae (p = 0.005) accounting for at least 6.25%-12.8% of the variability due to heredity. Despite the similarities found, the palatal rugae patterns showed significant differences between siblings of at least 46.9% (p = 0.001). Zero heritability was found in 9 of the 14 rugae patterns. Meanwhile, total number of rugae, primary, backward, and convergent rugae showed moderate heritability (h2 > 0.3) and total number of secondary rugae showed high heritability (h2 > 0.6). In conclusion, despite the individuality characteristics, an appreciable hereditary component is observed with significant similarities found between sibling pairs and the palatal rugae patterns were both environmentally and genetically influenced.

Matched MeSH terms: Palate, Hard/anatomy & histology*

Fulltext Primary tuberculosis of palate

Chen I, Jamal S, Pua KC

Malays Fam Physician, 2015;10(3):32-4.

PMID: 27570606 MyJurnal

Primary tuberculosis (TB) of the hard palate is very rare. A 74-year-old man was presented with 6-month history of dysphagia along with an irregular mass in the hard and soft palate. Magnetic resonance imaging (MRI) revealed thickened and increased signal intensity within hard and soft palate. Tissue biopsy showed focal caseating granulomatous-like lesion and the histochemical staining using Ziehl-Neelsen stain for acid-fast bacilli was positive. Positive histochemical studies provided evidences that the hard palate mass was most likely due to TB. Thus, the patient was started on antituberculous therapy.

Matched MeSH terms: Palate, Hard

Fulltext Hole on the palate, saliva in the nose: what is your diagnosis?

Irfan Mohamad, Shamina Sara Moses, Rose linda Abdul Rahman

Archives of Orofacial Sciences, 2013;8(1):44-45.

MyJurnal

A 69-year-old lady was diagnosed to have mucoepidermoid carcinoma of hard palate 3 years ago. She completed 20 cycles of external beam radiotherapy and 5 cycles of mould brachytherapy and remained asymptomatic until she again presented to us with the recurrence of a painless mass at the hard palate. The hard mass appeared as an ulcerated dimple measuring 2 x 1 cm located at the junction of the hard and soft palate, more towards the right. Excision biopsy of the mass was done with a 1cm circumferential margin deep to the periosteum, with the resulting exposed bony defect covered with a rotational flap from the soft palate. During follow-up, the patient complained that the saliva came up into the nose whenever she swallowed. Oral examination (Figure 1) and flexible nasopharyngolaryngoscopy (FNPLS) (Figure 2) were performed. What is your diagnosis?

Matched MeSH terms: Palate, Hard

Fulltext Evaluation of Mandibular Incisive Canal using Cone Beam Computed Tomography in Malaysians

Lim JTS, Kang WJ, Ajit Bapat R, Kanneppady SK, Pandurangappa R

J Maxillofac Oral Surg, 2019 Dec;18(4):596-603.

PMID: 31624443 DOI: 10.1007/s12663-018-1168-2

Objectives: The risk of damaging the mandibular incisive canal (MIC) during surgery in the anterior mandible should not be overlooked. Hence, preoperative radiographic assessment is essential to avoid complications. This study was aimed to estimate the length of the MIC in the interforaminal safe zone, to analyse its course in relation to the lingual and the buccal cortical plates of the mandible using cone beam computed tomography (CBCT) scans and to relate the above findings to age, gender, dental status and Malaysian races.

Methods: Retrospective analysis of 100 CBCT scans (n = 200) was performed on both sides of the mandible. Cross-sectional and panoramic images were reconstructed. The length of the MIC and the horizontal distances between the MIC and the buccal and the lingual cortical plates were measured at the three different points (starting, mid-, end points). Independent samples t-test and one-way ANOVA test were used to analyse the variation in the length and course of the MIC in gender, age, dental status and Malaysian races.

Results: The mean length of the MIC was 11.31 ± 2.65 mm, with the Malays having the longest MIC, followed by the Chinese and the Indians (p

Matched MeSH terms: Palate, Hard

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