79 Determination of intra-oral surface areas INTRODUCTION Knowledge of the integrity and anatomy of the intra-oral surface areas, including the oral mucosa, contributes to a better understanding of the physiology of the mouth and the oral health [23]. In addition, knowledge of the intra-oral anatomy and surface areas is important for therapeutic purposes [23], for example in orthodontic treatment and maxillofacial surgery. Under healthy conditions, the intra-oral surfaces are covered by a salivary film, which moistens the oral cavity [3, 24]. In this light, the size of the intra-oral surface area has previously been measured to determine the distribution and average thickness of the salivary film covering the teeth and oral mucosa [8, 19, 29]. For this reason, dental impressions were made of all structures (including hard and soft tissue) inside the oral cavity. Then, from these impressions, stone models were produced and covered with aluminium foil. Subsequently, this foil was weighed, and surface areas were deduced [8, 19, 29]. This foil technique has been proven to be reproducible [8, 19, 29]. However, the adaptation of the foil onto the models without stretching appeared to be technically challenging, as stretching would possibly lead to thinning of the foil and subsequent underestimation of the surface [8]. Another reported challenge was the difficulty to manually extend the foil completely into all interdental spaces, the labial and buccal vestibular mucosa. Aiming to provide an alternative method, we performed a study to quantify the intra-oral surface areas using cone-beam computed tomography (CBCT) in combination with digital analysis. This method was inspired by previous studies, in which CBCT was used for soft tissue analysis including determination of the void volume of the oral cavity [5, 11, 18, 28]. CBCT involves the use of ionizing radiation, rendering this approach unsuitable for routine medical care. This led to the concept to investigate correlations between facial anthropomorphic measurements and intra-oral surface areas. It was, therefore, hypothesized that a relation between anthropomorphic measurements and intra-oral surfaces would potentially enable easy approximation of the intra-oral surface area in a chair-side medical setting, without exposure to radiation. For ethical reasons, we explored this hypothesis on cadavers. 4
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