89 Determination of intra-oral surface areas DISCUSSION Using CBCT and digital analysis, it was possible to determine the intra-oral surface area. The good and excellent ICCs for the various intra-oral surface areas indicated that this technique is reliable. After the analysis of 20 available cadaver heads, it was found that the average total intra-oral surface was 173 ± 19 cm2. In addition, moderate significant correlations between the length of the head and the palatal surface area and between the depth of the head and tongue surface area were observed. The current study is not the first study to investigate the relationship between extra-oral and intra-oral measurements. Inoue and co-workers found significant correlations between the body profile (especially weight and Body Mass Index) and the salivary gland size [16]. This indicates the possibility to estimate the size of the oral structures by determining extra-oral measurements. In contrast to our study, they found a stronger correlation. A possible reason for this fact could be that they included more subjects (50 young adults vs. 20 cadavers). Another possibility is that some of the cadaver heads included in the current study were incomplete. As a consequence of missing part of the skull (N = 8 cadavers), the ICC of the length of the head was moderate. So, the number of included cadavers and the incompleteness of the cadaver heads could have influenced the strength of the correlation between anthropometric measurements and the intra-oral surface area. The mucosal surface area was found to be 152 ± 16 cm2. In comparison, the mucosal surface area found by Naumova and co-workers, who included cadavers of elderly individuals (age 65–75 years), was 197 ± 24 cm2 [23]. A possible explanation for this difference might be that, in contrast to our method, Naumova and co-workers used the aluminium foil technique where the outlines of the foils were digitized into AutoCAD [23]. Additionally, they used a profilometer to investigate the dorsal side of the tongue, which measures the tongue surface at high resolution on microscopic level [23]. The dorsal surface of the tongue is covered with lingual papillae which give the tongue an irregular surface texture. As a consequence, the use of this technique may have led to the determination of apparent larger surface areas than those found in the present study using CBCT. Other investigators also used the foil technique to determine the surface area in different regions of the mouth including the teeth. Two studies determining the oral surface areas in infants found that the average total surface area ranged between 118 ± 8 and 143 ± 15 cm2, which obviously is smaller than the surface area in the cadavers of the elderly subjects in the 4
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