97 Correlations of palatal surface area with anthropometric dimensions INTRODUCTION Human saliva is predominantly produced by three pairs of major glands known as the parotid, submandibular, and sublingual glands. These glands are responsible for the production of 90% of the volume of saliva [8]. Each of the glands excretes saliva with a unique consistency into the oral cavity via various salivary ducts [14]. The opening of these salivary ducts is located in various intra-oral locations, such as the buccal mucosa for the parotid glands and the floor of the mouth for the sublingual, and submandibular glands [14]. After secretion, saliva is distributed over the various intra-oral surfaces, especially during chewing and swallowing [16, 29]. Several studies have explored the thickness of the salivary film covering the teeth and oral mucosa at various intra-oral locations [6, 15, 28]. The salivary film thickness at the anterior part of the palate seems to be relatively thin compared to other intraoral surfaces [4, 5, 10, 18, 22, 23, 25, 29, 30]. In addition, in patients suffering from hyposalivation, a lower salivary film thickness at the anterior palate than in healthy controls was observed [4, 5, 10, 18, 22, 23, 25, 29, 30]. Next to e.g. the salivary volume, the size of the surface area of the intra-oral regions relates to the salivary film thickness. To investigate the surface area of the oral cavity, previous studies used the so-called foil technique; stone models of dental impressions were prepared and covered with aluminium foil. Subsequently, this foil was weighed to deduce the surface area [6, 15, 28]. Despite the fact that this foil technique has been proven to be reproducible [6, 15, 28], some drawbacks were noted as well; adaptation of the foil onto the models without stretching appeared challenging. Besides, it was difficult to fold the foil completely into interdental spaces, and around the labial and buccal vestibular mucosa [6]. Therefore, in a recent study, an alternative strategy was explored using cone-beam computed tomography (CBCT) in combination with digital analysis [3]. Though, in contrast to the studies which used the foil technique, the CBCT analysis was performed on cadavers [3]. It was found that CBCT analysis had good reliability for measuring various intra-oral surface areas such as the palate, tongue, mucosa, and hard tissues. The studies using the foil technique and the CBCT analysis showed almost identical results for the palatal surface area (20.1±1.9 vs. 20.0±2.9 cm2) [3, 6]. In the cadaver study, the sizes of several intra-oral surface areas, including the palatal surface area, were related to facial anthropomorphic measurements [3]. Moderate, yet statistically significant correlations were observed between the palatal surface area and the length of the head, as well as the surface area of the tongue and the depth of the head [3]. 5
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