Review articles

By Dr. Benedetta Toni , Dr. Emanuela Coppotelli , Dr. Loli Debora , Mrs. Ambra Maria Costantini , Mrs. Chiara Vompi
Corresponding Author Dr. Emanuela Coppotelli
Department of Oral and Maxillo-facial Sciences Sapienza University of Rome, - Italy
Submitting Author Dr. Benedetta Toni
Other Authors Dr. Benedetta Toni
Department of Oral and Maxillo-facial Sciences Sapienza University of Rome, via roma 82 - Italy 05100

Dr. Loli Debora
Department of Oral and Maxillo-facial Sciences Sapienza University of Rome, ANTONIO BALDISSERAn45 - Italy 00159

Mrs. Ambra Maria Costantini
Department of Oral and Maxillo-facial Sciences Sapienza University of Rome, - Italy

Mrs. Chiara Vompi
Department of Oral and Maxillo-facial Sciences Sapienza University of Rome, - Italy


palatal vault,morphology, Orthodontics, palate growth,3D tools,dental casts

Toni B, Coppotelli E, Debora L, Costantini A, Vompi C. The study of the palatal vault morphology. WebmedCentral ORTHODONTICS 2017;8(11):WMC005401

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 18 Nov 2017 12:24:38 PM GMT
Published on: 20 Nov 2017 08:16:32 AM GMT


The palate growth was a topic of interest for orthodontic literature because palatal dimensions often need to be modified during orthodontic or surgical-orthodontic treatment. The study of the morphology of the palate vault has been subjected to different researches with more sophisticated methods on plaster models (three-dimensional compass G. Gala 1984). For the determination of the height of the palate, photographs, models and recent studies have used 3D tools that have opened up a new frontier


The human hard palate is formed by the palatine processes of the jaw and the horizontal processes of the palatine bones. All components of the bone palate are joined by the median and transverse sutures (1). The growth of the upper jaw is influenced by genetic and environmental factors. Growth begins on trasversal plane, then in length and finally in height (2). Oral parafunctions or other spoiled habits can affect palatal growth in a pathological way, causing structural abnormalities in the bones (3). Breathing, sucking, chewing, swallowing, and articulating the word are under the brainstem and driven by the neuromuscular system. The palate growth was a topic of interest for orthodontic literature because palatal dimensions often need to be modified during orthodontic  or surgical- orthodontic (4). Most studies concerning dimensional palatal evaluations focus on skull-facial syndromes. A high or narrow palate is associated with a number of syndromes, based on simple clinical observations. There are no studies in literature that have produced a coherent view of the height and palatal width values ??in healthy subjects.


Previous research on the morphology of the palate has evaluated growth and remodeling mainly through longitudinal studies (1). The degree of transversal rotation of the upper jaw during growth was unknown before 1960; in that period, they were conducted by Bjork et al. In Copenhagen, the earliest longitudinal studies on jaw growth using metallic implants positioned on the infra-zygomatic ridge and cephalograms on lateral-lateral and antero-posterior radiographs. Generally, the two jaw processes rotate on the transverse plane during development while at the same time the upper jaw as a whole moves forward on the sagittal plane and rotates, forward or backward, on the vertical plane. The displacement of the jaw in the three planes of space can be explained by the complex form of palatine bone that seems to be “ growthwedge” in growth. The descent and rotation of the maxillo-palatine complex occurs against pterygoid processes. A further growth of the jaw on the vertical plane and a further transversal rotation are possible in the transverse suture of the hard palate(6-7-8). In 1975, Melsen, using autopsy samples, histologically has examined the maturation of the median suture of the palate at different stages, from zero to eighteen years4. Morphologically, the development of the median suture was divided into three phases. During childhood, the suture is short, wide, and Y-shaped; in the pre-adolescent phase (10 years) is more sinuous; In the initial adolescent phase (12 years), the suture is very tortuous and there is an interdigitation of the bone spears of the two half of the upper jaw (9)(10)(11)(12). Although both studies show clear evidence of growth, they are invasive and also limited to two dimensions. The study of the morphology of the palatal vault has been the object of several researches with increasingly sophisticated methods.  To measure the width and length of the palate, directly on the dental casts , a special compass was used to measure the breadth and depth of the palate vault 4. In 1984 G.Gola, by means of a three-dimensional compass, has determined the length of the arch from the incisive point to the perpendicular passing through the distal surfaces of the second molar; the width was measured by the cusp of the canines, among the central fossa of the premolars and molars finally at the molars' vestibular faces. The metric data obtained on dental casts were related to mean values obtained from the index of Pont (13)(14). Photographs and dental casts were used for height and volume determination of the palate vault. In 2002, H. Tsai, through a digital camera, has taken photos that were then digitized using custom software. From these studies  emerged that the height of the palatal vault increased with age and that men's palatal vault can be slightly higher than females of the same years. In addition, palatal width was greater in males than females, while palatal depth was independent of correlations (1)(15). Another method of investigation was the use of 3D computer tools (4). In the years 2000 V. F. Ferrario et al. digitized the palatal landmarks with a computerized program and their coordinates were used to obtain a palatal shape model. The palatal dimensions of the frontal plane and the sagittal plane were calculated and compared with age and sex. While in adolescent females the palatal shape had the characteristics of adults, in males were found some changes between adolescence and adulthood. These changes should be considered as a possible relapse factor after orthodontic treatment (5)(16)(17). Although reliable, these methods take a lot of time and intensive work. In addition, it is difficult to evaluate the area of the palate tridimensionally due to the methodological limits.  To overcome these problems, Primoziç et al. in 2013 used a 3D laser scanner to get three-dimensional (3D) images of dental casts. 3D images can be used to measure: linear dimensions, palatal surface area, and palate size(18). This study has showed that the growth of maxillary bone from the deciduous dentition, to the early and late mixed dentition, has an increase in palatal surface and volume. Orthopedic treatment in the upper jaw should be performed during this period to improve the efficiency of the therapy. To monitor changes in the palate vault during growth, the palatal area should be preferred to the volume (19)(20).



Over the years several authors have proposed methods to mesure the morphology of the palatal vault but each method has limits due to methodology or the sample patients. In the literature there are no studies that have produced a coherent view of the height values and palatal widths in healthy subjects.
3D methods using the laser scanner, to obtain three-dimensional images of study models, are reliable. There are still important metologic limits in the three-dimensional evaluation of the entire area of the palate. The new studies will focus on finding reliable and easy to use instrumentation.



  1.  H.Tsai and C.T. Tann (2004) Morphology of the palatal vault of primary dentition in Transverse View. The Angle Orthodontist: December 2004, Vol.74, No.6, pp.744-799.

  2. Primoziç, G.Perinetti, S.Richmond, and M.Ovsenik (2012) Three-dimensional longitudinal evaluation of palatal vault changes in growing subjects. The Angle Orthodontist: July 2012, Vol.82, No. 4, pp.632-636

  3. V.Ciusa; F.R. Dimaggio; C. Sforza; V.F. Ferrario (2007) Three-dimesional Palatal Development between 3 and 6 Years. The Angle Orthodontist: Vol 77, No 4,2007

  4. S.T. Yang, H.K. Kim, Y.S. Lim, M.S. Chang, S.P. Lee and Y.S. Park (2013) A three dimensional observation of palatal vault growth in children using mixed effect analysis: a 9 year longitudinal study. The European Journal of Orthodontics: Volume 35, issue6, pages 832-840

  5. Ferrario VF, Sforza C, Colombo A, Dallavia C, Dimaggio FR. Three-dimensional hard tissue palatal size and shape in human adolescents and adults. Clin Orthod Res. 2001; 4:141-147.

  6. Björk A 1966 Sutural growth of the upper face studied by the implant method. Acta Odontologica Scandinavica 24:109-127

  7. Björk A, Skieller V 1974 Growth in width of the maxilla studies by the implant method. Scandinavian Journal of Plastic and Reconstructive Surgery 8:26-33

  8. Björk A, Skieller V 1977 Growth of the maxilla in three dimensions as revealed radiographically by the implant method. British Journal of Orthodontics 4:53-64

  9. B.Melsen, D.D.S., Dr.odont. Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod. 1975 Jul; 68(1):42-54

  10. Melsen B, Melsen F1982 The postnatal development of the palatomaxillary region studied on human autopsy material. American Journal od Orthodontics 82:e329-e342

  11. Revelo B, Fishman L S 1944 Maturational evaluation of ossification of the midpalatal suture. American Journal od Orthodontics and Dentofacial Orthopedics 105:e288-e292

  12. Wehrbein H, Yildizhan F 2001 The mid-palatal suture in young adults. A radiological-histological investigation. European Journal od Orthodontics Volume 23, Issue 2Pp.105-114.

  13. Gola G, Ortodonzia vol.1- La diagnosi ortodontica, Maggioli Editore, Rimini 1983

  14. De Freitas F C N, Bastos E P, Primo L S, de Freitas V L 2001 Evaluation of the palate dimensions of patients with perennial allergic rhinitis. International jounal of pediatric dentistry / the British Pedodontic Society [and] the International Association of Dentistry for Children 11:365-371

  15. Tsai HH 2002 A computerized analysis of dental arch morphology in early permanent dentition. ASDC J Dent Child. 2002 Sep-Dec; 69(3):259-65,234.

  16. Ferrario VF, Sforza C, Schmitz JH, Colombo A. Quantitative description of the morphology of the human palate by a mathematical equation. Cleft Palate-Craniofac J 1988;35:396-401.

  17. Ferrario VF, Sforza C, Colombo A, Tartaglia GM, Carvajal R, Palomino H. The effect of ethnicity and age on palatal size and shape: a study in a northern Chilean healthy population. Int J Adult Orthod Orthognath Surg 2000;15:233-40.

  18. Santoro M, Galkin S, Teredesai M, Nicolay OF, Cangialosi TJ. Comparison of measurements made on digital and plaster models. Am J Orthod Dentofacial Orthop. 2003; 124:101-105

  19. Primoziç, Ovsenik M, Richmond S, Kau CH, Zhurov A. Early crossbite correction: a three-dimensional evaluation. Eur J Orthod. 2009;31:352-356.

  20. Primoziç J1, Perinetti G, Contardo L, Ovsenik M. 2013 Diagnostic performance of 3-dimensional evaluation of palatal valut changes in assessing successful tratment of constricted maxilla in growing subjects. Am J Orthod dentofacial Orthop.2013 Jan; 143(1):42-9.

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