Evaluation of Morphology and Anatomical Measurement of Nasopalatine Canal Using Cone Beam Computed Tomography
Abstract
Objectives: Precise radiographic assessment of the nasopalatine canal is required to prevent implant failure. The purpose of the current study was to determine the three dimensional (3D) morphology, as well as the dimensions of the nasopalatine canal using cone beam computed tomography (CBCT).
Materials and Methods: In this descriptive cross-sectional study, maxillary CBCT images from 300 patients (150 men, 150 women) were retrospectively evaluated. Sagittal and coronal views were reviewed to determine the nasopalatine canal morphology and dimensions. The difference in canal dimensions between men and women was evaluated using the Student’s t-test while the difference in canal morphology between the two sexes was assessed using Chi-square test.
Results: A total of 199 (66.3%) patients had type A canal (cylindrical without a branch), 69 (23%) had type B canal (a canal with a branch in the upper part), and 32 (10.7 %) had type C canal (a canal with a branch in the middle part). Incisive foramen diameter was 4.7±1.11mm on the sagittal section. Alveolar bone width in the anterior part of the canal was 12.3±1.7mm in the upper one third, 10.7±1.7mm in the middle one third, and 9.8±1.4mm in the lower one third. The angle of canal with palate was 109.5±5.7°. On the coronal sections, canal length was 14.1±3.0mm, incisive foramen diameter was 4.6±1.0mm, and canal diameter in the nasal floor was 5.1±1.0mm.
Conclusions: Significant differences in canal morphology were observed among the patients and CBCT was useful in determining nasopalatine canal morphology and its dimensions before implant placement.
- Teughels W, Merheb J, Quirynen M. Critical horizontal dimensions of interproximal and buccal bone around implants for optimal aesthetic outcomes: a systematic review. Clin Oral Implants Res. 2009 Sep; 20(s4):134-45.
- Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004 Nov;19(7):43-61.
- Mraiwa N, Jacobs R, Van Cleynenbreugel J, Sanderink G, Schutyser F, Suetens P, et al. The nasopalatine canal revisited using 2D and 3D CT imaging. Dentomaxillofac Radiol. 2004 Nov;33(6):396-402.
- Asaumi R, Kawai T, Sato I, Yoshida S, Yosue T. Three-dimensional observation of the incisive canal and the surrounding bone using cone-beam computed tomography. Oral Radiol. 2010 Jun;26(1):20-8.
- Tyndall DA, Brooks SL. Selection criteria for dental implant site imaging: a position paper of the American Academy of Oral and Maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 May;89(5):630-7.
- Bou Serhal C, Jacobs R, Persoons M, Hermans R, van Steenberghe D. The accuracy of spiral tomography to assess bone quantity for the preoperative planning of implants in the posterior maxilla. Clin Oral Implants Res. 2000 Jun;11(3): 242-7.
- Loubele M, Guerrero ME, Jacobs R, Suetens P, van Steenberghe D. A comparison of jaw dimensional and quality assessments of bone characteristics with cone-beam CT, spiral tomography, and multi-slice spiral CT. Int J Oral Maxillofac Implants. 2007 May-Jun;22(3):446-54.
- Chatriyanuyoke P, Lu CI, Suzuki Y, Lozada JL, Rungcharassaeng K, Kan JY, et al. Nasopalatine canal position relative to the maxillary central incisors: a cone beam computed tomography assessment. J Oral Implantol. 2012 Dec;38(6):713-7.
- Gupta J, Ali SP. Cone beam computed tomography in oral implants. Natl J Maxillofac Surg. 2013 Jan;4(1):2-6.
- Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol. 2003 Jul;32(4):229-34.
- Farman AG. ALARA still applies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Oct;100(4):395-7.
- Artzi Z, Nemcovsky CE, Bitlitum I, Segal P. Displacement of the incisive foramen in conjunction with implant placement in the anterior maxilla without jeopardizing vitality of nasopalatine nerve and vessels: a novel surgical approach. Clin Oral Implants Res. 2000 Oct;11(5):505-10.
- Rosenquist JB, Nyström E. Occlusion of the incisal canal with bone chips. A procedure to facilitate insertion of implants in the anterior maxilla. Int J Oral Maxillofac Surg. 1992 Aug;21(4):210-1.
- Scher EL. Use of the incisive canal as a recipient site for root form implants: preliminary clinical reports. Implant Dent. 1994 Spring;3(1):38-41.
- Peñarrocha M, Carrillo C, Uribe R, García B. The nasopalatine canal as an anatomic buttress for implant placement in the severely atrophic maxilla: a pilot study. Int J Oral Maxillofac Implants. 2009 Sep-Oct;24(5):936-42.
- Bornstein MM, Balsiger R, Sendi P, von Arx T. Morphology of the nasopalatine canal and dental implant surgery: a radiographic analysis of 100 consecutive patients using limited cone-beam computed tomography. Clin Oral Implants Res. 2011 Mar;22(3):295-301.
- Song WC, Jo DI, Lee JY, Kim JN, Hur MS, Hu KS, et al. Microanatomy of the incisive canal using three-dimensional reconstruction of microCT images: an ex vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Oct;108(4):583-90.
- Thakur AR, Burde K, Guttal K, Naikmasur VG. Anatomy and morphology of the nasopalatine canal using cone-beam computed tomography. Imaging Sci Dent. 2013 Dec;43(4):273-81.
- Jia X, Hu W, Meng H. Relationship of central incisor implant placement to the ridge configuration anterior to the nasopalatine canal in dentate and partially edentulous individuals: a comparative study. Peer J. 2015 Nov;3:e1315.
- Fernández-Alonso A, Suárez-Quintanilla JA, Muinelo-Lorenzo J, Varela-Mallou J, Smyth Chamosa E, Suárez-Cunqueiro MM. Critical anatomic region of nasopalatine canal based on tridimensional analysis: cone beam computed tomography. Sci Rep. 2015 Aug;5:12568.
- Mardinger O, Namani-Sadan N, Chaushu G, Schwartz-Arad D. Morphologic changes of thenasopalatine canal related to dental implantation: a radiologic study in different degrees of absorbed maxillae. J Periodontol. 2008 Sep;79(9):1659-62.
- Liang X, Jacobs R, Martens W, Hu Y, Adriaensens P, Quirynen M, et al. Macro- and micro-anatomical, histological and computed tomography scan characterization of the nasopalatine canal. J Clin Periodontol. 2009 Jul;36(7):598-603.
Files | ||
Issue | Vol 13, No 4 (2016) | |
Section | Original Article | |
Keywords | ||
Anatomy Cone Beam Computed Tomography Dental implants Maxilla. |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |