Incidence of nasopalatine canal perforation in relation to virtual implant placement: A cone beam computed tomography study.

Abstract

The nasopalatine canal (NPC) is of special importance when considering implant therapy in the maxillary central incisors' region. To investigate the incidence of NPC perforation in relation to virtual immediate implant placement. A search through the cone beam computed tomography (CBCT) database of The University of Oklahoma-College of Dentistry was conducted. First, canal related measurements were conducted. Second, digital prosthetic planning was performed. Then, immediate implants were virtually placed and additional measurements were performed. Perforation rate was assessed. Last, data obtained was statistically analyzed. A total of 217 scans fulfilled the inclusion criteria. Only 8% of cases showed NPC perforation. The perforation occurred at mid-third of the implant or at the mid and apical third in 33% and 22% of the cases, respectively. A statistically significant association was found between perforation of NPC and bone width palatal to the root of the central incisor (P < .0001) as well as canal angulation (P = .0196). NPC angulation (°) and palatal bone width (mm) predisposed to a higher risk of perforation. Only 27.78% of the perforations could be overcome by the installation of shorter implants. Low incidence of NPC perforation could be expected when immediately placing implants in the maxillary incisor region.