Morphological Characterization of the Anterior Palatine Region Using Cone Beam Computed Tomography.

Abstract

Surgery of the anterior maxillary zone has a strong impact upon dental and facial aesthetics and function. To determine the anatomical characteristics and dimensions of the nasopalatine canal and alveolar bone using cone beam computed tomography (CBCT). A retrospective, cross-sectional study was made of the nasopalatine canal in 122 randomly selected CBCT scans corresponding to 66 males (44.3%) and 56 females (55.6%). The following measurements were made: maximum length and diameters of the nasal and oral openings of the nasopalatine canal; distance from the crestal margin to the buccal wall (at apical, middle, and coronal level); and angulation of the nasopalatine canal. The anatomical variants were morphologically classified as follows: A (single canal), B (double canal), or C (Y-shaped canal). The anatomy of the nasopalatine canal showed important variability in terms of morphology and dimensions. Type A was observed in 48 patients (39.34%), type B in 10 (8.19%), and type C in 64 (52.45%). The mean diameter of the nasal opening or orifice was 3.02 ± 1.0 mm versus 3.29 ± 1.0 mm in the case of the oral opening. The mean length of the canal was 11.02 ± 2.4 mm. Significant differences were found between males and females, with greater canal dimensions and alveolar bone thickness values anterior to the nasal canal zone among males (p < .05). Our study shows gender to exert a significant influence upon the anatomical dimensions of the anterior maxilla and incisor canal. Given the anatomical variability characterizing the nasopalatine canal, we recommend CBCT evaluation prior to any type of surgery of the anterior maxillary zone.