Morphology of the nasopalatine canal and dental implant surgery: a radiographic analysis of 100 consecutive patients using limited cone-beam computed tomography

Abstract

To analyze the dimensions and anatomic characteristics of the nasopalatine canal and the corresponding buccal bone plate of the alveolar process, using limited cone-beam computed tomography (CBCT) imaging. Partially edentulous patients scheduled for CBCT imaging for further radiographic evaluation of a prospective implant recipient site in the anterior maxilla were consecutively enrolled in this study. For all CBCT images, a limited field of view (FOV) of 4 × 4 cm, 6 × 6 cm or 8 × 8 cm was selected. Reformatted sagittal and coronal slices were analyzed with regard to dimensions and anatomic characteristics of the nasopalatine canal as well as the dimensions of the buccal bone wall. Factors influencing these parameters were evaluated using univariate and multivariate linear regression models. The study population comprised 44 men and 56 women with a mean age of 43.09 years. Gender of the included patients had a statistically significant influence on the dimensions of the buccal bone plate, the mean values being generally higher for male subjects. In the multivariate linear regression model, the status of the central maxillary incisors (both present, one missing, and both missing) and the time elapsed since loss of the central incisors (<1 year vs. >1 year) were independently associated with buccal bone wall measurements, adjusted for age and sex. The present study demonstrates decreasing values for the coronal width of the buccal bone wall in patients with missing central incisors and a time span since tooth loss of over 1 year. The age of the patients had a significant influence only on the length of the nasopalatine canal, with the mean values generally decreasing with an increasing age. The limited CBCT scans with FOVs varying between 4 × 4 and 8 × 8 cm are a valid diagnostic alternative to cross-sectional imaging in the anterior maxilla for dental implant treatment planning.