Abstract
Objective: To evaluate the dimensions of the nasopalatine canal (NPC) and its relationship with the maxillary central incisors (MCI) using cone-beam computed tomography (CBCT) and to determine variations in the NPC in relation to age and gender. Methods: CBCT scans from 333 patients (67% female; 35.9 ± 14.6 years) were included. The CBCT scan was analyzed to determine the length and diameter of the NPC, the distance between the NPC and the MCI, and to evaluate the morphology of the NPC. The data were analyzed using the independent Student's t-test, the Mann–Whitney and Kruskal–Wallis tests, and Dunn's post-test (p < 0.05). Results: The average diameter and length of the NPC were 2.92 ± 0.91 mm and 12.67 ± 3.32 mm, respectively. The minimum and maximum distance between the MCI and the NPC were 0.78 ± 0.42 mm and 2.56 ± 1.38 mm, respectively. The NPC of male patients was greater in length compared with the female patients (p < 0.05). The majority presented a funnel-like morphology (34.1%), followed by a cylindrical morphology (27.5%). Conclusions: There was variability in the dimensions of the NPC and its relationship with the MCI, which was influenced by gender and age.
Highlights
The anterior region of the maxilla is the most relevant in dental rehabilitation due to high aesthetic, functional and phonetic demand (Kim, et al, 2020)
The diagnosis and planning of dental procedures in the anterior region of the maxilla should account for possible anatomical variations (Asaumi, et al, 2010), the nasopalatine canal (NPC) and its relationship with the maxillary central incisors (MCI), avoiding damage to vessels and nerves during anesthesia, implant positioning errors, osseointegration failures, and transient sensory alterations, which occur when the NPC is perforated, injuring the adjacent neural system (Friedrich, et al, 2015)
The proximity of the NPC to the MCI is relevant since an inflammatory process of endodontic or periodontal origin in these teeth can achieve, through inflammatory cytokines of the periradicular lesion or periodontal strain, the epithelial remains of the NPC and may play a role in the pathogenesis of nasopalatine duct cyst (NPDC) (Tsuneki, et al, 2013; Suter, et al, 2016)
Summary
The anterior region of the maxilla is the most relevant in dental rehabilitation due to high aesthetic, functional and phonetic demand (Kim, et al, 2020). The proximity of the NPC to the MCI is relevant since an inflammatory process of endodontic or periodontal origin in these teeth can achieve, through inflammatory cytokines of the periradicular lesion or periodontal strain, the epithelial remains of the NPC and may play a role in the pathogenesis of NPDC (Tsuneki, et al, 2013; Suter, et al, 2016) In this context, the use of cone-beam computed tomography (CBCT) provides high-resolution images that facilitate a three-dimensional evaluation of the morphology of the NPC, its variability, and its relationship with adjacent anatomical structures. CBCT is the most common method used in the diagnosis of pathological processes of nonspecific symptomatology involving maxillomandibular bone tissues because it facilitates the identification of early-stage lesions in the periradicular region It provides a differential diagnosis between pathological odontogenic processes ( of endodontic origin) and non-odontogenic processes (Lo Muzio, et al, 2017)
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