Evaluation of Nasopalatine Canal Morphology by Cone-Beam Computerized Tomography

Year 2024, Volume: 34 Issue: 1, 59 - 65, 18.01.2024

Hakan Yülek Gaye Keser Filiz Namdar Pekiner

https://doi.org/10.5152/CRDS.2024.22002

Abstract

ABSTRACT
Objective: A crucial anatomical component that joins the nasal cavity and oral cavity is the naso- palatine canal, which is located in the front region of the maxilla. This study aims to examine the morphology of the nasopalatine canals in cone-beam computed tomography (CBCT) images.
Methods: Sagittal CBCT images from 100 patients (50 females and 50 males, mean age
38.03 ± 12.98) were examined retrospectively. The nasopalatine canal was studied in 6 groups. Furthermore, the inferior and superior diameters and lengths of the nasopalatine canal were measured and assessed in male and female patients. For statistical analysis, the 1-way analysis of
variance test was used to compare the parameters across groups in quantitative data compari- son, and to compare qualitative data, the exact chi-square test and Halton–Fisher–Freeman were utilized. The level of significance was set at P < .05.
Results: The most prevalent nasopalatine canal shape was cylindrical (31%), with a ratio of 15% in females and 16% in males. The least frequent nasopalatine canal shape in both genders was tree branch (5%), while it was 3% in males and 1% in females. The average length of the nasopalatine canal in female patients was 9.40 ± 2.19 mm and 11.59 ± 2.45 mm in male patients. There was no
statistically significant variation between canal types based on gender (P > .05).
Conclusion: The nasopalatine canal’s anatomical features are varied. It is critical to use 3-dimen- sional conical beam computed tomography before proceeding with any treatment in the pre- maxilla region. Knowing the morphological variations of the canal allows spotting pathological alterations easily.
Keywords: Anatomical variation, cone-beam computed tomography, nasopalatine canal

ÖZ
Amaç: Maksilla anterior bölgede yerleşim gösteren nazopalatin kanal ağız kavitesi ve nazal kaviteyi birbirine bağlayan önemli anatomik yapılardan birisidir. Bu çalışmanın amacı, Konik Işınlı Bilgisayarlı Tomografi (CBCT) görüntülerinde nazopalatin kanal morfolojilerinin değerlendirilmesidir.
Yöntemler: Toplam 100 hastanın (50 kadın 50 erkek, ortalama yaş 38,03 ± 12,98) retrospektif görüntüleri sagittal kesitte değerlendirilmiştir. Nazopalatin kanal 6 farklı grupta sınıflandırılmıştır. Kadın ve erkeklerde nazopalatin kanalın inferior ve superior çapı ve uzunluğu ölçülerek değerlen-
dirilmiştir. İstatistiksel analiz için, nicel verilerin karşılaştırılmasında, parametrelerin gruplar arası değerlendirilmesi için tek yönlü varyans analizi testi, nitel verilerin karşılaştırılmasında ise kesin ki-kare testi ve Halton-Fisher-Freeman kullanılmıştır. Anlamlılık düzeyi P < .05 olarak belirlenmiştir.
Bulgular: Nazopalatin kanal morfolojisinin cinsiyete dayalı değerlendirmesinde en sık görülen nazopalatin kanal morfolojisinin tip 1 (silindir, 31%) şeklinde olduğu ve bu oran kadınlarda 15% ve erkeklerde 16% olarak saptanmıştır. Çalışmada her iki cinsiyette toplamda en az görülen nazopa- latin kanal morfolojisinin tip 5 (ağaç dalı, 5%) olduğu, cinsiyete göre değerlendirildiğinde ise erkek- lerde 3% ve kadınlarda ise %1 oranında bulgulanmıştır. Çalışmamızda nazopalatin kanalın ortalama
uzunluğu kadın hastalarda 9,40±2,19 mm, erkek hastalarda ise 11,59±2,45 mm olarak saptanmış- tır. Nazopalatin kanal morfolojisinde kadın ve erkek hasta görüntülerinin incelenmesi sonucunda sınıflar arasında istatistiksel olarak anlamlı farklılık saptanmamıştır (P> .05).
Sonuç: Nazopalatin kanal farklı anatomik yapılara sahiptir. Konvansiyonel dental radyografiler iki boyutlu olması sebebiyle değer- lendirmede yetersiz kalmaktadır. Bu sebeple üç boyutlu değerlendirme imkanı sunan konik ışınlı bilgisayarlı tomografi kullanımı önemlidir. Kanalın morfolojik yapısı ve varyasyonlarının iyi bilinmesi patolojik değişimlerin tespit edilmesinde kolaylık sağlamaktadır.
Anahtar Kelimeler: Anatomik varyasyon, konik ışınlı bilgisayarlı tomografi, nazopalatin kanal

Keywords

Anatomical variation, cone-beam computed tomography, nasopalatine canal

References

• 1. Jacobs R, Lambrichts I, Liang X, et al. Neurovascularization of the anterior jaw bones revisited using high-resolution magnetic reso- nance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(5):683-693. [CrossRef]
• 2. Fernández-Alonso A, Suárez-Quintanilla JA, Rapado-González O, Suárez-Cunqueiro MM. Morphometric differences of nasopalatine canal based on 3D classifications: descriptive analysis on CBCT. Surg Radiol Anat. 2015;37(7):825-833. [CrossRef]
• 3. Etöz M, Şişman Y. Evaluation of the nasopalatine canal and variations with cone-beam computed tomography. Surg Radiol Anat. 2014;36(8):805-812. [CrossRef]
• 4. Thakur AR, Burde K, Guttal K, Naikmasur VG. Anatomy and morphol- ogy of the nasopalatine canal using cone-beam computed tomog- raphy. Imaging Sci Dent. 2013;43(4):273-281. [CrossRef]
• 5. Linjawi AI, Othman MA, Dirham AA, et al. Morphological evaluation of the incisive canal with reference to gender and age: A cone-beam computed tomography study. Niger J Clin Pract. 2021;24(11):1596- 1601. [CrossRef]
• 6. Bahşi I, Orhan M, Kervancıoğlu P, Yalçın ED, Aktan AM. Anatomical evaluation of nasopalatine canal on cone beam computed tomogra- phy images. Folia Morphol (Warsz). 2019;78(1):153-162. [CrossRef]
• 7. Mardinger O, Namani-Sadan N, Chaushu G, Schwartz-Arad D. Mor- phologic changes of the nasopalatine canal related to dental implantation: a radiologic study in different degrees of absorbed maxillae. J Periodontol. 2008;79(9):1659-1662. [CrossRef]
• 8. Liang X, Jacobs R, Martens W, et al. Macro- and micro-anatomical, histological and computed tomography scan characterization of the nasopalatine canal. J Clin Periodontol. 2009;36(7):598-603. [CrossRef]
• 9. Hakbilen S, Mağat G. Nasopalatine canal and its clinical importance: A reviewSelcuk. Dent J. 2019;6:91-97.
• 10. Mraiwa N, Jacobs R, Van Cleynenbreugel J, et al. The nasopalatine canal revisited using 2D and 3D CT imaging. Dento Maxillo Fac Radiol. 2004;33(6):396-402. [CrossRef]
• 11. Demiralp KÖ, Kurşun-Çakmak EŞ, Bayrak S, Sahin O, Atakan C, Orhan K. Evaluation of anatomical and volumetric characteristics of the nasopalatine canal in anterior dentate and edentulous individu- als: a CBCT study. Implant Dent. 2018;27(4):474-479. [CrossRef]
• 12. López Jornet P, Boix P, Sanchez Perez A, Boracchia A. Morphological characterization of the anterior palatine region using cone beam computed tomography. Clin Implant Dent Relat Res. 2015;17(suppl 2):e459-e464. [CrossRef]
• 13. Schulze D, Heiland M, Thurmann H, Adam G. Radiation exposure dur- ing midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radi- ography. Dento Maxillo Facial Rad. 2004;33(2):83-86. [CrossRef]
• 14. Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for pre- operative planning of implant placement. Clin Oral Investig. 2006;10(1):1-7. [CrossRef]
• 15. Uysal S, Tomografi KIB. Turkiye Klinikleri. J Dent Sci Spec Top. 2010;1:36-43.
• 16. Jacob S, Zelano B, Gungor A, et al. Location and gross morphology of the nasopalatine duct in human adults. Archives of otolaryngol- ogy. Head Neck Surg. 2000;126:741-748.
• 17. Rodrigues MT, Munhoz EA, Cardoso CL, Junior OF, Damante JH. Uni- lateral patent nasopalatine duct: a case report and review of the literature. Am J Otolaryngol. 2009;30(2):137-140. [CrossRef]
• 18. Bornstein MM, Wölner-Hanssen AB, Sendi P, von Arx T. Comparison of intraoral radiography and limited cone beam computed tomogra- phy for the assessment of root-fractured permanent teeth. Dent Traumatol. 2009;25(6):571-577. [CrossRef]
• 19. Teughels W, Merheb J, Quirynen M. Critical horizontal dimensions of interproximal and buccal bone around implants for optimal aes- thetic outcomes: a systematic review. Clin Oral Implants Res. 2009;20(suppl 4):134-145. [CrossRef]
• 20. Tlili N, Abdallah SB, Amor FB. Anatomo-radiological assessment of incisive canal using cone beam computed tomographs. Int J Anat Res. 2017;5(3):4333-4342. [CrossRef]
• 21. Tözüm TF, Güncü GN, Yıldırım YD, et al. Evaluation of maxillary inci- sive canal characteristics related to dental implant treatment with computerized tomography: a clinical multicenter study. J Periodon- tol. 2012;83(3):337-343. [CrossRef]
• 22. Mağat G, Akyuz M. Are morphological and morphometric character- istics of maxillary anterior region and nasopalatine canal related to each other? Oral Radiol. 2023;39(2):372-385. [CrossRef]
• 23. Ladeira DB, da Cruz AD, de Almeida SM. Digital panorami radiogra- phy for diagnosis of the temporomandibular joint: CBCT as the gold standard. Braz Oral Res. 2015;29(1). [CrossRef]
• 24. Guyader E, Savéan J, Clodic C, Letellier P, Meriot P, Marianowski R. Three-dimensional reconstruction of the temporal bone: compari- son of in situ, CT, and CBCT measurements. Eur Ann Otorhinolaryn- gol Head Neck Dis. 2018;135(6):393-398. [CrossRef]
• 25. Iamandoiu AV, Mureşan AN, Rusu MC. Detailed morphology of the incisive or nasopalatine canal. Anatomia. 2022;1(1):75-85. [CrossRef]
• 26. Fernández-Alonso A, Suárez-Quintanilla JA, Muinelo-Lorenzo J, Bornstein MM, Blanco-Carrión A, Suárez-Cunqueiro MM. Three- dimensional study of nasopalatine canal morphology: A descriptive retrospective analysis using cone-beam computed tomography. Surg Radiol Anat. 2014;36(9):895-905. [CrossRef]
• 27. Acar B, Kamburoğlu K. Morphological and volumetric evaluation of the nasopalatinal canal in a Turkish population using cone-beam com- puted tomography. Surg Radiol Anat. 2015;37(3):259-265. [CrossRef]
• 28. Milanovic P, Selakovic D, Vasiljevic M, et al. Morphological character- istics of the nasopalatine canal and the relationship with the anterior maxillary bone-a cone beam computed tomography study. Diagnos- tics (Basel). 2021;11(5):915. [CrossRef]
• 29. Gönül Y, Bucak A, Atalay Y, et al. MDCT evaluation ofnasopalatine canal morphometry and variations: an analysis of 100 patients. Diagn Interv Imaging. 2016;97(11):1165-1172. [CrossRef] 30. Görürgöz C, Öztaş B. Anatomic characteristics and dimensions of the nasopalatine canal: a radiographic study using cone-beam com- puted tomography. Folia Morphol (Warsz). 2021;80(4):923-934. [CrossRef]
• 31. Sekerci AE, Buyuk SK, Cantekin K. Cone-beam computed tomo- graphic analysis of the morphological characterization of the naso- palatine canal in a pediatric population. Surg Radiol Anat. 2014;36(9):925-932. [CrossRef]
• 32. Güncü GN, Yıldırım YD, Yılmaz HG, et al. Is there a gender difference in anatomic features of incisive canal and maxillary environmental bone? Clin Oral Implants Res. 2013;24(9):1023-1026. [CrossRef]