Análisis de las Variaciones Anatómicas y Dimensionales del Canal Nasopalatino Mediante Tomografía Computarizada de Haz Cónico / Analysis of the Anatomical and Dimensional Variations of the Nasopalatine Canal by Cone Beam Computed Tomography

El conocimiento anatómico del canal nasopalatino (CNP) es fundamental para la realización de cirugías en el sector anterior del maxilar y así prever posibles complicaciones. El objetivo de este trabajo es evaluar y determinar las variaciones anatómicas y dimensionales del CNP según sexo, edad y estado dental. Este estudio transversal analizó un total de 251 imágenes de TCHC obtenidas de la base de datos del Servicio de Imagenología Oral y Maxilofacial de la Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile. Para evaluar la asociación estadística entre variaciones del CNP con sexo, edad y estado dentario se realizó la prueba T de Student, chi-cuadrado y ANOVA (p0,05). Además, se detectó diferencia significativa entre el estado dentario y la dimensión de la tabla vestibular en relación con el CNP (p<0,01). Se deben considerar las variaciones de CNP para evitar posibles complicaciones durante los procedimientos quirúrgicos.

SUMMARY: Anatomical knowledge of the nasopalatine canal (PNC) is essential for performing surgeries in the anterior sector of the maxilla and thus anticipating possible complications. The objective of this work is to evaluate and determine the anatomical and dimensional variations of the CNP according to sex, age and dental status. This cross-sectional study analyzed a total of 251 CBCT images obtained from the database of the Oral and Maxillofacial Imaging Service of the Faculty of Dentistry of the Andrés Bello University, Viña del Mar, Chile. To evaluate the statistical association between CNP variations with sex, age and dental status, the Student's T test, chi-square and ANOVA (p0.05). In addition, a significant difference was detected between the dental state and the dimension of the vestibular table in relation to the CNP (p<0.01). CNP variations should be considered to avoid potential complications during surgical procedures.

Morphological Analysis of Length and Shape Nasopalatine Canal onHuman Dry Skulls

Background:To assess length and shape of nasopalatine canal on human dry skulls. Subjects and Methods:Fifty- four dry human skulls of either gender was recruited for the study. The length of the nasopalatine canal was measured from the definite point (interproximal region) of the central incisors to the distal end of the incisive foramen. Incisive foramen diameter was calculated in the sagittal plane by measuring the anteroposterior distance of the oral entrance of the NPC. Shape was categorized into 4 types, Cylindrical, funnel, hourglass and spindle shape.Results:The mean length of nasopalatine canal was 16.2 mm in males and 13.4 mm in females. A significant difference was observed (P< 0.05). A non- significant difference in male (5.3 mm) and females (4.9 mm) incisive foramen diameter was observed. The most common shape of nasopalatine canal was cylindrical in 23, funnel in 7, hourglass in 21 and spindle shape in 3 skulls. A significant difference was observed (P< 0.05).Conclusion: Nasopalatine canal morphology assessment is essential to prevent iatrogenic injury to the anatomical structures. Mostcommon shape found to be hour glass and cylindrical

Caracterización anatómica del conducto nasopalatino mediante tomografía computarizada de haz cónico en una población peruana / Anatomic characterization of the nasopalatine canal through cone beam computed tomography in a Peruvian population

RESUMEN El Conducto Nasopalatino (CNP) es una estructura importante que puede ser susceptible de daño durante procedimientos quirúrgicos en el maxilar superior anterior; por lo tanto examinar meticulosamente la anatomía y variantes del CNP se hace imperativo para un buen diagnóstico y un apropiado plan de tratamiento. Objetivo: Realizar una caracterización anatómica del CNP utilizando Tomografía Computarizada de Haz Cónico (TCHC). Material y métodos: Se evaluaron 154 imágenes de TCHC, en las que se analizó CNP en cuanto a su longitud, forma, e inclinación con respecto al paladar duro y el diámetro anteroposterior del foramen incisivo (FI) en hombres y mujeres de 18 años de edad en adelante. Resultados: A la evaluación del CNP en cortes sagitales de TCHC presentó diferentes formas; se encontró que la forma más común fue la cilíndrica en 89 pacientes (58%), seguida de la forma de embudo en 38 (25%), y las menos frecuentes fueron la forma a de reloj de arena en 20 (13%) y de huso en 7 (5%). La longitud promedio del CNP fue de 10,83 mm (± 2,13), el promedio del diámetro anteroposterior del FI fue de 3,44 mm (± 0,80) y la angulación promedio en relación al paladar duro fue de 16,44° (± 7,32). Conclusiones: El estudio mostró la variabilidad del CNP en la población peruana, tanto en la forma, longitud e inclinación, así como también en el diámetro del FI.

SUMMARY Nasopalatine Canal (NPC) is an important structure that may be susceptible to damage during surgical procedures in the anterior maxilla, therefore a thorough examination of the anatomy and variants of the NPC is imperative for a good diagnosis and an appropriate treatment plan. Objective: To perform an anatomic characterization of NPC using Computed Beam Computed Tomography (CBCT). Material and methods: 154 images of CBCT were evaluated, in which the NPC was analyzed in terms of length, shape, and inclination with respect to the hard palate and the maximum anteroposterior of the incisive foramen (IF) in men and women of 18 years of age and onwards. Results: to the evaluation of the NCP in sagittal slices of CBCT, it presented different forms, it was found to the cylindrical shape as the most common in 89 patients (58%), followed by the funnel shape in 38 (25%), and the less frequent were the shape of hourglass in 20 (13%) and spindle (5%). The average length of the NCP was 10.83 mm (± 2.13), the average of the anteroposterior diameter of the FI was 3.44 mm (± 0.80) and the average angulation of the CNP in relation to the hard palate was 16.44 ° (± 7.32). Conclusions: The study showed the variability of NCP in the Peruvian population, like in shape, length and inclination, as well as the diameter of the FI.

Evaluation Of Nasopalatine Canal Using Cone Beam Computed Tomography – A Retrospective Study

Background:Implantology is a very significant branch of dentistry that deals with the rehabilitation of edentulous patients. Thus, knowledge of anatomical variations of related neurovascular structures such as the nasopalatine canal is essential. Aim:The aim of study was to determine the form, length, and diameter of the nasopalatine canal using CBCT. Materials and Methods:In this retrospective study, images were archived from CBCTunit and visualized using Romexis software. The nasopalatine canals of 50 patients between the age range of 18-59years were analyzed. The shape of the nasopalatine canal, length of the nasopalatine canal and the diameter of incisive foramen were assessed in sagittal and coronal section. The width of labial and palatal alveolar bone around the canal and inclination of the nasopalatine canal to hard palate were evaluated. Statistics: (1) if there is any relation between the gender and the assessed parameters (2) if there is any relation between edentulous and partially edentulous patients with the assessed parameters.Results:The most common shape of the nasopalatine canal was cylindrical. The average length of the nasopalatine canal was 12.14±2.41 mm and the average diameter of incisive foramen 3.45±0.84 mm anteroposteriorly and 3.77±0.94mm mediolaterally. The average inclination of the nasopalatine canal to hard palate was 119.93±9.73°Conclusion:This study highlights the variations seen in the nasopalatine canal. The close vicinity of nasopalatine canal and implant can lead to sensory disturbances and damage of the tissues. Thus, a thorough knowledge before the surgical - implant procedure using cone beam computed tomography seems beneficial.

Trifid nasopalatine canal: case report of a rare anatomical variation and its surgical implications / Conducto nasopalatino Trifid: presentación de caso de una variación anatómica rara y sus implicaciones quirúrgicas

The nasopalatine canal is a long slender structure present in the midline of the anterior maxilla that connects the palate to the floor of the nasal cavity. The nasopalatine canal contains the nasopalatine nerve, the terminal branch of the nasopalatine artery, fibrous connective tissue, adipose tissue, and minor salivary glands. The purpose of this article was to report a case of a trifid nasopalatine canal detected by cone beam computed tomography prior to dental implant placement. A 47-year-old female patient was submitted to cone beam computed tomography. Axial and sagittal sections revealed a trifurcation of the nasopalatine canal. Each canal was separated from the other by bony septa and extended independently from the floor of the nasal cavity to the incisive foramen in the remnant of the alveolar process in the anterior region of the maxilla. Cone beam computed tomography has permitted better visualization of the details and anatomical variations of the nasopalatine canal. Detailed knowledge of variations in the shape, number and size of the nasopalatine canal is fundamental for surgical procedures, such as local anesthesia in the anterior maxillary region and placement of dental implants, in order to prevent damage to important arteries and nerves(AU)

El canal nasopalatino es una larga estructura delgada presente en la línea media del maxilar anterior que conecta el palato al suelo de la cavidad nasal. El canal nasopalatino contiene el nervio nasopalatino, la rama terminal de la arteria nasopalatina, el tejido conectivo fibroso, el tejido adiposo y las glándulas salivales menores. El propósito de este artículo es presentar el caso de un canal nasopalatino trifid detectado a través de tomografía computarizada de haz cónico anterior a la colocación de implantes dentales, en una paciente de femenino 47 años de edad. Secciones axiales y sagitales revelaron la trifurcación del canal nasopalatino. Cada canal se apartó del otro por tabiques ósea y extendida independientemente del suelo de la cavidad nasal para el agujero incisivo en el remanente del proceso alveolar en la región anterior del maxilar. La tomografía computarizada de haz cónico ha permitido una mejor visualización de los detalles y variaciones anatómicas del canal nasopalatino. El conocimiento detallado de las variaciones en su forma, el número y el tamaño del canal nasopalatino es fundamental para los procedimientos cirúrgicos, así como la anestesia local en la región anterior del maxilar superior y la colocación de los implantes dentales, con el fin de prevenir el daño a las arterias y a los nervios importantes(AU)

Measurement and analysis of the nasopalatine canal and its relative position by cone-beam computed tomography / 北京大学学报(医学版)

Objective: To evaluate dimensions of the nasopalatine canal and the relationship between the canal and the central incisors, and the canal and the crest, by using cone-beam computed tomography ( CBCT) . Methods:This study included 129 CBCTs, and the sagittal slices were used to measure the lower diameter ( Sda) , median diameter ( Sdb) , and higher diameter ( Sdc) , for calculating the average sagittal diameter ( Sd ); the coronal slices through canals were used to measure the lower diameter ( Hda) , median diameter ( Hdb ) , and higher diameter ( Hdc ) for calculating the average horizontal diameter ( Hd) , length ( H);the sagittal slices were used to measure the buccal bone thickness off the canal ( Bt) , and the distance to the crest off the lowest point ( At) , the horizontal slices were used to measure the distance between the canal and the central incisors ( Id) . These subjects were divided into two groups by gender;and divided into three groups by ages: (1) ≤30 years old, (2) 31 -50 years old, and (3) ≥51 years old. SPSS 17. 0 statistical software was used for statistical analysis. Results:The overall Sd was (3. 41 ± 0. 87) mm, the Hd was (5. 16 ± 0. 93) mm, and the difference was statisti-cally significant. The H was (14. 29 ± 3. 27) mm, the Bt was (7. 49 ± 1. 05) mm, the At was (8. 25 ± 1. 71) mm, and the Id was (2. 71 ± 0. 89) mm. Of the male and female, the Sd were (3. 64 ± 0. 90) mm and (3. 28 ± 0. 82) mm, P=0. 017; the Hd were (4. 98 ± 0. 89) mm and (5. 27 ± 0. 94) mm, P=0. 081;the H were (15. 47 ± 2. 75) mm and (13. 59 ± 3. 32) mm, P=0. 001;the Bt were (7. 90 ± 0. 96) mm and (7. 25 ± 1. 03) mm, P=0. 001; the At were (7. 41 ± 1. 86) mm and (8. 44 ± 1. 90) mm, P=0. 001; the Id were (2. 71 ± 0. 87) mm and (2. 72 ± 0. 91) mm, P =0. 983. Among the groups, no statistically significant differences were detected of the Sd (P =0. 325), of the Hd (P =0 . 636 ) , of the H ( P=0 . 292 ) , and of the Bt ( P=0 . 116 );statistically significant differences were de-tected of the At ( P=0 . 010 ) , and of the Id ( P<0 . 001 ) . Conclusion:The nasopalatine canal anatomy is highly variable. Gender is related to the nasopalatine canal length, Bt width, and At distance. While age was related to At, and Id, but no effect on nasopalatine dimensions. The CBCT is a useful device for studying the nasopalatine canal in three dimensions, prior to dental implant placement.

Sexual dimorphism in the incisive canal in humans: a literature review / Dimorfismo sexual del canal incisivo en cráneos humanos: revisión de la literatura

Aim: To describe the morphometric characteristics of the maxillary incisor canal (IC) in human beings by gender. Material and method. Descriptive study. A systematic search for articles related to anatomical and topographical variations of the IC by sex and published in the last ten years was performed in the Medline database. Selected publications presented the following criteria: Number of samples and average values, in millimeters (mm), for length, diameter and distance from the IC to the maxillary central incisors (ICM). In addition, author and year of publication were considered. Data were presented using descriptive statistics. Results. Three studies were selected. In men, IC average dimensions were higher in diameter (2,79+/-0,94 mm v/s 2,43+/-0,85 mm), length (11,96+/-2,73 mm v/s 10,39+/-2,47 mm) and distance from the apex and middle third of the root of the MCI than in women. Conclusion. IC morphometric values were higher in men. It is important to keep in mind IC dimensions vary according to gender when planning surgeries and rehabilitations in this area of the oral cavity.

Objetivo. Describir las características morfométricas del canal incisivo del maxilar (CI) según el género en humanos. Material y método. Estudio descriptivo. Se realizó una búsqueda sistemática en la base de datos de MEDLINE, sobre artículos relacionados con las variaciones anatómicas y topográficas del CI entre géneros. Se registró autor, año de publicación, cantidad de muestras y valores promedios en milímetros de la longitud, diámetro y distancia del CI con respecto a los incisivos centrales del maxilar (ICM). Resultados. Se analizaron 3 Artículos. Las dimensiones promedio del CI fueron mayores en los hombres que en las mujeres tanto en el diámetro (2.79+/-0.94 mm v/s 2.43+/-0.85 mm ), longitud (11.96+/-2.73 mm v/s 10.39+/-2.47 mm) y distancia con el ápice y punto medio de la raíz de los ICM. Conclusión. Las características morfométricas del CI fueron mayores en hombres. Se debe tener en cuenta que las dimensiones del CI varían dependiendo del sexo para la planificación de cirugías y rehabilitación en este sector de la cavidad oral.

Anatomy and morphology of the nasopalatine canal using cone-beam computed tomography

PURPOSE: This study was performed to evaluate the general anatomy and morphology of the nasopalatine canal using cone-beam computed tomography (CBCT) and to determine the human anatomic variability of the nasopalatine canal in relation to age and gender. MATERIALS AND METHODS: The study included 100 subjects aged between 20 and 86 years who were divided into the following 3 groups: 1) 20-34 years old; 2) 35-49 years old; 3) > or =50 years old. The subjects were equally distributed between the genders. CBCT was performed using a standard exposure and patient positioning protocol. The data of the CBCT images were sliced in three dimensions. Image planes on the three axes (X, Y, and Z) were sequentially analyzed for the location, morphology and dimensions of the nasopalatine canal by two independent observers. The correlation of age and gender with all the variables was evaluated. RESULTS: The present study did not reveal statistically significant differences in the number of openings at the nasal fossa; diameter of the nasal fossa openings; diameter of the incisive fossa; shape, curvature, and angulation of the canal as viewed in the sagittal sections; antero-posterior dimensions and length of the canal in the sagittal sections; or the level of division of the canal in the coronal plane by age. However, males and females showed significant differences in the length of the canal in the sagittal sections and level of the division of the canal in the coronal plane. CONCLUSION: The present study highlighted important variability observed in the anatomy and morphology of the nasopalatine canal.