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Radiographic image of the gutta-percha cone passing from the IF to the floor of the left nasal fossa through the IC.
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A 15-year-old white female sought our institution complaining of a chirping noise during speech and swallowing. The noise was spontaneous, perceptible, and enhanced when hard suction on the anterior palate was performed. The patient reported no trauma, infection, or other clinical feature related to the noise. Clinical examination showed 2 small gr...
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Context 1
... groove was visually deeper than the right one. Careful probing with a gutta- percha cone without bleeding or pain was only possible on the left side ( Fig. 1). Periapical radiography showed 2 spindle-shaped radiolucent areas on both sides of the nasal septum extending from the nasal fossa to the IF between the apices of the upper central incisors (Fig. 2). All upper incisors presented pulp vitality, and their anatomical land- marks were considered to be normal after periapical radiography. Clinical probing and a radiopaque cone image revealed an anatomical passage extending from the mouth to the left nasal fossa. On the basis of the clinical and radiographic findings, the diagnosis of ...
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Citations
... The anatomical differences, size, and typical morphological structure of the NPC have been studied in the literature. 10,16,17,18 Studies have shown that the nasopalatine canal is classified into different types with 3D imaging. 2,3,6,7 While Mardinger et al 7 evaluated the nasopalatine canal on a sagittal section in 4 different groups, Etoz et al 3 evaluated it using 6 different forms. ...
Objective: A crucial anatomical component that joins the nasal cavity and oral cavity is the nasopalatine
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 comparison,
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-dimensional
conical beam computed tomography before proceeding with any treatment in the premaxilla
region. Knowing
... This study focuses on the subpopulation of the Qassim region of Saudi Arabia, exhibiting distinctive morphologic patterns than the people from other parts of the world. [11][12][13] Previous research has also revealed an association between neurovascular damage and osseointegration failure of implants. In roughly 4% of instances, the NPC measurements demonstrated to be an impediment to implant placement, and an NPC perforation rate of 8% may be anticipated following the immediate placement of implants in the maxillary central incisor region. ...
... Present study indicated that the NPC showed a great deal of variability with regard to its length as well as to its morphological appearance. In our study, four anatomical Shapes of NPC were seen in the sagittal CBCT slice [12,13] . The findings are similar to the results of the study done by Mraiwa et al. in 2013 [3] . ...
... Nevertheless, limited information about IC dimensions, morphology as well as anatomical variations are presented in literature and are frequently documented as case studies. [9][10][11][12] Mardinger and colleagues proposed the anatomical organization of the IC profile in the sagittal cross-sections of the skull. [13] IC shape was classified into four key types; banana-like, cylindrical-like, hourglass-like, and funnel-like. ...
... This study was focused on Saudi patients, who have different morphologic patterns as compared to subjects from other countries such as Malaysia [29] and Japan. [12] The age groups in the current study were classified into four groups (below and equal to 20, 21-40, 41-60 and above 60 years), compared to the three age groups used by Thakur et al. [14] (20-34, 35-49 and equal to or above 50 years old). The objective was to include younger and older age groups to represent the aging effects on bone remodeling and anatomical structure dimensional changes. ...
Background:
The incisive canal (IC) is an important anatomical structure in the premaxilla that should be considered during many dental procedures.
Aims:
The objective of this study is to associate the IC morphology and dimensions with reference to gender and age by means of cone-beam computed tomography (CBCT).
Patients and methods:
A retrospective study was conducted using archived CBCT records of patients who sought treatment at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. OnDemand 3D Imaging software was utilized in image reconstruction and measurement determination. The parameters evaluated were the IC shape and dimensions in a sagittal and coronal view at two levels: palatal opening and nasal opening. The variables were compared according to age and gender using one-way Analysis of Variance (ANOVA) and Kruskal Wallis tests. Confidence level was obtained at P < 0.05.
Results:
Out of the 370 CBCT images assessed, only 100 images fulfilled the inclusion criteria; 50 males and 50 females. No substantial variance in IC shapes was found in both the sagittal and coronal perspectives with reference to age and gender. Likewise, there was no statistical variation in IC dimensions with reference to age. On the other hand, there was a statistical difference in IC length when correlated with gender as the male subjects had longer IC as compared to females (P < 0.01).
Conclusion:
There is no association between IC morphology, age and gender. However, substantial variation in IC length was observed between genders.
... In our study, four anatomical shapes of NPC were seen in the sagittal CBCT slice. [8,9] The findings are similar to the results of the study done by Mraiwa et al. in 2013. [10] In our study, the cylindrical shape was found in 54% of the scans, the funnel-shaped canal was found in 32%, spindle shape 8%, and an hourglass in 6% [ Table 2]. ...
Aim: 1) To assess the morphological variation of the nasopalatine canal (NPC) concerning age and gender. 2). To assess the correlation between the gender and morphology of the canal. 3). To assess the correlation between age and length of the canal. Material and Method: This is a retrospective, randomized observational study. The study comprised of 50 CBCT scans of maxilla showing NPC completely. The scans were obtained in the department during the period ranging from December 2018 to June 2019. The patients were in the age range of 15–75 years. Scan of 22 females and 28 males were included in the study. Patient below 15 years of age and NPC pathology or impacted teeth in same region were excluded in the study. The scans were obtained using ICAT17-19 machine and analyzed Vision software. Cone-Beam 3D Imaging machine operating at 120 kvp, 37.07 mAs with 0.25 mm voxel size, and a field of view of 16 × 6 cm maxilla. Results: Nasopalatine canal has 4 different morphological shapes. The most common shape was the cylindrical shape amongst both males and females. The least common shape was found to be hourglass shape with increasing age the length of NPC was found to decrease. The length of the canal was found to be longer in males when compared to females. Conclusion: This study highlights the importance of NPC morphology before or during surgical procedures involving the maxilla.
... Recently, cone-beam computed tomography (CBCT) has allowed detailed 3-dimensional (3D) evaluations of anatomical configurations of the various anatomical structures (2,(10)(11)(12)(13)(14) and determined the degree of resorption of buccal bone thickness (BBT) in the anterior maxillary region after tooth loss in detail (15,16). It is important to bear in mind that the NPC can occupy 58% of the BBT (7), and the 3D anatomical features of the NPC need to be precisely defined to ensure safe and accurate surgical planning and placement of dental implants (11). ...
Background:
The aim of this study was to analyze as three dimensions the anatomical and morphometric dimensions of nasopalatine canal (NPC) in the coronal, axial and sagittal directions using cone beam volumetric tomography (CBCT) and to evaluate the effect of age, gender and maxillary dental status on NPC and buccal bone thickness (BBT).
Methods:
In this study, CBCT data of the 619 individuals aged between 17-86 years were examined retrospectively with respect to dimensions and anatomic variations of the NPC and BBTs. The correlation of age, gender, and status of edentulism of anterior maxilla with all the variables were evaluated.
Results:
The NPC and BBT showed important variability in terms of morphology and dimensions. Morphological assessment of NPC revealed that 26.17% of NPCs were conical shape, 24.71% of canals were hourglass-shaped, 16.80% of canals were cylindrical shaped, 15.83 % of canals were funnel-like shaped, 11.14 % of canals were banane-like shaped, and 5.33 % of canals were tree branch-like shaped. Males and females showed significant differences in the length of the NPC and BBTs in the sagittal sections. There were significant differences between age and BBTs. In addition, the length of NPC and BBTs were statistically different according to dental status.
Conclusions:
These anatomical changes in terms of dimensional and morphological parameters revealed the importance of 3D imaging. Dentists should know and consider the variations in this canal in order to avoid possible complications during anesthesia and surgical procedures which were applied to the maxillary anterior region. More precautions should be taken during surgical procedures in females, elderly and edentulous patients.
... Previous review articles about NPD were used as baseline information [11,22,33,42]. An additional literature search (without language restriction) of publications indexed in the MEDLINE database was conducted in December 2016 using the following search terms: -(patent OR palatal opening OR persistent) AND (nasopalatine duct OR nasopalatine canal OR incisive canal) -(oronasal OR nasopalatine) AND fistula -perforate nasopalatine communication. ...
Purpose:
The objective of this review is to present an update and summary of clinical findings of cases with a patent nasopalatine duct (NPD) reported in the literature from 1881 to 2016.
Methods:
Previous articles and reviews about patent NPDs were studied and copies of all original publications were obtained for data verification. Furthermore, a literature search was conducted. In addition, the study sample was complemented with four cases recently seen in our institution.
Results:
Ten out of 67 published cases were to be excluded for this analysis due to misinterpretation or misreporting in previous articles. Overall, 57 cases with NPD patency could be analyzed. Males outnumbered females in a ratio of 2:1. The mean age (when this information was available) was 34.1 ± 17.6 years (range 6-69 years). NPDs were located bilaterally (60%), unilaterally (20%) or centrally (20%). Complete or partial patency was reported in 73.9 and 26.1%, respectively. 74.1% of patients presented a variety of clinical signs and symptoms. The ability of the patient to produce a squeaky or whistling sound was the most frequent clinical finding (23.8%).
Conclusions:
Caution must be exercised when reading review articles about NPD patency since wrong data have been copied in several subsequent publications. Since epidemiological data are missing with regard to patent NPDs, age and gender predilections are not warranted. Bilateral occurrence and full patency were prevailing features in the evaluated case reports of patent NPDs.
... A variety of congenital oronasal fistulae and as- sociated cysts in the region of the incisive foramen have been described in adult humans ( Rodrigues et al., 2009;Werder et al., 2016). The origin of these fistulae is controversial: some may be sec- ondary to breakdown of primary dentigerous cysts associated with the roots of the central incisors, but it has been proposed that some may be persis- tent nasopalatine ducts associated with a vestigial vomeronasal or Jacobson's organ (Chapple and Ord, 1990;Jacob et al., 2000;Von Arx et al., 2017). ...
... Surgical excision of these cysts is usually advised (Escoda Francolí et al., 2008;Nelson and Linfesty, 2010). The isolated bilateral oronasal fis- tulae, not associated with any kind of cyst, which were present in our patient, are much less fre- quently described ( Rodrigues et al., 2009;Von Arx et al., 2017). We postulate that these are congeni- tal structures that only became obvious during or- thodontic treatment, perhaps due to tooth move- ment or perhaps due to sensory attention having been focused on this area by the presence of den- tal appliances. ...
The vomeronasal system is comprised of the nasopalatine duct and the vomeronasal organ. While this system functions in chemodetection in mammals, its presence and function in adult humans remains to be clearly elucidated. Here, a case of asymptomatic, bilateral, patent nasopala-tine ducts is presented. We postulate that the presence of these patent structures represents persistence of the embryological nasopalatine duct component of the vomeronasal organ into adult life.
... [1,2] Nevertheless, anatomical variations of the NPC are not very well documented in the literature and are often presented as case reports. [3][4][5][6] A proper image of the incisive canal and foramen before any surgical procedure such as implant placement in the anterior Departments of Oral Medicine and Radiology and 1 Oral Pathology and Microbiology, 2 Public Health Dentistry, Rishiraj College of Dental Science and Research Center, Bhopal, Madhya Pradesh, India maxilla is highly important. [7] In the anterior maxilla, patients consider the esthetic outcome to be an essential factor, often surpassing even functional aspects of the dental implant therapy. ...
... The canal contains the nasopalatine (incisive) nerve and the terminal branch of the descending nasopalatine artery, as well as fibrous connective tissue, fat, and small salivary glands. 3,4 Regular anatomical features and variations of the nasopalatine canal have been described and can be classified into three groups [5][6][7][8][9] : (1) a single canal, (2) two parallel canals, and (3) variations of the Y-shape type of the canal with one palatal opening and two or more nasal openings. ...
The objective of this study was to assess implant therapy after a staged guided bone regeneration procedure in the anterior maxilla by lateralization of the nasopalatine nerve and vessel bundle. Neurosensory function following augmentative procedures and implant placement, assessed using a standardized questionnaire and clinical examination, were the primary outcome variables measured. This retrospective study included patients with a bone defect in the anterior maxilla in need of horizontal and/or vertical ridge augmentation prior to dental implant placement. The surgical sites were allowed to heal for at least 6 months before placement of dental implants. All patients received fixed implant-supported restorations and entered into a tightly scheduled maintenance program. In addition to the maintenance program, patients were recalled for a clinical examination and to fill out a questionnaire to assess any changes in the neurosensory function of the nasopalatine nerve at least 6 months after function. Twenty patients were included in the study from February 2001 to December 2010. They received a total of 51 implants after augmentation of the alveolar crest and lateralization of the nasopalatine nerve. The follow-up examination for questionnaire and neurosensory assessment was scheduled after a mean period of 4.18 years of function. None of the patients examined reported any pain, they did not have less or an altered sensation, and they did not experience a "foreign body" feeling in the area of surgery. Overall, 6 patients out of 20 (30%) showed palatal sensibility alterations of the soft tissues in the region of the maxillary canines and incisors resulting in a risk for a neurosensory change of 0.45 mucosal teeth regions per patient after ridge augmentation with lateralization of the nasopalatine nerve. Regeneration of bone defects in the anterior maxilla by horizontal and/or vertical ridge augmentation and lateralization of the nasopalatine nerve prior to dental implant placement is a predictable surgical technique. Whether or not there were clinically measurable impairments of neurosensory function, the patients did not report them or were not bothered by them.
