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Janovic A, Bracanovic D, Antic S, Markovic-Vasiljkovic B. Morphological CBCT parameters for an accurate differentiation between nasopalatine duct cyst and the normal nasopalatine canal. Head Face Med 2024; 20:54. [PMID: 39342234 PMCID: PMC11438411 DOI: 10.1186/s13005-024-00458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/16/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND The incisive foramen width was a traditional imaging criterion for diagnosing nasopalatine duct (NPD) cysts. Recent CBCT studies demonstrated significant dimensional variations of the nasopalatine canal, which raised questions about the accuracy of this criterion. This study investigated whether nasopalatine canal diameters assessed on CBCT images can accurately differentiate NPD cysts from normal nasopalatine canals. METHODS The study included 19 patients with NPD cysts (12 (63.2%) males, 7 (36.8%) females, mean age 44.7 ± 13.3), and a control group of 164 patients (72 (43.9%) males, 92 (56.1%) females, mean age 47.25 ± 17.74). CBCT images were retrospectively evaluated. The following nasopalatine canal diameters were measured on reference sagittal, coronal, and axial reformation images: nasal opening anteroposterior (AP) and mediolateral (ML) diameter, oral opening AP (APOO) and ML (MLOO) diameter, nasopalatine canal length, minimum ML (minML) diameter, anterior wall expansion (AWE), nasopalatine canal angle, and the mid-level AP diameter (midAP). All parameters were compared between groups. Discriminant functional analysis (DFA) was applied to detect CBCT parameters that best differentiate the NPD cyst from the normal canal. RESULTS Patients with NPD cyst had significantly greater values of APOO (7.06 ± 2.09 vs. 5.61 ± 1.70), MLOO (6.89 ± 2.95 vs. 3.48 ± 1.24), minML (2.88 ± 1.53 vs. 2.25 ± 1.09), AWE (2.15 ± 0.65 vs. 0.41 ± 0.67), and midAP (4.58 ± 1.61 vs. 2.48 ± 0.96). DFA showed MLOO, AWE, and midAP as the most accurate in distinguishing NPD cyst from the normal canal. When combined in the discriminant function equation X = 0.390·MLOO + 1.010·AWE + 0.288·midAP (cut score 1.669), the differentiation can be performed with a sensitivity and specificity of 98.8% and 76.9%, respectively. CONCLUSION NPD cysts can be accurately distinguished from the normal nasopalatine canal by measuring MLOO, AWE, and midAP diameter on CBCT images.
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Affiliation(s)
- Aleksa Janovic
- School of Dental Medicine, Center for Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11 000, Serbia.
| | - Djurdja Bracanovic
- School of Dental Medicine, Center for Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11 000, Serbia
| | - Svetlana Antic
- School of Dental Medicine, Center for Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11 000, Serbia
| | - Biljana Markovic-Vasiljkovic
- School of Dental Medicine, Center for Diagnostic Radiology, University of Belgrade, 6 Rankeova, Belgrade, 11 000, Serbia
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Firincioglulari M, Orhan K. Morphological Variations of the Nasopalatine Canal in the North Cyprus Population: A Cone Beam Computed Tomography Study. Med Sci Monit 2024; 30:e944868. [PMID: 38943242 PMCID: PMC11305068 DOI: 10.12659/msm.944868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 05/14/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the morphological characteristics of the anterior maxillary nasopalatine canal and the width of the buccal bone using cone-beam computed tomography (CBCT) in 150 adults in Northern Cyprus. MATERIAL AND METHODS The study included 150 participants, and their anterior maxillary morphometric measurements (eg, length of the nasopalatine canal and anteroposterior diameter of the nasal foramen) were taken using CBCT with the scanning parameters of 90 kvP, 24 s, 4 mA, voxel size 0.3 mm, and field of view 10×6 cm. The shapes of the nasopalatine canal (NPC) were categorized into 4 types: cylindrical, hourglass, funnel-shaped, and banana (54%, 20.6%, 18.6%, and 4%, respectively). RESULTS The findings showed a clear link between the shape of the NPC and the horizontal dimensions of the anterior maxilla's morphometric properties. In general, decreased horizontal bone dimensions were found in the premaxilla at the banana- and funnel-shaped type for the nasopalatine canal. Also, the anteroposterior diameter of a nasal foramen in the hourglass shape was significantly larger in diameter than all other shapes. Additionally, the morphology of the nasopalatine canal is influenced by its shape. The sagittal cross-section has shown significant correlations with the sizes of the incisive foramen, nasal foramen, and the length of the nasopalatine canal. CONCLUSIONS The study found a correlation between the shape of the NPC and the horizontal dimensions of the anterior maxilla's anatomy. The measurements of NPC in a North Cyprus population slightly differ from the established standards found in the existing literature. Conducting more extensive studies with a larger number of CBCT images will offer additional insights.
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Affiliation(s)
- Mujgan Firincioglulari
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Cyprus International University, Nicosia, Cyprus
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Türkiye
- Visiting Prof., Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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Alhumaidi AM, Aseri AA, Alahmari MMM, Adawi HA, Aldhorae K, Gadah TS, Sayed ME, Daghriri AA, Al Ahmari NM, Alzahrani AH, Al Moaleem MM. Morphological and Dimensional Analysis of the Nasopalatine Canal: Insights from Cone-Beam Computed Tomography Imaging in a Large Cohort. Med Sci Monit 2024; 30:e944424. [PMID: 38870101 PMCID: PMC11184986 DOI: 10.12659/msm.944424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/15/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND The nasopalatine canal (NPC), or incisive canal, is located in the midline of the palate, posterior to the maxillary central incisors. Its anatomy is important in prosthetic dentistry procedures. This study aimed to assess the anatomical morphology of the NPC according to age, sex, and dental status using cone-beam computed tomography (CBCT) in 335 patients. MATERIAL AND METHODS In this retrospective cross-sectional study, a total of 335 patients were recruited and categorized according to sex, age, and dental status. Individual CBCT images were analyzed in the sagittal, coronal, and axial planes. Also, we recorded the dimensions and morphological shape of the NPC and adjacent buccal bone plate (BBP) under standardized conditions. The associations between sex, age group, NPC shapes and types, and presence of central incisors were assessed. A significance level was set at P<0.05. RESULTS Mean labio-palatal and mediolateral measurements of the incisive foramen were 5.13±1.45 mm and 3.21±0.96 mm, whereas the mean diameter of Stenson foramen was 2.57±1.25 mm, and the total length of the NPC was 11.79±2.50 mm. Funnel, Y, and round-shaped canals were the most prevalent shapes of the NPC in sagittal, coronal, and axial planes. BBP was greater in men, with P=0.011, P=0.000, and P=0.001 at BBP1, BBP2, and BBP3, respectively. CONCLUSIONS NPC and BBP parameter values were slightly higher among male patients. NPC parameters increased with older age. The crest width of BBP decreased with older age and after missing maxillary central incisor teeth.
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Affiliation(s)
| | - Abdulrahman Ahmed Aseri
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, Najran, Saudi Arabia
| | - Manea Musa M. Alahmari
- Department of Periodontics and Community Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Hafiz Ahmed Adawi
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Khalid Aldhorae
- Department of Orthodontics, College of Dentistry, Thamar University, Thamar, Yemen
- Department of Orthodontics, College of Dentistry, University of Ibn al-Nafis for Medical Sciences, Sanaa, Yemen
| | - Thrya S. Gadah
- Prosthetic Department, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed E. Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abdulelah Ali Daghriri
- Department of Restorative and Implant Dentistry, Armed Forces Hospital South Region, Aseer, Saudi Arabia
| | - Nasser M. Al Ahmari
- Prosthetic Department, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | - Mohammed M. Al Moaleem
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Alasmari D. Morphometric Evaluation of Morphological Variations of the Nasopalatine Canal: A Retrospective Study Using Cone-beam Computed Tomography. J Contemp Dent Pract 2023; 24:660-667. [PMID: 38152939 DOI: 10.5005/jp-journals-10024-3561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM The study aimed to analyze the morphological and anatomical variations of the nasopalatine canal (NPC) using cone-beam computed tomography (CBCT) images and their association with age and gender among the subpopulation of the Qassim region of Saudi Arabia. MATERIALS AND METHODS The CBCT records of 401 patients referred to the Department of Radiology between January 2020 and July 2023 were randomly selected in the retrospective cross-sectional study. The anatomical characteristics such as the length of the NPC, and the superior and inferior width of the canal, were analyzed. In the sagittal and axial planes, the morphological variants of the shape of the NPC were also investigated. The Statistical Package for the Social Sciences (SPSS) software was used for statistical analyses at a 5% significance level. RESULTS The study examined the CBCT images of 219 females (54.6%) and 182 males (45.4%) with an overall mean age of 40.17 ± 2.31 years. The overall length of the NPC and superior and inferior canal width were 13.86 ± 2.68 mm, 3.4 ± 1.42 mm, and 4.07 ± 2.06 mm, respectively. Independent t-test revealed that the males had a statistically significant larger superior (3.62 ± 1.78 mm) and inferior canal width (4.33 ± 1.79 mm). In terms of gender, the Chi-square test revealed a statistically significant association (p < 0.01) between the morphological shape of the NPC in the axial and sagittal planes. The heart-shaped (51.4%) and cone-shaped canals (34.2%) were the most frequently recorded NPC in the axial and sagittal planes, respectively. Pearson's correlation found a statistically significant positive relationship (p < 0.05) between the superior and inferior canal width and the canal length. Spearman's correlation revealed a statistically highly significant correlation between the NPC shape in the sagittal plane and gender (p < 0.001). CONCLUSION The study findings revealed a statistically significant difference in the anatomical and morphological traits of the NPC in the axial and sagittal planes based on gender. The effect of age and gender was found to exhibit significant differences with the NPC parameters. The heart-shaped canal in the axial plane and the cone-shaped canal in the sagittal plane were more prevalent in the study sample. A three-dimensional (3D) examination of the NPC will be crucial to avert challenging circumstances prior to surgical treatments in the anterior maxilla. CLINICAL SIGNIFICANCE The NPC is a long, narrow canal that can take up to 58% of the buccal bone plate width, and an accurate 3D anatomic illustration of the NPC allows for reliable surgical planning and dental implant placement.
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Affiliation(s)
- Dhafer Alasmari
- Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, Buraidah, Saudia Arabia, Phone: +966 504444183, e-mail:
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Anatomical and Morphological Assessment of Nasopalatine Canal in Pediatric and Adolescent Population via Cone Beam Computed Tomography. J Craniofac Surg 2021; 32:1994-1998. [PMID: 33534328 DOI: 10.1097/scs.0000000000007476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Anatomical and morphological structure of nasopalatine canal (NPC) is important for surgical techniques carried out on the maxilla. The aim of the present study was to analyze the anatomical and morphological characteristics of the NPC among pediatric and adolescent population using cone beam computed tomography (CBCT). MATERIALS AND METHODS A total of 437 cases were analyzed using CBCT images in this retrospective, cross-sectional study. Shape was analyzed as hourglass, cone, funnel, banana, cylindrical, and tree branch like. Number of foramina Stenson (FS) was evaluated through coronal, axial, and sagittal views. Landmark evaluation involved; diameter of FS, diameter of incisive foramen, diameter at the mid-canal length, NPC length, and narrowest buccal bone thickness. Pathology presence near NPC was evaluated to determine alterations on the landmark metrics. RESULTS Nasopalatine canal shape distribution revealed 32% hourglass, 9.6% conic, 10.8% funnel, 11.9% banana, 29.5% cylindrical and 6.2% tree branch. Number of FS (P = 0.021; P < 0.05), diameter of FS (P = 0.041; p < 0.05), NPC length (P: 0.020; P < 0.05), and narrowest buccal bone thickness from the mid-canal length was significantly higher in males (P: 0.000; P < 0.05). Diameter of incisive foramen and diameter at the mid-canal length revealed no significance among genders (P1 = 0.318, P2 = 0.105; P > 0.05). Incidence of pathology near NPC is 20.8% and was not affected by gender (P = 0,192; P > 0.05). CONCLUSIONS The current study demonstrates significant variations of NPC morphology among patients. Therefore, CBCT analysis is highly recommended for clinicians to reduce the complications in oral and maxillofacial surgery practices and to provide better surgical outcomes.
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Morphometric analysis of nasopalatine foramen in Sri Lankan population using CBCT. J Oral Biol Craniofac Res 2019; 10:238-240. [PMID: 32489828 DOI: 10.1016/j.jobcr.2019.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/29/2019] [Indexed: 11/24/2022] Open
Abstract
Nasopalatine canal (NPC) is an important anatomical structure present in the anterior mid maxilla. It has the synonyms of incisive canal or anterior palatine canal. The objective of this study was to identify the morphometric characteristics of the NPC in group of Sri Lankan people using Cone beam computer tomography (CBCT) and to determine normal morphological course and anatomical variations. Fifty Maxillary CBCT images of anterior maxilla, obtained from the archives of the University Dental Hospital, Peradeniya were retrospectively analyzed to determine the position of the NPC. Morphology, canal dimension of NPC and its relation to the maxilla. Majority had a single opening (48%) or 2 openings (46%). Average diameter of the canal was 3.692 mm with a range of 2-6 mm. Majority of the canals had funnel shape and were vertically curved. Average length of canal was 12.142 mm and angulations of the curvature was 115.6940. Average antero-posterior diameter at nasal fossa was 2.852 mm, at mid-palate 2.366 mm and at hard palate 3.034 mm. Our findings were different from the findings reported in the literature. This may be due to the differences in ethnicity or limited size of sample. Within the limits of this study, we conclude that the form of the NPC is variable; predominantly funnel shaped with a single or two openings and with an average diameter of 3.7 mm in Sri Lankan population. Identification of variations in the position and shape will help in clinical practice specially in introducing local anesthetic block injections during dental treatment.
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Zhang Z, Yin H, Wang Z, Li J, Lv H, Zhao P, Yang Z, Wang Z. Imaging re-evaluation of the tympanic segment of the facial nerve canal using cone-beam computed tomography compared with multi-slice computed tomography. Eur Arch Otorhinolaryngol 2019; 276:1933-1941. [DOI: 10.1007/s00405-019-05419-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/07/2019] [Indexed: 01/17/2023]
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