Cone Beam Computed Tomography Assessment of the Maxillary Incisive Canal and Foramen: Considerations of Anatomical Variations When Placing Immediate Implants

Abstract

IntroductionThe maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one’s ability to place immediate implants in ideal position.ObjectiveTo avoid causing complication, variations in their dimensions were studied.Material and MethodsImages of ninety Mongoloids patients examined with i-CAT Cone Beam Computed Tomography were included. The sizes of the nasopalatine foramen, the incisive canal and foramen, and anterior maxillary bone thickness were measured. The direction and course of the canals were assessed.ResultsThe mean labiopalatal and mesiodistal measurements of the incisive foramen were 2.80mm and 3.49 mm respectively, while the labiopalatal width of the nasal foramen was 6.06mm. The incisive canal was 16.33mm long and 3.85 mm wide. The anterior maxillary bone has an average thickness of 7.63 mm. The dimensions of the incisive foramen and incisive canal, and anterior maxillary bone thickness demonstrated gender differences with males showing greater values. The anterior maxillary bone thickness was affected by age but this difference was not observed in canal dimensions. The majority of subjects have a funnel shape-like incisive canal with the broader opening located at its superior. They seem to have a longer slanted-curve canal with one channel at its middle portion and a narrower incisive foramen opening than those reported elsewhere.ConclusionsThis study found that gender is an important factor that affected the characteristics of the IC and the amount of bone anterior to it. Male generally had bigger IC and thicker anterior bone. In addition, the anterior maxillary bone thickness was affected by aging, where it becomes thinner with increased age even though the subjects were fully dentate.

Assessment of the Nasopalatine Canal: an Anatomical Study

“…For Al-Amery et al (3) and Kajan et al (7), the labiopalatal (anteroposterior) diameter of the IF was 2.80 ±0.82 and 3.53 ± 1.1 mm respectively.…”

The Incisive Canal: A Comprehensive Review

“…Although limited by a small sample, the previously mentioned Lebanese study found that the length of the canal was shorter in females [ 3 , 21 - 23 ]. Additionally, the length of the canal also varies based on the height of the maxillary bone [ 22 ].…”

“…Morphological depictions of the direction and course of the canal from sagittal imaging views are described as vertical, vertically curved, slanted straight, or slanted curved [ 22 ]. Regarding the angulation of the canal, Song et al reported the slanting angle of the canal, i.e., the angle taken from a vertical reference point, ranged between -7.4 and 35.3 degrees [ 16 ].…”

Nasopalatine Canal Revisited: An Insight to Anterior Maxillary Implants

“…The oral opening of the NPC, the incisive foramen, is found in this region which maintains close proximity to the roots of the upper central incisors [4] [5]. In view of this anatomical relationship, thorough radiographic analysis is necessary during dental implant planning [5] [6].…”

“…Therefore, knowledge of anatomical variations in the size, shape and number of the NPC is important, but studies on this topic are sparse [4] [7] [8] [9] [10].…”