Evaluation of the Nasopalatine Canal of Patients With and Without Cleft Lip and Palate in CBCT Exams

Abstract

Objective To identify and compare the morphology and dimensions of the nasopalatine canal (NPC) of individuals with and without cleft lip and palate using Conical Beam Computed Tomography (CBCT) images and to relate the results to the type of cleft and tooth absences in the region. Setting This is a cross-sectional, analytical study with a retrospective sample. Patients, Participants 100 CBCT exams from patients with cleft lip and palate and 100 CBCT exams from patients without cleft lip and palate were used. Interventions The NPC was evaluated for its morphology and measurements in the coronal, sagittal, and axial reformatting of CBCT exams. Results It was obtained as a result that in the group of patients with a cleft, the shapes of funnel, banana, and needle of the NPC were more frequent than in the control group. Patients with cleft lip and palate had significantly a larger nasopalatine foramen and a larger NPC diameter, besides a significantly shorter NPC, compared to controls. In both groups, edentulous patients had less anterior maxillary bone thickness, when compared to patients with maxillary anterior teeth. Patients with clefts had a bone thickness buccal to the NPC less than in the control group. Conclusions This study confirms the anatomical variability of NPC in patients with cleft lip and palate. This finding reinforces the need for thorough surgical planning of the anterior region of the maxilla, in CBCT exams, by the dentist.

Quantitative assessment of cleft volume and evaluation of cleft’s impact on adjacent anatomical structures using CBCT imaging

“…It makes space for the nasopalatine nerve and the sphenopalatine artery [ 22 ]. The incisive foramen is the buccal opening of the incisive canal [ 25 ]. Both identification and evaluation of the incisive canal before surgical interventions in the area are important for their success, and prevention of complications [ 25 ].…”

“…The incisive foramen is the buccal opening of the incisive canal [ 25 ]. Both identification and evaluation of the incisive canal before surgical interventions in the area are important for their success, and prevention of complications [ 25 ]. Thus, the incisive foramen is an important anatomical landmark for alveolar bone graft surgery.…”

“…Caution is recommended in these cases. The cleft can in fact involve or be situated in the incisive canal [ 25 ].…”

“…Closing the cleft lip and palate negatively affects growth, and subsequently, the morphology of the nose in terms of a deviated septum and hypertrophic nasal turbinate [ 25 ]. That could be observed in the present study.…”

Unilateral Dudak Damak Yarıklı Hastalarda Nazopalatin Kanalın Konik Işınlı Bilgisayarlı Tomografi ile Değerlendirilmesi Evaluation of the Nasopalatine Canal with Cone-Beam Computed Tomography in Patients with Unilateral Cleft Lip and Palate

“…8,9 Ayrıca, lateral insizörler başta olmak üzere dişlerde agenezi görülebilmesi, primer cerrahi sonrası diş germlerinin hasara uğrayabilmesi, diş malformasyonlarına bağlı olarak erken diş kayıpları ve anterior bölgenin travmaya sık maruz kalması gibi durumlar da diş eksikliklerine veya kayıplarına neden olabilirler. 10 Bu durumda bölgenin estetik ve fonksiyonel olarak rehabilite edilebilmesi amacıyla implant tedavisine sıklıkla başvurulur. İmplantın nazopalatin kanal İ dolayısıyla da nöral yapı ile temas halinde olması osteointegrasyonun başarısız olmasına veya bölgede duyusal değişikliklere neden olabilir.…”