scholarly journals Clinical Evaluation of the Nasopalatine Canal in Implant-Prosthetic Treatment: A Pilot Study

2020 ◽  
Vol 8 (2) ◽  
pp. 30
Author(s):  
Enrique Fernández Bodereau ◽  
Viviana Yolanda Flores ◽  
Pablo Naldini ◽  
Daniel Torassa ◽  
Patricia Tortolini
Keyword(s):  
Clinical Performance ◽  
Three Dimensional ◽  
Anatomical Variations ◽  
Graft Material ◽  
Central Incisor ◽  
Anterior Maxilla ◽  
Aesthetic Result ◽  
Nasopalatine Canal ◽  
Facial Contour ◽  
Incisive Foramen

Implant-prosthetic rehabilitation of missing teeth in the anterior maxilla is often challenging due to ongoing bone resorption and remodeling events and may require regeneration procedures involving the nasopalatine canal (NPC). We describe a surgical approach with a block graft in relation to the NPC and evaluate clinical performance, sensory perception, and aesthetic result of the implant-prosthetic treatment over a two- to nine-year (mean: 3.5 years) follow-up. Ten implants (six in the right central incisor and four in the left central incisor) were, respectively, placed in 10 consecutive patients with bone defects affecting the NPC and unfavorable widening of the incisive foramen. Treatment stages included: (1) Diagnosis: evaluation of clinical-aesthetic parameters using Cone Beam Computed Tomography; (2) Surgery: block graft placement by palatine and incisal with simultaneous guided bone regeneration, and late (6–10 months) implant placement; (3) Prosthetics: placement of a screw-retained crown (torque of 32 N/cm). At treatment initiation, all the NPCs evaluated in our study were free of pathologies. Treatment evaluation included bone crest thickness, neurosensory status, patients’ treatment perception, and pink and white aesthetic scores (PES/WES). Pre-surgery, anterior ridge thickness at the level of the incisive foramen was (mean ± SD) 3.5 ± 2 mm, 5.4 ± 1.5 mm, and 6.1 ± 1.9 mm at heights of 4, 8, and 14 mm apical to the marginal bone crest, respectively. Post-treatment values were, respectively, 10.1 ± 2.0 mm, 10.5 ± 1.0 mm, and 13.4 ± 3.0 mm. The perception of treatment with the aesthetic pink and white indices (PES/WES) was an average of 7.5 and 7 points, respectively, out of a total of 10 each index, with a recovery of 100% of the neurosensory perception of the area. We propose that bone augmentation using block and particulate graft material can compensate for anatomical variations in the NPC, optimize implant’s three-dimensional positioning and improve facial contour, providing tissue and implant stability and good aesthetic outcomes.

scholarly journals Anatomical Patterns of the Nasopalatine Canal and Incisive Foramen in an African Setting – a Cross-sectional Study

2021 ◽  
Author(s):  
Krishan Sarna ◽  
Merna Akram Estreed ◽  
Khushboo Jayant Sonigra ◽  
Thomas Amuti ◽  
Florence Opondo ◽  
...  
Keyword(s):  
Sexual Dimorphism ◽  
Alveolar Bone ◽  
Bone Thickness ◽  
Cross Sectional ◽  
Anterior Maxilla ◽  
Maxillary Bone ◽  
Nasopalatine Canal ◽  
Anterior Nasal Spine ◽  
Incisive Foramen ◽  
The Mean

Abstract Purpose: Surgical procedures revolving around the anterior maxilla are of great interest due to their debilitating facial aesthetics and nerve injury effects if complications arise. Hence, sufficient knowledge concerning the morphology and morphometry of the nasopalatine canal (NPC) and incisive foramen (IF) is necessary to prevent such complications from arising. Materials and Methods: Measurements of the NPC and the IF were carried out on 150 CBCT scans. The maxillary bone thickness anterior to the NPC was measured at 3 levels. Independent t-test and chi-square test were performed to determine the presence of sexual dimorphism. Results: The presence of one Stenson’s foramen was most prevalent. The mean length of NPC was 13.21 ± 3.25 mm with significantly longer canals in males. The most prevalent shape of NPC was cylindrical in sagittal view and a single canal in coronal view. The mean angulation of NPC was 118.42° to the horizontal plane. The average dimensions of the IF were 3.53 mm and 3.07 mm in the anteroposterior and mediolateral diameter respectively while the most common shape was round. The anterior maxillary bone was thicker in males and generally reduced in thickness from the anterior nasal spine superiorly towards the alveolar crest inferiorly. Conclusion: This study highlights the anatomical characteristics of the NPC and IF, with significant sexual dimorphism observed regarding the number of Stenson’s foramina, length of NPC, shapes of the NPC and IF as well as alveolar bone thickness anterior to NPC.

scholarly journals Gender Differences in the Morphological Characteristics of the Nasopalatine Canal and the Anterior Maxillary Bone - CBCT Study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Pavle Milanovic ◽  
Milica Vasiljevic
Keyword(s):  
Gender Differences ◽  
Linear Regression Analysis ◽  
Morphological Characteristics ◽  
Anterior Maxilla ◽  
Surgical Interventions ◽  
Nasopalatine Canal ◽  
Estimated Parameters ◽  
Incisive Foramen ◽  
And Gender ◽  
Gender Variations

Abstract The aim of this study was to investigate the gender differences in anatomical and morphometric characteristics of the nasopalatine canal–NPC and horizontal dimensions of the anterior maxilla by CBCT, which could be of interest for clinicians who perform implant surgery in this region. A retrospective quantitative study was conducted using CBCT images from the radiological database of the Department of Dentistry (Kragujevac) on a total of 113 participants (63 male and 50 female). The results of our study confirmed no gender difference in the distribution of NPC type, while the most frequent NPC type confirmed gender variations (cylindrical in females, funnel in males), but the lowest incidence of NPC type in both males and females was banana-type. The NPC length was significantly increased in males with no significant gender impact on medio-lateral (M-L) and antero-posterior (A-P) dimensions of the incisive foramen, as well as the A-P dimension of the nasal foramen. Linear regression analysis revealed the significant correlation between the M-L dimension of incisive foramen and the anterior maxilla diameter at all bone levels for males, and between the NPC length and the anterior maxilla diameter only in females at the level D. Also, both NPC type and gender significantly affected the correlations between the estimated parameters (females showed significant correlation only in funnel NPC type at the level D, while males showed significant correlation in both funnel NPC type at the level A, but also in hourglass-type at the level D). Those results imply significant gender impact in planning of various surgical interventions in the anterior maxilla region.

scholarly journals Morphological Characteristics of the Nasopalatine Canal and the Relationship with the Anterior Maxillary Bone—A Cone Beam Computed Tomography Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 915
Author(s):  
Pavle Milanovic ◽  
Dragica Selakovic ◽  
Milica Vasiljevic ◽  
Nemanja U. Jovicic ◽  
Dragan Milovanović ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Morphological Characteristics ◽  
Cone Beam ◽  
Morphometric Characteristics ◽  
Anterior Maxilla ◽  
Nasopalatine Canal ◽  
Implant Placement ◽  
Significant Difference ◽  
Incisive Foramen

The aim of this study was to evaluate the interconnection between the type of nasopalatine canal (NPC) and morphometric characteristics of the anterior maxilla. The investigation involved 113 subjects, and the morphometric parameters were obtained using cone beam computed tomography (CBCT). NPC shapes were classified into four types: banana-, hourglass-, cylindrical-, and funnel-shaped (distribution of approximately 9, 25, 31, and 35%, respectively). The analysis revealed that the NPC shape was significantly connected with the morphometric properties of anterior maxilla horizontal dimensions. In general, a banana-shaped NPC was accompanied with an overall reduction in anterior maxilla diameters when compared to other NPC shapes, with no significant difference between the other three NPC shapes. Furthermore, the morphometric characteristics that depend on NPC shape at the sagittal cross-section were significantly correlated with diameters of the incisive foramen, nasal foramen, and NPC length. According to the results of our study, it seems that the presented analyses of morphometric data may allow useful insight into the algorithms of various interconnections between the measures obtained in the region of the anterior maxilla, which could be of interest for a time rationale approach when planning some surgical procedures, such as immediate dental implant placement planning.

scholarly journals Morphological and Morphometric Characteristics of Anterior Maxilla Accessory Canals and Relationship with Nasopalatine Canal Type—A CBCT Study

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1510
Author(s):  
Milica Vasiljevic ◽  
Pavle Milanovic ◽  
Nemanja Jovicic ◽  
Miroslav Vasovic ◽  
Dragan Milovanovic ◽  
...  
Keyword(s):  
Type A ◽  
The Other ◽  
Simultaneous Estimation ◽  
Alveolar Ridge ◽  
Central Incisor ◽  
Morphometric Characteristics ◽  
Anterior Maxilla ◽  
Lower Region ◽  
Nasopalatine Canal ◽  
The Relationship

This study aimed to evaluate principal morphological and morphometric characteristics of accessory canals (ACs) of the anterior maxilla, as well as to analyze the relationship with nasopalatine canal (NPC) type. The results of our study showed that ACs were observed in almost 50% of participants. They were mostly presented bilaterally and in a curved shape, with a palatal foramen position. The morphometric characteristics of ACs were significantly influenced by NPC type. NPC type had the strongest impact on the distance between the NPC and AC, as well as on the distance between the AC and the facial aspect of buccal bone wall, in inferior parts of the alveolar ridge. On the other hand, the distance between the AC and central incisors was not significantly influenced by NPC shape in the lower region of the anterior maxilla. However, the participants with the banana-type of the NPC expressed the reduction in distance from the AC to the central incisor at the upper part in comparison with the subjects with the cylindrical-type of the NPC. On the basis of the results of this study, the simultaneous estimation of ACs and the NPC seems reasonable, as this approach may be useful in the prevention of complications which could occur during implant surgery interventions.

scholarly journals Evaluation of Stress Generated with Different Abutment Materials and Angulations under Axial and Oblique Loading in the Anterior Maxilla: Three-Dimensional Finite Element Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Sumedha Kapoor ◽  
Shobha Rodrigues ◽  
M. Mahesh ◽  
Thilak Shetty ◽  
Umesh Pai ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Three Dimensional ◽  
The Body ◽  
Von Mises Stress ◽  
Central Incisor ◽  
Element Analysis ◽  
Anterior Maxilla ◽  
Maxillary Central Incisor ◽  
Von Mises

Purpose. The aim of this study was to assess and correlate the stress distribution in an anterior maxillary implant-supported prosthesis with 0°(degree), 15°, and 25° angulated titanium and zirconia abutments using a three-dimensional (3D) finite element analysis (FEA). Materials and Methods. Six FEA models consisting of a dentate anterior maxilla with a single bone-level implant of dimension 4.2 × 10 mm placed in the region of left maxillary central incisor and abutments of dimension 4.2 mm made of titanium and zirconia each with angulation 0° (IA and IB), 15° (IIA and IIB), and 25° (IIIA and IIIB) and ANSYS Workbench software were utilized to design a layered zirconia crown. Unilateral axial and oblique loads of 178 N were applied on the palatal aspect of the crown of left maxillary central incisor. Average von Mises stress values were evaluated in the implant and the peri-implant bone quantitatively and qualitatively. Results. Stress was shown to increase with an increase in angulation in all the areas that were examined. Zirconia abutments showed lesser stress in the implant and surrounding bone than titanium abutments. When compared with the body and apex of the implant, the implant neck values were higher in all models. In between cortical and cancellous bone, the stress recorded was higher in the cortical bone. Conclusion. Within the limitations of this study, straight abutments generated a more uniform and minimal stress in implant and peri-implant bone than angulated abutments. Titanium abutments generated higher stress levels than zirconia abutments. The stresses generated are directly proportional to an increase in abutment angulation, and therefore, straight abutments are most suitable for favourable stress transmission.

scholarly journals The Shape of Nasopalatine Canal as a Determining Factor in Therapeutic Approach for Orthodontic Teeth Movement—A CBCT Study

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2345
Author(s):  
Aleksandra Arnaut ◽  
Pavle Milanovic ◽  
Milica Vasiljevic ◽  
Nemanja Jovicic ◽  
Radisa Vojinovic ◽  
...  
Keyword(s):  
Risk Factor ◽  
Methodological Approach ◽  
Morphometric Characteristics ◽  
Anterior Maxilla ◽  
Additional Tool ◽  
Nasopalatine Canal ◽  
Incisive Foramen ◽  
The Impact ◽  
The Relationship ◽  
Determining Factor

The aim of this study was to evaluate the impact of the nasopalatine canal (NPC) shape and its morphometric characteristics on expected teeth movement by assessing the distance to maxillary central incisors (MCIs) according to NPC type. The retrospective study was performed on 133 CBCT images. The following parameters were obtained: the antero-posterior diameter (A-P) of the nasal foramen (NF), canal length, A-P and mediolateral diameter (M-L) of the incisive foramen (IF), and the distance between NPC and MCIs. With the exception of being hourglass-shaped, each NPC shape showed specific impacts of NPC shape on the relationship between NPC diameters at different sections and distances to MCIs. In banana-shaped NPC, a significant correlation was observed for A-P NF diameter, while in cylindrical-shaped NPC, a significant correlation was observed for NPC length. The increase in M-L IF, A-P IF, A-P NF, and NPC length in funnel-shaped NPC may be a risk factor for interventions that could result in teeth movement. According to the results, it seems that the proposed methodological approach for analysis of CBCT slices in the anterior maxilla may offer detailed information that could be an additional tool in planning the procedures that result in expected teeth movement.

scholarly journals Three-dimensional Assessment of the Nasopalatine Canal and the Surrounding Bone Using Cone-beam Computed Tomography

2018 ◽  
Vol 8 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Fateme Salemi ◽  
Fazele Atarbashi Moghadam ◽  
Zahra Shakibai ◽  
Maryam Farhadian
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Anterior Maxilla ◽  
Nasopalatine Canal ◽  
Size And Shape ◽  
Anterior Nasal Spine ◽  
Incisive Foramen ◽  
School Of Dentistry ◽  
Labial Surface

Background and aims. Because of increasing concerns about surgeries in the anterior maxilla, including implant placement, it is necessary to examine the morphology of the nasopalatine canal and its surrounding bones. This study aimed to analyze the shape and position of the nasopalatine canal and incisive foramen using cone-beam computed tomography (CBCT). Materials and methods. CBCT images of 110 patients referred to Hamadan School of Dentistry were examined. The size and shape of the nasopalatine canal and incisive foramen, the distance between the incisive foramen and the anterior nasal spine, and the distance between the anterior border of the nasopalatine canal and the labial surface of the buccal plate were recorded. Results. The nasopalatine canal length decreased and its diameter increased with aging. The canal was found to be longer and wider in men. Patients without incisors had longer and thicker nasopalatine canals. The distance from the nasopalatine canal to the labial surface of the buccal plate was not gender-related but decreased with age. The distance to the labial cortical surface decreased significantly with loss of incisors. Conclusion. Given the diversities in the size and shape of nasopalatine canals, it is highly important to perform CBCT to prevent neurovascular damage.

Influence of Platform and Abutment Angulation on Peri-Implant Bone. A Three-Dimensional Finite Element Stress Analysis

2013 ◽  
Vol 39 (6) ◽  
pp. 663-669 ◽  
Author(s):  
Ana Paula Martini ◽  
Rosália Moreira Barros ◽  
Amilcar Chagas Freitas Júnior ◽  
Eduardo Passos Rocha ◽  
Erika Oliveira de Almeida ◽  
...  
Keyword(s):  
Finite Element ◽  
Trabecular Bone ◽  
Three Dimensional ◽  
Central Incisor ◽  
Element Analysis ◽  
Anterior Maxilla ◽  
Dimensional Finite Element ◽  
Platform Switching ◽  
Solid Works ◽  
Three Dimensional Finite Element

The aim of this study was to evaluate stress distribution on the peri-implant bone, simulating the influence of Nobel Select implants with straight or angulated abutments on regular and switching platform in the anterior maxilla, by means of 3-dimensional finite element analysis. Four mathematical models of a central incisor supported by external hexagon implant (13 mm × 5 mm) were created varying the platform (R, regular or S, switching) and the abutments (S, straight or A, angulated 15°). The models were created by using Mimics 13 and Solid Works 2010 software programs. The numerical analysis was performed using ANSYS Workbench 10.0. Oblique forces (100 N) were applied to the palatine surface of the central incisor. The bone/implant interface was considered perfectly integrated. Maximum (σmax) and minimum (σmin) principal stress values were obtained. For the cortical bone the highest stress values (σmax) were observed in the RA (regular platform and angulated abutment, 51 MPa), followed by SA (platform switching and angulated abutment, 44.8 MPa), RS (regular platform and straight abutment, 38.6 MPa) and SS (platform switching and straight abutment, 36.5 MPa). For the trabecular bone, the highest stress values (σmax) were observed in the RA (6.55 MPa), followed by RS (5.88 MPa), SA (5.60 MPa), and SS (4.82 MPa). The regular platform generated higher stress in the cervical periimplant region on the cortical and trabecular bone than the platform switching, irrespective of the abutment used (straight or angulated).

scholarly journals Relationship of central incisor implant placement to the ridge configuration anterior to the nasopalatine canal in dentate and partially edentulous individuals: a comparative study

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1315 ◽  
Author(s):  
Xueting Jia ◽  
Wenjie Hu ◽  
Huanxin Meng
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Central Incisor ◽  
Nasopalatine Canal ◽  
Implant Placement ◽  
Bone Width ◽  
Incisive Foramen ◽  
Edentulous Patients ◽  
Bone Height

Background.The aims of this study were to investigate the ridge contour anterior to the nasopalatine canal, and the difference between the incidences of the nasopalatine canal perforation in dentate and partially edentulous patients by cone-beam computed tomography.Methods.Cone-beam computed tomography scan images from 72 patients were selected from database and divided into dentate and partially edentulous groups. The configuration of the ridge anterior to the canal including palatal concavity depth, palatal concavity height, palatal concavity angle, bone height coronal to the incisive foramen, and bone width anterior to the canal was measured. A virtual implant placement procedure was used, and the incidences of perforation were evaluated after implant placement in the cingulum position with the long axis along with the designed crown.Results.Comparing with variable values from dentate patients, the palatal concavity depth and angle were greater by 0.9 mm and 4°, and bone height was shorter by 1.1 mm in partially edentulous patients, respectively. Bone width in edentulous patients was narrower than in dentate patients by 1.2 mm at incisive foramen level and 0.9 mm at 8 mm subcrestal level, respectively. After 72 virtual cylindrical implants (4.1 × 12 mm) were placed, a total of 12 sites (16.7%) showed a perforation and three-fourths occurred in partially edentulous patients. After replacing with 72 tapered implants (4.3 × 13 mm), only 6 implants (8.3%) broke into the canal in the partially edentulous patient group.Conclusions.The nasopalatine canal may get close to the implant site and the bone width anterior to the canal decreases after the central incisor extraction. The incidence of nasopalatine canal perforation may occur more commonly during delayed implant placement in central incisor missing patients.

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