Report on the Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

Abstract of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

The main aim of this study is to analyze radiographic variation in the anatomical configuration of the nasopalatine canal. This will discuss anatomical and morphology of the nasopalatine canal. This will be analyzed on the cone beam computed tomographic images. According to these images the results will be compared properly. This results will show the comprehensive knowledge on the anatomical variation. Moreover, this knowledge is also mandatory in the skeletal surgery present in the anterior maxilla. It can be noted that the surgical procedure of dental implantation is done through using radiographic techniques. The main purpose of this study is to evaluate the anatomy of nasopalatine canal present in the human body. For that case, CBCT images of more than 300 patients will be evaluated for analyzing the nasopalatine canal characteristics. It can be noted that there are some five linear measurements will be analyzed properly. Then in the end apply some tests on these measurement for obtaining original results of the system.

Introduction of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

It can be observed that there are different implant procedures are considered for replacing the missing teeth. For that case, dental implants are used by different dentists all over the world. Moreover, through this they can easily restore the esthetic and functional need of the prosthodontics measures. The next point is that it is not easy for the dentist to implant teeth successfully. It is considered as a huge challenge for them. But it can be noted that there are some critical factors through which it will become easy to get success in any dental treatment. The next point is that quality of bone and its regular shape is providing a regular space for the implant fixtures. This shows that quality of bones are defining the future stability and Osseo integration success of the operation. The next point is that Maxillary anterior teeth are considered as extremely important. These teeth are also important for trauma during childhood. Moreover, it is considered as a huge tasks for the dentists for replacing these teeth. Due to this problem esthetic, repairing function and phonetics are satisfied and considered properly (Virdi, 2015).

The main reason is that Esthetic outcome is one of the most important factor for the dentist during implant. It will also surpass this function during the dental implants. The next point is that there is need a safe distance between dental implants and anatomical landmarks. Through this distance it will become easy to apply stable implant treatment. Furthermore, nasopalatine canal is considered as a bony connection between the oral cavities and nasal and it contains some neurovascular bundles (Thomas von Arx, 2016).

Materials and methods of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

This can be done through experimental method, for conducting the experiment, there is need to take approval from the Ethical committee. Then after this these patients are referred to the private Dent maxillofacial radiology clinic made for the patients. In this clinic, the radiographic technique CBCT will be applied. For that purpose pre-implant CBCT evaluation will be analyzed properly according to this cross sectional study.  For that case, there are number of patients were enrolled and according to that only 300 were selected. This shows that only 140 males and 160 females are meeting the criteria of exclusion-inclusion. This criteria shows that the individuals with more than 18 age contain central and maxillary incisors. There are also different criteria of exclusion include, radiolucent lesion, impacted teeth, suspected NPC, pathology, anatomical area of interest, bone graphs, cleft plate and related syndromes. If any person contains such things then it will be included in this criteria. Then after this, a written informed consent was taken from all patients participating in the experiment (Panjnoush M, 2016).

Then after this, according to radiographic technique, all CBCT images are obtained from all patients. Then after this all of these images were converted into the resolution mode through the help of different scanners. Such scanners must contain the value of kVp of 110 and also FOV of 8x8 cm. furthermore, after this a proper coronal and sagittal cross sections were made properly. For that case, the thickness of these intervals are set at 0.5 mm. All of these images were observed by different researchers related to the field of dentistry. Moreover, it is also analyzed under the supervision of the experienced maxillofacial radiologist. After this, both anatomy and nasopalatine canal dimension were analyzed properly. These measurements are made for analyzing the dimension of the nasopalatine canal given in mm. This can be done through the help pf sagittal CBCT and it is present as K1, K2, K3, K4 and K5. This means that the K1 is showing the diameter of the nasal opening of the canal. The K2 is considered as the diameter of the canal. On the other hand, K3 is the length of the canal and the vertical distance present between the oral opening and nasal. The width of buccal bone plate is given by K4 and K5 is considered as the width of the buccal bone plate that is present over the nasal opening of the nasopalatine canal (Koppolu, Pathakota, & Chappidi4, 2019).

Figure 1: Measured demission of the nasopalatine canal

In the above figure, all connections are shown with complete details. This shows that in the coronal CBCT cross section, there is NPC anatomy and it was then classified in different groups. All of these groups are made according to the classification of Bornstein. Moreover, this type of classification also include type A. This type only contains only single canal. On the other hand, in type B there are two parallel canals are present. Moreover, according to type C, there is some variation with the one oral opening of the nasopalatine canal. This can be explained with the help of figures.

Figure 2: Classification of anatomy of nasopalatine canal

The above figure showing the complete detail about these classification. Moreover, it is also known as anatomic classification of nasopalatine canal morphology.

Figure 3: Radiographic image of these types

The above image is showing the radiographic images of these types. Now for the statistical analysis, the SPSS software application is used that will show one way ANOVA tests. After this, these tests are compared with the dimensions present between the different participants. Moreover, another test was used for comparing the frequency of the canal shape groups (FRIEDRICH, LAUMANN, ZRNC, & ASSAF, 2015).

Results of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

The results are shown according to the study criteria. It also include more than 300 cases. It also shows that the age of these patients are more than 18 years. According to these results more than 100 cases are excluded due to some reasons. These reasons include, poor quality, artifacts, pathology and other missing incisors. The results are showing the value of all variables from K1 to K5. It is showing the highest value of K3 is about 21 and its main standard deviation is also high. According to these results it is also showing that the type C is considered as most prevalent type of NPC collected from these patients. On the other hand, the type B is considered at least frequents. Moreover, the value of K1 to K5 variables and also the percentage and frequencies of different type of NPC is given in tables below.

The frequency and percentage table

Discussion of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

It can be noted that the Maxillary anterior teeth are extremely important during childhood. The main reason is that they contain outmost esthetic importance during smiling. Moreover, another fact is that the angulation and location is responsible for determining the profiles of the individual. Another fact is that such teeth are responsible for incising. On the other hand, these teeth are also vulnerable to trauma because they are present in the exposed location. They are also called as thin planar teeth. If a person loss them permanently then there is a facility of surgical implants. Furthermore, it is considered as the broadest accepted method for the rehabilitation of tooth loss in anterior maxilla. On the other hand, one of the main drawback of this procedure is that it contains some anatomic limitations. This is because NPC is able to occupy more than 58% of the buccal bone plate width. This width can easily support the implants. But for that there is a need of comprehensive planning for implant treatment in anterior maxilla and it is also considered as risky phenomenon. On the other hand, the next fact is that incaution operations may damage this neurovascular content of the nasopalatine canal. Due to this case, the person may face some harmful problems like anesthesia, failure of Osseo integration and hemorrhage. But this problem can be solved easily through the help of CBCT imaging and it is a radiographic technique. These images are able to reveal the anatomic characteristics of the nasopalatine canal in a proper way without any difficulty (Leila, Haghnegahdar, & Keshtk, 2017).

Another fact is that this type of technology is increasing at fast rate. Moreover it is also applied for pre-implants radiographic evaluations. This whole technique is completely based on the cone-shaped x-ray source. It also contains two dimensional detector. This detector is involved in preparing data in a single rotation. The main advantage of this technology is that the patient dose and time is decreased comprehensively. There are some researchers that highlighted and evaluated the ridge configuration anterior according to nasopalatine canal. The results are showing that as the concavity depth and angle is high then bone height will be shorter in different patients. Moreover, there is also need to remove these negative effects in the morphology of the IC. On the other hand, another study is also showing the presence of maxillary central incisors. It is also showing that the Y-shaped canals present in the coronal section are present in high amount according to the current study. These sequences and percentages of nasopalatine canal types is quite similar to previous studies. It is also showing that the canal shapes are not affected by race. Moreover, some researches also shows that the buccal bone plate is majorly affected by gender. But the main fact is that characteristics of measurements are different between these studies. There are also various studies that are discussing the absence and presence of maxillary anterior teeth on the buccal bone plate. The main reason behind this is that the width of buccal bone is quite low (Khojastepour, Haghnegahdar, & Keshtkar, 2017).

Conclusion of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

Summing up all the discussion from above, it is concluded that nasopalatine canal is showing a large variety in dimensions and morphology. The next point is that it is not easy for the dentist to implant teeth successfully. Moreover, it is considered as a huge tasks for the dentists for replacing these teeth. Due to this problem esthetic, repairing function and phonetics are satisfied and considered properly. This criteria shows that the individuals with more than 18 age contain central and maxillary incisors. There are also different criteria of exclusion include, radiolucent lesion, impacted teeth, suspected NPC, pathology, anatomical area of interest, bone graphs, cleft plate and related syndromes. This type only contains only single canal.

On the other hand, in type B there are two parallel canals are present. The results are showing the value of all variables from K1 to K5. It is showing the highest value of K3 is about 21 and its main standard deviation is also high. This width can easily support the implants. But for that there is a need of comprehensive planning for implant treatment in anterior maxilla and it is also considered as risky phenomenon. These images are able to reveal the anatomic characteristics of the nasopalatine canal in a proper way without any difficulty. It is also showing that the Y-shaped canals present in the coronal section are present in high amount according to the current study.

References of Radiographic analysis of the variation in the anatomical configuration of the nasopalatine canal

Doukas, C., & V. Moulos, I. M. (2005). Performance of a Java-based Mobile 3-tier PACS Application for DICOM compliant Medical Images over Heterogeneous Radio Networks. In Proc. of INC2005 Fifth International Network Conference.

FRIEDRICH, R. E., LAUMANN, F., ZRNC, T., & ASSAF, A. T. (2015). The Nasopalatine Canal in Adults on Cone Beam Computed Tomograms–A Clinical Study and Review of the Literature. International Journal of Experimantal and Clinical .

Khojastepour, L., Haghnegahdar, A., & Keshtkar, a. M. (2017). Morphology and Dimensions of Nasopalatine Canal: a Radiographic a Radiographic . journal of Dentistry.

Koppolu, P., Pathakota, K. R., & Chappidi4, V. (2019). Maxillary Incisive Canal Characteristics: A Radiographic Study Using Cone Beam Computerized Tomography. Radiology Research and Practice.

Leila, K., Haghnegahdar, A., & Keshtk, M. (2017). Morphology and Dimensions of Nasopalatine Canal: a Radiographic Analysis Using Cone Beam Computed Tomography. J Dent Shiraz Univ Med Sci., 2017 December; 18(4): 244-250.

Panjnoush M, N. H. (2016). Evaluation of Morphology and Anatomical Measurement of Nasopalatine Canal Using Cone Beam Computed Tomography. Journal of Dentistry .

Thomas von Arx, S. L. (2016). Clinical Oral Anatomy: A Comprehensive Review for Dental Practitioners and Researchers. Springer,.

Virdi, M. (2015). Emerging Trends in Oral Health Sciences and Dentistry. BoD – Books on Demand.