Abstract
Objectives
The main purpose of this article was to clarify the relationship of anterior bone and tooth morphology with NPC. The anatomical features of the NPC region in three dimensions from coronal, axial, and sagittal directions were analyzed using CBCT and the effects of age, gender, sagittal root positions (SRPs) of central teeth, anterior overbite depth (AOD), central incisor (CI)/palatal plane (PP) angle, NPC/PP angle, and collum angles (CA) on NPC were evaluated in a group of the Turkish population.
Materials and methods
In this retrospective study, CBCTs of a total of 330 individuals between the ages of 17 and 82 were evaluated. The effects of SRP, AOD, CI/PP angle, NPC/PP angle and CA on the anatomical features of NPC were examined on the basis of age and gender. Descriptive statistics, Kolmogorov–Smirnov, Chi-square, Wilcoxon, Mann–Whitney-U, Kruskal–Wallis, and Spearman correlation tests were used. p values of < 0.05 were accepted as statistically significant.
Results
While the SRPs, CI/PP angle, NPC/PP angle, CA, and age did not differ statistically according to NPC shape (p > 0.05), NPC shape varied according to gender and AOD (p < 0.05). It was found that cylindrical NPC (32.8%) was more common in females, while conical-shaped NPC (30.7%) was more common in males (p < 0.01). While most conical NPC was detected in individuals with Class I overbite depth, cylindrical NPCs were found in Class II and III individuals (p < 0.01).
Conclusions
The results showed that gender and AOD are influential factors on NPC shape. While conical-shaped NPC is more common in individuals with bite depth incisal, cylindrical-shaped NPC is more likely to be seen in individuals with middle and cervical thirds.
Similar content being viewed by others
Availability of data and materials
Not applicable.
References
Khurana S, Parasher P, Mukherjee P, et al. Cone beam computed tomographic-based retrospective study on newark population for the assessment of distance between incisive canal and maxillary central incisors: Clinical implications. Indian J Dent Res. 2020;31:175–9.
Xu D, Wang Z, Sun L, et al. Classification of the root position of the maxillary central incisors and its clinical significance in immediate implant placement. Implant Dent. 2016;25:520–4.
Moss ML, Salentijn L. The primary role of functional matrices in facial growth. Am J Orthod. 1969;55:566–77.
Linjawi AI, Marghalani HYA. Relationship between maxillary central incisors and incisive canal (IC): a cone beam computed tomography study. Folia Morphol (Warsz). 2021.
Pan Y, Chen S. Contact of the incisive canal and upper central incisors causing root resorption after retraction with orthodontic mini-implants: a CBCT study. Angle Orthod. 2019;89:200–5.
Matsumura T, Ishida Y, Kawabe A, Ono T. Quantitative analysis of the relationship between maxillary incisors and the incisive canal by cone-beam computed tomography in an adult Japanese population. Prog Orthod. 2017;18:24.
Cho EA, Kim SJ, Choi YJ, Kim KH, Chung CJ. Morphologic evaluation of the incisive canal and its proximity to the maxillary central incisors using computed tomography images. Angle Orthod. 2016;86:571–6.
Costa ED, de Oliveira RL, Gaêta-Araujo H, et al. Comparison of distance of upper central incisor root and incisive canal in different sagittal and vertical skeletal patterns and sex: a retrospective CBCT study. Int Orthod. 2021;19:462–70.
Chatriyanuyoke P, Lu CI, Suzuki Y, et al. Nasopalatine canal position relative to the maxillary central incisors: a cone beam computed tomography assessment. J Oral Implantol. 2012;38:713–7.
Zhou Z, Chen W, Shen M, et al. Cone beam computed tomographic analyses of alveolar bone anatomy at the maxillary anterior region in Chinese adults. J Biomed Res. 2014;28:498–505.
Engstrom CM, Loeb GE, Reid JG, Forrest WJ, Avruch L. Morphometry of the human thigh muscles—a comparison between anatomical sections and computer tomographic and magnetic-resonance images. J Anat. 1991;176:139–56.
Etoz M, Sisman Y. Evaluation of the nasopalatine canal and variations with cone-beam computed tomography. Surg Radiol Anat. 2014;36:805–12.
Shrestha R, Liu X, Chen S, et al. Correlation of anterior overbite with root position and buccal bone thickness of maxillary anterior teeth: a CBCT study. Surg Radiol Anat. 2019;41:935–42.
Geiger AM, Wasserman BH, Turgeon LR. Relationship of occlusion and periodontal disease. VI. Relation of anterior overjet and overbite to periodontal destruction and gingival inflammation. J Periodontol. 1973;44:150–7.
Moss ML. The differential roles of periosteal and capsular functional matrices in orofacial growth. Rep Congr Eur Orthod Soc. 2007;29:96–101.
Kwon TG, Park HS, Ryoo HM, Lee SH. A comparison of craniofacial morphology in patients with and without facial asymmetry–a three-dimensional analysis with computed tomography. Int J Oral Maxillofac Surg. 2006;35:43–8.
Hilgers ML, Scarfe WC, Scheetz JP, Farman AG. Accuracy of linear temporomandibular joint measurements with cone beam computed tomography and digital cephalometric radiography. Am J Orthod Dentofacial Orthop. 2005;128:803–11.
Ladeira DB, da Cruz AD, de Almeida SM. Digital panoramic radiography for diagnosis of the temporomandibular joint: CBCT as the gold standard. Braz Oral Res. 2015;29:S1806-83242015000100300.
Guyader E, Savean J, Clodic C, et al. Three-dimensional reconstruction of the temporal bone: comparison of in situ, CT, and CBCT measurements. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135:393–8.
Panda M, Shankar T, Raut A, et al. Cone beam computerized tomography evaluation of incisive canal and anterior maxillary bone thickness for placement of immediate implants. J Indian Prosthodont Soc. 2018;18:356–63.
López Jornet P, Boix P, Sanchez Perez A, Boracchia A. Morphological characterization of the anterior palatine region using cone beam computed tomography. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e459–64.
Al-Amery SM, Nambiar P, Jamaludin M, John J, Ngeow WC. Cone beam computed tomography assessment of the maxillary incisive canal and foramen: considerations of anatomical variations when placing immediate implants. PLoS ONE. 2015;10:e0117251.
Hakbilen S, Magat G. Evaluation of anatomical and morphological characteristics of the nasopalatine canal in a Turkish population by cone beam computed tomography. Folia Morphol. 2018;77:527–35.
Alkanderi A, Al Sakka Y, Koticha T, et al. Incidence of nasopalatine canal perforation in relation to virtual implant placement: a cone beam computed tomography study. Clin Implant Dent Relat Res. 2020;22:77–83.
Bornstein MM, Balsiger R, Sendi P, von Arx T. Morphology of the nasopalatine canal and dental implant surgery: a radiographic analysis of 100 consecutive patients using limited cone-beam computed tomography. Clin Oral Implants Res. 2011;22:295–301.
Friedrich RE, Laumann F, Zrnc T, Assaf AT. The nasopalatine canal in adults on cone beam computed tomograms-a clinical study and review of the literature. In Vivo. 2015;29:467–86.
Tözüm TF, Güncü GN, Yıldırım YD, et al. Evaluation of maxillary incisive canal characteristics related to dental implant treatment with computerized tomography: a clinical multicenter study. J Periodontol. 2012;83:337–43.
Güncü GN, Yıldırım YD, Yılmaz HG, et al. Is there a gender difference in anatomic features of incisive canal and maxillary environmental bone? Clin Oral Implants Res. 2013;24:1023–6.
Song W, Jo D, Lee J, et al. Microanatomy of the incisive canal using three-dimensional reconstruction of microCT images: an ex vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:583–90.
Nayak SS, Pushpalatha C, Bhasin VS, Tammannavar P, Viswanathan V. A cephalometric evaluation of pretreatment and post-treatment outcome using tetragon analysis: a retrospective study. J Contemp Dent Pract. 2013;14:238–43.
Shen Y-W, Hsu J-T, Wang Y-H, Huang H-L, Fuh L-J. The Collum angle of the maxillary central incisors in patients with different types of malocclusion. J Dent Sci. 2012;7:72–6.
Selvan SR, Jain RK. Comparison of maxillary central incisor labial crown-root angle with collum angle in class I and class II division 2 malocclusion. J Evolut Med Dent Sc. 2020;9:2324–9.
Shailaja A, Gowda NC, Gowda S. The collum angle of Maxillary Central Incisors in different skeletal malocclusions–a Cephaometric study. Int J Applied Dental Sci. 2016;2:33–6.
Chung SH, Park YS, Chung SH, Shon WJ. Determination of implant position for immediate implant placement in maxillary central incisors using palatal soft tissue landmarks. Int J Oral Maxillofac Implants. 2014;29:627–33.
Kan JY, Rungcharassaeng K, Lozada J. Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study. Int J Oral Maxillofac Implants. 2003;18:31–9.
Lau SL, Chow J, Li W, Chow LK. Classification of maxillary central incisors—implications for immediate implant in the esthetic zone. J Oral Maxillofac Surg. 2011;69:142–53.
Jung YH, Cho BH, Hwang JJ. Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography. Imaging Sci Dent. 2017;47:181–7.
Ari-Demirkaya A, Biren S, Özkan H, Küçükkeleş N. Comparison of deep bite and open bite cases: normative data for condylar positions, paths and radiographic appearances. J Oral Rehabil. 2004;31:213–24.
Geiger AM, Wasserman BH, Turgeon LR. Relationship of occlusion and periodontal disease: Part VI—relation of anterior overjet and overbite to periodontal destruction and gingival inflammation. J Periodontol. 1973;44:150–7.
Sierwald I, John MT, Schierz O, Jost-Brinkmann PG, Reissmann DR. Association of overjet and overbite with esthetic impairments of oral health-related quality of life. J Orofac Orthop. 2015;76:405–20.
Chung HY, Kim HJ, Kim JW, Yu BP. The inflammation hypothesis of aging: molecular modulation by calorie restriction. Ann N Y Acad Sci. 2001;928:327–35.
Bahşi I, Orhan M, Kervancıoğlu P, Yalçın ED. Morphometric evaluation and surgical implications of the infraorbital groove, canal and foramen on cone-beam computed tomography and a review of literature. Folia Morphol. 2019;78:331–43.
Rai S, Misra D, Misra A, et al. Significance of morphometric and anatomic variations of nasopalatine canal on cone-beam computed tomography in anterior functional zone—a retrospective study. Ann Maxillofac Surg. 2021;11:108–14.
Rao JB, Tatuskar P, Pulla A, et al. Radiographic assessment of anatomy of nasopalatine canal for dental implant placement: a cone beam computed tomographic study. J Contemp Dent Pract. 2018;19:301–5.
Khojastepour L, Haghnegahdar A, Keshtkar M. Morphology and dimensions of nasopalatine canal: a radiographic analysis using cone beam computed tomography. J Dent (Shiraz). 2017;18:244–50.
Gopal KS, Kapoor P. Evaluation of nasopalatine canal using cone beam computed tomography–a retrospective study. Int J Sci Res. 2019;8:15–8.
Mraiwa N, Jacobs R, Van Cleynenbreugel J, et al. The nasopalatine canal revisited using 2D and 3D CT imaging. Dentomaxillofac Radiol. 2004;33:396–402.
Soumya P, Koppolu P, Pathakota KR, Chappidi V. Maxillary incisive canal characteristics: a radiographic study using cone beam computerized tomography. Radiol Res Pract. 2019;2019:6151253.
Jayachandran S, Ramamoorthy S. CBCT evaluation of morphological characteristics of Nasopalatine canal and its related structure-A hospital based retrospective study. JIDA J Indian Dental Assoc. 2019;13.
Thakur AR, Burde K, Guttal K, Naikmasur VG. Anatomy and morphology of the nasopalatine canal using cone-beam computed tomography. Imaging Sci Dent. 2013;43:273–81.
Liang X, Jacobs R, Martens W, et al. Macro- and micro-anatomical, histological and computed tomography scan characterization of the nasopalatine canal. J Clin Periodontol. 2009;36:598–603.
Arriola-Guillén LE, Flores-Mir C. Molar heights and incisor inclinations in adults with Class II and Class III skeletal open-bite malocclusions. Am J Orthod Dentofac Orthop. 2014;145:325–32.
Gomaa N, Elmarhoumy S, Fakhry N. Maxillary Central Incisors’ collum angle in different skeletal vertical malocclusions—a Cephaometric study. Egypt Dent J. 2019;65:1–7.
Arvind TRP, Felicita AS. Correlation between collum angle and lower lip position in different Class II malocclusions—a retrospective cephalometric study. Orthodontic Waves. 2021;80:81–6.
Feres MFN, Rozolen BS, Alhadlaq A, Alkhadra TA, El-Bialy T. Comparative tomographic study of the maxillary central incisor collum angle between Class I, Class II, division 1 and 2 patients. J Orthod Sci. 2018;7.
Elangovan B, Srinivasan B, Kailasam V, Padmanabhan S. Comparison of the collum angle of incisors and canines in skeletal malocclusions–a CBCT study. Int Orthod. 2020;18:468–79.
Linjawi AI. Comparison between characteristics of maxillary right and left central incisors: a cone-beam computed tomography study. J Contemp Dent Pract. 2020;21:723–7.
Nasseh I, Aoun G, Sokhn S. Assessment of the nasopalatine canal: an anatomical study. Acta Inform Med. 2017;25:34–8.
Safi Y, Moshfeghi M, Rahimian S, Kheirkhahi M, Eslami MM. Assessment of nasopalatine canal anatomic variations using cone beam computed tomography in a group of Iranian population. Iran J Radiol. 2017;14:e13480.
Panjnoush M, Norouzi H, Kheirandish Y, Shamshiri AR, Mofidi N. Evaluation of morphology and anatomical measurement of nasopalatine canal using cone beam computed tomography. J Dent (Tehran). 2016;13:287–94.
Arnaut A, Milanovic P, Vasiljevic M, et al. The shape of nasopalatine canal as a determining factor in therapeutic approach for orthodontic teeth movement—a CBCT study. Diagnostics (Basel). 2021;11:2345.
Milanovic P, Selakovic D, Vasiljevic M, et al. Morphological characteristics of the nasopalatine canal and the relationship with the anterior maxillary bone—a cone beam computed tomography study. Diagnostics (Basel). 2021;11:915.
Chan HL, Garaicoa-Pazmino C, Suarez F, et al. Incidence of implant buccal plate fenestration in the esthetic zone: a cone beam computed tomography study. Int J Oral Maxillofac Implants. 2014;29:171–7.
Acknowledgements
Not applicable.
Funding
The authors declare that they have no funding for this research article.
Author information
Authors and Affiliations
Contributions
GM and MA conceived and designed the study, analyzed and interpreted the data, and drafted the article. GM acquired the data, analyzed and interpreted the data, and revised the article. GM and MA conceived and designed the study, and revised the article for important intellectual content. GM read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Ethics approval and consent to participate
The Ethics Committee of Necmettin Erbakan University Dentistry Faculty approved the protocols of this retrospective study.
Consent for publication
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Magat, G., Akyuz, M. Are morphological and morphometric characteristics of maxillary anterior region and nasopalatine canal related to each other?. Oral Radiol 39, 372–385 (2023). https://doi.org/10.1007/s11282-022-00647-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11282-022-00647-6