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RETROSPECTIVE CBCT ANALYSIS OF ANATOMIC VARIATIONS OF THE NASOPALATINE CANAL IN A UNITED STATES DENTAL SCHOOL POPULATION
Tang, Kenneth
Tang, Kenneth
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2025-05
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Oral Biology
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https://doi.org/10.34944/f6p8-rp27
Abstract
Objective: The anatomical variations of the nasopalatine canal (NPC) play a critical role in implant planning, particularly in the esthetic zone of the maxilla. However, limited research exists regarding the relationship between NPC angle (NPCA), NPC shape, and NPC type with demographic and clinical factors. This study aims to investigate the influence of age, gender, ethnicity, maxillary anterior dentition status, and smoking history on NPC variations using cone beam computed tomography (CBCT) imaging in a diverse North American dental school population.
Methods: A retrospective cross-sectional study was conducted by reviewing 1450 CBCT scans, of which 692 met inclusion criteria. The NPCA was measured as the angle formed between the anterior nasal spine (ANS), posterior nasal spine (PNS) line and the midline of the NPC. NPC shape was classified into cylindrical, hourglass, cone, banana, funnel, and reverse-cone, while NPC type was categorized as single, double, and Y-shaped canal. One-way ANOVA and Tukey’s post-hoc tests were used to compare mean NPCA across demographic and clinical variables, while Pearson’s chi-squared tests assessed categorical relationships.
Results: The mean NPCA was 65.41° with range of 28.9° to 101°, aligning with literature values range of 69.32° to 76.41°. Ethnicity was significantly associated with NPCA (p < 0.01), with the highest mean values in Middle Eastern (70.15°) and Caucasian (69.26°) patients. Tukey’s multiple comparisons showed statistically significant differences between Caucasian-African American (p = 0.0001), Caucasian-Hispanic (p = 0.038), Caucasian-Asian (p = 0.021), and Hispanic-African American (p = 0.013). Males had a significantly greater NPCA 66.45° than females at NPCA 64.48° (p = 0.03). No significant association was found between NPCA and maxillary anterior dentition status (p = 0.783). Smoking history was significantly associated with NPCA (p = 0.005), with smokers having a higher mean of 67.73° than non-smokers with 64.64°. NPC shape was significantly associated with ethnicity (p = 0.00384) but not with gender (p = 0.319), age (p = 0.1879), dentition status (p = 0.351), or smoking history (p = 0.1294). NPC type was significantly associated with ethnicity (p = 0.0025) but not with gender (p = 0.2376), dentition status (p = 0.5764), or smoking history (p = 0.5525). The most common NPC shape was cylindrical with 30.64% prevalence, while the most common NPC type was single canal with 67.34% prevalence.
Conclusions: This study provides novel insights into NPC anatomical variations and their association with demographic and clinical factors. To the author’s knowledge, this is the first study to examine the relationship between NPCA and ethnicity, as well as NPCA and smoking history. The results highlight significant ethnic differences in NPCA, NPC shape, and NPC type, underscoring the importance of population-specific anatomical considerations in implant planning. The findings also suggest a potential relationship between smoking history and NPCA, warranting further research. In contrast, no significant correlation was found between NPCA and maxillary anterior dentition status. Future studies with larger, more diverse populations, standardized imaging protocols, and controlled variables are recommended to validate these findings and further investigate the clinical implications of NPC variations in dental implant therapy.
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