# Retrospective Evaluation of Nasopalatine Canal Anatomy, Dimensions, and Variations with Alveolar Bone in Patients Scheduled for Maxillary Anterior Dental Implant Surgery Using Cone Beam Computed Tomography

## TL;DR

This study used CT scans to examine the structure and variations of the nasopalatine canal in patients before dental implant surgery to reduce surgical risks.

## Contribution

The study provides detailed insights into the anatomical variability of the nasopalatine canal and its sex-related differences in implant patients.

## Key findings

- The nasopalatine canal was most commonly a single structure in the central incisor region.
- Cylindrical morphology was observed in 44.9% of cases in the sagittal plane.
- Accessory canal locations showed significant sex-related differences.

## Abstract

Objective: This study aimed to retrospectively evaluate the anatomical structure, dimensions, and variations in the nasopalatine canal using cone beam computed tomography (CBCT) in patients undergoing implant treatment in the maxillary anterior region. The goal was to identify potential risks and complications that may arise during surgical procedures. Additionally, canal shape, number, and its relationship with gender and nasal septa were assessed as secondary parameters. Methods: This retrospective study included CBCT scans of 185 patients who applied for implant treatment in the anterior maxilla between January 2021 and December 2023. Patients with edentulous anterior maxillae and no pathological lesions in the implant region were included. CBCT images were analyzed in sagittal, axial, and coronal planes using standardized measurement protocols. The shape, number, dimensions, and angulation of the nasopalatine canal were evaluated by two blind observers with high inter-rater agreement. Morphological classifications and canal–implant relationships were recorded as primary and secondary outcome parameters. Results: Among the 185 CBCT scans analyzed, the nasopalatine canal was most frequently observed as a single structure (87.6%), typically located in the central incisor region, with a cylindrical morphology in the sagittal plane (44.9%) and a single shape in the coronal plane (52.4%). While no significant differences were found in morphometric parameters by age or sex, accessory canal locations differed significantly between sexes (p = 0.040). Conclusions: The anatomical characteristics and morphometric measurements of the nasopalatine canal exhibit considerable variability, underscoring the importance of individualized CBCT assessment during implant planning in the anterior maxilla. Recognizing accessory canal positions, particularly their sex-related differences, is critical for minimizing surgical complications and optimizing outcomes.