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

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.

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

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.

An Anatomical Study of Incisive Canal and its Foramen

Introduction: Anatomically, the incisive canals start on the nasal fossa floor, close to the septum, and open at the incisive foramen of the maxillary palatine process. The nasopalatine nerve passes through the incisive foramen as well as the septal artery and the sphenopalatine vein. Also, there may be accessory canals. Typically, the incisive foramen has two incisive canals. This work aimed to analyze the morphology and morphometry of the foramen and incisive canals in the macerated cephalic skeletons. Material and methods: For this purpose, we selected 150 samples of adult individuals, with no distinctions of sex and ethnicity. We analyzed the frequency of incisive canals in the foramen was analyzed as well the area, diameter, and communications of incisive canals with the fossa and nasal cavity. Results: The cephalic analysis results showed that most incisive foramina have at least two canals that communicate the nasal cavity with the oral cavity. The right-side canal had an average of 1.975mm² in area and 1.281mm in diameter. Also, the left-side canal had an average of 1.468mm² in area and 1.182mm in diameter. The average area and total diameter of the incisive foramen were 8.148mm² and 3.101mm, respectively.Conclusion: Hence, understanding anatomy and its variations is essential for clinical applications, as it may alter surgical technique and prognosis. Besides, it can be said all incisive canals have communication with the nasal cavity.

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

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.

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

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.

Comparative morphology of the dormouse skull

Dormice exhibit both inter- and intrageneric variation in cranial and mandibular morphology. Using geometric morphometrics, the form of eight out of nine extant dormouse genera was analysed, to provide a better understanding of the overall morphological variation present within Gliridae. Three genera representing the subfamilies, were studied in more detail. Species-, genus- and family-specific morphological trends are linked with certain habitats and feeding strategies. Smaller dormice show adaptations to a more arboreal lifestyle such as a relatively enlarged braincase and an inferiorly reoriented foramen magnum. Larger dormice show cranial modifications, including clear flattening of the skull and a more posteriorly positioned foramen magnum, hinting towards a more rupicolous lifestyle. Furthermore, specimens inhabiting arid areas appear to have more inflated auditory bullae, whereas other variable features, such as the length of the incisive foramen, were not associated with either size changes nor climatic variables. Lastly, more robust and horizontally orientated zygomatic arches as well as increased robusticity of the molar row appear to be linked with herbivory in dormice, whereas thinner arches and small concave molars are seen in more insectivorous species. This study results in a better understanding of ecological drivers underpinning the morphological divergence present within Gliridae.

Association between speech and dental occlusion changes in children with cleft lip and palate and time of primary plastic surgeries

ABSTRACT Purpose: to describe the changes in speech and dental occlusion in children with cleft lip and palate and verify their association with each other and with the time of primary plastic surgeries. Methods: a cross-sectional study with collected data on the subjects’ identification, age at the time of primary surgeries, and clinical assessment of speech and dental occlusion. The chi-square test, Fisher's exact test, and t-test were used to verify the associations between the variables at the 5% significance level (p < 0.05). Results: the sample comprised 11 children aged 6 to 10 years, most of whom were males, self-reported white, with trans-incisive foramen cleft, predominantly on the left side. The mean age at lip repair surgery was 6 months, and 13 months at palatoplasty. Among the main dental occlusion changes, posterior and anterior crossbite stood out. All the subjects presented changed speech, with a prevalence of cases with dentoalveolar and palatine deformities, followed by passive and active changes. Subjects with anterior crossbite tended to have undergone primary lip repair surgery at a mean of four months earlier than the subjects without anterior crossbite. Conclusions: the associations between speech and dental occlusion changes, and between these and the time of primary plastic surgeries were not statistically significant. Even though it is known that early lip repair surgery is ideal to favor oral functions and aesthetics, the results revealed a tendency towards anterior crossbite, in these subjects.

Quantitative evaluation of palatal bone thickness to guide miniscrews insertion: a CBCT assessment

Introduction: The use of mini-implants has become common in orthodontic practice as it has increased the possibility of skeletal anchorage. The palate constitutes a site of choice for the insertion of miniscrews purposes because it is a site with relatively safety with appropriate bone thickness and less suitability for inflammation. Aim: To quantitatively evaluate the thickness of the palatal bone for miniscrews insertion. Material and Methods: Forty-seven sets of cone beam computed tomographic (CBCT) images were selected. The sample consisted of cone beam computed tomography from 47 patients (20 male, 27 female; mean age 22.4 years old/± 3.01 years). Palatal bone thickness (PBT) was measured in millimeters (mm) with 5 regions of interest (ROIs) which were determined used the coronal reconstructions of the patatal area: 4, 6, 8 and 10 mm posterior to the incisive foramen were evaluated. A total of 940 ROIs were evaluated. RESULTS: Significant differences were observed for PBT between various palatal sections (p<.01). The thickest area (6.31-7.03 mm) was found in the anterior part of the palate. The mean bone thicknesses in the 6, 8 and 10 mm sections were significantly less than those observed at 4 mm from the incisive foramen. Conclusions: The thickness of the palatal bone is progressively thinner from the palatine foramen to the posterior region. Transversally, the bone was thicker in the palatine suture than in paramedian areas, mainly in the coronal reconstructions located more laterally.