The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 24 , ISSUE 9 ( September, 2023 ) > List of Articles


Morphometric Evaluation of Morphological Variations of the Nasopalatine Canal: A Retrospective Study Using Cone-beam Computed Tomography

Dhafer Alasmari

Keywords : Cone-beam computed tomography, Implants, Incisive foramen, Nasopalatine canal, Stenson's foramen

Citation Information : Alasmari D. Morphometric Evaluation of Morphological Variations of the Nasopalatine Canal: A Retrospective Study Using Cone-beam Computed Tomography. J Contemp Dent Pract 2023; 24 (9):660-667.

DOI: 10.5005/jp-journals-10024-3561

License: CC BY-NC 4.0

Published Online: 13-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The study aimed to analyze the morphological and anatomical variations of the nasopalatine canal (NPC) using cone-beam computed tomography (CBCT) images and their association with age and gender among the subpopulation of the Qassim region of Saudi Arabia. Materials and methods: The CBCT records of 401 patients referred to the Department of Radiology between January 2020 and July 2023 were randomly selected in the retrospective cross-sectional study. The anatomical characteristics such as the length of the NPC, and the superior and inferior width of the canal, were analyzed. In the sagittal and axial planes, the morphological variants of the shape of the NPC were also investigated. The Statistical Package for the Social Sciences (SPSS) software was used for statistical analyses at a 5% significance level. Results: The study examined the CBCT images of 219 females (54.6%) and 182 males (45.4%) with an overall mean age of 40.17 ± 2.31 years. The overall length of the NPC and superior and inferior canal width were 13.86 ± 2.68 mm, 3.4 ± 1.42 mm, and 4.07 ± 2.06 mm, respectively. Independent t-test revealed that the males had a statistically significant larger superior (3.62 ± 1.78 mm) and inferior canal width (4.33 ± 1.79 mm). In terms of gender, the Chi-square test revealed a statistically significant association (p < 0.01) between the morphological shape of the NPC in the axial and sagittal planes. The heart-shaped (51.4%) and cone-shaped canals (34.2%) were the most frequently recorded NPC in the axial and sagittal planes, respectively. Pearson's correlation found a statistically significant positive relationship (p < 0.05) between the superior and inferior canal width and the canal length. Spearman's correlation revealed a statistically highly significant correlation between the NPC shape in the sagittal plane and gender (p < 0.001). Conclusion: The study findings revealed a statistically significant difference in the anatomical and morphological traits of the NPC in the axial and sagittal planes based on gender. The effect of age and gender was found to exhibit significant differences with the NPC parameters. The heart-shaped canal in the axial plane and the cone-shaped canal in the sagittal plane were more prevalent in the study sample. A three-dimensional (3D) examination of the NPC will be crucial to avert challenging circumstances prior to surgical treatments in the anterior maxilla. Clinical significance: The NPC is a long, narrow canal that can take up to 58% of the buccal bone plate width, and an accurate 3D anatomic illustration of the NPC allows for reliable surgical planning and dental implant placement.

PDF Share
  1. Nemtoi A, Sirghe AE, Nemtoi A, et al. CBCT analysis of the morphology and anatomical variants of the nasopalatine canal in north-eastern population of Romania. Rom J Oral Rehabil 2019;11(4):213–227. Available from:
  2. Nikkerdar N, Khavid A, Golshah A, et al. Anatomical variations of the nasopalatine canal using cone–beam computed tomography in a subpopulation residing in west of Iran. Ann Dent Spec 2018; 6(3):311–316. Available from: mKESBqeLovRLD2QgaEQ29as6WlYK8DB/anatomical-variations- of-the-nasopalatine-canal-using-cone-beam-computed-tomography-in-a-sub-popul.pdf.
  3. Mishra R, Thimmarasa V, Jaju P, et al. Influence of gender and age on nasopalatine canal: A cone–beam computed tomography study. J Dent Implant 2017;7(1):15–19. DOI: 10.4103/jdi.jdi_15_17.
  4. Khojastepour L, Haghnegahdar A, Keshtkar M. Morphology and dimensions of nasopalatine canal: A radiographic analysis using cone–beam computed tomography. J Dent (Shiraz, Iran) 2017;18(4):244–250. PMID: 29201966.
  5. 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(3):301–305. DOI: 10.5005/jp-journals-10024-2257.
  6. Thakur AR, Burde K, Guttal K, et al. Anatomy and morphology of the nasopalatine canal using cone–beam computed tomography. Imaging Sci Dent 2013;43(4):273–281. DOI: 10.5624/isd.2013.43.4.273.
  7. Safi Y, Moshfeghi M, Rahimian S, et al. Assessment of nasopalatine canal anatomic variations using cone–beam computed tomography in a group of Iranian population. Iran J Radiol 2017;14(1):e13480. DOI: 10.5812/iranjradiol.37028.
  8. Jain NV, Gharatkar AA, Parekh BA, et al. Three-dimensional analysis of the anatomical characteristics and dimensions of the nasopalatine canal using cone–beam computed tomography. J Maxillofac Oral Surg 2017;16(2):197–204. DOI: 10.1007/s12663-016-0879-5.
  9. Bornstein MM, Balsiger R, Sendi P, et al. 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(3):295–301. DOI: 10.1111/j.1600-0501.2010.02010.x.
  10. Mardinger O, Namani–Sadan N, Chaushu G, et al. Morphologic changes of the nasopalatine canal related to dental implantation: A radiologic study in different degrees of absorbed maxillae. J Periodontol 2008;79(9):1659–1662. DOI: 10.1902/jop.2008.080043.
  11. Linjawi A, Othman M, Dirham A, et al. Morphological evaluation of the incisive canal with reference to gender and age: A cone–beam tomography study. Niger J Clin Pract 2021;24:1596–1601. DOI: 10.4103/njcp.njcp_40_21.
  12. Neves FS, Oliveira LK, Mariz ACR, et al. Rare anatomical variation related to the nasopalatine canal. Surg Radiol Anat 2013;35(9): 853–855. DOI: 10.1007/s00276-013-1089-1.
  13. Rodrigues MTV, Munhoz EA, Cardoso CL, et al. Unilateral patent nasopalatine duct: A case report and review of the literature. Am J Otolaryngol 2009;30(2):137–140. DOI: 10.1016/j.amjoto.2008.02.015.
  14. 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 2021;11(5):915. DOI: 10.3390/diagnostics11050915.
  15. 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(6):713–717. DOI: 10.1563/AAID-JOI-D-10-00106.
  16. 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(3): 527–535. DOI: 10.5603/FM.a2018.0013.
  17. Bahsi I, Orhan M, Kervancioglu P, et al. Anatomical evaluation of nasopalatine canal on cone–beam computed tomography images. Folia Morphol 2019;78(1):153–162. DOI: 10.5603/FM.a2018.0062.
  18. Jornet PL, Boix P, Perez A, et al. Morphological characterization of the anterior palatine region using cone–beam computed tomography. Clin Implant Dent Relat Res 2015;17:e459–464. DOI: 10.1111/cid.12271.
  19. Fernández–Alonso A, Suárez–Quintanilla JA, Muinelo–Lorenzo J, et al. Three-dimensional study of nasopalatine canal morphology: A descriptive retrospective analysis using cone–beam computed tomography. Surg Radiol Anat 2014;36(9):895–905. DOI: 10.1007/s00276-014-1297-3.
  20. 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(7):598–603. DOI: 10.1111/j.1600-051X.2009.01429.x.
  21. Mraiwa N, Jacobs R, van Cleynenbreugel J, et al. The nasopalatine canal revisited using 2D and 3D CT imaging. Dentomaxillofacial Radiol 2004;33(6):396–402. DOI: 10.1259/dmfr/53801969.
  22. Etoz M, Sisman Y. Evaluation of the nasopalatine canal and variations with cone–beam computed tomography. Surg Radiol Anat 2014;36(8):805–812. DOI: 10.1007/s00276-014-1259-9.
  23. Al-Amery SM, Nambiar P, Jamaludin M, et al. Cone–beam computed tomography assessment of the maxillary incisive canal and foramen: Considerations of anatomical variations when placing immediate implants. PLoS One 2015;10(2):e0117251. DOI: 10.1371/journal.pone.0117251.
  24. Panjnoush M, Norouzi H, Kheirandish Y, et al. Evaluation of morphology and anatomical measurement of nasopalatine canal using cone–beam computed tomography. J Dent (Tehran) 2016;13(4):287–294. PMID: 28127321.
  25. Kajan ZD, Kia J, Motevasseli S, et al. Evaluation of the nasopalatine canal with cone–beam computed tomography in an Iranian population. Dent Res J (Isfahan) 2015;12(1):14–19. DOI: 10.4103/1735-3327.150289.
  26. Soumya P, Koppolu P, Pathakota KR, et al. Maxillary incisive canal characteristics: A radiographic study using cone–beam computerized tomography. Radiol Res Pract 2019;2019:6151253. DOI: 10.1155/2019/6151253.
  27. Salemi F, Moghadam FA, Shakibai Z, et al. Three-dimensional assessment of the nasopalatine canal and the surrounding bone using cone–beam computed tomography. J Periodontol Implant Dent 2016;8(1):1–7. DOI: 10.15171/jpid.2016.001.
  28. Talebian M, Etemadi S, Seimareh K, et al. Morphological and anatomical assessment of the nasopalatine canal in edentulous patients using cone–beam computed tomography. Rev Publicando 2018;5(16):494–502. Available from:
  29. Gönül Y, Bucak A, Atalay Y, et al. MDCT evaluation of nasopalatine canal morphometry and variations: An analysis of 100 patients. Diagn Interv Imaging 2016;97(11):1165–1172. DOI: 10.1016/j.diii. 2015.11.012.
  30. Kim YT, Lee JH, Jeong SN. Three-dimensional observations of the incisive foramen on cone–beam computed tomography image analysis. J Periodontal Implant Sci 2020;50(1):48–55. DOI: 10.5051/jpis.2020.50.1.48.
  31. Nasseh I, Aoun G, Sokhn S. Assessment of the nasopalatine canal: An anatomical study. Acta Inform Medica 2017;25(1):34–38. DOI: 10.5455/aim.2017.25.34-38.
  32. Keşkek CÖ, Aytuğar E, Çene E. Retrospective assessment of the anatomy and dimensions of nasopalatine canal with cone–beam computed tomography. J Oral Maxillofac Res 2022;13(2):e4. DOI: 10.5037/jomr.2022.13204.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.