Premium
Nasopalatine canal and periapical radiolucency fusion following dentoalveolar trauma: A CBCT‐based case‐control study
Author(s) -
Jacobs Reinhilde,
Shujaat Sohaib,
Salvo Natalia,
Bornstein Michael M.,
Politis Constantinus
Publication year - 2020
Publication title -
dental traumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 81
eISSN - 1600-9657
pISSN - 1600-4469
DOI - 10.1111/edt.12545
Subject(s) - radiodensity , dentistry , medicine , root canal , orthodontics , surgery , radiography
Background/Aim There is a lack of evidence regarding the radiological characteristics of a periapical radiolucency (PRL) fusion with the nasopalatine canal (NPC) following dentoalveolar trauma. The aim of this study was to assess the NPC enlargement resulting from fusion with a PRL and its relationship with the surrounding anatomical structures. Material and methods A total of 100 patients was retrospectively recruited and divided into two groups: case group and control group. The case group consisted of 50 cone‐beam computed tomography scans of the maxilla of patients (32 males, 18 females; age range: 11‐83 years) with a known history of dentoalveolar trauma in the maxillary anterior region and the presence of an undiagnosed and/or asymptomatic NPC and PRL fusion. An age‐ and gender‐matched control group of 50 patients (32 males, 18 females; age range: 11‐82 years) without trauma history to the upper anterior teeth, demonstrating normal maxillary scans, was recruited. A subjective scoring criterion was established for assessing the characteristics of the fused lesion and its relationship with the buccal/palatal alveolar cortex, nasal cavity cortex, NPC cortical border, and maxillary sinus floor. Results The fused NPC and PRL was mainly lobular in appearance (88%) with non‐corticated well‐defined margins (80%). Male patients showed larger (68%) dimensions compared with female patients (32%). The NPC cortical bone was the most commonly perforated structure in relation to fusion (72%), whereas maxillary sinus cortical bone was the least effected (2%). A statistically significant difference was observed between the NPC dimensions in the control and test groups, with fused lesions having larger mesiolateral, craniocaudal, and buccopalatal dimensions ( P < .001). Conclusions Periapical radiolucencies should be treated as soon as possible before they fuse with NPC. In case of fusion, surgical enucleation should be considered as the treatment of choice.