Nasopalatine Canal Augmentation for Implant Site Preparation: Literature Review and Case Report with Histomorphometric Analysis

The presence of a wide nasopalatine canal (NPC) and lack of adequate ridge width may affect the correct placement of implant in the central incisor area which could lead to functional and esthetic problems. Nasopalatine canal augmentation technique may be used in the central incisor area to achieve ideal position of implants during surgery. The aim of this article is to evaluate the treatment modalities in NPC region and related complications. A systematic electronic search in Pubmed database was performed. 

The current literatures regarding enucleation and lateralization techniques in NPC area are summarized and discussed. A case report is also presented, a fractured upper right central incisor was extracted and enucleation technique was performed in NPC in conjunction with ridge augmentation. A specimen harvested from augmented NPC after six months during the procedure of implant surgery. The specimen was fixed and sent to histomorphometric analysis. Histomorphometric analysis revealed 36.4 % newly-formed bone. The treatment of enucleation of NPC with the guided bone regeneration can be regarded as successful without sensory disturbance. According to the current literatures and the case report in the present study, NPC augmentation may be a feasible treatment option in implant therapy when encountering an atrophic anterior maxilla. As the results of histomorphometric analysis, new bone formation inside NPC could be expected by this procedure. However, more studies are needed to verify the clinical outcomes, especially the neurologic complications.