Anatomic study of the incisive canal in relation to midpalatal placement of mini-implant

Sung-Jin Kim; Sung-Hoon Lim

doi:10.4041/kjod.2009.39.3.146

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Kim and Lim: Anatomic study of the incisive canal in relation to midpalatal placement of mini-implant

Original Article

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2009; 39(3): 146-158.

Published online: 30 June 2009

DOI: https://doi.org/10.4041/kjod.2009.39.3.146

Anatomic study of the incisive canal in relation to midpalatal placement of mini-implant

Sung-Jin Kim, DDS^a, Sung-Hoon Lim, DDS, MSD, PhD^b

^aFellow, Department of Orthodontics, School of Dentistry, Chosun University, Korea.

^bAssociate Professor, Department of Orthodontics, School of Dentistry, Chosun University, Korea.

Corresponding author: Sung-Hoon Lim. Department of Orthodontics, Chosun University Dental Hospital, 421, Seoseok-dong, Dong-gu, Gwangju 501-825, Korea. +82 62 220 3876; shlim@chosun.ac.kr

Received 18 March 2009 Revised 30 April 2009 Accepted 5 May 2009

Abstract

Objective

The purpose of this study was to reveal the position of the incisive foramen in relation to the incisive papilla and cusp tips.

Methods

Plaster models and CT images of 25 adult orthodontic patients were used to measure the width of the incisive canal and positions of the anterior and posterior borders of the incisive foramen in relation to the incisive papilla.

Results

The palatal surface distance from the interdental papilla between the maxillary central incisors to the posterior border of the incisive foramen along the palatal surface was 1.7 fold of the distance from the interdental papilla between the central incisors to the posterior border of the incisive papilla. The distance between the posterior border of the incisive papilla and posterior border of the incisive foramen along the palatal surface was 6.15 ± 1.75 mm. The anteroposterior position of the posterior border of the incisive foramen was slightly anterior to the lingual cusp tips of the maxillary 1st premolars. The width of the incisive foramen was 4.03 ± 0.64 mm, therefore it is recommended to position the mini-implant more than 3 mm laterally when placing a mini-implant lateral to the incisive foramen, from the center.

Conclusions

These results can be used as a reference in presuming the position of the incisive foramen when placing mini-implant in the anterior palate area.

Keywords: Incisive canal, Incisive foramen, Incisive papilla, Mini implant

Figures and Tables

Fig. 1

Adjustment of reference lines. A, Occlusal plane in sagittal section - from incisal edge of maxillary central incisor to mesiobuccal cusp tip of maxillary 1st molar; B, anterior posterior line in axial section - from ANS to PNS; C, transverse line in coronal section - a line connecting lingual cusp tips of maxillary 1st molars.

Fig. 2

Landmarks and measurements made in the midsagittal sections. A, Landmarks, linear and angular mearsuremnets in midsagittal plane; B, measurement of bone thickness at the cusp tip areas. ⊥Surface, measurement along the perpendicular line to the tangent line to the bone surface; ⊥OP, measurement along the perpendicular line to the occlusal plane; C, mesiodistal width of incisive canal on axial section. Refer to Table 1.

Fig. 3

CTS (Cusp Tip Scale: anteroposterior numerical scale by cusp tip) was used to evaluate anteroposterior position of posterior border of incisive foramen and palatal bone thickness at each cusp tip area. C, Canine cusp tip scored as 3.5; CP, midpoint between canine cusp tip and lingual cusp tip of 1st premolar scored as 4.0; P1, lingual cusp tip of 1st premolar scored as 4.5; IP, midpoint between lingual cusp tips of 1st and 2nd premolars scored as 5.0; P2, lingual cusp tip of 2nd premolar scored as 5.5; PM, midpoint between lingual cusp tips of 2nd premolar and mesiolingual cusp tip of 1st molar scored as 6.0; Mm, mesioligual cusp tip of 1st molar scored as 6.5.

Fig. 4

Mesiodistal width of incisive foramen on 3-D view. WF3D, Width of incisive foramen of palate; WN3D, width of nasal aperture of incisive canal at nasal cavity.

Fig. 5

A, G-Pp length measurement on plaster model; B, cusp tip scale of posterior border of papilla on midsagittal section. Refer to Table 1.

Fig. 6

Midpalatal bone thickness at cusp tip areas. P1, Lingual cusp tip of 1st premolar; IP, midpoint between lingual cusp tips of 1st and 2nd premolars; P2, lingual cusp tip of 2nd premolar; PM, midpoint between lingual cusp tip of 2nd premolar and mesiolingual cusp tip of 1st molar; Mm, mesioligual cusp tip of 1st molar; OP, occlusal plane.

Fig. 7

Canal zone. A, Sagittal section. Anterior border of canal zone is on the perpendicular line to occlusal plane starting from the posterior border of incisive foramen. Posterior border of canal zone is on the perpendicular line to the occlusal plane starting from the posterior border of nasal aperture of incisive canal; B, Axial section. Lateral border of canal zone is along the lateral border of incisive canal.

Table 1

Landmarks and measurements used in this study

CTS, refer to Fig 3.

Table 2

Method error according to Dahlberg's fomula

Table 3

Mean, SD and range values of measurements

SD, Standard deviation; CV, coefficient of variation; CTS, cusp tip scale.

Table 4

Spearman rank correlation

^*Correlation is significant at the 0.05 level (2-tailed); ^†Correlation is significant at the 0.01 level (2-tailed).

Table 5

Midpalatal bone thickness posterior to incisive canal (unit, mm)

⊥Surface, Perpendicular to palatal surface; ⊥OP, perpendicular to occlusal plane.

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