Morphological Evaluation of the Incisive Canal in the Aspect of the Diagnosis and Planning of Orthodontic Treatment—CBCT Study

Abstract

Background: Understanding the anatomy of the incisive canal is crucial for effective diagnosis and treatment planning in clinical orthodontics. This is because, during orthodontic tooth movement, there is a risk of contact between the roots of the upper central incisors and the incisive canal. Objective: The aim of this study was to assess the anatomical variability of the incisive canal using cone beam computed tomography (CBCT), as well as to evaluate its correlation with age, sex, and the position of the maxillary central incisors. There are only a few studies on this topic. Materials and methods: We analysed CBCT data from 67 patients aged from 13 to 49 years. This study was conducted at the Wroclaw Medical University. Measurements were performed twice by two independent researchers, and intra-observer error and correlation were calculated. The mean difference between the first and second observations and between observers was also assessed. We examined the dimensions of the incisive canal and its relationship to the roots of the upper central incisors in relation to age and gender. Results: Our study results revealed a significant correlation between the width and length of the incisive canal. Males exhibited a significantly greater canal length at the lowest point of the incisive canal on the palatal wall. Additionally, males had wider canals compared to females. The analysis of canal width and distance between the most mesial point of the root and the line passing through the most anterior point of the incisive canal showed a negative correlation in all age groups of men. The analysis of incisal inclination and incisal canal inclination showed a very strong relationship, especially in the age group of 13 to 20 years. Several potential risk groups of contact between the roots of central incisors and the incisive canal have been identified based on their structure and the planned incisors’ orthodontic movement. Conclusions and implications: Knowledge of the anatomy of the incisive canal and the use of 3D imaging in high-risk patients can prevent resorption of the incisor root by considering the individual anatomical conditions of the patient when planning orthodontic tooth movement. We recommend performing a CBCT scan before starting orthodontic treatment in the case of moderate and significant retraction of the incisors, or a significant change in their inclination due to the wide anatomical diversity of the incisive canal, especially in adult patients.

Keywords

• anatomy
• CBCT
• root resorption
• incisive canal
• nasopalatine canal
• retraction