Cone-beam Computed Tomography Evaluation of Nasopalatine Canal Anatomy and Anterior Maxillary Bone Thickness for Immediate Implant Placement

Introduction: Successful implant placement in the anterior maxilla requires detailed assessment of anatomical structures, particularly the nasopalatine canal (NPC), due to its proximity to planned implant sites. This study evaluated the anatomy and morphology of the NPC and anterior maxillary bone using cone-beam computed tomography (CBCT) to guide immediate implant planning. Materials and Methods: A cross-sectional observational study was conducted using 60 CBCT scans retrospectively selected from dentate individuals. Measurements included anteroposterior (A-P) and mediolateral (M-L) dimensions of the nasal foramen, incisive canal (IC) and incisive foramen; canal length and location; anterior maxillary bone thickness (MBT) at multiple levels; shape, angle, curvature and type of the IC; and NPC proximity to maxillary central incisor roots. Intergroup comparisons were analysed using nonparametric tests, and correlations were assessed with Spearman’s analysis. Results: Males showed significantly longer NPCs and greater horizontal MBT compared to females ( P < 0.05). NPC length and MBT decreased significantly with age ( P < 0.05), while vertical bone height remained stable. The IC most commonly exhibited a funnel shape (70%). No significant gender or age differences were observed in IC shape. A slight but non-significant positive correlation was noted between mean MBT and IF location. Conclusion: Anatomical variability of the NPC and anterior maxillary bone is influenced by gender and age, with important clinical implications for implant placement. Preoperative CBCT evaluation is critical to optimise implant positioning, improve primary stability and minimise neurovascular complications, particularly in female and younger patients.