Lateral deviation pattern of the nasopalatine canal in patients exhibiting alveolar cleft defects

Abstract

Patients with facial cleft defects, such as alveolar clefts, represent quite a challenge for the dental practitioner. These patients require a multidisciplinary care approach from the time they are born up until the anomaly is completely repaired. Many guidelines have been established to improve the treatment and closure of cleft defects. To this day, little is known about the trajectory taken by the nasopalatine canal (NPC) in cleft patients. The aim of this study is to describe the lateral deviation pattern of the NPC in alveolar cleft patients as compared to sex- and age-matched controls without such defects. Cone Beam Computed Tomography images (CBCT) of 29 unilateral cleft patients were evaluated and compared to a control group. The dimensions of the NPC and of the buccal alveolar process overlying the canal itself were also assessed. Among the 29 unilateral alveolar cleft patients observed in this investigation, 59% occurred in males while 20 of 29 were on the left side. The NPC was significantly wider in a bucco-lingual dimension and slightly greater in a mesio-distal dimension in cleft patients than non-cleft patients. The width of the buccal alveolar process overlying the NPC was similar in both groups. Age was significantly and inversely associated with buccal alveolar bone width overlying the NPC in cleft patients, but not in control patients. The mean lateral deviation of the NPC was non-significant when compared between the groups. However, the absolute mean deviation of the NPC was statistically different between the 2 groups. Our data suggests there is a strong tendency for the NPC to be positioned on the opposite side of the cleft defect in patients exhibiting cleft alveolus.