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Case Reports
. 2018 Jul-Dec;8(2):347-351.
doi: 10.4103/ams.ams_161_17.

Implant Placement into the Nasopalatine Foramen: Considerations from Anatomical and Surgical Point of View

Mukesh Kumar Singhal  1 , Ramakant Dandriyal  2 , Asish Aggarwal  3 , Anshika Agarwal  4 , Sudhir Yadav  5 , Prashant Baranwal  5
Affiliations
Case Reports

Implant Placement into the Nasopalatine Foramen: Considerations from Anatomical and Surgical Point of View

Mukesh Kumar Singhal et al. Ann Maxillofac Surg. 2018 Jul-Dec.

Abstract

Implant placement is a challenge in the anterior maxilla if the available bone is reduced and esthetics is challenging. The ideal implant position should be considered in all three dimensions: mesiodistal, apicocoronal, and orofacial. This article includes a review and a case report for the anatomical and clinical perspective of implant placement in nasopalatine foramen (near incisal canal). In this case report, the edentulous space is mutilated in between the area #12 and #21 teeth. Therefore, only one, 3.0 W/10.00 L implant (bone size 4.2 mm width and 11 mm length) could be placed. Radiographically, D2 bone quality was diagnosed. Before surgery, an emphasis was given over the proper implant selection to avoid oversized implants due to critical anatomical landmark. Careful and with minimal trauma, the soft tissue was handled and implant placement was performed in a proper position, using information from panoramic radiograph, 3-D Dentascan. A surgical guide was used for placement of the implant. Finally, immediate loading of temporary implant prosthesis was done. The primary outcome was satisfactory, as after 72 h, no swelling and numbness were reported. The patient has been recalled after healing period of 24 weeks for permanent restoration.

Keywords: Bone expansion; dental implants; esthetics; imaging modalities; nasopalatine foramen region.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Classification of anatomic variations of the nasopalatine
Figure 2
Figure 2
Upper/lower cast
Figure 3
Figure 3
Intraoral periapical X-ray; #12 and #21 regions
Figure 4
Figure 4
Dentascan (coronal view): with gutta radiographic marker
Figure 5
Figure 5
Dentascan; orthopantomography view
Figure 6
Figure 6
Preoperative
Figure 7
Figure 7
Mucoperiosteal flap (reflection view) showing incisive foramina
Figure 8
Figure 8
Surgical – Incisal view
Figure 9
Figure 9
Pilot drill aspect
Figure 10
Figure 10
Parallel pin
Figure 11
Figure 11
Bone expander – Tip 1.6 mm to crest 2.6 mm
Figure 12
Figure 12
Bone expander at surgical site
Figure 13
Figure 13
Per mucosal extension
Figure 14
Figure 14
Intraoral periapical X-ray, after surgery
Figure 15
Figure 15
Temporary prosthesis
Figure 16
Figure 16
Final prosthesis with all-ceramic zirconia crown
See this image and copyright information in PMC

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