CBCT-Based Morphologic Evaluation of Nasopalatine Canal Variations in Unilateral Cleft Lip and Palate Patients

The nasopalatine canal (NPC) is a critical anatomic structure in maxillofacial surgery. Variations in its morphology among individuals with cleft lip and palate (CLP) may increase the risk of neurovascular injury and adversely affect surgical outcomes. This study aimed to investigate the anatomic characteristics of the NPC in CLP patients using cone beam computed tomography (CBCT).

This retrospective cross-sectional study was conducted at a Turkish university hospital, based on CBCT scan data collected between 2016 and 2024. The primary predictor variable was cleft status (yes/no), and the main outcome variables included NPC shape, number of canaliculi, canal length, diameters, and number of the incisive (IF) and nasopalatine foramen (NF), and buccal bone thickness. Appropriate statistics were computed using a significance threshold of P ≤0.05.

A total of 78 unilateral CLP patients (29 females and 49 males; mean age 16.23) and 78 matched controls were included. Tree-branch, needle-shaped, and funnel-shaped canals, as well as type 1 and 2 canaliculi, were significantly more common in the CLP group ( P <0.001, P =0.012). CLP patients exhibited significantly fewer NF, shorter canal length, and smaller IF diameters ( P <0.001). Buccal bone thickness differed by location, with the CLP group showing higher values at points B to D, and the control group at point A ( P ≤0.05).

Anatomic variability of the nasopalatine canal in CLP patients underscores the importance of individualized radiographic assessment. Incorporating CBCT into preoperative planning can enhance procedural safety and improve outcomes in maxillofacial interventions such as Le Fort I osteotomy, implant placement, and orthodontic procedures involving anterior tooth movement.