Grafting nasopalatine canal

Grafting nasopalatine canal for dental implant placement

Grafting nasopalatine canal can be done at the time of dental implant placement or prior to placement. The decision on when to bone graft the area depends on the severity of the bone loss and the size of the nasopalatine canal.

When to graft the nasopalatine canal

Grafting of the nasopalatine canal is done when there is a perforation into the canal during dental implant osteotomy. Grafting is also done when there is a severe maxilla atrophy or when a large canal is in the location of a preferable implant location.

Procedural steps for grafting nasopalatine canal

The first step is to expose the nasopalatine foramen, or the incisive foramen. Encluecation of the tissue in this Y shape canal is the easiest method, however some advocate displacing the tissue. Placement of bone graft and dental implant and finally a membrane completes the procedure. If no dental implant at time of grafting then wait 4-6 months before re-entering.

Grafting nasopalatine canal
Very nice image from Cavallaro

Risks of grafting the nasopalatine canal

The loss of sensation of the palatal soft tissue is a risk and intra-operative hemorrhage is as well. Neither is a major concern and we handle the bleeding with local measures. Loss of sensation is nearly or always temporary Waasdorp JOI 2016

Articles on grafting nasopalatine canal

Verardi shows the obliteration of the nasopalatine canal and places a collagen plug in the base of the hole and grafts over the top. Rosenquist is the first to have shown grafting of the incisive canal in the literature. Scher was also very early adopter of nasopalatine grafting.