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OBJECTIVES: To detect any association between palatally displaced canine (PDC) and nasal septal deviation (NSD), palatal bone thickness and volume, and nasal airway dimensions and volume. MATERIALS AND METHODS: A total of 92 patients were included and subdivided into two groups: group 1, unilateral PDCs (44 patients), and group 2, normally erupted canines (NDCs) (48 subjects). The following variables were measured using cone-beam computed tomography: presence and type of NSD, nasal width, inferior conchae, hard palate and nasal septum thickness, maxillary bone and nasal airway volumes. RESULTS: NSD was detected in 77% and 50% of PDC and NDC subjects, respectively. Within the PDC subjects, significant differences between the displaced and nondisplaced sides were detected. Palate thickness was increased in the canine region and reduced in the molar region. Compared with the control group, PDC subjects had reduced palate thickness and lower nasal airway volume. Two predictors were significant for predicting the odds of PDC occurrence: NSD and maxillary bone volume. CONCLUSIONS: NSD is more frequent in PDC subjects. PDC subjects have reduced palate thickness and decreased nasal airway volume. In the presence of NSD, the odds of developing PDC increase by 3.35 times, and for each one-unit increase in the maxillary bone volume, the odds of developing PDC decrease by 20%.

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BACKGROUND The greater palatine foramen (GPF) is anatomically located distal to the third maxillary molar tooth, midway between the midline of the palate and the dental arch. The GPF contains the major palatine artery, vein, and nerve, traversing the palatine sulcus. This study aimed to evaluate the anatomical position of the GPF in 93 women and 67 men at a single center in Cyprus using cone beam computed tomography (CBCT). MATERIAL AND METHODS A retrospective analysis was conducted on 160 CBCT scans. Measurements of the GPF's horizontal and vertical diameters, distances from GPF to the incisive foramen, posterior nasal spine, anterior nasal spine, and midaxillary suture, and positional relationships to molars were recorded. Statistical analyses compared these measurements between males and females. RESULTS The study included 93 females and 67 males with an average age of 46.6 (±11.6) years. Significant sex differences were observed in most GPF measurements, with males showing larger dimensions such as the anterior nasal spine, posterior nasal spine, mid-maxillary suture, and incisive foramen to the GPF. The GPF was predominantly located in the third molar region (96.25% on the right, 96.9% on the left). The left GPF showed a significantly larger horizontal diameter than the right (P<0.05). CONCLUSIONS There was a significant difference in the average distances from the anterior nasal spine, posterior nasal spine, mid-maxillary suture, and incisive foramen to the GPF, as well as in the size of the GPF, between males and females. Recognizing these variations enhances clinical planning and reduces the risk of complications.

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OBJECTIVES: The aim of this study was to evaluate the influence of palatal vault morphology and screw length on the accuracy of miniscrew insertion in dynamic computer-assisted surgery (d-CAS). METHODS: Twenty-four subjects were allocated into three groups, according to their palatal vault morphology (Group A: medium; Group B: steep/high; Group C: low/flat) and the length of miniscrew used. For each subject, two miniscrews were inserted using a dynamic navigation system. To assess the accuracy of insertion, a postoperative CBCT was performed, and the pre- and post-operative scans were superimposed. Five variables were evaluated: Entry-3D, Entry-2D, Apex-3D, Apex-vertical and angular deviation. Descriptive statistics, Shapiro-wilk, Kruskal-Wallis and Dunn's tests were used for the statistical analysis. The level of significance was P ≤ 0.05. RESULTS: The mean angular deviation values revealed strong discrepancies amongst the groups (Group A:7.11°±5.70°; Group B:13.30°±7.76°; Group C:4.92°±3.15°) and significant differences were found regarding the Apex-3D (P = 0.036) and angular deviations (P = 0.008). A Dunn's test revealed differences in angular deviation between the medium and high/steep palate group (P = 0.004), and between low/flat and high/steep palate group (P = 0.01) but did not confirm any significant difference in the Apex-3D parameter (Group A-B P = 0.10; Group B-C, P = 0.053; Group A-C, P = 1.00). No significant differences were found regarding the length of the miniscrews. CONCLUSIONS: Palatal vault morphology is a factor that influences the accuracy of miniscrew insertion in d-CAS. In subjects with steep and high palatal vaults, insertion accuracy is lower when considering the angular deviation value. Miniscrew length does not influence accuracy. CLINICAL SIGNIFICANCE: Although computer-guided surgery assists the clinician in preventing damage to nearby anatomical structures, individual anatomical variability is a crucial variable. In subjects with a high/steep palate, greater attention should be paid during the planning phase in order to allow for a wide margin from adjacent anatomical structures to achieve better outcomes.

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BACKGROUND: The morphology of the nasopalatine canal is crucial in the planning of prosthetic restorations in the anterior region of the maxilla, as well as in the placement of orthodontic mini-implants. OBJECTIVES: The aim of this study was to assess the morphology of the nasopalatine canal using cone beam computed tomography (CBCT) scans of patients from the University Dental Clinic in Krakow, Poland, to define the position of the canal in relation to common sites of palatal median microimplant placement, and to investigate potential correlations between the anatomy of the canal and age and gender of the patients. MATERIAL AND METHODS: A total of 120 CBCT images were used to assess the anatomy of the nasopalatine canal in 3 planes of space. The bone thickness anterior to the nasopalatine canal and the distance between the distal margin of Stenson's foramen and the predicted midpalatal microimplant position were also measured. RESULTS: The most frequently observed canal type in the coronal plane was the Y-shaped canal, which was present in 60.8% of patients. The nasopalatine canal was classified as cone-shaped in 31.7% of the scans, cylindrical in 28.3%, hourglass-shaped in 27.5%, and banana-shaped in 12.5%. The mean length of the nasopalatine canal was 11.58 mm. The mean width of the canal was 2.89 mm at the nasal fossa level, 1.94 mm in the middle, and 5.09 mm at the palatal level. The mean bone thickness anterior to the nasopalatine canal was 9.07 mm at the level of the nasal opening, 6.84 mm at the level of the oral opening, and 7.32 mm in the middle. The mean distance between the distal margin of Stenson's foramen and the predicted midpalatal microimplant position varied from 0 to 11.94 mm, with a mean of 2.49 mm. CONCLUSIONS: Given the variety of nasopalatine canal forms and dimensions, detailed analysis of CBCT scans is essential prior to the placement of implants and microimplants.

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We present a case of nasopalatine duct cyst in a 35-yearold female. The cyst was diagnosed based on the presence of only one clinical symptom and no obvious clinical signs, which is a relatively rare occurrence. However, the radiographic and histological presentation of this lesion was typical of a nasopalatine duct cyst. Therefore, this case report aims to highlight the variable presentations of the nasopalatine cyst, which is often misdiagnosed and treated as an endodontic infection.

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OBJECTIVE: Rapid maxillary expansion is a common orthodontic procedure to correct maxillary constriction. Assessing the midpalatal suture (MPS) expansion plays a crucial role in treatment planning to determine its effectiveness. The objectives of this preliminary investigation are to demonstrate a proof of concept that the palatal bone underlying the rugae can be clearly imaged by ultrasound (US) and the reconstructed axial view of the US image accurately maps the MPS patency. METHODS: An ex-vivo US scanning was conducted on the upper jawbones of two piglet's carcasses before and after the creation of bone defects, which simulated the suture opening. The planar images were processed to enhance bone intensity distribution before being orderly stacked to fuse into a volume. Graph-cut segmentation was applied to delineate the palatal bone to generate a bone volume. The accuracy of the reconstructed bone volume and the suture opening was validated by the micro-computed tomography (µCT) data used as the ground truth and compared with cone beam computed tomography (CBCT) data as the clinical standard. Also included in the comparison is the rugae thickness. Correlation and Bland-Altman plots were used to test the agreement between the two methods: US versus µCT/CBCT. RESULTS: The reconstruction of the US palatal bone volumes was accurate based on surface topography comparison with a mean error of 0.19 mm for pre-defect and 0.15 mm and 0.09 mm for post-defect models of the two samples, respectively when compared with µCT volumes. A strong correlation (R2 ≥ 0.99) in measuring MPS expansion was found between US and µCT/CBCT with MADs of less than 0.05 mm, 0.11 mm and 0.23 mm for US, µCT and CBCT, respectively. CONCLUSIONS: It was possible to axially image the MPS opening and rugae thickness accurately using high-frequency ultrasound. CLINICAL SIGNIFICANCE: This study introduces an ionizing radiation-free, low-cost, and portable technique to accurately image a difficult part of oral cavity anatomy. The advantages of conceivable visualization could promise a successful clinical examination of MPS to support the predictable treatment outcome of maxillary transverse deficiency.

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BACKGROUND: Prenatal diagnosis of cleft palate is challenging. Numerous 2-dimensional and 3-dimensional methods have been proposed to assess the integrity of the fetal palate, yet detection rates remain relatively low. We propose the "Hard Palate Sweep," a novel 2-dimensional method that enables clear demonstration of the entire fetal palate throughout pregnancy, in a single sweep, avoiding acoustic shadows cast by surrounding bones. OBJECTIVE: This study aimed to assess the feasibility and performance of the Hard Palate Sweep, performed throughout pregnancy. STUDY DESIGN: This was a prospective cross-sectional study performed between 2018 and 2022 in pregnant patients referred for a routine or targeted anomaly scan between 13 and 40 weeks of gestation. The presence or absence of a cleft palate was determined using the "Hard Palate Sweep." This was compared with the postnatal palate integrity assessment. Test feasibility and performance indices, including sensitivity, specificity, and positive and negative predictive values were calculated. Offline clips were reviewed by 2 investigators for the assessment of inter- and intraoperator agreement, using Cohen's kappa formula. The study protocol was approved by the institutional ethics committee. All participating patients were informed and provided consent. RESULTS: A total of 676 fetuses were included in the study. The Hard Palate Sweep was successfully performed in all cases, and 19 cases were determined to have a cleft palate. Of these, 13 cases were excluded because postmortem confirmation was not performed, leaving 663 cases available for analysis. Six cases determined to have a cleft palate were confirmed postnatally. In 655 of 657 cases prenatally determined to have an intact palate, this was confirmed postnatally. In the 2 remaining cases, rare forms of cleft palate were diagnosed postnatally, rendering 75% sensitivity, 100% specificity, 100% positive predictive value, and 99.7% negative predictive value for the Hard Palate Sweep (P<.001). There was complete intra- and interoperator agreement (kappa=1; P<.0001). CONCLUSION: The Hard Palate Sweep is a feasible and accurate method for prenatally detecting a cleft palate. It was successfully performed in all attempted cases between 13 and 40 weeks of gestation. This method is reproducible, offering high sensitivity and specificity. Implemented routinely, the Hard Palate Sweep is expected to increase the prenatal detection of cleft palate.

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Data on the features of the anatomical structure of the hard palate are little described in the scientific literature, and therefore are not taken into account when planning surgical treatment. One of the intraoperative complications during intervention on the lower part of the nasal septum is perforation of the bottom of the nasal cavity, which can develop during a christotomy. This complication mainly depends on the features of the anatomical structure of the hard palate. OBJECTIVE: To study the anatomical structure of the hard palate from the point of view of rhinosurgery, using vector analysis of multispiral computed tomography (MSCT), and to establish anatomical features that should be taken into account when performing surgical interventions on the nasal septum. MATERIAL AND METHODS: 107 patients (30 men, 77 women) were examined without congenital cleft palate and surgical interventions on the structures of the nasal cavity and hard palate. All patients underwent MSCT of the nose and paranasal sinuses (PNS) followed by multiplanar image reconstruction. The key point relative to which the measurements were carried out was the posterior wall of the incisor canal from the side of the nasal cavity. The line corresponding to the bottom of the nasal cavity was chosen as the main vector. In the work, measurements of the thickness of the hard palate (THP) at the level of the palatal suture and the width of the palatal suture (WPS) were carried out. RESULTS: Statistical analysis of the obtained results showed that the THP is 1.74 mm [min 0.28; max 6.46], the WPS is 0.9 mm [min 0.2; max 2.51] (conditional norm). In 19 patients (17.8%), the THP was 0.82 mm, in 2 patients (1.9%) - 0.2 mm. In 3 patients (2.8%), the WPS was equal to 2.5 mm. CONCLUSION: Thus, the data obtained by us indicate that the surgical anatomy of the hard palate is characterized by significant variability, while in some patients the THP can be reduced by 8.8 times, and the WPS increased by 2.7 times compared to normal values. Such anatomical features of the structure of the hard palate should be taken into account when planning septoplasty, since this contingent of patients has an increased risk of developing iatrogenic perforation of the nasal floor during surgical intervention on the lower floor of the nasal septum.

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BACKGROUND: Collagenous fibroma or desmoplastic fibroblastoma is a rare benign fibrous tissue tumor. It usually presents as a painless, slowly growing mass. Collagenous fibroma arises ordinarily inside the subcutaneous tissues or skeletal muscles. Histopathologically, the tumor consists of scattered stellate and spindle cells in a hypovascular collagenous stroma without atypia or infiltration. The oral cavity is a very uncommon site for desmoplastic fibroblastoma. Only 15 published articles in the literature reported the intraoral location. We present a case of collagenous fibroma with a bilateral distribution on the hard palate. This is the second case of bilateral collagenous fibroma after a previously reported one in literature; however, our case was larger, occupying almost the whole palate. We discuss the management of this rare tumor and how we can reach definite diagnosis. CASE PRESENTATION: A 37-year-old Caucasian female patient had a huge bilateral firm palatal mass that caused breathing problems. There was no history of trauma and the patient had no relevant medical history Total surgical excision under general anesthesia was carried out and histopathological examination suggested a benign mesenchymal tumor. Immunohistochemistry was necessary to confirm the tumor origin and to exclude aggressive fibromatosis. A diagnosis of bilateral collagenous fibroma was reached. Six months after surgery, there was no recurring lesion and the patient's health was good. CONCLUSIONS: Collagenous fibroma is a benign fibrous tissue tumor of unknown cause that is treated with simple excision. The prognosis is good with no recurrence. Reaching an accurate diagnosis is mandatory to avoid aggressive treatment since collagenous fibroma may be misdiagnosed as aggressive fibromatosis in case of massive size. Clinicians and pathologists should be aware of this unusual tumor for conservative management without side effects.

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OBJECTIVES: To compare the skeletal and dental effects of different types of rapid maxillary expansion (RME) appliances using cone-beam computed tomography (CBCT). MATERIALS/METHODS: This multi-centre study was conducted with a total of 56 patients. The sample consisted of two groups including the McNamara-Type RME (MNR) group with 30 patients (16 females, 14 males, mean age: 13.38 ± 1.16 years) and Full-Coverage RME (FCR) group with 26 patients (10 females, 16 males, mean age:13.78 ± 1.06 years). Twenty-one parameters were measured on CBCT images including 4 maxillary skeletal, 12 maxillary alveolar, and 5 maxillary dental measurements, and the data were analysed using the SPSS 20.0 software. RESULTS: The rates of increase in the palatal maxillary width (PMW) (3), PMW(4), and PMW(6) were significantly higher in the MNR group (P < .05). While the rates of increase in the buccal maxillary width (BMW) (3) and BMW(4) were statistically higher in the MNR group, the rate of increase in BMW (6) was higher in the FCR group (P < .05). The increases in HPW (4), HPW (6), PAA4(°), and PAA6(°), which are parameters about hard palate width (HPW) and palatal alveolar angle (PAA), were also significantly higher in the MNR group (P < .05). The increases in PAW (4) and PAW (6), referring to the widths between the palatal root apices were significantly higher in the MNR group (P < .05).The increase in Slope-6(°) was also higher in the MNR group (P < .05). CONCLUSION: Expansion in the palatal region on the alveolar level was higher in MNR than in FCR, while expansion in FCR was the highest in the posterior. In both appliances, there was tipping in the buccal direction in both alveolar bone and teeth, and the rate of this tipping was higher in MNR.

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The aim of this study was to update the midpalatal suture classification after surgically assisted rapid maxillary expansion (SARME) using computed tomography (CT). Thirty-five patients with a transverse maxillary deficiency and unilateral or bilateral posterior crossbite underwent SARME with osteotomy of the pterygoid apophysis of the sphenoid. CT was performed before installation of the Hyrax expander appliance and after the final activation. Opening of the midpalatal suture was classified into three types: type I, total midpalatal suture opening from anterior nasal spine (ANS) to posterior nasal spine (PNS); type II, partial midpalatal suture opening from ANS to the transverse palatine suture, with partial or non-existent opening of the midpalatal suture posterior to the transverse palatine suture; type III, complete maxillary opening from ANS, but not of PNS, because a paramedian fracture completed the opening of the hard palate. Type I was observed in 42.8% of the patients, type II in 40%, and type III in 17.2%. Opening of the transverse palatine suture was found in all midpalatal suture opening patterns and was more frequent in type III, followed by type II and type I. CT was used to update the classification of midpalatal suture patterns, with the inclusion of type III: total opening of the hard palate due partly to opening of the midpalatal suture and partly to a paramedian fracture.

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INTRODUCTION: The aim of the present study was to evaluate the thickness of the hard palate at the different angles formed by the palatal plane and the Frankfort horizontal line using computed tomography in patients with different facial patterns for planning the installation of MARPE. MATERIALS AND METHODS: The measurements were analysed in the hard palate of 106 patients. Four regions were selected passing through the mesial face, tangent at the level of the cemento-enamel junction of the premolars and molars. The bone thickness was measured from the floor of the nasal cavity to the cortical bone of the hard palate, 02 measurements with a distance of 05 mm between them (2.5 mm on each side starting from the midsagittal line) and 2 more with a distance of 7 mm between measurements (3.5 mm on each side starting from the midsagittal line). The palatal plane cant was determined based on the palatal plane and the Frankfort horizontal plane. The sagittal skeletal pattern was determined based on the ANB angle and the vertical skeletal pattern based on the SN.Go.Gn angle. RESULTS: Palatal bone thickness was greater in males than in females. Regarding the sagittal skeletal pattern, patients with Class II were found to have a thinner hard palate than Class I and Class III patients. No difference in the vertical skeletal pattern was observed between groups. Regarding the palatal plane cant, bone thickness was greater in patients with clockwise rotation. CONCLUSIONS: Careful planning should be considered in the case of female patients; patients with greater angles of the palatal plane cant and Class II patients have a smaller bone thickness.

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ABSTRACT: Osteonecrosis of the hard palate is rare. Here, we demonstrated the dynamic metabolic and structural changes during the process of osteonecrosis of the hard palate by serial 18F-FDG PET/CT scans in a patient with nasal NK/T-cell lymphoma. On the baseline scan, increased FDG uptake in the periphery of the hard palate could be observed. On the following scans after treatment, a focal metabolic defect on the hard palate with no structural changes and with bone sequestration and perforation have been observed successively. Our case indicates that the metabolic defect on 18F-FDG PET/CT may be an early sign of osteonecrosis.

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OBJECTIVE: To analyze the variations of hard palate volume in adults with normal occlusion and different facial types and patterns, by using a three-dimensional analysis on digital casts. METHODS: The dental casts of 70 Caucasian adults (28 men, 42 women), mean age of 16.4 years (SD 1.3 years), were scanned by using a tridimensional scanner (Delcam PowerSHAPE™, 2010, Birmingham, UK). Close points were selected in the gingival and cervical regions on the lingual surface of the maxillary teeth, to analyze palatal morphology. The facial patterns and types, and the measurements (width, length, height, volume) of the space on the hard palate were compared using analysis of covariance (ANCOVA), with age as the covariate, and sex as the independent variable. The significance level of 5% (p < 0.05) was adopted. RESULTS: This study showed that the measurements of the width and length were similar among the mesofacial, dolichofacial and brachyfacial facial types, although the height and volume of the space on the hard palate were slightly smaller in dolichofacial individuals, and both Pattern I and Pattern II individuals showed no significant changes for the four measurements. The mean values among facial patterns were: Pattern I - width 38.31±2.59 mm; length 37.44±2.42 mm; height 17.03±2.42 mm and volume 10.52±1.72 mm3; Pattern II - width 37.48±2.44 mm; length 37.48±2.44 mm; height 16.79±2.42 mm and volume 10.41±1.65 mm3 (p>0.05 for all variables). CONCLUSION: There were no significant differences for the facial patterns and facial types of the individuals compared in the analyzed sample.

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Background: The tooth movements were generally analyzed in two dimensions on cephalometric radiographs. Nowaday, 3D digital model analysis, which does not have any harmful effects on patients, can be used to evaluate the palatal morphology and coronal tooth movements in a very comfortable and easy way. Aims: To investigate the effect of palatal morphology on anchorage reinforcement during intraoral molar distalization with pendulum appliance using 3D model analysis. Materials and Methods: The material consisted of before (T0) and after (T1) dental plaster models of Class II malocclusion patients (17 females, 3 males) treated with pendulum appliance for molar distalization and Nance appliance for anchorage. T0 and T1 digital models were superimposed using the palatal area as a reference via three points and surface-matching software, and the changes in teeth movement were calculated for left and right central incisors, first premolars, and first and second molars. Palatal morphology was evaluated at T0 on digital models as palatal inclination, palatal depth angles, and anterior hard palate area. Wilcoxon test was used to evaluate the treatment results and Spearman's correlation analysis was performed to evaluate the relationship between palatal morphology and dental movement. The upper limit for the level of significance was taken as 0.05. Results: Mesial movement of first premolars and distal movement of first and second molars were found to be statistically significant (P < 0.001). A weak negative correlation was found between the palatal inclination and the movement of first premolars (P < 0.045 and P < 0.003). Palatal depth angles and anterior hard palate area had no correlation with dental movements. Conclusion: Presented results supported that the mesial movement of premolar teeth decreased as the inclination of the palate increased.

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BACKGROUND: Midpalatal suture (MPS) repair in growing patients after RPE has been previously reported. However, differences between young and adult patients for timing and pattern of MPS repair after rapid maxillary expansion are expected. The aim of this study was to evaluate the midpalatal suture repair pattern after miniscrew-assisted rapid palatal expansion (MARPE) in adult patients. MATERIALS AND METHODS: The study included 21 patients (six males, 15 females) successfully treated with MARPE with a mean initial age of 29.1 years of age (SD = 8.0; range = 20.1-45.1). MPS repair was evaluated using maxillary axial and coronal sections derived from CBCT exams taken 16 months after the expansion (SD = 5.9). Objective and subjective assessments of MPS repair were performed. Objective assessments were performed measuring MPS bone density at anterior, median and posterior region of hard palate. Pre-expansion and post-retention bone density changes were evaluated using paired t tests (p < 0.05). Midpalatal suture bone repair was scored 0 to 3 considering, respectively, the complete absence of bone repair in the MPS, the repair of less than 50% of the MPS, the repair of more than 50% of the MPS and the complete repair of the MPS. Intra- and interexaminer reliability evaluation were assessed using Kappa coefficient. RESULTS: The objective evaluation showed a significant higher bone density at the pre-expansion stage in all palatal regions. The reliability of the subjective method was adequate with intra- and interexaminer agreements varying from 0.807 to 0.904. Scores 1, 2 and 3 were found in 19.05%, 38.09% and 42.86% of the sample, respectively. The most common region demonstrating absence of bone repair was the middle third. The anterior third of the midpalatal suture was repaired in all patients. CONCLUSIONS: A decreased bone density was observed after the retention period when compared to pre-expansion stage. Most adult patients demonstrated incomplete repair of the midpalatal suture 16 months after MARPE. However, adequate bone repair covering more than half of the hard palate extension was observed in 80.95% of the patients.

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OBJECTIVE: The study aimed to determine the relationships between contrast-enhanced computed tomography (CECT) features of hard palate cancer (radiological depth of invasion [r-DOI], detectability of the lesion, and tumor invasion into the palatal bone) and the pathological DOI (p-DOI) of the tumors. STUDY DESIGN: In total, 36 lesions were retrospectively evaluated by 2 board-certified radiologists, who examined CECT scans for the radiological features, and 2 board-certified pathologists, who measured the p-DOI on histopathologic sections. Correlation between r-DOI and p-DOI was calculated. The Youden index was used to calculate the optimal p-DOI cutoff values to distinguish between detectable and undetectable lesions and between tumors with and without bony structure invasion. RESULTS: There was excellent agreement between r-DOI and p-DOI (intraclass correlation coefficient = 0.80). The p-DOI of CECT-detectable lesions was significantly greater than that of CECT-undetectable lesions (P < .001), with a p-DOI cutoff value of 4 mm. The p-DOI of lesions that had invaded the palatal bone was significantly larger than that of lesions without invasion (P = .039), with a p-DOI cutoff value of 7 mm. CONCLUSION: Radiological DOI, tumor detectability, and invasion into the palatal bone can be useful in planning surgical treatment strategies for hard palate cancer.

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OBJECTIVES: To assess the influence of sagittal and vertical skeletal patterns, and sex in the angulation and relationship between the maxillary central incisors and the nasopalatine canal. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) exams of 172 patients were classified into sagittal (class I, II, and III) and vertical skeletal patterns (mesofacial, brachyfacial and dolichofacial). Hard palate-nasopalatine canal and hard palate-long axis of maxillary central incisors angles were measured in sagittal reconstructions. The obtained angles were used to calculate the angulation between maxillary central incisors and nasopalatine canal by triangle geometric relationship. Analysis of variance (multi-way ANOVA) and Tukey post-hoc test were used for data analysis (α=5%). RESULTS: Sagittal and vertical skeletal patterns, and sex presented a low influence on the angulation of maxillary central incisors and nasopalatine canal. Dolichofacial class II women showed the greatest hard palate-nasopalatine canal angulations (P<0.05) and maxillary central incisors and nasopalatine canal angulations (P<0.05). Mesofacial class II and III men presented the lowest maxillary central incisors and nasopalatine canal angulations (P<0.05). CONCLUSIONS: The sagittal and vertical skeletal patterns, and sex have a low influence on the angulation of the maxillary central incisors and the nasopalatine canal.

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