The nasopalatine canal is a long slender structure present in the midline of the anterior maxilla that connects the palate to the floor of the nasal cavity. The nasopalatine canal contains the nasopalatine nerve, the terminal branch of the nasopalatine artery, fibrous connective tissue, adipose tissue, and minor salivary glands. The purpose of this article was to report a case of a trifid nasopalatine canal detected by cone beam computed tomography prior to dental implant placement. A 47-year-old female patient was submitted to cone beam computed tomography. Axial and sagittal sections revealed a trifurcation of the nasopalatine canal. Each canal was separated from the other by bony septa and extended independently from the floor of the nasal cavity to the incisive foramen in the remnant of the alveolar process in the anterior region of the maxilla. Cone beam computed tomography has permitted better visualization of the details and anatomical variations of the nasopalatine canal. Detailed knowledge of variations in the shape, number and size of the nasopalatine canal is fundamental for surgical procedures, such as local anesthesia in the anterior maxillary region and placement of dental implants, in order to prevent damage to important arteries and nerves.

El canal nasopalatino es una larga estructura delgada presente en la línea media del maxilar anterior que conecta el palato al suelo de la cavidad nasal. El canal nasopalatino contiene el nervio nasopalatino, la rama terminal de la arteria nasopalatina, el tejido conectivo fibroso, el tejido adiposo y las glándulas salivales menores. El propósito de este artículo es presentar el caso de un canal nasopalatino trifid detectado a través de tomografía computarizada de haz cónico anterior a la colocación de implantes dentales, en una paciente de femenino 47 años de edad. Secciones axiales y sagitales revelaron la trifurcación del canal nasopalatino. Cada canal se apartó del otro por tabiques ósea y extendida independientemente del suelo de la cavidad nasal para el agujero incisivo en el remanente del proceso alveolar en la región anterior del maxilar. La tomografía computarizada de haz cónico ha permitido una mejor visualización de los detalles y variaciones anatómicas del canal nasopalatino. El conocimiento detallado de las variaciones en su forma, el número y el tamaño del canal nasopalatino es fundamental para los procedimientos cirúrgicos, así como la anestesia local en la región anterior del maxilar superior y la colocación de los implantes dentales, con el fin de prevenir el daño a las arterias y a los nervios importantes.

OBJETIVO: Descrever os aspectos clinicopatológicos de dois casos de cisto odontogênico ortoqueratinizado e a compará-los a relatos anteriores. RELATO DO CASO: No caso 1, uma mulher de 17 anos de idade, apresentou edema endurecido e indolor na mandíbula posterior esquerda. Radiograficamente, uma área radiolúcida com uma radiopacidade foi observada. O diagnóstico clínico de ameloblastoma ou tumor odontogênico ceratocístico foi estabelecido. O exame histopatológico revelou um cisto odontogênico ortoqueratinizado. No caso 2, uma mulher de 23 anos apresentou duas lesões radiolúcidas circundadas por halos radiopacos simetricamente distribuídas, associada aos terceiros molares inferiores irrompidos. Um diagnóstico clínico de cisto dentígero bilateral (DC) foi estabelecido. O exame histopatológico mostrou ser um cisto odontogênico ortoqueratinizado. CONCLUSÃO: Cisto odontogênico ortoqueratinizado deve ser considerado no diagnóstico diferencial das lesões que ocorrem na mandíbula associado com dentes impactados, especialmente aqueles casos que simulem o cisto dentígero. Além disso, observamos a importância de tomadas radiográficas antes do tratamento ortodôntico no diagnóstico de patologias bucais.

PURPOSE: To describe the behavior clinical and pathological features of two cases of odontogenic cyst orthokeratinized. CASE DESCRIPTION: In case 1, a 17-year-old woman presented hard and painless swelling in the left posterior mandible. Radiographically, a radiolucent area with a radiopaque was observed. A clinical diagnosis of ameloblastoma or odontogenic keratocystic tumor was established. The histopathological examination revealed an orthokeratinized odontogenic cyst. In case 2, a 23-year-old woman presented a radiolucent lesion surrounded by radiopaque halo symmetrically distributed on both partially erupted lower third molars. A clinical diagnosis of bilateral dentigerous cyst (DC) was rended. The histopathological examination showed bilateral orthokeratinized odontogenic cyst. CONCLUSION: Orthokeratinized odontogenic cyst should be considered in the differential diagnosis of lesions occurring in the jawbones associated with an impacted tooth, particularly those cases simulating dentigerous cyst. In addition, we observed the importance of radiographs taken prior to orthodontic treatment as an important tool in the diagnosis of oral pathologies. Performing routine radiograph is of high clinical value, especially before orthodontic treatment.