Branch of the canalis sinuosus: a rare anatomical variation—a case report

Abstract

The canalis sinuosus (CS) is a neurovascular canal, a branch of the infraorbital canal through which the anterior superior alveolar nerve passes. There are no studies or case reports of anatomical variations related to this canal. A rare case of anatomical variation in the CS is reported that was detected by cone beam computed tomography done in a 47-year-old female as a pre-operative workup before dental implants. In this case, in the region slightly medial to tooth 23, a wide accessory branch from the CS was observed, running an intraosseous course in the inferior and posterior direction up to a foramen located in the hard palate, slightly medial in relation to tooth 23. The location of this branching, as well as its neurovascular component, is important for dental implant planning because of its proximity to the upper teeth. Identification of neurovascular bundles is fundamental to avoid complications for the patient.

An anatomical variant: evaluation of accessory canals of the canalis sinuosus using cone beam computed tomography

“…Especially, due to increased frequency of dental implant applications, preoperative multiplanar radiologic evaluation became necessary to avoid unexpected complications. Although some reports in literature emphasize that the CS was rare [13,14], Wanzeler et al [17] reported the frequency of this structure as 87.5% in 100 CBCT scans. They also suggested that anatomical structure should not be considered as an anatomical variation.…”

“…Moreover, many practitioners identify this structure as a periapical radiolucency or pathologic lesion [3,17]. The widespread use of CBCT in dentistry allowed obtaining detailed and accurate 3D views of the structures, high resolution images with greater reliability and reproducibility than 2D images [13,14,17]. Especially, due to increased frequency of dental implant applications, preoperative multiplanar radiologic evaluation became necessary to avoid unexpected complications.…”

Anatomical Variation of Canalis Sinuosus: Reports of Two Cases

“…However, in 2D imaging techniques, CS is hardly ever seen owing to the porosity of its cortical layers or its small caliber [1,7].…”

“…The anterior superior alveolar (ASA) nerve rises in the anterior region of the maxilla to innervate the anterior teeth, as well as adjacent soft tissues. The infraorbital nerve runs through the infraorbital canal, which has a small branch on its lateral face, called the canalis sinuosus (CS), to allow the transition of the ASA nerve [1,2].…”

Canalis Sinuosus and radiographic procedures in the region of anterior maxilla

“…1,2,6-8 However, some authors describe it as a common anatomical structure. 9 Regardless of the anatomical classification, the professional must consider this structure in surgical planning, since many surgical procedures are performed in the anterior maxilla.…”