Evaluation of the morphology of the canalis sinuosus using cone-beam computed tomography in patients with maxillary impacted canines

Abstract

PurposeThe nasopalatine canal is a well-known, important anatomical structure in the anterior maxilla, but this region contains many accessory canals. The canalis sinuosus (CS) is one of these canals; it contains the anterior superior alveolar nerve, along with veins and arteries. The purpose of this study was to evaluate the CS using conebeam computed tomography (CBCT) in patients with maxillary impacted canines.Materials and MethodsA total of 111 patients admitted to the Istanbul Medipol University School of Dentistry for the exposure, orthodontic treatment, and/or extraction of an impacted canine were included in this study. CBCT images were obtained for these patients under standard conditions. Axial, coronal, and sagittal sections were evaluated to assess the prevalence of CS, the direction and diameter of the canal, its relation with the impacted canine, and its distance from the alveolar crest. Further, possible correlations with patient gender and age were analyzed.ResultsThe CS could be detected bilaterally in all the evaluated tomography images. The mean canal diameter was significantly larger in males than in females (P=.001). The CS ran significantly closer to the impacted canine when the canal was located horizontally (P=.03). Variations of the canal, such as accessory canals, were identified in 6 patients.ConclusionCS is an anatomical entity that may resemble periapical lesions and other anatomical structures. Evaluation with CBCT prior to surgical procedures in the anterior maxilla will help to prevent overlooking such anatomical structures and to decrease possible surgical complications.

Canalis Sinuosus Damage after Immediate Dental Implant Placement in the Esthetic Zone

“…The anterior superior alveolar nerve (ASAN) is a branch of infraorbital nerve that enters in the infraorbital canal, which has a side intrabony branch called the canalis sinuosus (CS) [5,6]. The canalis sinuosus goes through the anterior wall of the maxilla and then along the lateral wall of the nasal cavity [7], residing in the alveolar process of the maxilla [8][9][10][11][12]. CS nerves and vessels supply anterior teeth and adjacent soft tissues [13].…”

Anatomical Variation of Canalis Sinuosus: Reports of Two Cases

“…The CS generally terminates on the lower border of the nasal aperture; but, it may run downward to the alveolar ridge and can seldom be detected near to the apical region of anterior teeth [8]. The CS and its variations may mimic a periapical lesion due to its anatomical position [7].…”

“…The CS should be assessed carefully when its branches are near the apical region of the incisor teeth and extend to the alveolar ridge [8]. Gurler et al [8] described the evaluation of the morphology of the CS using CBCT.…”

“…Gurler et al [8] described the evaluation of the morphology of the CS using CBCT. They used hundreds of data for analysis.…”

“…But a few patients were detected anatomical variations which have accessory branches extend to the alveolar crest. Their localization was variable, but the localization was most frequently observed at the palatal to the lateral incisors followed by the central incisors and canine [8].…”