Evaluation of the Frequency, Location, and Classification of Canalis Sinuosus in Cone-Beam Computed Tomography Images

The canalis sinuosus (CS) is an auxiliary canal that encompasses the anterior superior alveolar nerve, artery, and vein. Understanding the location of this neurovascular structure during surgery can help prevent severe complications. This study aimed to assess the frequency, location, and classification of the CS using CBCT images.

CBCT images of 200 patients were examined considering factors, such as age, sex, presence of impacted teeth, the diameter of the canal’s orifice, and the location of the CS. In sagittal images, the distance from the CS to the buccal cortex, nasal floor, and alveolar crest was measured. Statistical analyses were conducted to compare variables between males and females, as well as between the right and left sides. The Chi-square, Fisher’s exact test, Wilcoxon test, paired t-test, and Kruskal-Wallis tests were utilized for data analysis at a significance level of 5%.

The CS was detected in 135 cases (67.5%) on both sides, while it was not visible in 19 cases (9.5%). In 46 images (23%), the CS was observed only on one side. The canal was most commonly located in the lateral incisor region, followed by the canine area. The average distance from the canal’s orifice to anatomical landmarks, such as the alveolar crest, buccal cortex, and nasal floor, was greater in males than in females. However, this difference was not significant between the right and left sides (P=0.56, P=0.31, P=0.98; respectively). When comparing males and females, no significant differences were observed in the occurrence of CS(P=0.728), the diameter of the canal(P=0.114), the buccopalatal position of the CS(P=0.800), or the canal location within the arch(P=0.132).

It appears that CBCT and other 3D imaging techniques are essential for detecting the CS prior to performing surgery in the anterior maxillary region.