Abstract
Background The aim of this study is to describe the presence, to reveal the frequency and characteristics of accessory canals (ACs) of the canalis sinuosus (CS) by cone beam computed tomography (CBCT). Material and Methods A total of 326 CBCT examinations were scanned retrospectively. The anatomical views were evaluated on sagittal, axial, coronal and cross sectional imaging. The following parameters were recorded: age, sex, presence or absence of ACs, location in relation to the adjacent teeth and distance to the nasal cavity floor (NCF), alveolar ridge crest (ARC) and buccal cortical bone (BCB), and incisive canal. All the collected data were statistically analyzed. Results 113 patients (34,7%); presented ACs in total 214 foramina of the sample. There were no statistically significant changes in the presence of ACs regarding age groups excluding 80-89 years. But there is a statistically significant difference regarding the frequency of ACs and the gender. The prevalence for male patients was higher than female patients. Curved-shape configuration of CS prevalence is found as 69,15%. The prevalence of vertical tracing is 26,16% and Y-shape configuration of CS prevalence is 4,67%. Diameter of the foramens of the CS branches was 1.30 mm. The mean distance of the AC to the NCF, BCB, and ARC were found 13,83 mm, 6,60 mm and 5,32 mm, respectively. Conclusions In the anterior palatal region, ACs are mostly related to CS’s branches. So; knowing the course of CS branches in surgical planning and radiographic evaluations in this region is extremely important for preventing complications and avoiding misdiagnosis. Key words:Anterior superior alveolar nerve, canalis sinuosus, maxilla.
Highlights
Several surgical procedures are performed in the anterior maxillary region such as placement of dental implants, surgical removal of impacted or supernumerary teeth, periodontal surgery, endodontic surgery, orthognathic surgery and cyst therapy (1)
They may damage the structures and cause sensory dysfunction and haemorrhage. These bundles may alter the osseointegration and may lead to failure of implants. They may mimic a lesion, can cause diagnostic confusion where Shah et al reported a case with accessory branch of canalis sinuosus (CS) mistakenly prediagnosed as an external root resorption at periapical radiographies (4,10,11) (Fig. 1)
Porous cortical layers and variable course suggested as a difficulty factor for diagnosis in conventional radiographic methods (4,10)
Summary
Several surgical procedures are performed in the anterior maxillary region such as placement of dental implants, surgical removal of impacted or supernumerary teeth, periodontal surgery, endodontic surgery, orthognathic surgery and cyst therapy (1). The anterior superior alveolar (ASA) nerve is a branch of infraorbital nerve and innervate incisors, canines, and soft tissues (2) Another important anatomical structure in the premaxillary is nasopalatinal canal. The aim of this study is to determine the location and diameter of accessory canals (ACs) and to correlate the canal with gender, age and distance from the major structures such as the buccal cortical bone (BCB), nasal cavity floor (NCF), alveolar ridge crest (ARC), and the incisive foramen. The following parameters were recorded: age, sex, presence or absence of ACs, location in relation to the adjacent teeth and distance to the nasal cavity floor (NCF), alveolar ridge crest (ARC) and buccal cortical bone (BCB), and incisive canal. ; knowing the course of CS branches in surgical planning and radiographic evaluations in this region is extremely important for preventing complications and avoiding misdiagnosis
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