Canalis Sinuosus Research Articles

Anatomy and function of the canalis sinuosus and its injury prevention and treatment strategies in implant surgery

The canalis sinuosus, a canal containing the anterior superior alveolar nerve bundle, originates from the infraorbital canal and extends along the maxillary sinus and nasal cavity edges to the anterior maxilla. It was once regarded as an anatomical variation. However, with the widespread application of cone beam computed tomography (CBCT), the detection rate of canalis sinuosus in the population has increased. The canalis sinuosus exhibits diverse courses, branching into multiple accessory canals and terminating at the nasal floor or the anterior tooth region, with the majority traversing the palatal side of the central incisor. The anterior superior alveolar nerve bundle within the canalis sinuosus not only innervates and nourishes the maxillary anterior teeth and the corresponding soft tissues, and the maxillary sinus mucosa, but also relates to the nasal septum, lateral nasal wall, and parts of the palatal mucosa. To minimize surgical complications, strategies for preventing and treating canalis sinuosus injuries need to be investigated. Preoperatively, CBCT is used to identify the canalis sinuosus and to virtually design implant placement at a distance of more than 2 mm from the canalis sinuosus. Intraoperatively, assessing bleeding and patient comfort, complemented by precision surgical techniques such as the use of implant surgical guide plates. Postoperatively, CBCT is used to examine the relationship between the implant and the canalis sinuosus, and treatment of canalis sinuosus injuries can be tailored based on the patient's symptoms. This review summarizes the detection of canalis sinuosus in the population, its anatomical characteristics, and the physiological functions in the anterior maxilla, and discusses strategies for avoiding canalis sinuosus injuries during implant surgery, thereby enhancing clinical awareness and providing references for clinical decision-making.

Evaluation of canalis sinuosus and accessory canal morphology by cone-beam computed tomography.

To evaluate canalis sinuosus (CS) and accessory canalis sinuosus (AC) morphology and their relationship with the impacted canine on cone-beam computed tomography (CBCT) images. The diameter and location of the CS, its distance from the nasal cavity (NC-CS), its distance from the buccal cortical plate (BC-CS), and its distance from the alveolar ridge crest (AR-CS) were evaluated on 1000 CBCT scans. The prevalence and termination of AC and the presence of impacted canines were also evaluated. CS was detected in 89 (8.9%) of 1000 CBCTs. The mean CS diameter was found as 1.34 ± 0.53mm. No statistically significant difference was found between gender, age, direction, and CS presence and diameter. CS was most frequently seen in regions 11 (23.6%) and 13 (23.6%). The average NC-CS, BC-CS, and AR-CS length was 6.14, 6.06 and 4.35mm, respectively. AC was detected in 22 patients (24.71%). There was no statistically significant difference between the presence of AC and gender, age, CS diameter, NC-CS, BC-CS, and AR-CS distance. BC-CS length and AR-CS length were statistically significantly higher in patients with impacted canines. It should be kept in mind that the CS diameter, NC-CS, BC-CS, and AR-CS distance may increase in the presence of an impacted canine and the integrity of the neurovascular structure should be preserved. The fact that the CS is often localized in the palatial region requires a detailed evaluation of the anterior maxillary region with three-dimensional imaging methods.

ASSESSMENT OF THE ANATOMICAL STRUCTURE OF CANALIS SINUOSUS IN THE ANTERIOR MAXILLA TO AVOID SURGICAL COMPLICATIONS

Aims: The study's objective was to evaluate the canalis sinuosus (CS) anatomical structure in the front maxilla in order to prevent surgical problems in an adult Yemeni population sample acquired using cone-beam computed tomography (CBCT). Materials and Methods: A retrospective descriptive cross-sectional study was carried out to assess 226 participants' CBCT pictures. 452 sides in total were assessed. There were 140 females (61.9%) and 86 males (38.1%) among the samples. The age distribution was 18–34 years (65%) and over 35 years (35%), with a mean age of 32.13. Version 25 of the Statistical Package of the Social Sciences (SPSS) was used for all statistical analyses. Result: It was discovered that 160 right (35.4%) and 175 left (38.7%) of the 226 patients and 452 sides had CS. Among these individuals, 117 (51.8%) had unilateral CS and 109 (48.2%) had bilateral CS. The CS was 8.12 mm from the nasal cavity floor (D1), 6.99 mm from the buccal cortical bone ridge (D2), and 13.47 mm from the crest of the alveolar ridge (D3), as the mean distances were measured. Males and females had somewhat higher mean values for the linear measurements D1 and D3, but females had slightly higher mean values for the linear measurement D2. The CS had a mean diameter of 1.11 mm. Left central incisor area was the most commonly observed location of CS, and palataly was the most frequently recorded location of CS. Conclusion: Since the CS is present in 100% of adult Yemenis, it is imperative that general practitioners and maxillofacial surgeons become more knowledgeable about the position and structure of the CS. Peer Review History: Received 19 May 2024; Reviewed 12 July 2024; Accepted 23 August; Available online 15 September 2024 Academic Editor: Dr. Iman Muhammad Higazy, National Research Center, Egypt, imane.higazy@hotmail.com Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Gorkem Dulger, Duzce University, Turkey, gorkemdulger@yandex.com Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com

Quantitative evaluation of the Canalis Sinuosus relative to adjacent structures in cone-beam computed tomography images

Quantitative evaluation of the Canalis Sinuosus relative to adjacent structures in cone-beam computed tomography images

Anatomical Variations of the Canalis Sinuosus: A CBCT Study

Objective: Canalis sinuosus (CS) is a bony canal separated from the infraorbital nerve containing the anterior superior alveolar vessel-nerve bundle. This study aimed to assess the anatomical variations of the canalis sinuosus from cone-beam computed tomography (CBCT) images. Methods: CBCT images of 568 patients (328 females and 240 males; aged between 18 and 81 years old) were evaluated retrospectively. Axial, sagittal, coronal, and cross-sectional images with 0.5 mm slice thicknesses were used to evaluate the presence of CS and associated accessory canal (AC). Results: Bilateral CS was detected in the entire sample (n=568, 100%). A total of 340 ACs were detected, including at least one AC in 41.9% of the patients. The median value of AC diameter was calculated as 0.89 mm both for females and males. ACs were found in 135 females and in 103 males. One up to five ACs were found per patient. However, the majority of the patients had one AC. ACs were mostly located at tooth region 11 (17.9%) and tooth region 12 (16.4%). Only 59.71% of ACs had a radiographically observed foramen. Conclusion: In conclusion, all patients had CS and ACs were in nearly half of the patients. Knowledge about these structures aid to correct radiographic diagnosis of these canals and minimize the risk of complications during surgical procedures.

Retrospective evaluation and descriptive analysis of the prevalence of anatomical structures and variations in CBCT images before dental implant planning in a group Turkish population, part I.

The aim of this study is to emphasize the importance of using cone-beam computed-tomography in order to determine the anatomical structures and their variations before the treatment in patients who apply to the dentist clinic for implant treatment. In the study, CBCT images of 500 adult patients (240 female and 260 male), aged between 21 and 82 years, who applied for implant treatment due to missing teeth, were retrospectively analyzed. Anatomical structures and variations such as nasopalatine canal(NPC), canalis sinuosus(CS), antral alveolar artery(AAA), were evaluated in multiplanar reformation(MPR) sections which are axial, sagittal and coronal can be viewed in consistence with each other. The incidence of anatomical variation of CS in the right region was similar according to gender. The "Funnel" appearance of the NPC shape was found most common shape in both female and male patients (n = 89; 37.1% for females and n = 71; 27.3% for males). CBCT has become the most popular 3D imaging method in dental practice especially for planning dental implants. Understanding the relationship with important anatomical structures before implant applications is crucial in dealing with potential complications that may arise afterward. Assessing significant anatomical structures by CBCT and taking precautions against possible risks facilitate the work of dentists during and after procedures.

Canalis Sinuosus Mimicking Periapical Pathology on, Radiographic Assessment

The canalis sinuosus is an anatomical variation whereby the infraorbital canal sometimes generates a small, lateral branch (canal) close to its midpoint, to allow the passage of the anterior superior alveolar neurovascular bundle in the anterior maxilla. This article focuses on an incidental finding of this variant, in a 74-year-old Trinidadian female of Afro-Caribbean descent with an endodontic presenting complaint. The canalis sinuosus shadow on conventional radiography resulted in uncertainty as to the offending tooth until a 3-dimensional scan was undertaken in this region. This report will discuss the implications of the presence of this canal from radiologic, endodontic, and surgical perspectives.

Evaluation of the Accessory Canals of Canalis Sinuosus Via Cone Beam CT

Objective: Canalis sinuosus (CS) is a common anatomical variation in the anterior maxilla that originates from the infraorbital canal and carries the anterior superior alveolar nerve and vessels. This study aimed to examine the presence, frequency, and features of CS and its accessory canals (ACs) using cone beam computed tomography (CBCT) images.
 Methods: A total of 495 CBCT images were retrospectively analyzed in axial, sagittal, and coronal sections. Patient age and sex, presence or absence of CS, location as right, left, or bilateral if CS was present, and number of ACs were recorded. In addition, the end regions of the ACs were recorded as central incisor, central-lateral incisor, lateral incisor, lateral incisor-canine, and canine regions. All recorded data were statistically analyzed.
 Results: At least one CS was found in 54 (10.9%) of 495 CBCT images. CS(s) were bilateral in 26 (48.2%) cases and unilateral in 28 (51.8%; 25 on the left and 3 on the right side). The ACs of the CS predominantly terminated in the lateral incisor region (p =.025). The frequency of CS was not statistically different between males and females (p =.313).
 Conclusion: Accessory canals in the anterior maxilla are mostly associated with branches of the CS. In the current study, the prevalence of CS was 10.9%, and most of the CSs were opening in the lateral incisor region. Detection of accessory canals in the anterior maxilla and examination of this region with CBCT will prevent misdiagnoses and postoperative complications arising from damage to these structures.

Cone-beam computed tomography of accessory canals of the canalis sinuosus and analysis of the related risk factors.

Cone-beam computed tomography (CBCT) was used in this study for evaluating the diameter, prevalence, spatial location, and risk factors of the accessory canal (AC) of the canalis sinuosus. A comprehensive assessment of the incidence rate, diameter, three-dimensional (3D) spatial location, and direction of travel of AC was performed on 1003 CBCT images. The CBCT data were used to reconstruct a 3D model of the maxilla to determine the alveolar bone volume. The obtained data were further analyzed and processed. AC was present in 50.1% of images. Male patients more frequently had ACs than female patients did (P < 0.01) and was positively correlated with the maxillary alveolar bone volume (P < 0.001, OR 1.532). Age or nasopalatine canal diameter were not significantly associated with the occurrence of AC (P > 0.05). Among the 502 patients with AC, AC was present on the left side, right side, and bilaterally in 189, 98, and 215, respectively. The maximum number of ACs observed per individual was eight. The average AC diameter was 0.89 ± 0.26mm (minimum, 0.5mm; maximum, 2.02mm). As the prevalence of AC and its trajectory display considerable variation among individuals, surgeons must consider the possibility of the presence of AC when devising surgical plans involving the anterior maxillary region.

Assessment of canalis sinuosus, rare anatomical structure using cone-beam computed tomography: A prospective study.

This prospective study was performed with cone-beam computed tomography (CBCT) images for evaluating canalis sinuosus (CS), determine its location and diameter in relation to gender, age, and distances from important structures, including floor of nasal cavity, incisive foramen, edge of buccal cortical bone, and palatal cortical bone. The scans of 650 patients in total were included in this prospective analysis. Gender, age, the position of the CS, its presence or absence, diameter, and its location in reference to the adjacent teeth were the factors that were noted. The study had 301 female participants and 349 male participants, with a mean age of 42.19. Compared to females, males had a statistically higher frequency of CS. Higher age groups showed a higher presence of CS in comparison to the other age groups. The mean distances of these parameters on the left and right side did not differ significantly. Nonetheless, the distance on both sides between CS and nasal cavity floor for males and females, as well as the diameter and border of buccal-palatal cortical bone on the right side, were statistically significant different. On the left side, both genders demonstrated significance in buccal cortical margin and nasal cavity floor. IIn addition, in females, the diameter of the CS on the right and left sides differed on average. The associations between age and number of CS, CS diameter, and number of CS versus sex were all extremely weak. Overall, the study findings showed that CS is a typical anatomical feature in anterior maxillary region, irrespective of age, or gender. The bony canal, CS is an obscure feature located in the frontal region of the maxilla. Surgeons can avoid complications by being aware of the auxiliary canals derived from this structure. With the use of CBCT, it is now feasible to examine the course of CS as it passes through the maxillary sinus's anterolateral wall with better radiological accuracy has already been documented.

A cone-beam computed tomography study of canalis sinuosus and its accessory canals in a South African population.

Canalis sinuosus (CS) is a clinically relevant structure in the anterior maxilla. The present study aimed to determine the prevalence and distribution of CS and its accessory canals (ACs) in the South African population and describe its anatomical variations. In total, 500 cone-beam computed tomography (CBCT) scans of the anterior maxilla were assessed for prevalence, sidedness, diameter, and distribution of CS. The frequency, number, diameter, configuration, and point of termination of ACs were also recorded. Statistical analysis was performed using analysis of variance, Kruskal-Wallis, chi-squared, and Fisher Exact tests with P < 0.05. CS was present in most cases (99.6%), and commonly occurred bilaterally (98.8%). The mean diameter of CS was 1.08mm (range: 0.50mm-2.39mm). Sex, population group, and age had no significant effect on the prevalence or sidedness of CS. Additionally, 535 ACs were observed in 58.8% of the sample, with 42.9% of ACs found bilaterally and 57.1% unilaterally. The mean diameter of the ACs was 0.86mm on the left and 0.87mm on the right (range; 0.50mm-1.52mm). The majority of ACs maintained a straight vertical configuration (72.3%). ACs most commonly terminated in the anterior palatal region of the maxilla (57.2%). No significant differences were found in any groups mentioned (P > 0.05). A high prevalence of CS as well as ACs were observed in thesample population. Due to their clinical significance, surgical planning with the aid of high quality CBCT scans of the anterior maxilla is advisable.

Cone Beam Computed Tomography in observing the presence and location of canalis sinuosus.

Cone Beam Computed Tomography (CBCT) was used to observe and describe the distribution of canalis sinuosus (CS) in the Chinese population and the location of CS in the maxillary alveolar bone, so as to help oral surgeons evaluate the intraoperative risk and prognosis before maxillary surgery and reduce the complications caused by the injury of this structure in anterior surgery. CBCT images of 600 patients admitted from 2021 to 2022 were collected to observe the anatomical structure of CS in the maxillary region. The following parameters were recorded: age, sex, number of CS, left and right distribution of CS, CS diameter, and location. Statistical analysis was performed on all of the collected data. The discovery rate of CS in this study was 59.75%, and it is commonly found in the lateral incisor area (64.82%). No significant difference can be found in the presence and number of CS in different gender and age groups (p>0.05). The use of high-resolution CBCT before implantation is of irreplaceable significance in the diagnosis and analysis of CS, which is conducive to reducing implantation complications and failure rate. The incidence of CS was independent of age or sex, while the location of CS was statistically significant.

Prevalence and localization of Canalis Sinuosus: a mini review

In recent years, scientific literature has been focusing on the study of the Canalis Sinuosus (CS); this canal contains the anterior superior alveolar nerve (ASAN), together with bundles. Accordingly, the CS may vary its frequency and anatomical features. These variations can be identified through imaging technologies such as cone beam computed tomography (CBCT). The aim of this mini review is to present the current understanding of the CS, its prevalence and localization in order to decrease the potential surgical risk associated with this region. As revealed by the analysis of the international literature available, presence of CS is a crucial factor to consider in implantology and generally in oral surgery procedures in this area. In conclusions the use and analysis of CBCT imaging in the diagnosis stage is fundamental to preserve the most important anatomical structures which are present in the jaws.

Middle superior and anterior superior alveolar nerve injury following trauma to the maxillary sinus: a prospective clinico-radiographic evaluation.

Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

Evaluation of Extension Type of Canalis Sinuosus in the Maxillary Anterior Region: a CBCT Study.

To evaluate the extension of canalis sinuosus (CS) into the alveolar crest for surgical reference in the anterior maxilla. In this cross-sectional study, 485 CBCT images were evaluated in three orthogonal planes (axial, coronal and sagittal). The type of extension of CS into the alveolar ridge in the anterior maxilla was evaluated. The alveolar ridge was divided into four equal parts in a vertical and horizontal direction. In a vertical direction from apical to incisal and in a horizontal direction from labial to palatal, the four parts were designated as types 0, I, II and III, respectively. The extension of CS into the alveolar ridge was then traced. CS was present in 380 subjects (78.35%), and the extension type was unilateral in 217 of them (57.11%) and bilateral in 163 of them (42.89%). There was no significant relationship between incidence of CS and sex. Regarding the distribution of vertical and horizontal types, type II (the third quadrant of the ridge from apical to incisal and from labial to palatal, respectively) was significantly more prevalent than other types. The most common location of CS into the alveolar ridge in both horizontal and vertical directions was type II (which is not close to the cortex). Awareness about the presence and possible locations of CS helps to reduce the risk of unjustifiable postoperative complications.

Assessment of Canalis Sinuosus located in maxillary anterior region by using cone beam computed tomography: a retrospective study

BackgroundThe aim of the study is to determine the distribution, location, diameter, and distance measurements of Canalis Sinusosus (CS) in relation with age and sex.Methods300 Cone-Beam Computed Tomography (CBCT) images were evaluated. The distance between CS and nasal cavity floor (NCF), buccal cortical bone margin (BCM), alveolar ridge (AR), respectively.The presence of CS smaller than 1 mm, and the diameter of CS larger than 1 mm were determined. Accessory canals (AC) were classified according to their position relative to the teeth.Results435 CS with a diameter of at least 1 mm and 142 CS < 1 mm were identified. The most frequently observed location of CS was the region of the right central incisors. The mean diameter of the canals ( CS ≥ 1) was 1.31 ± 0.19 on the right side and 1.29 ± 0.17 on the left side. No gender differences were found in canal diameter were observed (p > 0.05). There was no significant difference between men and women in the distance between CS and the NCF on the right side, and a significant difference was found in the distance of CS-NCF on the left side (p = 0.047). There were no significant differences between age groups in all parameters.ConclusionCBCT is a useful tool for identifying CS. Location and diameter of ACs could not be associated with a specific age group or sex.

Evaluation of the morphology of accessory canals of the canalis sinuosus via cone-beam computed tomography

Purpose: This study aims to assess the presence of accessory canal (AC) associated with canalis sinuous (CS), describing their frequency, lateralization, location, direction, and measurements in cone beam computed tomography (CBCT).Methods: Axial, coronal, sagittal, and cross-sectional reconstructions were analyzed in 248 CBCT images and the presence of CS, the presence of AC associated with CS, the lateralization, localization, and direction course of AC associated with CS was evaluated. CS diameter, AC diameter, the distance between the nasal cavity floor and CS (M1), CS and the buccal cortical bone (M2), and CS and the alveolar ridge (M3) were measured.Results: CS was detected in all CBCT scans as bilaterally. The prevalence of AC associated with CS was 35.5%. There was a significant difference between dental status anthe d presence of AC associated with CS. There was a significant difference between gender, dental status, and lateralization of AC associated with CS. While M1 was greater in male patients than females, M3 was greater in female patients. M2 and M3 were greater in younger patients.Conclusion: Clinicians performing surgical procedures should keep in mind that anatomical variations of the vascular nerve bundle may be seen. M1, M2, and M3 measurements can be affected by gender, age, and dental status.

Frequency and characteristics of accessory canals of canalis sinuosus using cone beam computed tomography – A retrospective study

Frequency and characteristics of accessory canals of canalis sinuosus using cone beam computed tomography – A retrospective study

Evaluation of the presence and general characterization of canalis sinuosus based on cone-beam computed tomography images: a literature review

Evaluation of the presence and general characterization of canalis sinuosus based on cone-beam computed tomography images: a literature review

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography

PurposeThis study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity.Methods212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant.ResultsPSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males.ConclusionsThe use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.Graphical