Evaluation of the Frequency, Location, and Classification of Canalis Sinuosus in Cone-Beam Computed Tomography Images
Journal of Dental School,
Vol. 41 No. 3 (2023),
13 March 2024
,
Page 102-108
https://doi.org/10.22037/jds.v41i3.44211
Abstract
Objectives 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.
Methods 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%.
Results 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).
Conclusion It appears that CBCT and other 3D imaging techniques are essential for detecting the CS prior to performing surgery in the anterior maxillary region.
- Cone beam computed tomography
- Neurovascular
- Diagnosis
- Anatomy
How to Cite
References
Tomaszewska IM, Zwinczewska H, Gładysz T, Walocha JA. Anatomy and clinical significance of the maxillary nerve: a literature review. Folia Morphol (Warsz). 2015;74(2):150-6.
Shah PN, Arora AV, Kapoor SV. Accessory branch of canalis sinuosus mimicking external root resorption: a diagnostic dilemma. J Conserv Dent. 2017;20(6):479-81.
de Oliveira-Santos C, Rubira‐Bullen IR, Monteiro SA, León JE, Jacobs R. Neurovascular anatomical variations in the anterior palate observed on CBCT images. Clin Oral Implants Res. 2013;24(9):1044-8.
Orhan K, Icen M, Aksoy S, Ozan O, Berberoğlu A. Cone-beam CT evaluation of morphology, location, and course of mandibular incisive canal: considerations for implant treatment. Oral Radiology. 2014;30(1):64-75.
Gurler G, Delilbasi C, Ogut EE, Aydin K, Sakul U. Evaluation of the morphology of the canalis sinuosus using cone-beam computed tomography in patients with maxillary impacted canines. Imaging Sci Dent. 2017;47(2):69-74.
Varshosaz M, Sharifi S. Cone beam volumetric tomography versus conventional computed tomography in evaluation of paranasal sinuses. Tehran Univ Med J. 2010;68(7): 406-11.
Eskandarlo A, Sartipi V, Ghazikhanlou Sani. Assessment of the anatomical position and shape of mental foramen in the cone beam computed tomography images. Avicenna J Clin Med. 2012;19(2):39-43.
Brandão FH, Machado MR, Aquino JE, Coelho R, Pereira S, Fabi RP. The foramen and infraorbital nerve relating to the surgery for external access to the maxillary sinus (CALDWELL-LUC). Int. Arch. Otorhinolaryngol. 2008;12(3):342-6.
Faria CA, Barros RA, Modesto D, Navarro JA. Anatomical variation of the infra-orbital plexus. Rev Bras Otorrinolaringol. 1981;47(2):161-5.
Shelley AM, Rushton V, Horner K. Radiography: canalis sinuosus mimicking a periapical inflammatory lesion. Br Dent J. 1999;186(8):378-9.
Olenczak JB, Hui-Chou HG, Aguila DJ 3rd, Shaeffer CA, Dellon AL, Manson PN. Posttraumatic midface pain: clinical significance of the anterior superior alveolar nerve and canalis sinuosus. Ann Plast Surg. 2015;75(5):543-7.
Neves FS, Crusoé-Souza M, Franco LC, Caria PH, Bonfim-Almeida P, Crusoé-Rebello I. Canalis sinuosus: a rare anatomical variation. Surg Radiol Anat. 2012;34(6):563-6.
Torres MG, de Faro Valverde L, Vidal MT, Crusoé-Rebello IM. Branch of the canalis sinuosus: a rare anatomical variation—a case report. Surg Radiol Anat. 2015;37(7):879-81.
Von Arx T, Lozanoff S, Sendi P, Bornstein MM. Assessment of bone channels other than the nasopalatine canal in the anterior maxilla using limited cone beam computed tomography. Surg Radiol Anat. 2013;35(9):783-90.
Tanaka R, Hayashi T, Ohshima H, Ida-Yonemochi H, Kenmotsu S-i, Ike M. CT anatomy of the anterior superior alveolar nerve canal: a macroscopic and microscopic study. Oral Radiology. 2011;27(2):93-7.
Sekerci AE, Cantekin K, Aydinbelge M. Cone beam computed tomographic analysis of neurovascular anatomical variations other than the nasopalatine canal in the anterior maxilla in a pediatric population. Surg Radiol Anat. 2015;37(2):181-6.
Horner K, O'Malley L, Taylor K, Glenny AM. Guidelines for clinical use of CBCT: a review. Dentomaxillofac Radiol. 2014;44(1):20140225.
Machado VC, Chrcanovic B, Felippe M, Júnior LM, de Carvalho P. Assessment of accessory canals of the canalis sinuosus: a study of 1000 cone beam computed tomography examinations. Int J Oral Maxillofac Surg. 2016;45(12):1586-91.
Wanzeler AM, Marinho CG, Junior SMA, Manzi FR, Tuji FM. Anatomical study of the canalis sinuosus in 100 cone beam computed tomography examinations. Oral Maxillofac Surg. 2015;19(1):49-53.
Manhães Júnior LR, Villaça-Carvalho MF, Moraes ME, Lopes SL, Silva MB, Junqueira JL.Location and classification of Canalis sinuosus for cone beam computed tomography: avoiding misdiagnosis. Braz Oral Res. 2016;30(1):e49.
Ghandourah AO, Rashad A, Heiland M, Hamzi BM, Friedrich RE. Cone-beam tomographic analysis of canalis sinuosus accessory intraosseous canals in the maxilla. Ger Med Sci. 2017;15:Doc20.
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