Prevalence and Anatomical Importance of the Canalis Sinuosus in an Iranian Population Using CBCT Imaging
Journal of Dental School,
Vol. 44 No. 1 (2026),
29 December 2025
,
Page e21
https://doi.org/10.22037/jds.v44i1.48208
Abstract
Objective(s): Canalis sinuosus (CS) is a neurovascular canal in the anterior maxilla that contains branches of the Anterior Superior Alveolar (ASA) arteries and nerves. The aim of this study was to introduce this important anatomical landmark and investigate its prevalence in Cone Beam Computed Tomography (CBCT) images in a sample of Iranian population. Methods: In this study, using Ondemand software, 580 CBCT images of the maxilla were analyzed. The presence of the CS in axial, coronal, and sagittal sections was evaluated using four anatomical criteria and its prevalence was calculated. The reliability assessment of qualitative variables was performed using the Kappa agreement coefficient. At the patient level, the distribution of qualitative variables was compared using the Chi-Square test. Analyses were performed at p<0.05. Results: In this study, the prevalence of the CS canal was estimated to be 37.8%, which was found to be significantly higher in males than in females (P = 0.002). Conclusion: This study showed that the CS canal has a relatively high prevalence in Iranian population. Therefore, in order to prevent possible surgical complications in the anterior maxillary area, it is recommended that the anatomical location of the canal be reported in CBCT images of patients, and appropriate treatment planning decisions be made by clinicians accordingly.
- Canalis Sinuosus
- Cone Beam Computed Tomography
- Anterior Maxilla
How to Cite
References
1. de Oliveira-Santos C, Rubira-Bullen IR, Monteiro SA, Leon JE, Jacobs R. Neurovascular anatomical variations in the anterior palate observed on CBCT images. Clin Oral Implants Res. 2013;24(9):1044-8. doi: 10.1111/j.1600-0501.2012.02497.x
2. Anatoly A, Sedov Y, Gvozdikova E, Mordanov O, Kruchinina L, Avanesov K, et al. Radiological and Morphometric Features of Canalis Sinuosus in Russian Population: Cone-Beam Computed Tomography Study. Int J Dent. 2019;2019:2453469. doi: 10.1155/2019/2453469
3. Shan T, Qu Y, Huang X, Gu L. Cone beam computed tomography analysis of accessory canals of the canalis sinuosus: A prevalent but often overlooked anatomical variation in the anterior maxilla. J Prosthet Dent. 2021;126(4):560-8. doi: 10.1016/j.prosdent.2020.05.028
4. Ferlin R, Pagin BSC, Yaedú RYF. Evaluation of canalis sinuosus in individuals with cleft lip and palate: a cross-sectional study using cone beam computed tomography. Oral Maxillofac Surg. 2021;25:337-43. doi: 10.1007/s10006-020-00919-7
5. Sedov YG, Avanesov AM, Mordanov OS, Zurnacheva DD, Mustafaeva RS, Blokhina AV. Visualization features of canalis sinuosus with cone beam computed tomography. Indian J Dent Res. 2019;30(5):656-60. doi: 10.4103/ijdr.ijdr_26_19
6. Orhan K, Gorurgoz C, Akyol M, Ozarslanturk S, Avsever H. An anatomical variant: evaluation of accessory canals of the canalis sinuosus using cone beam computed tomography. Folia Morphol (Warsz). 2018;77(3):551-7. doi: 10.5603/fm.a2018.0003
7. 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. doi: 10.4103/jcd.jcd_375_16
8. Beyzade Z, Yilmaz HG, Unsal G, Caygur-Yoran A. Prevalence, Radiographic Features and Clinical Relevancy of Accessory Canals of the Canalis Sinuosus in Cypriot Population: A Retrospective Cone-Beam Computed Tomography (CBCT) Study. Medicina (Kaunas). 022;58(7). doi: 10.3390/medicina58070930
9. Rao W-X, Ma Y-X, Li M-X, Wen Y-M, Rao Y-L, Wu J-Q, et al. Cone Beam Computed Tomography in observing the presence and location of canalis sinuosus. Eur Rev Med Pharmacol Sci. 2024;28(3). doi: 10.26355/eurrev_202402_35331
10. Manhaes Junior LR, Villaca-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. doi: 10.1590/1807-3107bor-2016.vol30.0049
11. Marzook H, Elgendy A, Darweesh F. New accessory palatine canals and foramina in cone-beam computed tomography. Folia Morphol (Warsz). 2021;80(4):954-62. doi: 10.5603/fm.a2020.0114
12. 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. doi:10.5624/isd.2017.47.2.69
13. Neves FS, Crusoe-Souza M, Franco LC, Caria PH, Bonfim-Almeida P, Crusoe-Rebello I. Canalis sinuosus: a rare anatomical variation. Surg Radiol Anat. 2012;34(6):563-6. doi:10.1007/s00276-011-0907-6
14. von Arx T, Lozanoff S. Anterior superior alveolar nerve (ASAN): A morphometric-anatomical analysis. Swiss Dent J. 2015;125(11):1202-9. doi:10.61872/sdj-2015-11-01
15. Aoki R, Massuda M, Zenni LTV, Fernandes KS. Canalis sinuosus: anatomical variation or structure? Surg Radiol Anat. 2020;42:69-74. doi:10.1007/s00276-019-02352-2
16. Lopes dos Santos G, Ikuta CRS, Salzedas LMP, Miyahara GI, Tjioe KC. Canalis sinuosus: an anatomic repair that may prevent success of dental implants in anterior maxilla. J Prosthodont. 2020;29(9):751-5. doi:10.1111/jopr.13256
17. Volberg R, Mordanov O. Canalis sinuosus damage after immediate dental implant placement in the esthetic zone. Case Rep Dent. 2019;2019(1):3462794. doi: 10.1155/2019/3462794
18. Olenczak JB, Hui-Chou HG, Aguila III DJ, Shaeffer CA, Dellon AL, Manson PN. Posttraumatic midface pain: clinical significance of the anterior superior alveolar nerve and canalis sinuosus. Ann Plas Surg. 2015;75(5):543-7. doi:10.1097/sap.0000000000000335
19. Sarma AB, Mishra SS, Sonawane SR, Pasalkar LH, Munde AD, Panchbhai AS. Frequency and Characteristics of Accessory Canals of Canalis Sinuosus using Cone Beam Computed Tomography–A Retrospective Study. J Indian Acad Oral Med Radiol. 2023;35(3):388-92. doi: 10.4103/jiaomr.jiaomr_12_23
20. Tomrukçu DN, Köse TE. Assesment of accessory branches of canalis sinuosus on CBCT images. Med Oral Patol Oral Cir Bucal. 2020;25(1):e124-30. doi:10.4317/medoral.23235
21. Samunahmetoglu E, Kurt MH. Assessment of Canalis Sinuosus located in maxillary anterior region by using cone beam computed tomography: a retrospective study. BMC Med Imaging. 2023;23(1):46. doi:10.1186/s12880-023-01000-x
22. Torres MGG, de Faro Valverde L, Vidal MTA, Crusoé-Rebello IM. Branch of the canalis sinuosus: a rare anatomical variation—a case report. Surg Radiol Anat. 2015;37:879-81. doi:10.1007/s00276-015-1432-9
23. Warhekar S, Nagarajappa S, Dasar PL, Warhekar AM, Parihar A, Phulambrikar T, et al. Incidental findings on cone beam computed tomography and reasons for referral by dental practitioners in indore city (mp). J Clin Diagn Res. 2015;9(2):ZC21-4. doi:10.7860/jcdr/2015/11705.5555
24. Yeap CW, Danh D, Chan J, Parashos P. Examination of canalis sinuosus using cone beam computed tomography in an Australian population. Aust Dent J. 2022;67(3):249-61. doi:10.1111/adj.12910
25. Wanzeler AMV, 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;19:49-53. doi:10.1007/s10006-014-0450-9
26. 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. doi:10.3205/000261
27. Rusu M, Săndulescu M, Bichir C, Muntianu L. Combined anatomical variations: The mylohyoid bridge, retromolar canal and accessory palatine canals branched from the canalis sinuosus. Ann Anat. 2017;214:75-9. doi: 10.1016/j.aanat.2017.07.006
28. Şalli GA, Öztürkmen Z. Evaluation of location of canalis sinuosus in the maxilla using cone beam computed tomography. Balkan J Dent Med. 2021;25(1):7-12. doi:10.2478/bjdm-2020-0032
29. Machado VdC, 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. I Int J Oral Maxillofac Surg. 2016;45(12):1586-91. doi:10.1016/j.ijom.2016.09.007
30. 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;35:783-90. doi:10.1007/s00276-013-1110-8
31. Khojastepour L, Akbarizadeh F. Evaluation of Extension Type of Canalis Sinuosus in the Maxillary Anterior Region: a CBCT Study. Chin J Dent Res. 2023;26(1):29-34. doi:10.3290/j.cjdr.b3978675
- Abstract Viewed: 6 times
- PDF Downloaded: 5 times