Evaluation of anatomical variations of canalis sinuosus - a cone beam computed tomography (cbct) study

Background: Canalis sinuosus is a neurovascular canal in the anterior maxillary region. The importance of this anatomical variation can be considered during the surgical interventions in the anterior maxilla. Injury to this canal results in the paresthesia after surgery. CBCT plays a important role in evaluating these anatomical variations as it provides reliable images of maxillomandibular complex. CBCT helps the clinician to evaluate CS for treatment planning and to prevent the intra and post operative surgical complications. Objectives: To assess the anatomical variations of Canalis sinuosus (CS) by using Cone beam computed tomography (CBCT) and to emphasize CBCT is necessary before invasive procedures to preserve important anatomical structures. Materials and methods: The study involved the evaluation of 63 CBCT scans by carestream 3D software. Presence, occurrence, position and distance of CS from its emergence to nasal cavity floor, buccal cortical bone edge, crest of alveolar ridge were noted in saggital plane and distance from incisive foramen was noted in axial plane. Results: Out of the 63 scans performed Canalis sinuosus was present in 39.7%. Unilateral and bilateral occurrences were 30.2% and 9.5% respectively. The side predilection was more on the left side (22.2%). Position of CS near lateral incisor region is 12.7% on left side and 12.7% on the right side. There was no significant difference in the mean distance of CS from its emergence to nasal cavity floor, buccal cortical bone edge, crest of alveolar ridge and incisive foramen. Conclusions: Canalis sinuosus is a rare anatomical variation in the anterior maxilla region. Clinicians should carefully assess these variations and it should be highlighted that CBCT is necessary prior to any surgical intervention to decrease the risk of complications and to preserve important anatomical structures.