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.