Evaluation of the morphology of the canalis sinuosus using cone-beam computed tomography in patients with maxillary impacted canines

Purpose: The nasopalatine canal is a well-known, important anatomical structure in the anterior maxilla, but this region contains many accessory canals. The canalis sinuosus (CS) is one of these canals; it contains the anterior superior alveolar nerve, along with veins and arteries. The purpose of this study was to evaluate the CS using cone-beam computed tomography (CBCT) in patients with maxillary impacted canines. Materials and Methods: A total of 111 patients admitted to the Istanbul Medipol University School of Dentistry for the exposure, orthodontic treatment, and/or extraction of an impacted canine were included in this study. CBCT images were obtained for these patients under standard conditions. Axial, coronal, and sagittal sections were evaluated to assess the prevalence of CS, the direction and diameter of the canal, its relation with the impacted canine, and its distance from the alveolar crest. Further, possible correlations with patient gender and age were analyzed. Results: The CS could be detected bilaterally in all the evaluated tomography images. The mean canal diameter was significantly larger in males than in females(P=.001). The CS ran significantly closer to the impacted canine when the canal was located horizontally (P=.03). Variations of the canal, such as accessory canals, were identified in 6 patients. Conclusion: CS is an anatomical entity that may resemble periapical lesions and other anatomical structures. Evaluation with CBCT prior to surgical procedures in the anterior maxilla will help to prevent overlooking such anatomical structures and to decrease possible surgical complications.