Canalis sinuosus: anatomical variation or structure?

  • Renata Aoki
  • Mariana Massuda
  • Lysiane Tereza Valler Zenni
  • Karin Sá FernandesEmail author
Original Article



The main goal of the present study was to verify the presence, spatial location, the end of the canalis sinuosus (CS) trajectory and size of CS using cone beam computed tomography (CBCT) to characterise it as either a structure or an anatomical variation.


A trained examiner specialist in dental radiology and imagenology selected 200 CBCT images of the maxilla from 107 (53.5%) female and 93 (46.5%) male individuals aged between 18 and 85 years.


A total of 133 (66.5%) patients had CS, being 61 (45.86%) unilateral and 72 (54.14%) bilateral. A higher frequency of CS was observed in males (P < 0.05) and no relationship was found between its presence and age. The end of the CS trajectory was more frequent in the regions of central incisor (n = 91; 44.39%), followed by lateral incisor (n = 45; 21.95%) and canine (n = 29; 14.15%). In our sample, the majority of these canals had a diameter of up to 1 mm (n = 198/205; 96.6%). No statistically significant relationship between diameter and the end of the CS trajectory, with location (i.e. bilateral or unilateral) was found. Gender and age had no influence on diameter, spatial location and the end of the CS trajectory (P > 0.05%).


As CS was frequently found in our sample, it can be considered an anatomical structure, and as such, it is fundamental that the dentist requests a CBCT examination before performing any invasive procedure in the maxillary region to preserve this important structure.


Canalis sinuosus Cone beam computed tomography Anatomical variation Anatomical structure Maxilla 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.


  1. 1.
    Arruda JA, Silva P, Silva L, Álvares P, Silva L, Zavanelli R, Rodrigues C, Gerbi M, Sobral AP, Silveira M (2017) Dental implant in the canalis sinuosus: a case report and review of the literature. Case Rep Dent 8:1–5Google Scholar
  2. 2.
    De Chacón VERG, Becerra JMM (2017) Canalis sinuosus: report de cuatro casos y revisión de la literatura. Rev Estomatol Herediana 27:39–43CrossRefGoogle Scholar
  3. 3.
    Ghandourah AO, Rashad A, Heiland M, Hamzi BM, Friedrich RE (2017) Cone-beam tomographic analysis of canalis sinuosus accessory intraosseous canals in the maxilla. Ger Med Sci 15:1–12Google Scholar
  4. 4.
    Gurler G, Delilbasi C, Ogut EE, Aydin K, Sakul U (2017) Evaluation of the morphology of the canalis sinuosus using cone beam computed tomography in patients with maxillary impacted canines. Imaging Sci Dent 47:69–74CrossRefGoogle Scholar
  5. 5.
    Jones FW (1939) The anterior superior alveolar nerve and vessels. J Anat 73:583–591PubMedPubMedCentralGoogle Scholar
  6. 6.
    Kim JH, Abdala R Jr, Aoki EM, Baladi MG, Cortes ARG, Watanabe PCA, Arita ES (2015) Canalis sinuosus and radiographic procedures in the region of anterior maxilla. Clin Lab Res Dent 21:180–184CrossRefGoogle Scholar
  7. 7.
    Kose EMRE, Sekerci AE, Soylu E, Nazlim S (2014) An extremely rare anatomical variation bilateral canalis sinuosus and nasopalatine duct cyst and role of TCCB in diagnosis. Int J Sci Res 23:361–363Google Scholar
  8. 8.
    Leven AJ, Sood B (2018) Pathosis or additional maxillary neurovascular channel? A case report. J Endod 44:1048–1051CrossRefGoogle Scholar
  9. 9.
    Machado VC, Chrcanovic BR, Felippe MB, Manhães LRC Jr, Carvalho PSP (2016) Assessmet of accessory canals of the canalis sinuosus: a study of 1000 cone beam computed tomography examinations. Int J Oral Maxillofacc 45:1586–1591CrossRefGoogle Scholar
  10. 10.
    Manhães LRC Jr, Villaça-Carvalho MF, Moraes ME, Lopes SL, Silva MB, Junqueira JL (2016) Location and classification of canalis sinuosus for cone beam computed tomography: avoiding misdiagnosis. Bras Oral Res 30:e49Google Scholar
  11. 11.
    McCrea SJJ (2017) Aberrations causing neurovascular damage in the anterior maxilla during dental implant placement. Case rep Dent 2017:5969643PubMedPubMedCentralGoogle Scholar
  12. 12.
    Neves FS, Crusoé-Souza M, Franco LCS, Caria PHF, Bonfim-Almeida P, Crusoé-Rebello I (2012) Canalis sinuosus: a rare anatomical variation. Surg Radiol Anat 34:563–566CrossRefGoogle Scholar
  13. 13.
    Oliveira-Santos C, Rubira-Bullen IRF, Monteiro SAC, León JE, Jacobs R (2013) Neurovascular anatomical variations in the anterior palate observed on CBCT images. Clin Oral Implants Res 24:1044–1048PubMedGoogle Scholar
  14. 14.
    Orhan K, Gorurgoz C, Akyol M, Ozarslanturk S, Avsever H (2018) An anatomical variant: evaluation of accessory canals of the canalis sinuosus using cone beam computed tomography. Folia Morphol 77:551–557CrossRefGoogle Scholar
  15. 15.
    Rusu MC, Sãndulescu M, Bichir C, Muntianu LAS (2017) Combined anatomical variations: the mylohyoid bridge, retromolar canal and accessory palatine canals branched from the canalis sinuosus. Ann Anat 214:75–79CrossRefGoogle Scholar
  16. 16.
    Shah PN, Arora AV, Kapoor SV (2017) Accessory branch of canalis sinuosus mimicking external root resorption: a diagnostic dilemma. J Conserv Dent 20:479–481CrossRefGoogle Scholar
  17. 17.
    Shelley AM, Rushton VE, Horner K (1999) Canalis sinuosus mimicking a periapical inflammatory lesion. Br Dent J 186:378–379CrossRefGoogle Scholar
  18. 18.
    Torres MGG, Valverde LF, Vidal MT, Crusoe-Rebello IM (2015) Branch of the canalis sinuosus: a rare anatomical variation—a case report. Surg Radiol Anat 37:879–881CrossRefGoogle Scholar
  19. 19.
    Von Arx VT, Lozanoff S, Sendi P, Bornstein MM (2013) Assessment of bone channels other than the nasopalatine canal in the anterior maxilla using limited cone beam computed tomography. Surg Radiol Anat 35:783–790CrossRefGoogle Scholar
  20. 20.
    Wanzeler AMV, Marinho CG, Alves SM Jr, Manzi F, Tuji FM (2015) Anatomical study of canalis sinuosus in 100 cone beam computed tomography examinations. Oral Maxillofacc Surg 19:49–53CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Dentistry of the City of São Paulo University, UNICIDSão PauloBrazil
  2. 2.Valler Zenni Clinical RadiologyItajaíBrazil

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