Cone Beam Computed Tomography Analysis of Canalis Sinuosus in Association with an Osteolytic Lesion of Maxilla: A Case Report and Review of Literature

Abstract

Canalis Sinuosus (CS) is a frequent anatomical variation arising from the infraorbital canal. It is a neurovascular channel carrying the anterior superior alveolar nerve and vessels. Anterior maxilla is often the site for invasive procedures like implants, supernumerary teeth extraction, impacted canine extractions and periapical surgeries. Knowledge of anatomical variations in this area is of utmost importance to avoid iatrogenic surgical trauma and post-surgical distress to the patient. Although numerous unnamed accessory canals have been reported in the anterior maxilla, there is a lack of literature explaining the exact position, course and significance of CS. The purpose of this article is to increase awareness amongst the clinicians through a CBCT based case report in which CS was identified as an incidental finding in close proximity to an osteolytic lesion of the maxilla. Additionally, a Pubmed-Medline based analysis was also performed with select keywords which revealed 18 relevant results and eight reported cases from 1999 to 2018. This further emphasises the fact that CS is a significant structure that often gets misdiagnosed and conventional radiography fails to display these configurations accurately.

Keywords

• anterior maxilla
• anterior superior alveolar nerve
• dental implant
• infraorbital canal