Canalis Sinuosus: a Systematic Review of the Literature

Objective: The aim of this study was to conduct a systematic review of the frequency, location, diameter, variations in course, relationship to the course of the anterior superior alveolar nerve (ASAN), patient age and gender, and surgical implications of canalis sinuosus (CS), identified through imaging examinations, macerated skulls, or cadaver heads.

Study Design: Medline, Scopus, and Web of Science databases were searched, and the retrieved articles were analyzed by 2 reviewers. The articles were selected by using well-established inclusion criteria. The Hawker scale was used for quality analysis. A kappa test was used to measure interobserver agreement.

Result: The search identified 70 articles, of which 11 were selected for extraction and data analysis. Most studies consisted of cone beam computed tomography examinations of the location, diameter, and variable presence of accessory channels (ACs) in the CS. In total, 90.9% of the studies were of high or moderate quality.

Conclusions: The CS may present variations in its course, location, and diameter. It involves ASAN and a extension to the anterior palate region, the ACs. No statistically significant differences with regard to age or gender were discovered in the studies. Most articles report the relevance of the CS identification in surgical procedures close to the canal and emphasize the importance of awareness of the variable appearance of the CS.