Prevalence, Radiographic Features and Clinical Relevancy of Accessory Canals of the Canalis Sinuosus in Cypriot Population: A Retrospective Cone-Beam Computed Tomography (CBCT) Study

Abstract

Background and Objectives: This retrospective study aims to evaluate the prevalence, radiographic features, and clinical relevancy of the accessory canals (AC) of the canalis sinuosus (CS) in patients referred for implant surgery. Materials and Methods: Cone-beam computed tomography (CBCT) images of the patients were collected and ACs were evaluated. Age, sex, bilateral distribution, localization, diameter, distance to the buccal cortical plate, distance to the crest of the alveolar ridge, terminal ending localization, and the presence of tooth or implant were recorded. Ninety-one patients who were eligible for this study were enrolled. Results: A total of 188 ACs were found in 91 patients with 86 bilateral and 5 unilateral distributions. The mean age of the patients was 45.39. All ACs had a terminal ending at the palatal cortical border. All parameters showed a non-normal distribution; thus, the Mann–Whitney U test was preferred. Bilateral AC distribution (p = 0.761), AC distance to the crest of the alveolar ridge (p = 0.614), AC distance to the buccal cortical plate (p = 0.105), and AC diameter (p = 0.423) showed no significant difference between females and males. According to our study, a CS might be an anatomical structure rather than an anatomical variation, as all patients had at least one AC of the CS. It can be inferred that the detection of ACs will be achievable once clinicians are aware of these structures with continuous regular anatomy reworks and with small voxel-sized CBCT devices. Conclusion: This study was conducted to find the features and prevalence of the CS, and it was found that the CS is an anatomical structure rather than an anatomical variation. This argument is in line with the information on the CS in Gray’s Anatomy, 42nd Edition. Impaired healings and complications of the CS can be avoided if clinicians follow the American Academy of Oral and Maxillofacial Radiology guidelines regarding pre-operative implant examination. Otherwise, avertible complications may cause significant impairments in quality of life.

Cone-beam computed tomography of accessory canals of the canalis sinuosus and analysis of the related risk factors

“…This result is consistent with that of another study, which reported a prevalence of 58.0% in males and 46.6% in females in a sample of 1000 patients [12]. It is noteworthy that the presence of AC was unrelated to age in the current study, which is consistent with the results of previous investigations [2,3,9,12,16,19,27].…”

“…The average distance between the nal position of AC and the peak of the alveolar ridge was 5.78 ± 2.25 mm. This outcome is in line with the ndings of two more studies [3,19], where the longest distance recorded was 15.72 mm, and the shortest distance recorded was 1.1 mm. In the assessment of the position relationship between AC and the maxillary anterior teeth, 845 among 870 ACs showed a horizontal relationship with the roots of the anterior teeth within the alveolar bone, whereas only 25 ACs were located above the roots.…”

“…However, Shan et al [19] reported a prevalence of 100% in their study conducted on a Cypriot population. These disparities can be ascribed to several factors, including the differences in imaging techniques, voxel resolution, sample size, inclusion and exclusion criteria, ethnic variations, and the lack of a universally accepted standardized approach for evaluating the presence of AC [3]. Moreover, some of these studies had small sample sizes, and most studies excluded AC with diameters of < 1 mm, which directly affected the nal assessment results.…”

A cone-beam computed tomography study of canalis sinuosus and its accessory canals in a South African population

“…No relationships regarding the prevalence or sidedness of CS and sex were found in the present study. This is consistent with studies conducted in Brazilian, Belgian, Turkish, German, Chinese, Australian, and Cypriot populations [ 1 , 3 , 5 , 7 , 11 , 17 , 18 , 29 ]. Age was also shown to have no effect on the presence or sidedness of CS, in keeping with studies of Brazilian, Turkish, Russian, and Chinese populations [ 1 , 6 , 7 , 12 , 13 , 17 , 19 ].…”

“…Ferlin et al .’s review of literature suggested CBCT scans to be the best modality for the evaluation of CS, where conventional radiographic techniques (periapical and panoramic radiographs) proved less effective [ 8 ]. Many studies investigating CS and its ACs have evaluated CBCT scans [ 1 , 2 , 5 – 7 , 11 – 13 , 17 – 19 , 25 , 29 , 30 ].…”