Rare Variation of the Canalis Sinuosus Mimicking an Aberrant Position of Incisive Canal: A Case Report

For the rehabilitation of the edentulous anterior maxilla, implant surgeons need to take precautions regarding the nasopalatine canal and its contents. However, another important anatomical structure in this area, i.e., the canalis sinuosus, can sometimes be easily overlooked.

In this case report, a well-corticated, small radiolucency was noted adjacent to the palatal aspect of the alveolar process in an edentulous area. Initially, it was hypothesized that the nasopalatine canal was positioned laterally due to aberrant embryonic development. Image manipulation of the CBCT scan revealed that the structure was indeed canalis sinuosus.

CBCT technology can offer the implant surgeon not only the chance of increased accuracy but also the avoidance of surgical and restorative complications. However, implant surgeons need to be aware of identifying key anatomical canals and foramen variations during implant planning. In addition, surgery for the placement of dental implants in the anterior maxilla is often complicated due to biomechanical, phonetic, and aesthetic requirements. Therefore, there is a need to make practical adjustments when anatomical limitations exist in the anterior maxilla. Hence, CBCT scans are mandatory before any implant placements, as any interference with the canal may cause non-osseointegration of the implant, sensory dysfunction, and even haemorrhage.