{Reference Type}: Journal Article
{Title}: Anatomy and function of the canalis sinuosus and its injury prevention and treatment strategies in implant surgery.
{Author}: Sun Z;Lou Y;Liu Z;Wang B;Yu M;Wang H;
{Journal}: Zhejiang Da Xue Xue Bao Yi Xue Ban
{Volume}: 0
{Issue}: 0
{Year}: 2024 May 20
暂无{DOI}: 10.3724/zdxbyxb-2023-0502
{Abstract}: The canalis sinuosus, a canal containing the anterior superior alveolar nerve bundle, originates from the infraorbital canal and extends along the maxillary sinus and nasal cavity edges to the anterior maxilla. It was once regarded as an anatomical variation. However, with the widespread application of cone beam computed tomography (CBCT), the detection rate of canalis sinuosus in the population has increased. The canalis sinuosus exhibits diverse courses, branching into multiple accessory canals and terminating at the nasal floor or the anterior tooth region, with the majority traversing the palatal side of the central incisor. The anterior superior alveolar nerve bundle within the canalis sinuosus not only innervates and nourishes the maxillary anterior teeth, their corresponding soft tissues, and the maxillary sinus mucosa, but also relates to the nasal septum, lateral nasal wall, and parts of the palatal mucosa. To minimize surgical complications, implantologists need to investigate strategies for preventing and treating canalis sinuosus injuries. Preoperatively, implantologists should use CBCT to identify the canalis sinuosus and virtually design implant placement at a distance of more than 2 mm from the canalis sinuosus. Intraoperatively, implantologists should assess bleeding and patient comfort, complemented by precision surgical techniques such as the use of implant surgical guide plates. Postoperatively, CBCT can be employed to examine the relationship between the implant and the canalis sinuosus, and treatment of canalis sinuosus injuries can be tailored based on the patient's symptoms. This review summarizes the detection of canalis sinuosus in the population, its anatomical characteristics, and its physiological functions in the anterior maxilla, and discusses strategies for effectively avoiding canalis sinuosus injuries during implant surgery, thereby enhancing implantologists' awareness and providing references for clinical decision-making.<BR>窦管是一种包含上牙槽前神经束的管道，起自眶下管，沿上颌窦和鼻腔边缘延伸到上颌骨前部。窦管曾被认为是一种解剖变异。随着锥形束计算机体层摄影技术（CBCT）的广泛使用，人群中窦管检出增多。窦管在上颌骨前部走行较为多样，可发出多个副管，终止在鼻底或上前牙区，其中走行于中切牙腭侧居多。窦管中走行的上牙槽前神经束不仅支配上颌前牙及其相应软组织和上颌窦黏膜并提供营养支持，还涉及鼻中隔与鼻侧壁及部分腭部黏膜。为减少手术并发症，种植医师需要研究窦管损伤的防治策略。如术前使用CBCT识别窦管并通过虚拟手术的方式设计种植体距离窦管2 mm以上；术中评估患者的出血情况及关注患者感受并辅以数字化种植术导板等精准手术方式；术后通过CBCT检查种植体与窦管的关系并根据患者感受治疗窦管损伤。本文通过总结窦管在人群中的检出情况、分析窦管解剖结构特点以及窦管在上颌骨前部所发挥的生理功能，探讨在种植术中有效回避窦管损伤的策略，以期提高种植医师的认识，为临床决策提供参考。.