Prevalência do Canalis Sinuosus e dos canais acessórios do Canalis Sinuosus em tomografias computadorizadas de feixe cônico: revisão sistemática e metanálise

Abstract

State of the problem: The Canalis Sinuosus and its accessory canals have been described as anatomical variations and, due to their importance for surgical planning, this information must be confirmed or refuted. Aim: To determine the prevalence of Canalis Sinuosus and accessory canals of Canalis Sinuosus using cone-beam computed tomography. Methodology: Two systematic reviews were carried out, one of them with meta-analysis, with electronic searches performed in MEDLINE via PubMed, Scopus, LILACS, Cochrane CENTRAL, Web of Science and SIGLE via OpenGrey. The primary variable was the prevalence of Canalis Sinuosus and accessory canals of Canalis Sinuosus. The secondary variables related to Canalis Sinuosus and/or its accessory canals were: ending in the vestibulo-palatal and mesio-distal direction; diameter; distance to anatomic landmarks; morphology; and best slice thickness for tomographic visualization. Complementary variables were: number and age of participants, distributed according to sex (male/female). Kappa statistics were calculated to determine the level of agreement between raters. The risk of bias of the primary studies was assessed using the AQUA tool. In one of the articles produced, a prevalence meta-analysis was performed with a 95% confidence interval. Heterogeneity, publication bias and sensitivity analyzes were also performed. Results: Seventeen primary studies were included, evaluated predominantly as of moderate risk of bias. The meta-analysis with 1994 participants showed a prevalence of Canalis Sinuosus of 0.80 (95% CI= 0.51.0.99; p=0.001; I2=99%) and of Canalis Sinuosus accessory channels, considering 4505 participants, showed a prevalence of 0.52 (95% CI). = 0.36,0.69; p=0.001; I2=99%). Sensitivity analyzes of Canalis Sinuosus accessory canals considering studies with more and less than 1000 participants did not change their condition of normal anatomical structure presented in the overall metaanalysis. Conclusion: With the results obtained from the meta-analyses carried out, both the Canalis Sinuosus and the accessory canals of the Canalis Sinuosus should be considered as normal anatomical structures, that is, present in most people, thus discrediting their conditions of anatomical variations.