Background Data on Canalis Sinuosus (CS) morphology in South Asian populations remain limited, despite frequent anterior maxillary implant placements. This study aimed to evaluate the occurrence, positional characteristics, and morphometric features of the CS in Indian adults using cone-beam computed tomography (CBCT) and to assess sex-related differences. Methods A cross-sectional analysis was conducted on 245 CBCT scans with intact maxillary incisors and canines. Multiplanar reconstructions were used to identify the CS and document its laterality, tooth relationship, and orientation. Measurements included canal diameter at the alveolar crest and distances to the alveolar crest, buccal cortical plate, and nasal floor. Inter-observer agreement was assessed using Cohen’s κ. Sex differences were analyzed using χ2 and independent-samples t-tests (α = 0.05). Results CS was detected in 67.3% of individuals, with bilateral presentation in 55.9% and unilateral in 11.4%. Detection rates were similar between sides (left: 62.4%, right: 60.8%). The canal was most frequently adjacent to the lateral incisor (44.7% left, 50.3% right), and approximately half of the canals showed palatal orientation. The mean canal diameter was 0.8 mm. Mean distances to the alveolar crest, buccal cortical plate, and nasal floor were 9.2 mm, 7.0 mm, and 11.5 mm, respectively. Males showed significantly larger canal diameters on the left side (p = 0.008), greater buccal cortical distances bilaterally (p < 0.001), and larger right nasal floor distances (p = 0.011). Conclusions The CS is a frequently observed, typically bilateral anatomical structure in the anterior maxilla of Indian adults, mostly located palatal adjacent the lateral incisor. The morphometric and sex-specific data obtained provide valuable reference parameters for implant planning and minimizing surgical complications.
