open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Published online: 2017-08-22
Submitted: 2017-07-02
Accepted: 2017-08-04
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Ponticulus posticus in a cohort of orthodontic children and adolescent patients with different sagittal skeletal anomalies: a comparative cone beam computed tomography investigation

İ. Ş. Bayrakdar, Ö. Miloğlu, S. Yeşiltepe, A. B. Yılmaz
DOI: 10.5603/FM.a2017.0075
·
Pubmed: 28832088
·
Folia Morphol 2018;77(1):65-71.

open access

Vol 77, No 1 (2018)
ORIGINAL ARTICLES
Published online: 2017-08-22
Submitted: 2017-07-02
Accepted: 2017-08-04

Abstract

Background: The objective of this study was to evaluate the prevalence and characteristics of ponticulus posticus (PP) in groups with sagittal skeletal anomalies in a Turkish population using cone beam computed tomography (CBCT).

Materials and methods: A total of 181 CBCT images were evaluated according to gender, side and characteristics of PP in the three different sagittal skeletal groups.

Results: The average age of the patients was 13.88 ± 2.99 years (ranging 8–18 years). The study population consisted of 104 (57.5%) females and 77 (42.5%) males. PP was detected in 66 (36.5%) patients. Unilateral and bilateral PP was identified in 29 (43.9%) and 37 (56.1%) patients, respectively. The prevalence of PP in the atlas vertebrae was found to be higher in males than in females and this was statistically significant (p ≤ 0.05). PP was most frequently detected in class III patients (25, 13.8%). Statistically significant differences between the different sagittal skeletal groups were observed (p ≤ 0.05).

Conclusions: Ponticulus posticus is a common anomaly in Turkish populations and is associated with different sagittal skeletal patterns. The highest frequency of PP was found in angle class III patients. (Folia Morphol 2018; 77, 1: 65–71)  

Abstract

Background: The objective of this study was to evaluate the prevalence and characteristics of ponticulus posticus (PP) in groups with sagittal skeletal anomalies in a Turkish population using cone beam computed tomography (CBCT).

Materials and methods: A total of 181 CBCT images were evaluated according to gender, side and characteristics of PP in the three different sagittal skeletal groups.

Results: The average age of the patients was 13.88 ± 2.99 years (ranging 8–18 years). The study population consisted of 104 (57.5%) females and 77 (42.5%) males. PP was detected in 66 (36.5%) patients. Unilateral and bilateral PP was identified in 29 (43.9%) and 37 (56.1%) patients, respectively. The prevalence of PP in the atlas vertebrae was found to be higher in males than in females and this was statistically significant (p ≤ 0.05). PP was most frequently detected in class III patients (25, 13.8%). Statistically significant differences between the different sagittal skeletal groups were observed (p ≤ 0.05).

Conclusions: Ponticulus posticus is a common anomaly in Turkish populations and is associated with different sagittal skeletal patterns. The highest frequency of PP was found in angle class III patients. (Folia Morphol 2018; 77, 1: 65–71)  

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Keywords

ponticulus posticus, malocclusions, cone beam computed tomography

About this article
Title

Ponticulus posticus in a cohort of orthodontic children and adolescent patients with different sagittal skeletal anomalies: a comparative cone beam computed tomography investigation

Journal

Folia Morphologica

Issue

Vol 77, No 1 (2018)

Pages

65-71

Published online

2017-08-22

DOI

10.5603/FM.a2017.0075

Pubmed

28832088

Bibliographic record

Folia Morphol 2018;77(1):65-71.

Keywords

ponticulus posticus
malocclusions
cone beam computed tomography

Authors

İ. Ş. Bayrakdar
Ö. Miloğlu
S. Yeşiltepe
A. B. Yılmaz

References (38)
  1. Adisen MZ, Misirlioglu M. Prevalence of ponticulus posticus among patients with different dental malocclusions by digital lateral cephalogram: a comparative study. Surg Radiol Anat. 2017; 39(3): 293–297.
  2. Afrand M, Ling CP, Khosrotehrani S, et al. Anterior cranial-base time-related changes: A systematic review. Am J Orthod Dentofacial Orthop. 2014; 146(1): 21–32.e6.
  3. Afsharpour S, Hoiriis KT, Fox RB, et al. An anatomical study of arcuate foramen and its clinical implications: a case report. Chiropr Man Therap. 2016; 24: 4.
  4. Bayrakdar IS, Miloglu O, Altun O, et al. Cone beam computed tomography imaging of ponticulus posticus: prevalence, characteristics, and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014; 118(6): e210–e219.
  5. Buyuk SK, Sekerci AE, Benkli YA, et al. A survey of ponticulus posticus: Radiological analysis of atlas in an orthodontic population based on cone-beam computed tomography. Niger J Clin Pract. 2017; 20(1): 106–110.
  6. Chen CH, Chen YK, Wang CK. Prevalence of ponticuli posticus among patients referred for dental examinations by cone-beam CT. Spine J. 2015; 15(6): 1270–1276.
  7. Chitroda PK, Katti G, Baba IA, et al. Ponticulus posticus on the posterior arch of atlas, prevalence analysis in symptomatic and asymptomatic patients of gulbarga population. J Clin Diagn Res. 2013; 7(12): 3044–3047.
  8. D'Attilio M, Epifania E, Ciuffolo F, et al. Cervical lordosis angle measured on lateral cephalograms; findings in skeletal class II female subjects with and without TMD: a cross sectional study. Cranio. 2004; 22(1): 27–44.
  9. Elgafy H, Pompo F, Vela R, et al. Ipsilateral arcuate foramen and high-riding vertebral artery: implication on C1-C2 instrumentation. Spine J. 2014; 14(7): 1351–1355.
  10. Elliott RE, Tanweer O. The prevalence of the ponticulus posticus (arcuate foramen) and its importance in the Goel-Harms procedure: meta-analysis and review of the literature. World Neurosurg. 2014; 82(1-2): e335–e343.
  11. Faruqui S, Fida M, Shaikh A. Cervical vertebral anomalies in skeletal malocclusions: a cross-sectional study on orthodontic patients at the Aga Khan University Hospital, Pakistan. Indian J Dent Res. 2014; 25(4): 480–484.
  12. Festa F, Tecco S, Dolci M, et al. Relationship between cervical lordosis and facial morphology in Caucasian women with a skeletal class II malocclusion: a cross-sectional study. Cranio. 2003; 21(2): 121–129.
  13. Friedrich RE. Ponticulus posticus is a frequent radiographic finding on lateral cephalograms in nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome). Anticancer Res. 2014; 34(12): 7395–7399.
  14. Geist JR, Geist SMRY, Lin LM. A cone beam CT investigation of ponticulus posticus and lateralis in children and adolescents. Dentomaxillofac Radiol. 2014; 43(5): 20130451.
  15. Gibelli D, Cappella A, Cerutti E, et al. Prevalence of ponticulus posticus in a Northern Italian orthodontic population: a lateral cephalometric study. Surg Radiol Anat. 2016; 38(3): 309–312.
  16. Goel A, Desai KI, Muzumdar DP. Atlantoaxial fixation using plate and screw method: a report of 160 treated patients. Neurosurgery. 2002; 51(6): 1351–1357.
  17. Goel A. Screws, facets, and atlantoaxial instability. World Neurosurg. 2013; 80(5): 514–515.
  18. Kamak H, Yildırım E. The distribution of cervical vertebrae anomalies among dental malocclusions. J Craniovertebr Junction Spine. 2015; 6(4): 158–161.
  19. Kendrick GS, Biggs NL. Incidence of the ponticulus posticus of the first cervical vertebra between ages six to seventeen. Anat Rec. 1963; 145: 449–453.
  20. Kim KH, Park KW, Manh TH, et al. Prevalence and morphologic features of ponticulus posticus in koreans: analysis of 312 radiographs and 225 three-dimensional CT scans. Asian Spine J. 2007; 1(1): 27–31.
  21. Kim SH, Shin HC, Shin DAh, et al. Early clinical experience with the mobi-C disc prosthesis. Yonsei Med J. 2007; 48(3): 457–464.
  22. Koletsis DD, Halazonetis DJ. Cervical vertebrae anomalies in orthodontic patients: a growth-based superimpositional approach. Eur J Orthod. 2010; 32(1): 36–42.
  23. Koutsouraki E, Avdelidi E, Michmizos D, et al. Kimmerle's anomaly as a possible causative factor of chronic tension-type headaches and neurosensory hearing loss: case report and literature review. Int J Neurosci. 2010; 120(3): 236–239.
  24. Krishnamurthy A, Nayak SR, Khan S, et al. Arcuate foramen of atlas: incidence, phylogenetic and clinical significance. Rom J Morphol Embryol. 2007; 48(3): 263–266.
  25. Lamberty BG, Zivanović S. The retro-articular vertebral artery ring of the atlas and its significance. Acta Anat (Basel). 1973; 85(1): 113–122.
  26. Leonardi R, Santarelli A, Barbato E, et al. Atlanto-occipital ligament calcification: a novel sign in nevoid basal cell carcinoma syndrome. Anticancer Res. 2010; 30(10): 4265–4267.
  27. Segatto E, Segatto A, Braunitzer G, et al. Sagittal spinal posture in relation to craniofacial morphology. Angle Orthod. 2006; 76(4): 625–631.
  28. Paraskevas G, Papaziogas B, Tsonidis C, et al. Gross morphology of the bridges over the vertebral artery groove on the atlas. Surg Radiol Anat. 2005; 27(2): 129–136.
  29. Pyo J, Lowman RM. The ponticulus posticus of the first cervical vertebra. Radiology. 1959; 72(6): 850–854.
  30. Pękala PA, Henry BM, Pękala JR, et al. Prevalence of foramen arcuale and its clinical significance: a meta-analysis of 55,985 subjects. J Neurosurg Spine. 2017; 27(3): 276–290.
  31. Sabir H, Kumbhare S, Rout P. Evaluation of ponticulus posticus on digital lateral cephalograms and cone beam computed tomography in patients with migraine and healthy individuals: a comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014; 118(3): 348–354.
  32. Sekerci AE, Soylu E, Arikan MP, et al. Is there a relationship between the presence of ponticulus posticus and elongated styloid process? Clin Imaging. 2015; 39(2): 220–224.
  33. Sekerci AE, Soylu E, Arikan MP, et al. Prevalence and morphologic characteristics of ponticulus posticus: analysis using cone-beam computed tomography. J Chiropr Med. 2015; 14(3): 153–161.
  34. Sharma V, Chaudhary D, Mitra R. Prevalence of ponticulus posticus in Indian orthodontic patients. Dentomaxillofac Radiol. 2010; 39(5): 277–283.
  35. Silva MB, Gois BC, Sant'Anna EF. Evaluation of the reliability of measurements in cephalograms generated from cone beam computed tomography. Dental Press J Orthod. 2013; 18(4): 53–60.
  36. Sonnesen L. Associations between the cervical vertebral column and craniofacial morphology. Int J Dent. 2010; 2010: 295728.
  37. Takaaki M, Masanori O, Hidenori U, et al. Ponticulusponticus: Its clinical significance. Acta Med Kinki Univ. 1979; 4: 427–430.
  38. Zhang XL, Huang DG, Wang XD, et al. The feasibility of inserting a C1 pedicle screw in patients with ponticulus posticus: a retrospective analysis of eleven patients. Eur Spine J. 2017; 26(4): 1058–1063.

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