Evaluation of the relationship between impacted canines and three-dimensional sella morphology

  • Mehmet Ugurlu
  • Ibrahim Sevki BayrakdarEmail author
  • Fatih Kahraman
  • Rıdvan Oksayan
  • Ilhan Metin Dagsuyu
Original Article



The purpose of this study was to assess the three-dimensional morphometric features of the sella turcica using cone beam computed tomography (CBCT) in subjects with unilateral and bilateral maxillary impacted canines and normal controls.


In this retrospective study, CBCT images captured with ultra-low dose protocol of 73 subjects (21 males, 52 females; mean age 20.01 ± 6.53 years) with unilateral or bilateral maxillary impacted canines (29 unilateral and 29 bilateral) and 15 controls were evaluated. Nineteen different measurements of the pituitary fossa were made on CBCT images. To evaluate the normality, the Kolmogorov–Smirnov test was used. The nonparametric statistical Kruskal–Wallis and Mann–Whitney U tests were applied to analyze the significant differences among and between the groups. Statistical significance was set at 5%.


No measurement differed significantly among the groups (all p > 0.05) other than the right sella length, which differed between the unilateral and bilateral test groups and the unilateral test group and controls (both p < 0.05). The bilateral test group and control group did not differ significantly, but both exhibited greater right sella length than did the unilateral test group (p > 0.05).


Other than the right sella length, there were no among-group differences in the mean pituitary fossa measurements of subjects with impacted unilateral and bilateral canines and normally erupted canines. The right sella length was lower in subjects with impacted unilateral canines than in those with bilateral impacted canines and normal controls.


Impacted canine Sella turcica Pituitary fossa Cephalometry Cone-beam computed tomography 


Author contributions

Each author is expected to have made substantial contributions to the conception. ISB design of the work; FK the acquisition, analysis, RO and MU interpretation of data; ISB the measurement and evaluation of images; IMD have drafted the work or substantively revised it.


There is no funding to report for this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Additional informed consent was obtained from all individual participants included in the study.


  1. 1.
    Ali B, Shaikh A, Fida M (2014) Association between sella turcica bridging and palatal canine impaction. Am J Orthod Dentofac Orthop 146(4):437–441CrossRefGoogle Scholar
  2. 2.
    Alkofide EA (2008) Sella turcica morphology and dimensions in cleft subjects. Cleft Palate Craniofac J 45:647–653CrossRefGoogle Scholar
  3. 3.
    Alkofide EA (2007) The shape and size of the sella turcica in skeletal Class I, Class II, and Class III Saudi subjects. Eur J Orthod 29(5):457–463CrossRefGoogle Scholar
  4. 4.
    Andredaki M, Koumantanou A, Dorotheou D, Halazonetis DJ (2007) A cephalometric morphometric study of the sella turcica. Eur J Orthod 29(5):449–456CrossRefGoogle Scholar
  5. 5.
    Axelsson S, Storhaug K, Kjaer I (2004) Post-natal size and morphology of the sella turcica. Longitudinal cephalometric standards for Norwegians between 6 and 21 years of age. Eur J Orthod 26:597–604CrossRefGoogle Scholar
  6. 6.
    Axelsson S, Storhaug K, Kjaer I (2004) Post-natal size and morphology of the sella turcica in Williams syndrome. Eur J Orthod 26:613–621CrossRefGoogle Scholar
  7. 7.
    Baccetti T (1998) A controlled study of associated dental anomalies. Angle Orthod 68:267–274Google Scholar
  8. 8.
    Baidas LF, Al-Kawari HM, Al-Obaidan Z, Al-Marhoon A, Al-Shahrani S (2018) Association of sella turcica bridging with palatal canine impaction in skeletal Class I and Class II. Clin Cosmet Investig Dent. 20(10):179–187CrossRefGoogle Scholar
  9. 9.
    Becker A, Chaushu S (2015) Etiology of maxillary canine impaction: a review. Am J Orthod Dentofac Orthop 148(4):557–567CrossRefGoogle Scholar
  10. 10.
    Becktor JP, Einersen S, Kjaer I (2000) A sella turcica bridge in subjects with severe craniofacial deviations. Eur J Orthod 22:69–74CrossRefGoogle Scholar
  11. 11.
    Canigur Bavbek N, Dincer M (2014) Dimensions and morphologic variations of sella turcica in type 1 diabetic patients. Am J Orthod Dentofac Orthop 145:179–187CrossRefGoogle Scholar
  12. 12.
    Choi WJ, Hwang EH, Lee SR (2001) The study of shape and size of normal sella turcica in cephalometric radiographs. Korean J Oral Maxillofac Radiol 31:43–49Google Scholar
  13. 13.
    Duverger O, Morasso MI (2008) Role of homeobox genes in the patterning, specification, and differentiation of ectodermal appendages in mammals. J Cell Physiol 216:337–346CrossRefGoogle Scholar
  14. 14.
    El Wak T, Akl R, Mati M, Khoury E, Ghoubril J (2018) Association between sella turcica bridging and palatal canine impaction: evaluation using lateral cephalograms and CBCT. Int Orthod 16(2):338–348CrossRefGoogle Scholar
  15. 15.
    Haji Ghadimi M, Amini F, Hamedi S, Rakhshan V (2017) Associations among sella turcica bridging, atlas arcuate foramen (ponticulus posticus) development, atlas posterior arch deficiency, and the occurrence of palatally displaced canine impaction. Am J Orthod Dentofac Orthop 151(3):513–520CrossRefGoogle Scholar
  16. 16.
    Kjaer I (2015) Sella turcica morphology and the pituitary gland—a new contribution to craniofacial diagnostics based on histology and neuroradiology. Eur J Orthod 37:28–36CrossRefGoogle Scholar
  17. 17.
    Korayem M, Alkofide E (2015) Size and shape of the sella turcica in subjects with Down syndrome. Orthod Craniofac Res 18:43–50CrossRefGoogle Scholar
  18. 18.
    Leonardi R, Barbato E, Vichi M, Caltabiano M (2009) Skeletal anomalies and normal variants in patients with palatally displaced canines. Angle Orthod 79:727–732CrossRefGoogle Scholar
  19. 19.
    Lurie SN, Doraiswamy PM, Husain MM, Boyko OB, Ellinwood EH, Figiel GS, Krishnan KR (1990) In vivo assessment of pituitary gland volume with magnetic resonance imaging: the effect of age. J Clin Endocrinol Metab 71:505–508CrossRefGoogle Scholar
  20. 20.
    Miletich I, Sharpe PT (2004) Neural crest contribution to mammalian tooth formation. Birth Defects Res C Embryo Today 72:200–212CrossRefGoogle Scholar
  21. 21.
    Moss ML (1997) The functional matrix hypothesis revisited. 1. The role of mechanotransduction. Am J Orthod Dentofac Orthop 112:8–11CrossRefGoogle Scholar
  22. 22.
    Najim AA, Al-Nakib L (2011) A cephalometric study of sella turcica size and morphology among young Iraqi normal population in comparison to patients with maxillary malposed canine. J Baghdad Coll Dent 23:53–58Google Scholar
  23. 23.
    Ouakinine GE, Hardy J (1987) Microsurgical anatomy of the pituitary gland and the sellar region. 2. The bony structures. Am Surg 53:291–297Google Scholar
  24. 24.
    Ortiz PM, Tabbaa S, Flores-Mir C, Al-Jewair T (2018) A CBCT Investigation of the Association between sella-turcica bridging and maxillary palatal canine impaction. Biomed Res Int 2018:4329050CrossRefGoogle Scholar
  25. 25.
    Paknahad M, Shahidi S, Khaleghi I (2017) A cone beam computed tomographic evaluation of the size of the sella turcica in patients with cleft lip and palate. J Orthod 44(3):164–168CrossRefGoogle Scholar
  26. 26.
    Peck S, Peck L, Kataja M (1994) The palatally displaced canine as a dental anomaly of genetic origin. Angle Orthod 64:249–256Google Scholar
  27. 27.
    Sahni D, Jit I, Harjeet Neelam, Bhansali A (2006) Weight and dimensions of the pituitary in northwestern Indians. Pituitary 9:19–26CrossRefGoogle Scholar
  28. 28.
    Sakran AMEA, Khan MA, Altaf FMN, Faragalla HEH, Mustafa AYAE, Hijazi MM, Niyazi RR, Tawakul AJ, Malebari AZ, Salem AA (2015) A morphometric study of the sella turcica; gender effect. Int J Anat Res 3:927–934CrossRefGoogle Scholar
  29. 29.
    Sathyanarayana HP, Kailasam V, Chitharanjan AB (2013) Sella turcica—its importance in orthodontics and craniofacial morphology. Dent Res J (Isfahan) 10(5):571–575Google Scholar
  30. 30.
    Shrestha GK, Pokharel PR, Gyawali R, Bhattarai B, Giri J (2018) The morphology and bridging of the sella turcica in adult orthodontic patients. BMC Oral Health 18(1):45CrossRefGoogle Scholar
  31. 31.
    Silverman FN (1957) Roentgen standards fo-size of the pituitary fossa from infancy through adolescence. Am J Roentgenol Radium Ther Nucl Med 78:451–460Google Scholar
  32. 32.
    Swallow CE, Osborn AG (1998) Imaging of sella and parasellar disease. Semin Ultrasound CT MRI 19:257–271CrossRefGoogle Scholar
  33. 33.
    Tepedino M, Laurenziello M, Guida L, Montaruli G, Grassia V, Chimenti C, Campanelli M, Ciavarella D (2019) Sella turcica and craniofacial morphology in patients with palatally displaced canines: a retrospective study. Folia Morphol (Warsz). Google Scholar
  34. 34.
    Tetradis S, Kantor ML (1999) Prevalence of skeletal and dental anomalies and normal variants seen in cephalometric and other radiographs of orthodontic patients. Am J Orthod Dentofac Orthop 116(5):572–577CrossRefGoogle Scholar
  35. 35.
    Yasa Y, Bayrakdar IS, Ocak A, Duman SB, Dedeoglu N (2017) Evaluation of sella turcica shape and dimensions in cleft subjects using cone-beam computed tomography. Med Princ Pract 26(3):280–285CrossRefGoogle Scholar
  36. 36.
    Yasa Y, Ocak A, Bayrakdar IS, Duman SB, Gumussoy I (2017) Morphometric analysis of sella turcica using cone beam computed tomography. J Craniofac Surg 28(1):e70–e74CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthodontics, Faculty of DentistryEskisehir Osmangazi UniversityEskisehirTurkey
  2. 2.Department of Oral and Maxillofacial Radiology, Faculty of DentistryEskisehir Osmangazi UniversityEskisehirTurkey

Personalised recommendations