Surgical and Radiologic Anatomy

, Volume 39, Issue 3, pp 293–297 | Cite as

Prevalence of ponticulus posticus among patients with different dental malocclusions by digital lateral cephalogram: a comparative study

Original Article
  • 178 Downloads

Abstract

Purpose

The aim of the present study was to investigate the prevalence of ponticulus posticus among patients with dental Angle class I, II, and III malocclusions in Middle Anatolian population.

Methods

A total of 1246 cephalometric radiographs were examined in a 6 months period. Each patient was assigned an identification number, and demographic information, absence/presence of PP, if present, type of PP and type of dental malocclusion were recorded by two observers. In cases where there was any disagreement, a third observer was consulted. Distributions of obtained values were analysed using Pearson’s Chi-square test.

Results

The mean age of subjects was 20.98 ± 6.95 years (range 10–39). In the analysed sample, PP had a prevalence of 18.8 % (complete form 9.6 %, incomplete form 9.2 %). There was a significant difference between genders (p = 0.002) (more prevalent in male patients: 119/522; 23 %). No significant difference was found between age groups (p > 0.05). PP was most frequently detected in Angle class III patients (78/351; 22.2 %) but there was no significant difference between malocclusion groups (p > 0.05).

Conclusion

In the present study, PP is found to be a relatively common anomaly in patients with dental malocclusions. Although Angle class III patients showed a higher frequency of PP, statistically no significant difference was found among dental malocclusion groups.

Keywords

Ponticulus posticus Lateral cephalometric radiography Dental malocclusion 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest.

References

  1. 1.
    Ahmad FU, Wang MY (2014) Lateral mass of C1 fixation and ponticulus-posticus. World Neurosurg 82:e145–e146. doi: 10.1016/j.wneu.2014.02.011 CrossRefPubMedGoogle Scholar
  2. 2.
    Bayrakdar IS, Miloglu O, Altun O, Gumussoy I, Durna D, Yilmaz AB (2014) Cone beam computed tomography imaging of ponticulus posticus: prevalence, characteristics, and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 118:e210–e219. doi: 10.1016/j.oooo.2014.09.014 CrossRefPubMedGoogle Scholar
  3. 3.
    Bui C, King T, Proffit W, Frazier-Bowers S (2006) Phenotypic characterization of Class III patients. Angle Orthod 76:564–569. doi:10.1043/0003-3219(2006)076[0564:PCOCIP]2.0.CO;2Google Scholar
  4. 4.
    Cederberg RA, Benson BW, Nunn M, English JD (2000) Arcuate foramen: prevalence by age, gender and degree of calcification. Clin Orthod Res 3:162–167CrossRefGoogle Scholar
  5. 5.
    Chen CH, Chen YK, Wang CK (2015) Prevalence of ponticuli posticus among patients referred for dental examinations by cone-beam CT. Spine J 15:1270–1276. doi: 10.1016/j.spinee.2015.02.031 CrossRefPubMedGoogle Scholar
  6. 6.
    Cho YJ (2009) Radiological analysis of ponticulus posticus in Koreans. Yonsei Med J 50:45–49. doi: 10.3349/ymj.2009.50.1.45 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    D’Attilio M, Epifania E, Ciuffolo F, Salini V, Filippi MR, Dolci M, Festa F, Tecco S (2004) Cervical lordosis angle measured on lateral cephalograms. Findings in skeletal class II female subjects with and without TMD: a cross sectional study. Cranio-the J Craniomandib Pract 22:27–44Google Scholar
  8. 8.
    Elliott RE, Tanweer O (2014) 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 82:e335–e343CrossRefPubMedGoogle Scholar
  9. 9.
    Eriksen K (2003) Upper cervical subluxation complex: a review of chiropractic and medical literature. In: Eriksen K (ed) Vertebral arteries. Lippincott Williams and Wilkins, Philadelphia, p 57Google Scholar
  10. 10.
    Festa F, Tecco S, Dolci M, Ciufolo F, Di Meo S, Filippi MR, Ferritto AL, D’Attillio M (2003) Relationship between cervical lordosis and facial morphology in Caucasian women with a skeletal class II malocclusion: a cross-sectional study. Cranio-the J Craniomandib Pract 21:121–129Google Scholar
  11. 11.
    Geist JR, Geist SM, Lin LM (2014) A cone beam CT investigation of ponticulus posticus and lateralis in children and adolescents. Dentomaxillofac Radiol 43:20130451. doi: 10.1259/dmfr.20130451 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Gibelli D, Cappella A, Cerutti E, Spagnoli L, Dolci C, Sforza C (2015) Prevalence of ponticulus posticus in a Northern Italian orthodontic population: a lateral cephalometric study. Surg Radiol Anat 38:309–312. doi: 10.1007/s00276-015-1554-0 CrossRefPubMedGoogle Scholar
  13. 13.
    Hoenig JF, Schoener WF (1992) Radiological survey of the cervical spine in cleft lip and palate. Dentomaxillofac Radiol 21:36–39. doi: 10.1259/dmfr.21.1.1397450 CrossRefPubMedGoogle Scholar
  14. 14.
    Hong JT, Lee SW, Son BC, Sung JH, Yang SH, Kim IS, Park CK (2008) Analysis of anatomical variations of bone and vascular structures around the posterior atlantal arch using three-dimensional computed tomography angiography. J Neurosurg-Spine 8:230–236. doi: 10.3171/Spi/2008/3/3/230 CrossRefPubMedGoogle Scholar
  15. 15.
    Kamak H, Yildirim E (2015) The distribution of cervical vertebrae anomalies among dental malocclusions. J Craniovertebral Junction Spine 6:158–161. doi: 10.4103/0974-8237.167857 CrossRefGoogle Scholar
  16. 16.
    Kendrick GS, Biggs NL (1963) Incidence of the ponticulus posticus of the first cervical vertebra between ages six to seventeen. Anat Rec 145:449–453CrossRefPubMedGoogle Scholar
  17. 17.
    Kim KH, Park KW, Manh TH, Yeom JS, Chang BS, Lee CK (2007) Prevalence and morphologic features of ponticulus posticus in Koreans: analysis of 312 radiographs and 225 three-dimensional CT scans. Asian Spine J 1:27–31. doi: 10.4184/asj.2007.1.1.27 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Leonardi R, Santarelli A, Barbato E, Ciavarella D, Bolouri S, Harle F, Palazzo G, Lo Muzio L (2010) Atlanto-occipital ligament calcification: a novel sign in nevoid basal cell carcinoma syndrome. Anticancer Res 30:4265–4267PubMedGoogle Scholar
  19. 19.
    Lippold C, Danesh G, Hoppe G, Drerup B, Hackenberg L (2006) Sagittal spinal posture in relation to craniofacial morphology. Angle Orthod 76:625–631. doi:10.1043/0003-3219(2006)076[0625:SSPIRT]2.0.CO;2Google Scholar
  20. 20.
    Mudit G, Srinivas K, Satheesha R (2014) Retrospective analysis of ponticulus posticus in Indian orthodontic patients—a lateral cephalometric study. Ethiop J Health Sci 24:285–290CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Paraskevas G, Papaziogas B, Tsonidis C, Kapetanos G (2005) Gross morphology of the bridges over the vertebral artery groove on the atlas. Surg Radiol Anat 27:129–136. doi: 10.1007/s00276-004-0300-9 CrossRefPubMedGoogle Scholar
  22. 22.
    Proffit WR (2000) Contemporary orthodontics, 3rd edn. Mosby, St.Louis, pp 2–3Google Scholar
  23. 23.
    Sabir H, Kumbhare S, Rout P (2014) 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 118:348–354. doi: 10.1016/j.oooo.2014.04.016 CrossRefPubMedGoogle Scholar
  24. 24.
    Sekerci AE, Soylu E, Arikan MP, Aglarci OS (2015) Is there a relationship between the presence of ponticulus posticus and elongated styloid process? Clin Imaging 39:220–224. doi: 10.1016/j.clinimag.2014.11.016 CrossRefPubMedGoogle Scholar
  25. 25.
    Sekerci AE, Soylu E, Arikan MP, Ozcan G, Amuk M, Kocoglu F (2015) Prevalence and morphologic characteristics of ponticulus posticus: analysis using cone-beam computed tomography. J Chiropr Med 14:153–161. doi: 10.1016/j.jcm.2015.06.003 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Sharma V, Chaudhary D, Mitra R (2010) Prevalence of ponticulus posticus in Indian orthodontic patients. Dentomaxillofac Radiol 39:277–283. doi: 10.1259/dmfr/16271087 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Takaaki M, Masanori O, Hidenori U, Eikazu H, Seisuke T, Sotaro I (1979) Ponticulus ponticus: its clinical significance. Acta Med Kinki Univ 4:427–430Google Scholar
  28. 28.
    Ugar DA, Semb G (2001) The prevalence of anomalies of the upper cervical vertebrae in subjects with cleft lip, cleft palate, or both. Cleft Palate-Cran J 38:498–503. doi: 10.1597/1545-1569(2001)038<0498:Tpoaot>2.0.Co;2 CrossRefGoogle Scholar
  29. 29.
    Wight S, Osborne N, Breen AC (1999) Incidence of ponticulus posterior of the atlas in migraine and cervicogenic headache. J Manip Physiol Ther 22:15–20CrossRefGoogle Scholar
  30. 30.
    Young JP, Young PH, Ackermann MJ, Anderson PA, Riew KD (2005) The ponticulus posticus: implications for screw insertion into the first cervical lateral mass. J Bone Jt Surg Am 87:2495–2498. doi: 10.2106/Jbjs.E.00184 Google Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial Radiology, Faculty of DentistryKirikkale UniversityKirikkaleTurkey

Personalised recommendations