Frequency of Ponticulus Posticus, Sella Turcica Bridge and Clinoid Enlargement in Cleft Lip and Palate Peruvian Patients: A Comparative Study with Non-Cleft Patients

Abstract

SUMMARY:The aims of this study were to determine the frequency of the Ponticulus posticus (PP) in the C1 vertebra and the Sella Turcica Bridge (STB) and Clinoid enlargement (CLEN) variants in two samples of Peruvian cleft lip and palate patients (CLP), determine if there are significant differences between sexes and compare the results with two samples of non-cleft controls. The digital images of the lateral cephalometric radiography of 163 and 150 CLP patients were utilized to determine the frequency of PP and, STB-CLEN respectively. The controls were composed of 1056 and 417 radiography of non-cleft patients. The chi-square statistic was utilized to determine if there were significant differences between genres for the CLP patients, and between the CLP and control samples. The confidence level was set at p<0.05. The frequency of PP (partial and complete) in CLP patients was 11.04% (18 cases) and 6.13% (10 cases) respectively; both of them were more frequent in males and there were no significant differences between sexes and between the CLP and control groups (p>0.05). The frequency of STB and CLEN in CLP patients was 6% (9 cases) and 8.7% (13 cases) respectively; both of them were more frequent in males and there were no significant differences between sexes and between the CLP and control samples for the STB (p>0.05). The frequency of CLEN was significantly lower (p<0.05) in the cleft group and in the female cleft group when compared to the control group. The frequencies of the Ponticulus Posticus, Sella Turcica Bridge and Clinoid Enlargement were similar to the control group and should not be considered as Cleft Lip and Palate associated anomalies; the frequency of the Clinoid Enlargement was significantly lower in cleft patients and this could be confirmed through studies centered on the Clinoid apophysis.

Cervicovertebral anomalies and/or normal variants in patients with congenitally bilateral absent maxillary lateral incisors:

“…7 In addition, these anomalies in the cervical vertebrae have been previously reported to be associated with dental anomalies (such as hypodontia, hyperdontia, and palatally displaced canine impaction), 1,2,5,10 maxillofacial malformations, 10 and condylar and vertical craniofacial morphology. 10,24,25 Additionally, the prevalence of PP formation has been reported in patients with craniofacial problems 10 and dental anomalies 1,14 and has also been reported to be associated with certain diseases and syndromes. 7 The results of this study showed that the prevalence of PP formation decreased and PADA increased in patients with BAMLI.s In the absence of any clinical signs or symptoms, STB is considered to be a normal variant, although it is known to be affected by pathological processes.…”

“…1,5 Calcification of the atlanto-occipital ligament, called ''arcuate foramen'' or ''PP,'' was evaluated visually and scored using a standardized method. 3,10,19 It was scored according to the degree of atlantooccipital ligament ossification as no calcification (absent), partial calcification (incomplete), or complete calcification (complete) ( Figure 2). The presence of STB has been previously demonstrated on lateral cephalometric radiographs.…”

“…[1][2][3][4][5][6][7] However, many developmental anomalies or normal variants may be associated with a significant problem in other systemic diseases. [5][6][7][8][9][10] Some of these radiologic findings can be detected early during examinations performed at specific time points and may appear before other signs and symptoms in some syndromes. 4,7,[11][12][13] Recently, a higher incidence of ponticulus posticus (PP) in the atlas, sella turcica bridge (STB) calcification, and specific craniofacial morphology has been associated with dental agenesis.…”

Cone beam computed tomography evaluation of ponticulus posticus in patients with cleft lip and palate: a retrospective radio-anatomic study

“…In patients with PP, it can be misidentified as a broad posterior arch and the screw can be inserted into the PP. This can cause critical complications [22,24,40].…”

“…CLP results in many complications including feeding, speech, hearing and psychological development. Patients with CLP have higher risk than patients in general population for the appearance of cervical vertebral anomalies [7,9,24,25,38]. The purpose of the this study was twofold: to determine of the prevalence and characteristics of PP in patients with CLP, and to compare the findings with patients in general population using cone beam computed tomography (CBCT).…”