Ponticulus Posticus: Is It Important for a Dentist as an Radiological Finding?

Abstract

SUMMARYDevelopmental anomalies of the atlas are of interest not only to anatomists but also clinicans, radiologists, surgeons, who should be aware of their distinct morphological manifestations as well as correlated clinical expressions. Dentists should look carefully for Ponticulus posticus (PP) because these abnormalities may be related to otherwise unexplainable head and neck pain, visual disturbances, problems with speech and swallowing, vertigo, vascular problems and other symptoms related to compression of the vertebral artery and suboccipital nerve. The aim of this paper, although the dentists especially oral and maxillofacial radiologists and orthodontists are not directly concerned with the management of cervical spine anomalies to sensitize them to realize the cervical spine and be equipped to identify differences from normal anatomy.

Prevalence and characteristics of ponticulus posticus and its association with cervicogenic headache and migraine

“…[ 1 2 3 ] The relationship between these effects and PP plays a more important role when the patient's symptoms are relieved through corrective PP surgery. [ 4 ] Some studies are focused on the effect of PP on screw implantation techniques in the atlas vertebrae because unawareness of this anomaly can lead to a misunderstanding of the large size of the posterior arch, which causes unwanted damage to the vertebral arteries during the surgical procedure. Therefore, accurate determination of the screw entry point based on three-dimensional computerized tomography (CT) before surgery is the most crucial factor to avoid this complication.…”