Prevalence of ponticuli posticus among patients referred for dental examinations by cone-beam CT

Chen, Chia Hui; Chen, Yuk Kwan; Wang, Chien-Kuo

doi:10.1016/j.spinee.2015.02.031

Cited by 30 publications

(23 citation statements)

References 26 publications

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“…This finding is in agreement with those of previous studies [12, 17, 21, 24, 25]. But, few studies have reported male predilection for this anomaly [6, 22].…”

Section: Discussionsupporting

confidence: 93%

“…Some studies have suggested that this anomaly is a result of senile ossification and has predilection for older age groups [15, 18, 20]. However, other studies did not find a statistically significant association between the chronological age and the presence of ponticulus posticus [12, 23, 26]. This study could not elucidate the relationship between chronological age and this anomaly owing to a narrow range of chronological age of the samples (13–41 years).…”

Section: Discussionmentioning

confidence: 69%

“…It has been reported in literature with different names viz; Kimmerle anomaly [7], Atlas bridging [8], Arcuate foramen [9] etc. The clinical significance of this anomaly is somewhat controversial because studies have found a possible association of this cervical spine anomaly with conditions like Migraine, cervicogenic headache and vertigo but there are patients who are asymptomatic despite having ponticulus posticus [10–12]. However, failure to detect ponticulus posticus can have grave complications during cervical spine surgical intervention, especially those requiring screw placement in lateral mass region of Atlas vertebra [13].…”

Section: Introductionmentioning

confidence: 99%

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How common is ponticulus posticus on lateral cephalograms?

2017

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BackgroundPonticulus posticus is an anomaly of first cervical vertebra visible on lateral cephalogram and has some serious medical and surgical implications. Unfortunately, it is often overlooked or undetected by orthodontists. The general objective of this study is to sensitize orthodontists about this anomaly by depicting its prevalence among a group of Nepalese orthodontic patients.MethodsFour hundred and fourteen digital lateral cephalograms of orthodontic patients were retrieved from the archives of the department. The lateral cephalograms were carefully assessed for the presence of ponticulus posticus in the posterior spine of atlas vertebra by two investigators independently and the findings were recorded.ResultsPonticulus posticus was observed in 35.7% of the cases, of which 30.9% had partial ponticulus posticus and 4.8% had complete ponticulus posticus. Even though there was some female predilection, no statistically significant association was found between gender of the patient and presence of ponticulus posticus.ConclusionPonticulus posticus is a fairly common anomaly with more than one-third (35.7%) of a group of Nepalese orthodontic patients affected and is independent of gender. Since, this anomaly is associated with numerous medical conditions and has surgical implications, orthodontists should use lateral cephalogram as screening radiograph for this anomaly.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2494-z) contains supplementary material, which is available to authorized users.

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“…This finding is in agreement with those of previous studies [12, 17, 21, 24, 25]. But, few studies have reported male predilection for this anomaly [6, 22].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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How common is ponticulus posticus on lateral cephalograms?

2017

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“…If PP exists, the sulcus can become a foramen which is known as arcuate foramen, foramen arcuale atlantis, sagittal foramen, retroarticular canal, retroarticular vertebral ring, atlantal posterior foramen or the upper retroarticular foramen. [1][2][3][4][5][6][7] The causes of the PP remain debated, but it has been proposed to be linked to either an ossification of the posterior atlantooccipital ligament or a congenital anomaly. However, it is usually regarded as a simple variation of the atlas which is usually ignored by the physician.…”

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confidence: 99%

Evaluation of the groove for vertebral artery using CT angiography

Fırat¹,

Erbil²,

Rahsan³

2017

Anatomy

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The groove for vertebral atery (sulcus arteriae vertebralis) is located on the first cervical vertebra (atlas, C1) where the vertebral artery passes over the posterior arch of atlas to reach the foramen magnum. A bony bridge between the posterior of the superior articular process and the posterolateral of the posterior arch of the atlas is a common variation that can be detected by radiographic images. This bony process encircles the groove for vertebral artery and the first cervical nerve partially or completely. It is known by numerous names such as ponticulus posticus (little posterior bridge, PP), Kimmerle's anomaly and Kimmerle's variant ( Figure 1); PP is the most commonly used terminology. If PP exists, the sulcus can become a foramen which is known as arcuate foramen, foramen arcuale atlantis, sagittal foramen, retroarticular canal, retroarticular vertebral ring, atlantal posterior foramen or the upper retroarticular foramen. [1][2][3][4][5][6][7] The causes of the PP remain debated, but it has been proposed to be linked to either an ossification of the posterior atlantooccipital ligament or a congenital anomaly. However, it is usually regarded as a simple variation of the atlas which is usually ignored by the physician. [8][9][10][11] We may observe the PP in patients who do not have any evidence of a symptom in the craniocervical region. However, recent studies have suggested otherwise. AbstractObjectives: Groove for vertebral artery (sulcus arteriae vertebralis) is located on the posterior arch of the first cervical vertebra (atlas) where the vertebral artery passes over to reach the foramen magnum. The bony process between the posterior arch and the superior articulating process of the atlas is a common variation usually detected by lateral radiographies. This bony bridge is most commonly named as the ponticulus posticus. The aim of this study was to evaluate the existence of the ponticulus posticus and morphological features of the groove for vertebral artery. Methods:We performed a retrospective analysis of the groove for vertebral artery from 347 head and neck CT angiographies (694 bilaterally) at the Department of Radiology, Hacettepe University School of Medicine.Results: Complete ponticulus posticus incidence was found to be 12.1%, and 27.38% of these were bilateral. Post-sulcus arterial dimensions were found to be narrower than the pre-sulcus dimensions of the vertebral artery if the ponticulus posticus was incomplete. Conclusion:The groove for vertebral artery is a commonly studied variation among different nations and using different methods like lateral dental graphies, cadaveric studies and dry skulls. This study will be a guide for clinical problems like headache, vascular diseases and surgical interventions of the atlas in a very large patient population and using CT angiography, a sensitive method for visualizing this area.

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“…3,12 The pathophysiology of PP may be related to the pressure applied on the vertebral artery and the suboccipital nerve root. 11 The presence of PP is a possible cause of posterior circulation ischaemia and cervicogenic headache, 1 or mechanical dysfunction at the atlanto-occipital joint resulting in traction of the dura mater or initiation of neurodynamic processes. 3 In regard to clinical significance, patients with PP can be either symptomatic or asymptomatic.…”

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confidence: 99%

Associação Radiográfica entre Ponticulus Posticus e as Alterações Morfológicas Condilares

et al. 2017

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a ResumoO ponticulus posticus (PP) é definido como uma pequena ponte óssea formada entre a porção posterior do processo articular superior e a porção posterolateral da margem superior do arco posterior da vértebra atlas. A fisiopatologia do PP pode ser relatada pela compressão vascular da artéria vertebral e nervo suboccipital, levando a isquemia circulatória e dor de cabeça cervicogênica, ou por disfunção mecânica da articulação atlanto-occiptal, resultando no tracionamento da dura máter ou iniciando um processo neurodinâmico. O objetivo deste estudo foi avaliar a associação entre PP e alterações morfológicas condilares, por meio das radiografias panorâmicas e teleradiografia lateral. Foram selecionados 1200 pacientes que realizaram documentação ortodôntica em uma clínica de radiologia. O PP foi avaliado e classificado em parcial ou completo. Os dados foram tabulados no SPSS e analisados por regressão logística multinomial. Houve diferença estatística significativa na prevalência do PP parcial entre homens e mulheres (P< 0,001), com odds ratio de 1,91 (95% IC 1,34-2,71), e na prevalência do PP complete (P = 0,002), com odds ratio de 1,72 (95% IC 1,21-2,43). Diferença estatística também foi encontrada na associação entre alteração morfológica condilar e PP complete (P = 0,004). Concluiu-se que o PP é mais prevalente em homens e que existe correlação entre a presença do PP completa e alterações morfológicas condilares.Palavras-chave: Radiografia. Atlas cervical. Côndilo Mandibular. Abstract The ponticulus posticus (PP) is defined as an abnormal small bony bridge formed between the posterior portion of the superior articular process and the posterolateral portion of the superior margin of the posterior arch of the atlas. The pathophysiology may be related to

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Prevalence of ponticuli posticus among patients referred for dental examinations by cone-beam CT

Cited by 30 publications

References 26 publications

How common is ponticulus posticus on lateral cephalograms?

How common is ponticulus posticus on lateral cephalograms?

Evaluation of the groove for vertebral artery using CT angiography

Associação Radiográfica entre Ponticulus Posticus e as Alterações Morfológicas Condilares

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