Ponticulus posticus in skeletal malocclusions: A lateral cephalometric study

Abstract

Aims:The ponticulus posticus (PP), a morphological variation in the atlanto-occipital region, is considered a cause of potential entrapment of the vertebral artery segment that traverses the foramen. This study investigated the prevalence and characteristics of PP in different skeletal malocclusion groups using lateral cephalograms.Methods:This retrospective study evaluated 1,400 lateral cephalometric radiographs of subjects aged between 18-40 years. The radiographs were scrutinized for the presence of PP and its types as partial or complete. We evaluated PP according to gender and skeletal malformations as skeletal class-I, II, or III (determined using Point A - Nasion - Point B angle) by two independent examiners.Results:The study included 1400 cephalograms from 607 males (43.4%) and 793 females (56.6%). The mean age was 21.96±0.24 years. PP was more common among male subjects (30.9%) compared with the female subjects (p=0.001). It was predominantly observed among the skeletal class-III (27.8%) malocclusion, followed by class-I (23.1%) and class-II (20.6%) malocclusion (p=0.049). Considering the types of PP, the partial form was more frequent among males (71.8%) and females (75.2%).Conclusions:In this study, the occurrence of PP was observed in 23.5% of the population, predominantly among males. The highest frequency of PP was in the population with skeletal class-III malocclusion.

Keywords

• cephalometry
• cervical vertebrae
• malocclusion
• headache
• ponticulus posticus