Abstract
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.
Highlights
Ponticulus posticus is an anomaly of first cervical vertebra visible on lateral cephalogram and has some serious medical and surgical implications
Ponticulus posticus was observed in 35.7% of cases, of which 30.9% had partial ponticulus posticus and 4.8% had complete ponticulus posticus
The data indicate that this anomaly is higher among females compared to males. 79 females (32.11% of female sample) had partial ponticulus posticus and complete ponticulus posticus was seen in 15 females (6.09%)
Summary
Ponticulus posticus is an anomaly of first cervical vertebra visible on lateral cephalogram and has some serious medical and surgical implications. It is often overlooked or undetected by orthodontists. The importance of lateral cephalogram in orthodontics cannot be overstated. Studies have shown that various cervical vertebral anomalies and pathologies can be detected in lateral cephalograms [2,3,4,5]. One of such anomalies that can be discerned by watchful eyes is ponticulus posticus
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