Posterior Arch Deficiency Research Articles

How successful is the CatBoost classifier in diagnosing different dental anomalies in patients via sella turcica and vertebral morphologic alteration?

BackgroundTo investigate how successfully the classification of patients with and without dental anomalies was achieved through four experiments involving different dental anomalies.MethodsLateral cephalometric radiographs (LCRs) from 526 individuals aged between 14 and 22 years were included. Four experiments involving different dental anomalies were created. Experiment 1 included the total dental anomaly group and control group (CG). Experiment 2 only had dental agenesis and a CG. Experiment 3 consisted of only palatally impacted canines and the CG. Experiment 4 comprised patients with various dental defects (transposition, hypodontia, agenesis-palatally affected canine, peg-shaped laterally, hyperdontia) and the CG. Twelve sella measurements and assessments of the ponticulus posticus and posterior arch deficiency were given as input. The target was to distinguish between anomalies and controls. The CatBoost algorithm was applied to classify patients with and without dental anomalies.ResultsIn order from lowest to highest, the predictive accuracies of the experiments were as follows: experiment 4 < experiment 2 < experiment 3 < experiment 1. The sella area (SA) (mm2) was the most important variable in experiment 1. The most significant variable in prediction model of experiment 2 was sella height posterior (SHP) (mm). Sella area (SA) (mm2) was again the most relevant variable in experiment 3. The most important variable in experiment 4 was sella height median (SHM) (mm).ConclusionsEvery prediction model from the four experiments prioritized different variables. These findings may suggest that related research should focus on specific traits from a diagnostic perspective.

Cephalometric Evaluation of the Relationship Between Cervical Vertebral Morphology and Anomalies and the Cranial Base Angle in Different Facial Types and Skeletal Classes

This study examines the morphology and common anomalies of the cervical vertebrae in different skeletal classes and facial types. This cross-sectional study was conducted on 137 lateral cephalometric images of patients aged 18-55 years. The images were evaluated for fusion and posterior arch deficiency as the two most common anomalies along with cervical vertebral morphology (dense angle, the height of the posterior arch of the atlas, the external anterior posterior diameter of the atlas, and the cranial base angle). Data were categorized into three skeletal classes based on the Wits analysis and the ANB angle and also three facial types based on the SN-MP angle. These calculations were performed in SPSS 22 at the significance level of P&lt;0.05. The height of the posterior arch of the atlas was directly and significantly related to age and increased with it. The mean external anterior posterior diameter of C1 was higher in men and in the hypodivergent group. As for the other factors, including cervical spine anomalies, no significant relationship was observed with age, sex, skeletal classes, facial types, and the cranial base angle. Moreover, the mean morphology of the cervical spine was not significantly associated with skeletal classes. Based on the results, the height of the posterior arch of the atlas was associated with age and increased along with it. Moreover, the mean external anterior posterior diameter of the atlas was greater in men and in hypodivergent individuals.

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits

IntroductionDespite researchers' recent interest in identifying links between some dental and craniovertebral abnormalities, there are many important, unassessed gaps in our knowledge of this matter. In addition, previous samples were small. This large study aimed to examine, for the first time, the occurrence/severity of numerous dental and skeletal anomalies or variations and their correlations with each other and with growth patterns.MethodsThis epidemiological study was conducted on pretreatment radiographs of 1194 patients from 3 cities (815 females). Skeletal sagittal skeletal relationships and vertical growth patterns were determined. The occurrence/severity were assessed for: cervical vertebral fusion (CVF), atlas posterior arch deficiency (APAD), ponticulus posticus (PP), sella turcica bridging (STB), hypodontia, oligodontia, hyperdontia, missing of maxillary laterals, microdontia, macrodontia, root dilaceration, odontoma, taurodontism, dental fusion, dental gemination, enamel pearl, permanent molar ankylosis, primary molar ankylosis, dens in dente, dens invaginatus, dental impaction, ectopic eruption, and dental transposition. Incidental findings were recorded as well. Concurrent anomalies, sex dimorphism, and correlations across variables were examined statistically, adjusting for the false discovery rate (α = 0.05).ResultsPrevalence was calculated for 43 dentoskeletal traits/anomalies (22 abnormalities/variations [plus their severities/types] as well as 21 incidentally found traits/anomalies). Dental impaction may be more common in hyperdivergent and severer cases of sella bridging; also, primary molar ankylosis was associated with missing teeth. Dental impaction was associated only with STB and not with PP, APAD, or vertebral fusion. The only association observed among the four skeletal anomalies was seen between APAD and CVF. Merely the variables ‘sagittal skeletal relationships, vertical growth patterns, PP, and APAD’ showed sexual dimorphism; of these, only vertical growth pattern and APAD remained sexually dimorphic after adjusting for the FDR; still, the other two remained marginally significant and worth further evaluations. Sex dimorphism did not exist in concurrent abnormalities. The skeletal Class III was associated with the concurrent occurrence of craniovertebral, dental, and dentoskeletal abnormalities. Skeletal Class I was associated with fewer occurrences of concurrent dental anomalies. Vertical growth patterns were not associated with concurrent dental or dentoskeletal anomalies. However, the hyperdivergent pattern was associated with fewer cases of concurrent craniovertebral abnormalities.ConclusionsSTB and hyperdivergent pattern were associated with dental impaction. However, APAD, CVF, or PP were not associated with dental impaction. APAD was associated with CVF. Sexual dimorphism existed conclusively in the case of vertical growth patterns and APAD. Concurrent abnormalities (dental, skeletal, and dentoskeletal) were associated with skeletal Class III.

Assessments of Prevalence of Ponticulus Posticus, Atlas Posterior Arch Deficiency, Sella Turcica Bridging, Maxillary Canine Impaction, and Associations Among Them in 500 CBCTs of Italian Orthodontic Patients

Background: The ponticulus posticus (PP) is an important anomaly of the atlas (C1 vertebra) with a complete or partial bone bridge that transforms the groove of the vertebral artery (VA) into a canal (arcuate foramen). The aim was to retrospectively determine prevalence of PP evaluating morphological features and the possible association with other dentoskeletal anomalies in the midface and neck area such as maxillary canine impaction (MCI), atlas posterior arch deficiency (APAD), and sella turcica bridging (SB).Methods: This study was conducted in the Department of Medical, Oral and Biotechnological Sciences of the University “G. D'Annunzio” in Chieti. The detection of PP was performed on 500 patients with cone beam CT (CBCT) images (6 to 87 years).Results: Analysis revealed the presence of uni- and bi-lateral PP in 110 patients (22%): 24 (4.8%) patients with bilateral complete PP, 12 (2.4%) patients with complete PP on the left, 6 (1.2%) patients with complete PP on the right, 8 (1.6%) patients with complete PP on the right and partial PP on the left, 6 (1.2%) patients with complete PP on the left and partial PP on the right, 26 (5.2%) patients with partial bilateral PP, 18 (3.6%) patients with partial left PP, and 10 (2%) patients with partial PP on the right. The Chi-squared statistic confirmed that there are significant associations between MCI and PP (p = 0.020) and between SB and MCI (p &amp;lt;0.00001). No correlation between chronological age and presence of the PP (p = 0.982), between chronological age and morphotypes of the PP (p = 0.779), between APAD and the PP (p = 0.0757), between SB and the PP (p = 0.111), and between APAD and MCI (p = 0.222) were found.Conclusion: This observational study showed how bilateral partial variant and bilateral complete variant are the most represented morphotypes in all the age groups. The prevalence of MCI is positively associated with PP and with SB.

Effect of Obstructive Sleep Apnea on Condylar Malformation, Vertebral Column, and Head Posture: A Cephalometric Evaluation.

Aims and objectivesObstructive sleep apnea (OSA) is by far the most common sleep-related breathing disorder, affecting 2–4% of the adult population. The present study aims to compare the descriptive morphology of the cervical column in subjects with normal craniofacial morphology with those having condylar hypoplasia with OSA and to evaluate a positive correlation between the cervical columns, the cranial base angle, and the posture of the head and neck in subjects of condylar hypoplasia.Materials and methodsThe present study comprised of lateral cephalogram of 40 subjects divided into two equal groups—control groups (n = 20) and OSA with condylar hypoplasia (n = 20).Results and observationThe condylar hypoplasia group has fusion anomalies of 65% and 35% has a posterior arch deficiency. The cervical lordosis, inclination of the cervical column is found to have a positive statistically significant correlation in condylar hypoplasia subjects.ConclusionMorphological deviations and deviation pattern of the cervical column occurred significantly more often in subjects with condylar hypoplasia as compared with normal craniofacial morphology which can be verified by the increased cranial base angle, cervical lordosis, the inclination of the upper cervical spine, and cranial base angle were positively correlated with a fusion of cervical column.Clinical significanceSpecific types of craniofacial morphology and head postures such as a reduced posterior airway space, an abnormally long soft palate, a low position of the hyoid bone, and an extended head posture are considered predisposing factors of OSA. As posture of the head and neck is considered to be associated with OSA, OSA may be associated with fusion of the cervical column. Hence, to know the result of malformation in the cervical column prove to be important with regard to phenotypical subdivision, diagnosis, and treatment of OSA.How to cite this articleDivya, Navit P, Singh R, et al. Effect of Obstructive Sleep Apnea on Condylar Malformation, Vertebral Column, and Head Posture: A Cephalometric Evaluation. Int J Clin Pediatr Dent 2020;13(S-1):S64–S68.

Evaluation of the cervical vertebral anomalies in patients with cleft lip and palate in Aegean region of Turkey.

To identify the cervical vertebral anomalies in patients with cleft lip and palate, and to compare unilateral and bilateral cleft lip and palate. The retrospective cohort study was conducted in 2018 at Department of Orthodontics, Ege University, Izmir, Turkey, and comprised non-deteriorated lateral cephalometric radiographs of non-syndromic patients which showed the entire cervical spine. The radiographs were divided into two groups, with group A having those of patients with cleft lip and palate exposure, and control group B having those with non-exposure. Within group A, unilateral and bilateral cleft lip and palate cases were compared. Data was analysed using SPSS 22. Of the 220 subjects, 110(50%) were in group A with a mean age of 15±6.3 years, and 110(50%) were in group B with a mean age of 15±2.1 years. Within group A, 56(50.9%) subjects had unilateral and 54(49.1%) had bilateral cleft lip and palate. Cervical vertebral anomalies were found in 71(64.5%) patients and 45(40.9%) controls (p<0.001). Among those with bilateral condition, it was found in 41(75.9%) and in unilateral 56(56.6%) (p<0.05). Occipitalisation was 21(38.9%) in bilateral and 4(7.1%) in unilateral cases (p<0.001). Fusion was higher in bilateral patients 16(63%) compared to 23(41.1%) unilateral (p<0.05). Posterior arch deficiencies were found in 30(27.3%) patients in group A and 18(16.4%) controls in group B (p<0.05). Fusion was seen in 57(51.8%) group A patients and 33(30%) group B controls (p<0.001). Cervical vertebral anomalies were mostly found in patients with cleft lip and palate. In patients with bilateral condition, more than one anomaly was seen.

Association between Anatomical Variations and Maxillary Canine Impaction: A Retrospective Study in Orthodontics

This study aims to evaluate whether or not there is a higher prevalence of skeletal abnormalities in subjects with maxillary canine impaction (MCI). This retrospective study was performed on 67 subjects with maxillary canine impaction (test group) and on 67 patients without dental displacement (control group). Sella turcica bridging (SB), ponticulus posticus (PP), atlas posterior arch deficiency (APAD) and the morphology of sella turcica and pterygopalatine fissure were evaluated on lateral cephalometric radiographs. Statistical analysis was performed using chi-square, Mann–Whitney test and multivariate logistic models; the level of significance was p &lt; 0.05. Results showed that in the test and control groups 87% and 62.7% of patients had SB, respectively. PP was observed in 60% of patients in the test group and in 16.4% of patients in the control group. APAD was observed in 9% of test group and in 4.5% of the control group. Skeletal anomalies were significantly increased (p &lt; 0.05) in subjects with MCI. A significant difference between the groups was observed in regards to the shape of the pterygopalatine fissure, found to be less wide and longer in the test group. SB, PP and APAD were higher in subjects with MCI; furthermore, an elongated pterygopalatine fissure was significantly associated with MCI.

Association of congenital missing of maxillary lateral incisors with cervical vertebral body fusions and/or atlas posterior arch deficiency

To evaluate the association between congenital missing of maxillary lateral incisor (MLI) with cervical vertebral body fusions, posterior arch deficiency, and both anomalies. A total of 64 subjects (24 males and 40 females; mean age 16 ± 4.5 years) were detected to have congenital missing of MLI and selected as a study group. Two hundred and fifty-six subjects (87 males and 169 females, mean age 18.1 ± 3.2 years) were assigned to the control group. In the congenital absence of MLI, 53.7% revealed cervical column body fusion, 11.1% indicated a posterior arch deficiency, and 9.3% showed cervical column body fusion with posterior arch deficiency. Morphological deviations of the cervical column showed significant associations with congenital absence of MLI compared to control group (p < 0.001). There were no significant differences in gender among the study and control groups (p > 0.05). Subjects with congenial MLI tend to have an increased frequency of cervical anomaly.

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

To determine whether there is a relationship between congenitally bilaterally absent maxillary lateral incisors (BAMLIs) and skeletal anomalies and/or normal variants. The records of 86 patients (62 girls, 24 boys; age 12-17 years) with congenitally BAMLIs and 86 patients (55 girls, 34 boys; age 13-18 years) without any dental or skeletal anomalies were collected and evaluated retrospectively. The study was based on the evaluation of lateral cephalometric and orthopantomographic radiographs. Posterior arch deficiency of the atlas bone (PADA); atlanto-occipital ligament calcification, known as "ponticulus posticus" (PP); and interclinoid ligament calcification, known as "sella turcica bridging" were recorded for each participant. Pearson χ2 and Fisher exact tests were used to evaluate and compare skeletal anomalies and/or normal variants between patients with BAMLIs and the control group. The prevalence of cervicovertebral anomalies and/or normal variants seen in the lateral cephalometric radiographs was higher in patients with BAMLI than in the control group. The prevalence of PP was lower and that of PADA was higher in patients with BAMLIs than in the control group (P < .05). The prevalence of PADA was increased and that of PP formation was decreased in patients with BAMLIs. There was a significant relationship between skeletal anomalies and/or normal variants.

A LATERAL CEPHALOGRAPHIC EVALUATION OF ASSOCIATION OF CLEFT LIP AND PALATE WITH CERVICAL VERTEBRAL ANOMALIES

Generally, orthodontic treatment and intervention are timed to take place before or during the peak growth velocity or pubertal growth spurt to achieve favorable effects in correcting sagittal, transverse, and vertical plane disharmonies. Skeletal maturity and growth spurts have been assessed by several methods in the literature, including chronological age, dental development, and sexual maturation characteristics. All of these methods have limitations, such as poor correlation with growth spurt. Hence based on above findings the present study was planned for A Lateral Cephalographic Evaluation of Association of Cleft Lip and Palate with Cervical Vertebral Anomalies.&#x0D; The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. In the present study 20 cases of the age from 5 to 20 years suffered from the cleft lip and Palate were enrolled and evaluated with the different parameters. The radiographs were traced for cervical spine from C1- C4 on an acetate paper with 3H pencil under optimal illumination. Cervical vertebral anomalies were recorded and categorized into posterior arch deficiencies and fusion or both.&#x0D; The data generated from the present study concludes that the association between cleft lip and palate and cervical vertebral anomalies indicates that cervical vertebral anomalies may be implicated as the etiology of cleft lip and palate. As oral and maxillofacial radiologists, lateral cephalographs are easily available in records of dental patients and can be used to identify cervical vertebral anomalies. Cervical vertebral anomalies can predispose to further disorders and identification of such anomalies mandates referral to the concerned specialist for appropriate management.&#x0D; Keywords: Cleft Lip and Palate; Cervical Vertebral Anomalies; Dehiscence; Fusion; Lateral Cephalographs, etc.

Upper cervical spine abnormalities as a radiographic index in the diagnosis and treatment of temporomandibular disorders.

The aim of this study was to investigate the clinical characteristics and treatment outcomes of patients with temporomandibular disorders (TMD) according to the presence of upper cervical spine abnormalities and craniofacial morphology. Clinical examinations were conducted on 43 patients with TMD. Upper cervical spine characteristics (fusion, posterior arch deficiency [PAD], and craniofacial morphology) reflecting head-and-neck posture were evaluated on lateral cephalograms. Condylar bone changes in the temporomandibular joint were evaluated by using cone beam computed tomography. Clinical characteristics and treatment outcomes after 1 year of conservative therapy were statistically analyzed between groups, according to the presence of upper cervical spine abnormalities. Pain on neck muscle palpation was more frequent in patients with cervical fusion (P = .019) and with either fusion or PAD (P = .004) before treatment. Patients with PAD had smaller comfortable mouth opening ranges compared with those without the deficiency (P = .044) before treatment and smaller comfortable (P = .020) and maximum (P = .021) mouth opening ranges after treatment. Patients with PAD also had mouth opening limitation (P = .028) and pain on masticatory muscle palpation (P = .014) more frequently after treatment compared with patients without the deficiency. Associations exist between upper cervical spine characteristics and treatment outcomes in patients with TMD, suggesting such parameters as a possible radiographic index in TMD diagnosis and treatment.

EVALUATION OF ASSOCIATION OF CLEFT LIP AND CLEFT PALATE WITH CERVICAL VERTEBRAL ANOMALIES: A LATERAL CEPHALOGRAPH STUDY

The precise origin of cervical vertebral anomalies is still unstated, but it has been suggested that the association between abnormal development of cervical vertebrae and the maxilla and the mandible might be caused by a developmental fault of the mesenchyme as these structures might be dependent on the similar para-axial mesoderm. Hence it is appropriate to focus on this area of research and to consider the craniofacial morphology as an important diagnostic tool in Orthodontic treatment planning. The present study was planned to evaluate the association of Cleft lip and Cleft palate with cervical vertebral anomalies.&#x0D; The present study was planned in Department of Pediatric and Preventive Dentistry, Buddha Institute of Dental Sciences &amp; Hospital, Patna, Bihar, India. Thirty cases of Cleft Lip and Cleft Palate (CLCP) patients were enrolled in the present study. The age of the patients ranged from 5 years to 15 years. The cleft sample were subdivided into patients with CP only, and unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). Radiographs were examined on a film viewer by a single examiner. The profile of first four cervical vertebrae and Atlanto Occipital Articulation were structurally traced on an acetate paper with 3H lead pencil under optimum illumination and Cervical Vertebral Anomalies (CVA) were registered and categorized into Posterior Arch Deficiencies - PAD (dehiscence and spina bifid) and fusion.&#x0D; The present study concludes the association between cleft lip and palate and Cervical Vertebral Anomalies indicating that CVA may be implicated as the etiology of cleft lip and palate. The present study showed a specific relation between the Cleft Palate and cervical anomalies and the vertebral anomalies following a specific pattern in different types of cleft was found to be PAD which occurred more frequently in UCLP and CP only and fusion occurring significantly more often in BCLP.&#x0D; Keywords: Cleft Lip and Cleft Palate; Cervical Vertebral Anomalies; Dehiscence; Fusion; Lateral Cephalograph

Morphologic Anomalies of Upper Cervical Vertebrae in Swedish Children Born with Nonsyndromic Cleft Lip and/or Palate Compared to Swedish Children without Cleft.

To examine and compare the prevalence of morphologic anomalies of the upper cervical vertebrae in Swedish children with nonsyndromic cleft lip and/or palate to Swedish children without cleft. Retrospective study on lateral cephalograms. Division of Orthodontics, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. The cleft group consisted of 325 children (150 girls and 175 boys) born with nonsyndromic cleft lip and/or palate (mean age: 11.1 years). The control group consisted of 325 children without cleft, matched for age and gender. Lateral cephalograms exposing upper cervical vertebrae (C1-C3) were examined regarding morphologic anomalies such as posterior arch deficiencies, fusion of vertebrae, odontoid anomalies, and deviations of the vertebral artery canal. The prevalence of children with morphologic anomalies of the upper cervical vertebrae was 24.3% (n = 79) in children with cleft and 12.6% (n = 41) in children without cleft. Posterior arch deficiency and vertebral fusion were significantly more frequent in children with cleft (P < .001). No statistically significant differences were found between the 2 groups regarding odontoid and vertebral artery canal anomalies. Morphologic anomalies of the upper cervical vertebrae in Swedish children with nonsyndromic cleft lip and/or palate were significantly more frequent compared to similar anomalies in Swedish children without cleft.

Role of cone-beam computed tomography with a large field of view in Goldenhar syndrome.

Goldenhar syndrome is a rare disease with hemifacial microsomia and craniofacial disorders originating from the first and second branchial arches, such as ocular, auricular, and vertebral anomalies. The complexity and variety of the ways in which the disease presents itself usually need several examinations. In this study, we aimed to evaluate both craniofacial and vertebral skeletal anomalies and asymmetries between the nonaffected and affected sides in patients with Goldenhar syndrome by using cone-beam computed tomography. Ten patients (7-14years old; 6 boys, 4 girls) were evaluated via NewTom 5G cone-beam computed tomography (QR srl, Verona, Italy) with a large field of view (18×16cm). Ten anatomic facial landmarks were identified to measure the following distances bilaterally: sella turcica (ST)-mandibular angle, ST-condyle, ST-mastoid, ST-mental foramen, ST-fronto zygomatic suture, ST-zygomatic temporal suture, ST-zygomatic facial foramen, ST-sphenopalatine fossa, mandibular angle-mandibular symphysis, and mandibular angle-condyle. The following 6 volumes were calculated bilaterally: orbit, maxillary sinus, condyle, external ear canal, middle ear, and internal auditory canal. These measurements were performed to assess skeletal asymmetries to compare the nonaffected side with the affected side by the Wilcoxon test. Cervical spine anomalies were classified into fusion anomalies and posterior arch deficiencies. All patients showed a deficit of skeletal development on the affected side. Statistically significant differences (0.001≤ P value≤0.043) between the nonaffected and affected sides were recorded for all measurements, except for ST-frontozygomatic suture, mandibular angle-mandibular symphysis, and maxillary sinus volume. Vertebral fusion anomalies and posterior arch deficiencies were found in 7 and 4 patients, respectively. Cone-beam computed tomography with a large field of view was able to accurately identify craniofacial and vertebral skeletal anomalies, and to quantify asymmetries between the nonaffected and affected sides for an efficient maxillofacial treatment planning.

The association of cleft lip and palate with cervical vertebral anomalies- a lateral cephalographic study

Background: Cleft lip and palate is the most common major congenital craniofacial abnormality noted, which is 1 in 700 births. Although inheritance may play a role, cleft lip and palate is considered to be of multifactorial etiology, including chemical exposures, radiation, maternal hypoxia, teratogenic drugs, nutritional deficiencies, especially folic acid and cervical vertebral anomalies.Objective: To assess an association between cleft lip and palate and cervical vertebral anomalies.Methodology: The lateral cephalographs of 74 cleft lip and palate patients aged 6- 20yr were traced for cervical spine from C1- C4 on an acetate paper. Cervical vertebral anomalies were recorded and categorized into posterior arch deficiencies and fusion or both.Results: 12.16% of cleft lip and palate patients had cervical vertebral anomalies.Conclusion: The association between cleft lip and palate and cervical vertebral anomalies indicates that cervical vertebral anomalies may be implicated in the etiology of cleft lip and palate. Cervical vertebral anomalies can predispose to further disorders and identification of such anomalies mandates referral to the concerned specialist for appropriate management.

Associations among sella turcica bridging, atlas arcuate foramen (ponticulus posticus) development, atlas posterior arch deficiency, and the occurrence of palatally displaced canine impaction.

Head and neck skeletal anomalies or normal variants might predict the occurrence of palatally displaced impacted maxillary canines. Despite their clinical importance, studies in this regard are rare, especially when it comes to vertebral anomalies. This case-control study was performed on cephalographs of 35 orthodontic patients (11 male, 24 female) with palatally displaced canines (PDC) and 75 patients without them (29 male, 46 female). PDC were diagnosed on panoramic and lateral cephalographs and from clinical reports. The occurrence and severity of sella turcica bridge and the atlas ponticulus posticus, and deficiency of the posterior atlas arch were evaluated twice on lateral cephalographs. The associations between the occurrence and level of these skeletal anomalies and variations of PDC occurrence as well as additional correlations were assessed using multivariable and bivariate statistics (α=0.05; β≤0.2). The patients' mean age was 18.4±1.9years. In the control and patient groups, 23 (30.7%) and 21 subjects (60%) had sella turcica bridging, respectively (chi-square, P=0.003). Ponticulus posticus was observed in 14 (18.7%) controls and 15 (42.9%) patients (chi-square, P=0.007). Posterior atlas arch deficiency was observed in 4 (5.3%) controls and 5 (14.3%) patients (chi-square, P=0.111). The presence of ponticulus posticus and sella turcica bridging might be associated with increased odds of PDC occurrence for about odds ratios of 3.1 and 3.5 times, respectively (binary logistic regression). PDC is positively associated with the occurrence and severity of sella turcica bridging and ponticulus posticus. The association between PDC and posterior atlas arch deficiency was inconclusive.

The Relation Between Cervical Vertebral Body Morphology and Craniofacial Parameters in Normal and Deep Bite Patients

Aims: The aims of the present study were to describe the morphology of the cervical column in adult patients with a skeletal deep and normal bite occlusion, the prevalence of these morphology within them and to analyse the associations between the morphology of the cervical column and craniofacial parameters. Materials and Methods: The sample of this study composed of two groups, deep bite and normal over bite. The normal or control group composed of 50 adult subjects (25 males and 25 females) aged 18-25 years. The deep bite group composed of 59 adult subjects (20 males and 39 females) aged 18-25 years. Lateral cephalometric radiograph were taken for both normal and deep bite groups. We used 12 variables 11 angular and 1 linear measurements. The morphology of the cervical column was evaluated by visual inspection of the first five cervical vertebrae as they are normally seen in on a standardized lateral cephalometric radiograph. Results: In the skeletal deep bite group, 53.4 per cent had fusion of the cervical column and 23.2 per cent posterior arch deficiency (partial cleft). The fusion always occurred between C2 and C3. In the normal over bite group, 12.9 per cent fusion of the cervical column and 5.35 per cent of posterior arch deficiency, the fusion always occurred between C2 and C3. The significant correlations were seen between fusion and the angle between palatal plane and mandibular plane, the angle formed between the long axis of upper central incisor and palatal plane and the distance between the incisal edges of upper and lower central incisors, also the significant correlation between posterior arch deficiency and the angle between palatal plane and mandibular plane, the angle between the mandibular plane and chin line, gonial angle and the angle formed between the long axis of upper central incisor and palatal plane. Conclusions: The deep bite group had more deviations of the cervical column than the normal group. Our results showed that the craniofacial parameters, occlusion and malformations of the jaws were affected by morphological deviations of the upper cervical vertebrae including fusion and posterior arch deficiency.

Cervical vertebral anomalies in patients with obstructive sleep apnea

Objective The aim of this study was to find an association between the patients with obstructive sleep apnea (OSA) and with cervical vertebral anomalies and any further correlation between various anomalies with varying severities of OSA. Materials and Methods The sample consisted lateral cephalograms of 70 subjects who were diagnosed with OSA and 70 other orthodontic patients who were selected as a control group. The lateral radiographs of both cases and controls were traced and findings were recorded. Results In total, 21.42% of subjects in the OSA group and 8.57% in the control group were affected with cervical vertebrae anomalies. The statistical analysis reveals that the number of subjects affected with cervical vertebrae anomalies in OSA group is highly significant. A number of cases of fusion were higher than posterior arch deficiency in OSA group and equal in the control group. However, in both the groups, the number of cases with two vertebrae fusion was higher. Further, the higher number of two vertebrae fusion cases in OSA group was found to be statistically significant. The findings of one-way ANOVA for OSA cases reveals the number of cases affected with cervical vertebrae anomalies were statistically highly significant (P &lt; 0.01) in severe cases of OSA. Conclusion Patients of cervical vertebral anomalies may be at higher risk of developing OSA, and the possibility of the presence of cervical vertebral anomalies may increase with the increase in the severity of OSA. The most common vertebral anomaly was found to be two vertebral fusions.

The assessment of cervical vertebral anomalies on lateral cephalograms and cone-beam computed tomographs

Objectives: The aims of this study were (1) to determine the occurrence of cervical vertebral anomaly in the selected population, (2) to evaluate the reliability of the findings obtained from lateral cephalograms. For this purpose, the lateral cephalogram findings were compared with those obtained from cone beam computed tomography (CBCT).Subjects and Methods: A sample of 123 subjects who had both lateral cephalogram and CBCT were comprised from the archive. Only the subjects with images presenting the first four cervical vertebrae were included; thus 25 subjects (14 female, 11 male) formed the study group. Normal appearance was determined when the first four vertebrae could be traced as separate entities, with all anatomical components present. Characteristics of the cervical column were classified according to Sandham as posterior arch deficiencies (PAD) and fusions.Results: The lateral cephalogram findings of the 25 subjects revealed an occurrence of 16% for fusion and an occurrence of 20% for PAD. However, none of these findings were confirmed by the evaluation of CBCT images.Conclusions: The occurrence of cervical vertebral anomalies was zero in the evaluated orthodontic population. Our findings suggest that the evaluation of two-dimensional radiographs for the diagnosis of cervical vertebral anomalies was not a reliable method

The distribution of cervical vertebrae anomalies among dental malocclusions

Aims:The aims of our study were to investigate the distribution of cervical vertebrae anomalies (CVAs) among dental Angle Class I, II, and III malocclusions in Turkish population and whether a correlation between CVA and dental malocclusion.Materials and Methods:The study was performed on lateral cephalometric radiographs which were taken at the Department of Orthodontics, Faculty of Dentistry, Kirikkale University. The final sample of 318 orthodontic patients was included in the study. Dental malocclusions were performed according to Angle classification. CVAs were categorized: (1) fusion and (2) posterior arch deficiency (PAD). The Chi-square test was used to the analysis of the potential differences among dental malocclusions.Results:The final sample of 318 patients was examined. CVA was observed in 42 individuals (of 26 [8.17%] had fusion and 16 [5.03%] had PAD), with a frequency of 13.2%. Of the 26 fusion defect, 8 (30.7%) had Angle Class I, 8 (30.7%) had Angle Class II, and 10 (38.4%) had Angle Class III malocclusion. Of the 16 PAD, 8 (50%) had Angle Class I, 8 (50%) had Angle Class II but no patients with Angle Class III malocclusion was observed. The distribution of dental malocclusions regarding CVA was not statistically significant (P = 0.076). Of these 42 individuals with CVA, 52.3% (15 fusions and 7 PAD) were females and 47.7% (11 fusions and 9 PAD) were males.Conclusion:In our study, the prevalence of fusion and PAD were found 8.1% and 5.0% in Turkish population, respectively. Besides, no statistically significant correlation between CVA and Angle Class I, II, and III malocclusions were found. Our findings support the studies showing no gender dimorphism.