A CBCT Investigation of the Association between Sella-Turcica Bridging and Maxillary Palatal Canine Impaction

Abstract

Objectives To investigate the association between unilateral/bilateral maxillary canine impaction and sella-turcica bridging using CBCT imaging. Methods This retrospective comparative study analyzed 76 CBCT images of the craniofacial complex including sella-turcica. The impacted cuspid group consisted of thirty-eight subjects (7 males, 31 females; mean age, 14.6 ± 3.2 years) diagnosed with unilateral (left n = 14, right n = 11) or bilateral (n = 13) palatal canine impaction. The control group included thirty-eight subjects matched by sex (7 males, 31 females; mean age, 19.5 ± 3.6 years) with no impaction. Multinomial logistic regression analysis was used to determine the association between unilateral/bilateral canine impaction and right and left sella-turcica bridging. Results The prevalence of sella-turcica bridging was 59.3% and 50% in the impacted canine and control groups, respectively. Although the odds for unilateral canine impaction were increased in the right and left sella-turcica bridging groups compared to the controls, the difference was not statistically significant. The risk of bilateral impaction was different between the two sides of sella-turcica bridging, but, again, the findings were not statistically significant. Conclusion Contrary to previous 2D studies, there is no statistically significant association between unilateral/bilateral palatal canine impaction and sella-turcica bridging when using 3D CBCT.

Morphology of Sella Turcica and Bridging Prevalence Correlated with Sex and Craniofacial Skeletal Pattern in Eastern Asia Population: CBCT Study

“…Subsequently, the 3D structural images of sella turcica were captured to obtain linear measurements, such as the sella turcica dimensions (Figures 2 and 3), and sella bridging ratios. The sella turcica bridging ratios were calculated, and the calcification levels of the ICL were quantified using objective quantization methods [16,27]. The formula is as follows:…”

“…In addition, the left or right side of the sella turcica cannot be distinguished in lateral cephalometric radiographs, and false positives can result from structure overlapping. Therefore, true bridging (fusion of anterior and posterior clinoid process) is difficult to distinguish from pseudobridging (superposition of ICL) in 2D lateral cephalometric images [ 16 ]. Recently, due to the advancement in craniofacial imaging technology, cone beam computed tomography (CBCT) can be used to reconstruct 3D structures [ 5 , 16 , 17 ], thus making the shortcomings of 2D lateral cephalometric images more critical in comparison with 3D CBCT scans.…”

“…Therefore, true bridging (fusion of anterior and posterior clinoid process) is difficult to distinguish from pseudobridging (superposition of ICL) in 2D lateral cephalometric images [ 16 ]. Recently, due to the advancement in craniofacial imaging technology, cone beam computed tomography (CBCT) can be used to reconstruct 3D structures [ 5 , 16 , 17 ], thus making the shortcomings of 2D lateral cephalometric images more critical in comparison with 3D CBCT scans. Compared to conventional CT, the technology of CBCT can achieve high-quality images with lower-cost equipment and at a lower radiation dose.…”

“…In cases of craniofacial development anomalies or tooth anomalies, 2D studies [ 7 – 9 ] have found apparent increases in STB incidence rates in patients with palatal canine impactions and tooth transpositions. However, using 3D CBCT, Ortiz et al [ 16 ] observed no significant correlation between palatal canine impactions and STB. This result is inconsistent with the other studies that have used 2D X-ray radiographs.…”

“…In addition, STB incidence rates differ across populations [ 25 , 26 ]. Reviewing English literature, most studies on sella turcica have been conducted in Western countries with most of them have used 2D X-ray images [ 11 – 13 , 20 ] and only a few employed 3D CBCT scans [ 16 ]. Furthermore, to our knowledge, there are no CBCT studies on sella turcica for Eastern Asia population.…”