A sella turcica bridge in subjects with dental anomalies

Abstract

Calcification of the interclinoid ligament (ICL) of the sella turcica, or sella turcica bridging, has been associated with severe craniofacial deviations. Despite no comprehensive study on the sella turcica bridge, a relationship with tooth and eruption disturbances has been reported. In order to investigate whether congenital absence of the second mandibular premolar, or the presence of a palatally displaced canine (PDC), is associated with sella bridging, a retrospective study was performed. Lateral cephalometric radiographs from 20 males and 14 females, aged between 8 and 16 years, with a PDC and second mandibular premolar aplasia were reviewed and compared with a control group. A standardized scoring scale was established to quantify the extent of a sella turcica bridge from each radiograph (no calcification, partially calcified, and completely calcified). The prevalence of complete calcification of the ICL in adolescents with dental anomalies was equal to 17.6 per cent, while an incidence 9.9 per cent was found in the control group. A partially calcified sella turcica was observed in 58.8 per cent of adolescents with dental anomalies compared with 33.7 per cent in the control group. The association between the degree of calcification of the ICL and the presence of dental anomalies in the studied adolescents was statistically significant according to chi-square statistics (P = 0.004). This was confirmed by Fisher's exact test (P = 0.003). According to these findings, the prevalence of a sella turcica bridge in adolescents with dental anomalies is increased, while age and gender do not greatly influence ossification of the ICL. The very early appearance during development of a sella turcica bridge should alert clinicians to possible tooth anomalies in life later.

Skeletal Anomalies and Normal Variants in Patients with Palatally Displaced Canines

“…These results are consistent with the reported radiographic data of sella turcica bridge in patients with dental anomalies. 5 Posterior arch deficiency of the atlas occurred more frequently in individuals with PDC (15.8%) compared to the control sample (4.3%). In fact, no anomaly was detected in our sample of orthodontic patients without PDC.…”

“…On the other hand, a greater frequency of sella turcica bridge has been described in patients with severe craniofacial deviations 4 and tooth anomalies 5 and has also been noted in some patients with other disorders and syndromes. 10,[24][25][26] The results of the present study demonstrate an increased prevalence of posterior arch deficiency, ponticulus posticus, and sella turcica bridge in patients with PDC.…”

“…5,19 Briefly, the sella turcica length (the distance from the tuberculum sella to the tip of the dorsum sella) and anteroposterior greatest diameter (from the tuberculum sella to the furthest point on the inner wall of the pituitary fossa) were measured.…”

“…Various occult pathologies and rare normal variants involving the head or spine have been reported thanks to this information. [1][2][3][4][5][6][7][8] On the other hand, most of these pathologic conditions, developmental abnormalities, or normal variants are associated with a significant problem in other systems. 4,9,10 Interestingly, some of these findings are detectable very early in life 11 and often precede other signs or symptoms in syndromes.…”

“…5 Thus the occurrence of a new sign in craniofacial skeletal anomalies, concomitant with PDC, has been estab-lished. This relationship may be based on the involvement of neural crest cells (NCCs) and/or homeobox or hox genes during the development stage.…”