Prevalence of ponticulus posticus in a Northern Italian orthodontic population: a lateral cephalometric study

Abstract

The current investigation provided the first data concerning the frequency of ponticulus posticus in Italy: further studies are needed to widen the sample, verify possible regional variations and improve the analysis by more advanced radiological examinations such as CT and cone beam CT scans.

Prevalence of Ponticulus Posticus on Lateral Cephalometric Radiographs, its Association with Cervicogenic Headache and a Review of Literature

“…7,15,34 In this study it was observed that Ponticulus Posticus had a prevalence rate of 15.8% with a total of 79 ponticuli ( In terms of prevalence by sex, male predilection has been noted more often than female predilection. 17,47,56,76 In a study by Paraskevas et al 47 the presentation of a complete bony arch was slightly higher in men (11.11%) compared with women (9.3%). However, in this study there was a female predominance with a prevalence of 17.9% as against male prevalence of 13.1% (Table 2).…”

Associação Radiográfica entre Ponticulus Posticus e as Alterações Morfológicas Condilares

“…12 The presence of lamellar patterns within the bone matrix and a cortex indicating endochondral ossification suggests that PP may originate from the dorsal arch of the proatlas. 4,12 We believe that the higher prevalence observed in males may also be related to genetic factors, as the bone mass is higher in males than in females. This gender disparity is present early in life, and is considered an important factor during growth, regulating the size and/or density of the bone.…”

“…[1][2][3] Historically, the PP has been referred to by many names including Kimmerle anomaly, foramen sagitale, atlantal posterior foramen, arcuate foramen and upper retroauricular foramen. 4,5 Its prevalence has been reported to be between 5-38%, depending on the population and age group studied. 1,6,7 A range of factors including genetic factors, 8 ossification caused by age 1,9 or external mechanical factors, such as carrying heavy objects on the head, 10 have been suggested to be possible causes of PP formation.…”

“…5 The presence of PP has been associated with symptoms such as headaches (migraine and chronic tension-type), neck and cervical pain, acute hearing loss and vertigo. 14 Patients often report headaches and neck pain 4 without any apparent dental causes. This pain may be related to the presence of PP, which can be easily identified on lateral cephalograms.…”

Ponticulus Posticus: Is It Important for a Dentist as an Radiological Finding?

“…34 The potential clinical significance of PP is controversial because the majority of patients with this finding are asymptomatic 11,15,17 but this bony arch may be linked to different symptoms, ranging from neckache to headache and migraine and it may also be incorrectly assessed during orthopedic surgery for fixation of C1-C2, with consequent risk of damaging the vertebral artery. 35 Spine surgeons, neurosurgeons, otorhinolaryngologists, neurologists, and chiropractors interest in this anomaly. It has been included in the differential diagnosis of numerous diseases and considered an indication as well as a contraindication for several surgical procedures.…”