Skeletal Anomalies and Normal Variants in Patients with Palatally Displaced Canines

Abstract

Objective: To test the null hypothesis that there is no increased prevalence of skeletal anomalies and/or normal variants as evidenced by the cephalometric radiographs of patients with palatally displaced canines (PDC). Materials and Methods:The treatment records of 38 white subjects between 14 and 20 years old with PDC were collected and evaluated retrospectively. Inclusion criteria for the study required that the case records include good-quality panoramic radiographs and lateral cephalometric radiographs with the first four cervical vertebrae clearly visible. The anomalies recorded for each case included sella bridge, atlanto-occipital ligament calcification or ponticulus posticus, and posterior arch atlas deficiency. A control group consisted of 70 consecutively treated subjects who had no other dental anomalies and whose maxillary canines had erupted normally. Fisher's exact test and Pearson's chi-square test were used to determine possible statistically significant differences in the incidence of skeletal anomalies and/or normal variants between the group of patients with PDC and the control group. Results: The prevalence of skull anomalies and normal variants seen in cephalometric radiographs was increased in patients with PDC. Because of the presence of ponticulus posticus (Pearson's chi-square, P Ͻ .050; Fisher's exact test, P Ͻ .052), sella bridge (Pearson's chisquare, P Ͻ .042; Fisher's exact test, P Ͻ .042), and posterior arch deficiency (Pearson's chisquare, P Ͻ .047; Fisher's exact test, P Ͻ .039), statistically significant differences were observed between subjects with PDC and the control group. Conclusions: The null hypothesis was rejected. There is an increased prevalence of skull skeletal anomalies and/or normal variants in patients with PDC. (Angle Orthod. 2009;79:727-732.)

Investigation of the relationship between "Sella Turcica Bridge" and "Ponticulus Posticus": A Lateral Cephalometric Study

“…This study found a higher percentage of males with PP but there is no consensus regarding the prevalence of PP in males compared with females (Geist et al). The frequency of PP increased in subjects with palatally displaced canines in accordance with Leonardi et al (2009). It may act as a useful diagnostic predictor of susceptibility to local dental problems.…”

Could idiopathic osteosclerosis have correlations with palatally impacted maxillary canines?

“…A dentist on the alert may suspect a new case of Gardner syndrome by observing atypical osteoma-like lesions in a young patient and referring him/her to medical evaluation 10 . Palatally impacted maxillary canines seem to have a genetic etiology 6,11 , and are frequently associated with other changes, such as microdontia of maxillary lateral incisors [11][12] , delayed tooth eruption 13 and fusion of the clinoid processes of the sella turcica 14 . Idiopathic osteosclerosis is a bone tissue structural change whose etiologic factor remains unknown.…”

How common is ponticulus posticus on lateral cephalograms?

“…Apart from that, the cervical vertebrae are not given due attention during routine orthodontic evaluation of lateral cephalograms. Studies have shown that various cervical vertebral anomalies and pathologies can be detected in lateral cephalograms [2–5]. One of such anomalies that can be discerned by watchful eyes is ponticulus posticus.…”