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Year : 2017  |  Volume : 20  |  Issue : 1  |  Page : 106-110

A survey of ponticulus posticus: Radiological analysis of atlas in an orthodontic population based on cone-beam computed tomography

1 Department of Orthodontics, Faculty of Dentistry, Ordu University, 52100 Ordu, Turkey
2 Department of Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
3 Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey

Correspondence Address:
Dr. S K Buyuk
Department of Orthodontics, Faculty of Dentistry, Ordu University, 52100 Ordu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1119-3077.178916

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Background: The ponticulus posticus (PP; Latin for little posterior bridge) has become an important anomaly of the atlas, as the use of the C1 lateral mass screw has become common in treating atlantoaxial instability. Aim: The purpose of this study was to retrospectively determine the prevalence and morphologic characteristics of PP in an orthodontic patient population using cervical three-dimensional (3-D) cone beam computed tomography (CBCT) images. Material and Methods: A retrospective study was conducted by selecting cervical 3-D CBCT images of 374 adolescent population and examining them for the presence and type of PP. Results: 161 patients with 298 complete or partial or bilateral or unilateral PPs were identified based on the 374 cervical 3-D CBCT scans. The prevalence of posticulus ponticus was founded 43.04% in adolescent population. Conclusion: Our results show that the presence of this anomaly should be carefully examined using preoperative lateral radiographs before lateral mass screw placement. If a PP is suspected or confirmed on radiographs, 3-D CBCT scanning should be considered before lateral mass screw placement into the posterior arch because of the variation in the size and shape of PPs and the possibility of injury.

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