Top

BMC Oral Health

Published in:

Open Access 01-12-2023 | Odontoma | Research

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits

Authors: Farhad Sobouti, Sepideh Dadgar, Parsa Goleyjani, Vahid Rakhshan

Published in: BMC Oral Health | Issue 1/2023

Abstract

Introduction

Despite researchers' recent interest in identifying links between some dental and craniovertebral abnormalities, there are many important, unassessed gaps in our knowledge of this matter. In addition, previous samples were small. This large study aimed to examine, for the first time, the occurrence/severity of numerous dental and skeletal anomalies or variations and their correlations with each other and with growth patterns.

Methods

This epidemiological study was conducted on pretreatment radiographs of 1194 patients from 3 cities (815 females). Skeletal sagittal skeletal relationships and vertical growth patterns were determined. The occurrence/severity were assessed for: cervical vertebral fusion (CVF), atlas posterior arch deficiency (APAD), ponticulus posticus (PP), sella turcica bridging (STB), hypodontia, oligodontia, hyperdontia, missing of maxillary laterals, microdontia, macrodontia, root dilaceration, odontoma, taurodontism, dental fusion, dental gemination, enamel pearl, permanent molar ankylosis, primary molar ankylosis, dens in dente, dens invaginatus, dental impaction, ectopic eruption, and dental transposition. Incidental findings were recorded as well. Concurrent anomalies, sex dimorphism, and correlations across variables were examined statistically, adjusting for the false discovery rate (α = 0.05).

Results

Prevalence was calculated for 43 dentoskeletal traits/anomalies (22 abnormalities/variations [plus their severities/types] as well as 21 incidentally found traits/anomalies). Dental impaction may be more common in hyperdivergent and severer cases of sella bridging; also, primary molar ankylosis was associated with missing teeth. Dental impaction was associated only with STB and not with PP, APAD, or vertebral fusion. The only association observed among the four skeletal anomalies was seen between APAD and CVF. Merely the variables ‘sagittal skeletal relationships, vertical growth patterns, PP, and APAD’ showed sexual dimorphism; of these, only vertical growth pattern and APAD remained sexually dimorphic after adjusting for the FDR; still, the other two remained marginally significant and worth further evaluations. Sex dimorphism did not exist in concurrent abnormalities. The skeletal Class III was associated with the concurrent occurrence of craniovertebral, dental, and dentoskeletal abnormalities. Skeletal Class I was associated with fewer occurrences of concurrent dental anomalies. Vertical growth patterns were not associated with concurrent dental or dentoskeletal anomalies. However, the hyperdivergent pattern was associated with fewer cases of concurrent craniovertebral abnormalities.

Conclusions

STB and hyperdivergent pattern were associated with dental impaction. However, APAD, CVF, or PP were not associated with dental impaction. APAD was associated with CVF. Sexual dimorphism existed conclusively in the case of vertical growth patterns and APAD. Concurrent abnormalities (dental, skeletal, and dentoskeletal) were associated with skeletal Class III.

Mosavat F, Sarmadi S, Amini A, Asgari M. Evaluation of Dimension and Bridging of Sella Turcica and Presence of Ponticulus Posticus in Individuals With and Without Cleft: A Comparative Study. Cleft Palate Craniofac J. 2023;60(6):695–700.

Macrì M, Perrella G, Varvara G, Murmura G, Traini T, Rendina F, et al. Assessments of Prevalence of Ponticulus Posticus, Atlas Posterior Arch Deficiency, Sella Turcica Bridging, Maxillary Canine Impaction, and Associations Among Them in 500 CBCTs of Italian Orthodontic Patients. Front Dent Med. 2021;2:708169.

Kaya Y, Öztaş E, Goymen M, Keskin S. Sella turcica bridging and ponticulus posticus calcification in subjects with different dental anomalies. Am J Orthod Dentofacial Orthop. 2021;159(5):627–34.CrossRefPubMed

Acevedo AM, Lagravere-Vich M, Al-Jewair T. Diagnostic accuracy of lateral cephalograms and cone-beam computed tomography for the assessment of sella turcica bridging. Am J Orthod Dentofacial Orthop. 2021;160(2):231–9.CrossRefPubMed

Chou S-T, Chen C-M, Chen P-H, Chen Y-K, Chen S-C, Tseng Y-C. Morphology of Sella Turcica and Bridging Prevalence Correlated with Sex and Craniofacial Skeletal Pattern in Eastern Asia Population: CBCT Study. Biomed Res Int. 2021;2021:6646406. https://doi.org/10.1155/2021/6646406.CrossRefPubMedPubMedCentral

Dadgar S, Alimohamadi M, Rajabi N, Rakhshan V, Sobouti F. Associations among palatal impaction of canine, sella turcica bridging, and ponticulus posticus (atlas arcuate foramen). Surg Radiol Anat. 2021;43(1):93–9.CrossRefPubMed

Jankowski T, Jedliński M, Grocholewicz K, Janiszewska-Olszowska J. Sella turcica morphology on cephalometric radiographs and dental abnormalities—is there any association?—systematic review. Int J Environ Res Public Health. 2021;18(9):4456.CrossRefPubMedPubMedCentral

Siddalingappa D, Urala AS, Pentapati KC, Vineetha R, Prasad GL. Sella turcica bridging and its association with dental anomalies. Open Dent J. 2021;15(1):473–8.CrossRef

Amini F, Hamedi S, Ghadimi MH, Rakhshan V. Associations between occlusion, jaw relationships, craniofacial dimensions and the occurrence of palatally-displaced canines. Int Orthod. 2017;15(1):69–81.PubMed

10.

Ghadimi MH, Amini F, Hamedi S, Rakhshan V. Associations among sella turcica bridging, atlas arcuate foramen (ponticulus posticus) development, atlas posterior arch deficiency, and the occurrence of palatally displaced canine impaction. Am J Orthod Dentofacial Orthop. 2017;151(3):513–20.CrossRef

11.

Ali B, Shaikh A, Fida M. Association between sella turcica bridging and palatal canine impaction. Am J Orthod Dentofacial Orthop. 2014;146(4):437–41. https://doi.org/10.1016/j.ajodo.2014.06.010.CrossRefPubMed

12.

Sobouti F, Aryana M, Ghadiri SM, Modanloo K, Dadgar S. Relationship between Craniovertebral Abnormalities and Maxillary Lateral Incisors Agenesis: A Case-Control Study. Int J Dent. 2022;2022:3389741. https://doi.org/10.1155/2022/3389741.CrossRefPubMedPubMedCentral

13.

Leonardi R, Barbato E, Vichi M, Caltabiano M. Skeletal anomalies and normal variants in patients with palatally displaced canines. Angle Orthod. 2009;79(4):727–32. https://doi.org/10.2319/082408-448.1.CrossRefPubMed

14.

Sandham A. Cervical vertebral anomalies in cleft lip and palate. Cleft Palate J. 1986;23(3):206–14.PubMed

15.

Horswell BB. The incidence and relationship of cervical spine anomalies in patients with cleft lip and/or palate. J Oral Maxillofac Surg. 1991;49(7):693–7.CrossRefPubMed

16.

Ugar DA, Semb G. The prevalence of anomalies of the upper cervical vertebrae in subjects with cleft lip, cleft palate, or both. Cleft Palate Craniofac J. 2001;38(5):498–503. https://doi.org/10.1597/1545-1569(2001)038%3c0498:tpoaot%3e2.0.co;2.CrossRefPubMed

17.

Sonnesen L, Kjaer I. Cervical column morphology in patients with skeletal Class III malocclusion and mandibular overjet. Am J Orthod Dentofacial Orthop. 2007;132(4):427.e7–12. https://doi.org/10.1016/j.ajodo.2007.01.019.CrossRefPubMed

18.

Miletich I, Sharpe PT. Neural crest contribution to mammalian tooth formation. Birth Defects Res C Embryo Today. 2004;72(2):200–12. https://doi.org/10.1002/bdrc.20012.CrossRefPubMed

19.

Kjaer I. Sella turcica morphology and the pituitary gland–a new contribution to craniofacial diagnostics based on histology and neuroradiology. Eur J Orthod. 2012. https://doi.org/10.1093/ejo/cjs091.CrossRefPubMed

20.

Duverger O, Morasso MI. Role of homeobox genes in the patterning, specification, and differentiation of ectodermal appendages in mammals. J Cell Physiol. 2008;216(2):337–46. https://doi.org/10.1002/jcp.21491.CrossRefPubMedPubMedCentral

21.

Matsuoka T, Ahlberg PE, Kessaris N, Iannarelli P, Dennehy U, Richardson WD, et al. Neural crest origins of the neck and shoulder. Nature. 2005;436(7049):347–55. https://doi.org/10.1038/nature03837.CrossRefPubMedPubMedCentral

22.

Kjaer I, Becktor KB, Lisson J, Gormsen C, Russell BG. Face, palate, and craniofacial morphology in patients with a solitary median maxillary central incisor. Eur J Orthod. 2001;23(1):63–73.CrossRefPubMed

23.

Kjaer I, Fischer Hansen B, Reintoft I, Keeling JW. Pituitary gland and axial skeletal malformations in human fetuses with spina bifida. Eur J Pediatr Surg. 1999;9(6):354–8.CrossRefPubMed

24.

Leonardi R, Barbato E, Vichi M, Caltabiano M. A sella turcica bridge in subjects with dental anomalies. Eur J Orthod. 2006;28(6):580–5. https://doi.org/10.1093/ejo/cjl032.CrossRefPubMed

25.

Leonardi R, Farella M, Cobourne MT. An association between sella turcica bridging and dental transposition. Eur J Orthod. 2011;33(4):461–5. https://doi.org/10.1093/ejo/cjq106.CrossRefPubMed

26.

Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop. 1995;107(1):58–66.CrossRefPubMed

27.

Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod. 2002;72(4):316–23.PubMed

28.

Rakhshan V. Meta-analysis and systematic review of factors biasing the observed prevalence of congenitally missing teeth in permanent dentition excluding third molars. Prog Orthod. 2013;14:33. https://doi.org/10.1186/2196-1042-14-33.CrossRefPubMedPubMedCentral

29.

Alkofide EA. The shape and size of the sella turcica in skeletal Class I, Class II, and Class III Saudi subjects. Eur J Orthod. 2007;29(5):457–63. https://doi.org/10.1093/ejo/cjm049.CrossRefPubMed

30.

Meriç P, Naoumova J. Web-based Fully Automated Cephalometric Analysis: Comparisons between App-aided, Computerized, and Manual Tracings. Turk J Orthod. 2020;33(3):142–9. https://doi.org/10.5152/TurkJOrthod.2020.20062.CrossRefPubMedPubMedCentral

31.

Steiner CC. Cephalometrics for you and me. Am J Orthod. 1953;39(10):729–55. https://doi.org/10.1016/0002-9416(53)90082-7.CrossRef

32.

Sonnesen L, Kjaer I. Cervical vertebral body fusions in patients with skeletal deep bite. Eur J Orthod. 2007;29(5):464–70. https://doi.org/10.1093/ejo/cjm043.CrossRefPubMed

33.

Kimonis VE, Goldstein AM, Pastakia B, Yang ML, Kase R, DiGiovanna JJ, et al. Clinical manifestations in 105 persons with nevoid basal cell carcinoma syndrome. Am J Med Genet. 1997;69(3):299–308.CrossRefPubMed

34.

Baidas LF, Al-Kawari HM, Al-Obaidan Z, Al-Marhoon A, Al-Shahrani S. Association of sella turcica bridging with palatal canine impaction in skeletal Class I and Class II. Clin Cosmet Investig Dent. 2018;10:179–87. https://doi.org/10.2147/ccide.s161164.CrossRefPubMedPubMedCentral

35.

Divya S, Urala AS, Prasad GL, Pentapati KC. Sella turcica bridging a diagnostic marker for impacted canines and supernumerary teeth. J Int Oral health. 2018;10(2):94–8.CrossRef

36.

Scribante A, Sfondrini MF, Cassani M, Fraticelli D, Beccari S, Gandini P. Sella turcica bridging and dental anomalies: is there an association? Int J Paediatr Dent. 2017;27(6):568–73. https://doi.org/10.1111/ipd.12301.CrossRefPubMed

37.

Ortiz PM, Tabbaa S, Flores-Mir C, Al-Jewair T. A CBCT Investigation of the Association between Sella-Turcica Bridging and Maxillary Palatal Canine Impaction. Biomed Res Int. 2018;2018:4329050.

38.

Axelsson S, Storhaug K, Kjaer I. Post-natal size and morphology of the sella turcica in Williams syndrome. Eur J Orthod. 2004;26(6):613–21. https://doi.org/10.1093/ejo/26.6.613.CrossRefPubMed

39.

Kjaer I, Keeling JW, Reintoft I, Nolting D, Fischer HB. Pituitary gland and sella turcica in human trisomy 21 fetuses related to axial skeletal development. Am J Med Genet. 1998;80(5):494–500.CrossRefPubMed

40.

Becktor JP, Einersen S, Kjaer I. A sella turcica bridge in subjects with severe craniofacial deviations. Eur J Orthod. 2000;22(1):69–74.CrossRefPubMed

41.

Alqahtani H. Association between sella turcica bridging and congenitally missing maxillary lateral incisors. J Dent Sci. 2020;15(1):59–64. https://doi.org/10.1016/j.jds.2019.07.004.CrossRefPubMed

42.

Arcos-Palomino I, Ustrell-Torrent JM. Association between sella turcica bridging and altered direction of dental eruption: A case-control study. J Clin Exp Dent. 2019;11(10):e913–20. https://doi.org/10.4317/jced.56165.CrossRefPubMedPubMedCentral

43.

Sato D, Endo T. Size and bridging of the sella turcica in Japanese orthodontic patients with tooth agenesis. Odontology. 2020;108(4):730–7. https://doi.org/10.1007/s10266-020-00508-w.CrossRefPubMed

44.

Adisen MZ, Misirlioglu M. Prevalence of ponticulus posticus among patients with different dental malocclusions by digital lateral cephalogram: a comparative study. Surg Radiol Anat. 2017;39(3):293–7.CrossRefPubMed

45.

Tassoker M, Kok H, Ozcan S. Investigation of the relationship between" Sella Turcica Bridge" and" Ponticulus Posticus": A Lateral Cephalometric Study. Int J Morphol. 2017;35(1):337–44.CrossRef

46.

Kamak H, Yildırım E. The distribution of cervical vertebrae anomalies among dental malocclusions. J Craniovertebr Junction Spine. 2015;6(4):158–61. https://doi.org/10.4103/0974-8237.167857.CrossRefPubMedPubMedCentral

47.

Patcas R, Tausch D, Pandis N, Manestar M, Ullrich O, Karlo CA, et al. Illusions of fusions: Assessing cervical vertebral fusion on lateral cephalograms, multidetector computed tomographs, and cone-beam computed tomographs. Am J Orthod Dentofacial Orthop. 2013;143(2):213–20. https://doi.org/10.1016/j.ajodo.2012.09.017.CrossRefPubMed

48.

Bishara SE. Impacted maxillary canines: a review. Am J Orthod Dentofacial Orthop. 1992;101(2):159–71. https://doi.org/10.1016/0889-5406(92)70008-x.CrossRefPubMed

49.

Rakhshan V, Rakhshan A. Systematic review and meta-analysis of congenitally missing permanent dentition: Sex dimorphism, occurrence patterns, associated factors and biasing factors. Int Orthod. 2016;14(3):273–94. https://doi.org/10.1016/j.ortho.2016.07.016.CrossRefPubMed

50.

Fernandez CCA, Pereira CVCA, Luiz RR, Vieira AR, De Castro CM. Dental anomalies in different growth and skeletal malocclusion patterns. Angle Orthod. 2018;88(2):195–201. https://doi.org/10.2319/071917-482.1.CrossRefPubMed

51.

Ashoori N, Ghorbanyjavadpour F, Rakhshan V. Associations between 44 nonmetric permanent dental traits or anomalies with skeletal sagittal malocclusions and sex, besides correlations across the variations or abnormalities. BMC Oral Health. 2022;22(1):544. https://doi.org/10.1186/s12903-022-02481-y.CrossRefPubMedPubMedCentral

52.

Radwan MT, Sin Ç, Akkaya N, Vahdettin L. Artificial intelligence-based algorithm for cervical vertebrae maturation stage assessment. Orthod Craniofac Res. 2023;26(3):349–55. https://doi.org/10.1111/ocr.12615.CrossRefPubMed

53.

Rakhshan V, Rakhshan H, Sheibaninia A. Developing an automatic lateral cephalometric landmark identification program and evaluating its performance. Int J Comput Dent. 2009;12(4):327–43.PubMed

54.

Sharma P, Arora A, Valiathan A. Age changes of jaws and soft tissue profile. Sci World J. 2014;2014:301501. https://doi.org/10.1155/2014/301501.CrossRef

Title: Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits
Authors: Farhad Sobouti
Sepideh Dadgar
Parsa Goleyjani
Vahid Rakhshan
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Odontoma
Odontoma
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03504-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

Temporal and spatial patterns of recurrence in oral squamous cell carcinoma, a single-center retrospective cohort study in China

Evaluation of oral care using MA-T gel for high-risk patients: a pilot study

Association of root morphology of mandibular second molars on panoramic-like and axial views of cone-beam computed tomography

Association between sleep duration and dental caries in a nationally representative U.S. population

New biomaterials for modern dentistry

Evaluation of delphinidin as a storage medium for avulsed teeth