Os odontoideum detected on a lateral cephalogram of a 9-year-old orthodontic patient

A 9-year-old girl was seen for routine orthodontic care. The lateral cephalogram revealed an irregularity, os odontoideum, of the second cervical vertebra. The patient was referred to a pediatric orthopedist, and subsequent surgical correction was accomplished without complications. This condition has significant implications for the spinal cord at the level of C1 and C2. Phase I orthodontic care proceeded normally.