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Ponticulus Posticus: An Important Diagnostic Finding Often Missed in Lateral Cephalograms.

Nivedita Sahoo1, Rudraraju Amrutha2, George Sam3

  • 1Department of Orthodontics and Dentofacial Orthopedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India. Phone: +91 7894391909,

The Journal of Contemporary Dental Practice
|August 25, 2023
PubMed
Summary

The ponticulus posticus (PP) is a common atlas vertebra variation. Patients with complete PP report more symptoms, and this condition is more frequent in females, though not statistically significant with gender.

Keywords:
Cervical spineDiagnostic toolLateral cephalograms Ponticulus posticus.

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Area of Science:

  • Anatomy
  • Radiology
  • Orthodontics

Background:

  • The ponticulus posticus (PP) is an anatomical variation of the atlas vertebra.
  • It is often overlooked in routine lateral cephalograms.
  • PP can be associated with various neurological and pain symptoms.

Purpose of the Study:

  • To investigate the prevalence and characteristics of the ponticulus posticus (PP) in a patient cohort.
  • To assess the correlation between PP variants and reported symptoms.
  • To determine the relationship between PP presence and patient gender.

Main Methods:

  • A retrospective analysis of 500 digital lateral cephalograms from patients aged 12-40.
  • Categorization of PP as absent, complete, or partial based on radiographic findings.
  • Evaluation of patient-reported symptoms including migraine, headache, and orofacial pain.
  • Statistical analysis using the Chi-square test to assess gender association.

Main Results:

  • Approximately 10% of patients had a complete PP, 70% had a partial PP, and 20% had no PP.
  • No statistically significant association was found between PP presence and gender (p=0.526).
  • Patients with complete PP reported a higher incidence of symptoms compared to those with partial PP.

Conclusions:

  • The ponticulus posticus (PP) is a notable anatomical variation with potential clinical implications.
  • Complete PP is associated with a greater symptom burden than partial PP.
  • While PP frequency was higher in females, the association with gender was not statistically significant.