Cephalometric Study of Occipital Spurs and Their Association With Various Malocclusions and Facial Patterns

Occipital spurs (OS), bony outgrowths from the external occipital protuberance, are increasingly observed in young adults and have been associated with headache and neck pain. However, the available literature on this condition remains limited. This study aimed to determine the prevalence, morphological variations, and lengths of OS and assess their associations with gender, skeletal malocclusion, vertical facial patterns, overjet, and overbite in an Indian population using lateral cephalograms.

A retrospective cross-sectional study was conducted on 180 lateral cephalometric radiographs of individuals aged 18-24 years. OS were identified and classified as type 1 (flat), type 2 (crest), and type 3 (spine). Spur length was measured from its highest point to the most distant point from the cranial contour. Radiographs were grouped by gender, skeletal malocclusion (class I-III), vertical growth patterns, overjet, and overbite. Statistical analyses were performed using SPSS v26 (IBM Corp., Armonk, NY).

OS were present in 65% of cases (117/180), with type 2 being most frequent (41.6%), followed by type 1 (17.2%) and type 3 (6.1%). Males showed slightly higher prevalence (35.55%) than females (29.44%) without statistical significance (p = 0.16). No significant associations emerged between OS type and sagittal skeletal malocclusion (p = 0.08), facial patterns (p = 0.37), or overjet (p = 0.07). However, spur length was significantly greater in deep bite individuals (10.24 ± 2.37 mm) than in those with normal overbite (8.64 ± 2.19 mm; p = 0.007).

Type 2 OS was the most prevalent morphology across groups. Increased spur length in deep bite cases suggests a possible link with vertical skeletal relationships or postural factors, warranting further prospective studies.