Ponticulus posticus: is it important for a dentist as a radiological finding?

Atlas omurundaki gelişimsel anomaliler sadece anatomistlerin değil, morfolojideki farklılığın kliniğe yansımasının bilincinde olması gereken klinisyenlerin, radyologların ve cerrahların da ilgi alanıdır. Diş hekimleri, nedeni açıklanamayan baş ve boyun ağrısı, görme rahatsızlıkları, konuşma ve yutma problemleri, vertigo, vasküler problemler, vertebral arter ve suboksipital sinirin sıkışması ile ilgili semptomlarla ilişkili olabileceğinden, bu durumların varlığında Ponticulus posticus'u (PP) dikkatlice incelemelidirler. Bu yazının amacı, diş hekimlerini, özellikle oral ve maksillofasiyal radyologları ve ortodontistleri, doğrudan servikal omur anomalilerinin tedavileri ile ilgili olmasalar da, servikal omurları inceleme ve normal anatomiden ayrılan farklılıklarını saptama konusunda duyarlı hale getirmektir

Ponticulus Posticus: Radyolojik bir bulgu olarak bir diş hekimi için önemli midir?

Developmental anomalies of the atlas are of interest not only to anatomists but also clinicans, radiologists, surgeons, who should be aware of their distinct morphological manifestations as well as correlated clinical expressions. Dentists should look carefully for Ponticulus posticus (PP) because these abnormalities may be related to otherwise unexplainable head and neck pain, visual disturbances, problems with speech and swallowing, vertigo, vascular problems and other symptoms related to compression of the vertebral artery and suboccipital nerve. The aim of this paper, although the dentists especially oral and maxillofacial radiologists and orthodontists are not directly concerned with the management of cervical spine anomalies to sensitize them to realize the cervical spine and be equipped to identify differences from normal anatomy

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Kavakli A, Aydinlioglu A, Yesilyurt H, Kus I, Diyarbakirli S, Erdem S, Anlar O. Variants and deformities of atlas verte- brae in Eastern Anatolian people. Saudi Med J 2004; 25: 325.
Wysocki J, Bubrowski M, Reymond J, Kwiatkowski, J. Anatomical variants of the cervical vertebrae and the first thoracic vertebra in man. Folia Morphol 2003; 62: 357
Schilling J, Schilling A, Galdames IS. Ponticulus posti- cus on the Posterior Arch of Atlas, Prevalence Analysis in Asymptomatic Patients. Int J Morphol 2010; 28:317-322.
Kuhta P, Hart J, Greene-Orndorff L, McDowell-Reizer B, Rush P. The prevalence of posticus ponticus: retrospec- tive analysis of radiographs from a chiropractic health center. J Chiropr Med 2010; 9: 162-165
Sekerci AE, Soylu E, Arikan MP, Aglarci OS. Is there a re- lationship between the presence of ponticulus posticus and elongated styloid process? Clin Imaging 2015;3 9: 224.
Sekerci AE, Soylu E, Arikan MP, Ozcan G, Amuk M, Ko- coglu F. Prevalence and Morphologic Characteristics of Ponticulus Posticus: Analysis Using Cone-Beam Comput- ed Tomography. J Chiropr Med 2015; 14: 153-161.
Baeesa SS, Bokhari RF, Bajunaid KM, AlSayyad MJ. Prevalence of the foramen arcuale of the atlas in a Saudi population. Neurosciences 2012; 17: 345-351.
Geist JR, Geist SM, Lin LM. A cone beam CT investi- gation of ponticulus posticus and lateralis in children and adolescents. Dentomaxillofac Radiol 2014; 43:
Sharma V, Chaudhary D, Mitra R. Prevalence of pontic- ulus posticus in Indian orthodontic patients. Dentomaxil- lofac Radiol 2010; 39: 277-283.
Perez IE, Chavez AK, Ponce D. Frequency of Pontic- ulus Posticus in Lateral Cephalometric Radiography of Peruvian Patients. Int J Morphol 2014; 32: 54-60.
Chitroda PK, Katti G, Baba IA, Najmudin M, Ghali SR, Kalmat B. Ponticulus posticus on the posterior arch of atlas, prevalence analysis in symptomatic and asymp- tomatic patients of gulbarga population. J Clin Diagn Res ; 7: 3044-3047.
Saokar PC, Nawale S. Radiographic Correlative Study of Ponticulus Posticus in Dental Patients. Indian J Appl Res 2014; 4: 503-505.
Cho YJ. Radiological Analysis of Ponticulus Posticus in Koreans. Yonsei Med J 2009; 50: 45-49.
Young JP, Young PH, Ackermann MJ, Anderson PA, Riew KD. The ponticulus posticus: implications for screw insertion into the first cervical lateralmass. J Bone Joint Surg Am 2005; 87: 2495-2498.
Anupama K, Shetty S, Jyothi KC, Das S. Ponticulus posticus: a case report. Int J Curr Res 2014; 6: 7515-7517.
Bayrakdar IS, Miloglu O, Altun O, Gumussoy I, Durna D, Yilmaz AB. Cone beam computed tomography imag- ing of ponticulus posticus: prevalence, characteristics, and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118: e210-219.
Mudit G, Srinivas K, Satheesha R. Retrospective analy- sis of ponticulus posticus in Indian orthodontic patients-a lateral cephalometric study. Ethiop J Health Sci 2014; 24: 290.
Kim KH, Park KW, Manh TH, Yeom JS, Chang BS, Lee CK. Prevalence and Morphologic Features of Ponticulus Posticus in Koreans: Analysis of 312 Radiographs and Three-dimensional CT Scans. Asian Spine J 2007; 1: 31.
Krishnamurthy A, Nayak SR, Khan S, Prabhu LV, Ra- manathan LA, Ganesh Kumar C, Prasad Sinha A. Arcuate foramen of atlas: incidence, phylogenetic and clinical significance. Rom J Morphol Emryol 2007; 48: 263-266.
Wight S, Osborne N, Breen AC. Incidence of pontic- ulus posterior of the atlas in migraine and cervicogenic headache. J Manipulative Physiol Ther 1999; 22: 15-20.
Huang DG et al. Ponticulus posticus. Spine J 2015; : e17-19.
MacAlister A. Notes on the development and vari- ations of the atlas. Journal of Anatomy and Physiology ; 27: 519-542. Lamberty BGH, Zivanovic S. The retroarticular ver- tebral artery ring of atlas and its significance. Acta Anat ; 85: 113-122. Kendrick GS, Biggs NL. Incidence of the ponticulus posticus of the first cervical vertebra between ages six to seventeen. Anat Rec 1963; 145: 449-454.
Tubbs RS, Johnson PC, Shoja MM, Loukas M, Oakes WJ. Foramen arcuale: anatomical study and review of the literature. J Neurosurg Spine 2007; 6: 31-34.
Selby S, Garn M, Kanareff V. The incidence and famil- ial nature of a bony bridge on the first cervical vertebra. Am J Phys Anthropol 1955; 13: 129-141.
Saunders SR, Popovich F. A familial study of two skel- etal variants: atlas bridging and clinoid bridging. Am J Phys Anthropol 1978; 49: 193-204.
Paraskevas G, Papaziogas B, Tsonidis C, Kapetanos G. Gross Morphology of The Bridges Over The Vertebral Artery Groove On The Atlas. Surg Radiol Anat 2005; 27: -136.
Manjunath KY. Posterior bridging of the atlas vertebra in South Indians. Indian J Med Sci 2001; 55: 488-490.
Unur E, Erdoğan N, Ülger H, Ekinci N, Ömer Ö. Radio- graphic incidence of complete arcuate foramen in Turk- ish population. Erciyes Med J 2004; 26: 50-54.
Pyo J, Lowman RM. The 'Ponticulus Posticus' of first cervical vertebra. Radiology 1959; 72: 850-854.
Taitz C. Nathan H. Some observations on the posteri- or and lateral bridge of the atlas. Acta Anat (Basel) 1986; : 212-217.
Mitchell J. The incidence and dimensions of the ret- roarticular canal of the atlas vertebra. Acta Anat 1998; : 113-120.
Carella A. Slight anomalies of the atlas: their pathoge- netic meaning. Neuroradiology 1972; 3: 224-227.
Gibelli D, Cappella A, Cerutti E, Spagnoli L, Dolci C, Sfor. Prevalence of ponticulus posticus in a Northern Italian orthodontic population: a lateral cephalometric study. Surg Radiol Anat 2016; 38: 309-312.
Ercegovac N, Davidovic R. Foramen arcuale atlantis as the etiological factor of vertebrobasilar insufficien- cy-decompression of the vertebral artery. Vojnosanit Pregl 1970; 27: 435-441.
Barsukov SF, Grishin GP. The vertebrobasilar blood circulation of the brain in the presence of Kimmerle's anomaly. Voen Med Zh 1991; 6: 42-45.
Cakmak O, Gurdal E, Ekinci G, Yildiz E, Cavdar S. Ar- cuate foramen and its clinical significance. Saudi Med J ; 26: 1409-1413.
Leonardi R et al. Atlanto-occipital ligament calcifi- cation: a novel sign in nevoid basal cell carcinoma syn- drome. Anticancer Res 2010; 30: 4265-4267.
Baba IA, Shah AF, Yousuf A, Adhnan MM, Manzoor H, Safdar Z. Prevalence of ponticulus posticus in Kashmiri population. Annals of Dental Specialty 2015; 3: 6-8.
Elliott RE, Tanweer O. The Prevalence of the Ponticu- lus Posticus (Arcuate Foramen) and Its Importance in the Goel-Harms Procedure: Meta-Analysis and Review of the Literature. World Neurosurg 2014; 82: e335-342.
Shanthi KC, Ravichandran D. The incidence and di- mensions of the foramen arcuale in Tamil Nadu state. NJBMS 2011; 2: 96-98.
Romanus T, Tovi A. A variation of the atlas. Roent- genologic incidence of a bridge over the groove of the atlas for the vertebral artery. Acta Radiol Diagn (Stockh) ; 2: 289-297.