Sella turcica variations in lateral cephalometric radiographs and their association with malocclusions

Year 2018, Volume: 12 Issue: 1, 13 - 19, 04.06.2018

Hale Öktem , N. İrem Tuncer Tugçe Sencelikel Z. İlayda Bagci Sude Cesaretli Almina Arslan İlgaz Tuana Gürsel Bengisu Degirmenci

Abstract

Objectives: Classification of the skeletal facial types is performed using certain reference points and planes in lateral

cephalometric radiographs to plan orthodontic treatments. One of these reference points is sella turcica which is closely associated

with craniofacial bone development. The aim of this study was to identify the association between the sella turcica

variations and skeletal Class I, II, and III malocclusions.

Methods: This study retrospectively evaluated 94 orthodontic patients (48 males and 46 females) between 14–26 years of age.

Lateral cephalometric radiographs of the patients with skeletal Class I, II, and III malocclusions were classified into six groups

according to sella turcica morphology: normal sella turcica, oblique anterior wall, double contour of the floor, sella turcica bridge,

irregularity in the posterior part, and pyramidal shape of sella turcica. The length, depth, and diameter of sella turcica were measured.

Sella turcica variations and radiographs of patients with Class I, II, and III malocclusions were compared statistically.

Results: The correlation between the sella turcica variations and skeletal sagittal classification was statistically significant

(p=0.017). 36.8% of the radiographs, which were classified as normal sella turcica were classified as Class I patients. There were

no statistically significant differences between the skeletal Class I, II, and III malocclusions and sella turcica variations in terms of

the length, depth, and diameter.

Conclusion: For adequate patient referral and management, orthodontists should recognize sella turcica variations in lateral

cephalometric radiographs, and these findings should arise an index of suspicion for associated pathologies, especially of

the hypophyseal gland.

Keywords

sella turcica; lateral cephalometric radiography; malocclusion; skeletal class I, II, III

References

• 1. Arıncı K, Elhan A. Anatomi. Cilt 1. Ankara: Günefl Kitabevi; 2001. p. 35–6.
• 2. Kucia A, Jankowski T, Siewniak M, Janiszewska-Olszowska J, Grocholewicz K, Szych Z, Wilk G. Sella turcica anomalies on lateral cephalometric radiographs of Polish children. Dentomaxillofac Radiol 2014;43:20140165.
• 3. Sathyanarayana HP, Kailasam V, Chitharanjan AB. Sella turcica – its importance in orthodontics and craniofacial morphology. Dent Res J (Isfahan) 2013;10:571–5.
• 4. Yasa Y, Ocak A, Bayrakdar IS, Duman SB, Gumussoy I. Morphometric analysis of sella turcica using cone beam computed tomography. J Craniofac Surg 2017;28:70–4.
• 5. Taflç›o¤lu B. Sellar bölge anatomisi. Türk Nöroflirürji Dergisi 2006; 16:75–6.
• 6. Tekiner H, Acer N, Kelestimur F. Sella turcica: an anatomical, endocrinological, and historical perspective. Pituitary 2015;18:575– 8.
• 7. Valizadeh S, Shahbeig S, Mohseni S, Azimi F, Bakhshandeh H. Correlation of shape and size of sella turcica with the type of facial skeletal class in an Iranian group. Iran J Radiol 2015;12: e16059.
• 8. Cheng Y, Chen Y, Zhou Z, Zhu J, Feng Y, Zhao G. Anatomical study of posterior clinoid process (PCP) and its clinical meanings. J Craniofac Surg 2015;26:537–40.
• 9. Brock-Jacobsen MT, Pallisgaard C, Kjaer I. The morphology of the sella turcica in monozygotic twins. Twin Res Hum Genet 2009;12: 598–604.
• 10. Kjær I. Sella turcica morphology and the pituitary gland-a new contribution to craniofacial diagnostics based on histology and neuroradiology. Eur J Orthod 2015;37:28–36.
• 11. Axelsson S, Storhaug K, Kjaer I. Post-natal size and morphology of the sella turcica. Longitudinal cephalometric standards for Norwegians between 6 and 21 years of age. Eur J Orthod 2004;26: 597–604.
• 12. Canigur Bavbek N, Dincer M. Dimensions and morphologic variations of sella turcica in type 1 diabetic patients. Am J Orthod Dentofacial Orthop 2014;145:179–87.
• 13. Korayem M, Alkofide E. Size and shape of the sella turcica in subjects with Down syndrome. Orthod Craniofac Res 2015;8:43–50.
• 14. Alkofide EA. The shape and size of the sella turcica in skeletal Class I, Class II, Class III Saudi subjects. Eur J Orthod 2007;29:457–63.
• 15. Brahmbhatt RJ, Bansal M, Mehta C, Chauhan KB. Prevalence and dimensions of complete sella turcica bridges and its clinical significance. Indian J Surg 2015;77:299–301.
• 16. Ali B, Shaikh A, Fida M. Association between sella turcica bridging and palatal canine impaction. Am J Orthod Dentofacial Orthop 2014; 146:437–41.
• 17. Meyer-Marcotty P, Reuther T, Stellzig-Eisenhauer A. Bridging of sella turcica in skeletal Class III subjects. Eur J Orthod 2010;32:259–63.
• 18. Marflan G, Öztafl E. Incidence of bridging and dimensions of sella turcica in Class I and III Turkish adult female patients. World J Orthod 2009;10:99–103.
• 19. Rai AR, Rai R, Pc V, Rai R, Vadgaonkar R, Tonse M. A cephalometric analysis on magnitudes and shape of sella turcica. J Craniofac Surg 2016;27:1317–20.