The association between Sella Turcica bridging and maxillary palatal canine impaction: A CBCT study
Ortiz, Pamela M.
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Purpose: Cone Beam Computed Tomography (CBCT) overcomes the shortcoming of 2D cephalometric analysis by allowing 3D assessment of structures without overlap, a feature conducive to accurate diagnosis. The aim of this retrospective comparative study was to assess the incidence of sella turcica bridging and investigate the association between unilateral or bilateral maxillary canine impaction and Sella Turcica bridging using CBCT. Method: Records of diagnostic CBCT images of the craniofacial complex including sella turcica were selected for the study. The treatment group consisted of thirty-eight subjects (7 males and 31 females, mean age 14.6 ± 3.2 years, range 10.4-29.9 years) diagnosed with unilateral (left n = 14, right n = 11) or bilateral (n = 13) palatal canine impaction. The control groups included thirty-eight subjects (7 males and 31 females, mean age 19.5 ± 3.6 years, range 14.0-27.7) with a fully erupted dentition, with the exception of third molars and were matched to the treatment group by sex. The association of sella turcica bridging with impacted canines was analyzed using univariate logistic regression. A separate analysis using logistic regression was performed to test the association between sella turcica bridging, age and sex. Results: The overall occurrence of sella bridging (complete and partial) was 59.3% for the treatment group and 50% for the control group. The occurrence of complete bridging in the treatment group was 2.6% for the right side, 7.9% for the left side, and 5.3% overall. The occurrence of complete bridging in the control group was 13.2% for the right side, 5.3% for the left side, and 9.3% overall. The occurrence of partial bridging in the treatment group was 50% on the right side, 57.9% on the left, and 54% overall. The occurrence of partial bridging in the control group was 36.8% on the right side, 44.7% on the left side, and 40.6% overall. The percentage of subjects with a left sella turcica bridge in the treatment group, was increased for all three groups (unilateral left = 64.3%, unilateral right = 63.6%, bilateral = 62.2%) compared to controls (50%). These percentages correspond to odds ratios of 1.80 (95% CI [0.508, 6.676] for those with unilateral left side impactions, and 1.75 (95% CI [0.439, 6.979]) for those with unilateral right side impaction, and 2.25 (95% CI [0.590, 8.580]) for those with bilateral canine impaction. However, none of the observed increases were statistically significant (p = 0.362, p = 0.428 and p = 0.235 for left, right and both respectively). The percentage of subjects with a right sella turcica bridge among unilateral canine impactions was increased for both right (54.5%) and left (57.1%) unilateral canine impaction groups, compared to the controls (50.0%). Unlike the unilateral impaction groups, the percentage of subjects with a bridge among those with bilateral (46.7%) canine impactions was decreased, a result that was different when compared to the contralateral side. These percentages correspond to the odds ratios of 1.33 (95% CI [0.388, 4.584]) for those with unilateral left side impactions, 1.20 (95% CI [0.312, 4.612]) for unilateral right side impactions and 0.86 (95% CI [0.243, 3.029]) for those with bilateral canine impaction. However none of the observed differences were statistically significant (p = 0.648, p = 0.791 and p = 0.811 for left, right and both respectively). Age and sex do not impact the degree of sella turcica bridging. Conclusion: The results of this study found no statistically significant association between sella turcica bridging and palatal canine impaction. Also, no relationship was found between sella turcica bridging, age and sex.