ASSOCIATION BETWEEN VARIATIONS IN SELLA TURCICA DIMENSIONS AND MORPHOLOGY AND SKELETAL MALOCCLUSIONS
AbstractBackground: The growth of sella turcica is completed early in life, therefore it can be used as a stable landmark for the prediction of future skeletal malocclusions. This early diagnosis may help in planning less complicated treatment modalities. Therefore, this study aimed to evaluate the relationship between sella turcica dimensions and morphology with various skeletal patterns. Methods: A cross sectional study was conducted using the pre-treatment cephalograms of 180 subjects aged 13–19 years. The subjects were divided into two groups based on skeletal patterns. The dimensions of sella turcica and skeletal patterns were digitally measured using View Pro-X software. One-way ANOVA was applied to compare sella turcica dimensions among skeletal patterns. Sella dimensions and vertical growth patterns were compared using Post-hoc Tukey test. Chi-square test was applied to compare sella morphology among malocclusion groups. Results were taken as statistically significant at p-value of ≤0.05. Results: Sella dimensions showed insignificant differences among sagittal groups whereas, significant differences were found for sella length (p ≤0.02) and depth (p ≤0.03) among the vertical groups. Multiple comparisons showed significant differences between sella length (p ≤0.03) and diameter (p ≤0.04) between normodivergent versus hyperdivergent groups. Moreover, significant differences were found in the sella turcica morphology among sagittal malocclusion (p ≤0.03). Conclusions: Increased dimensions of sella turcica were associated with hyperdivergent growth pattern. Bridging of the sella turcica was found to be prevalent in class III malocclusion.Keywords: Sella Turcica; Maxillofacial Development; Vertical Dimension; Malocclusion
Nanda RS, Ghosh J. Facial soft tissue harmony and growth in orthodontic treatment. Semin Orthod 1995;1(2):67–81.
Downs WB. Variations in facial relationships: their significance in treatment and prognosis. Am J Orthod 1948;34(10):812–40.
Kolodziej RP, Southard TE, Southard KA, Casko JS, Jakobsen JR. Evaluation of antegonial notch depth for growth prediction. Am J Orthod Dentofacial Orthop 2002;121(4):357–63.
Moss ML. A theoretical analysis of the functional matrix. Acta Biotheor 1968;18(1):195–202.
Baccetti T, Franchi L, Toth LR, McNamara JA. Treatment timing for Twin-block therapy. Am J Orthod Dentofacial Orthop 2000;118(2):159–70.
Merwin D, Ngan P, Hagg U, Odont D, Yiu C, Wei SH. Timing for effective application of orthopedic force to the maxilla of anteriorly directed. Am J Orthod Dentofacial Orthop 1997;112(3):292–9.
Skieller V, Björk A, Linde-Hansen T. Prediction of mandibular growth rotation evaluated from a longitudinal implant sample. Am J Orthod 1984;86(5):359–70.
Huggare J. Association between morphology of the first cervical vertebra, head posture, and craniofacial structures. Eur J Orthod 1991;13(6):435–40.
Solow B, Siersbaek-Nielsen S. Cervical and craniocervical posture as predictors of craniofacial growth. Am J Orthod Dentofacial Orthop 1992;101(5):449–58.
Rossouw PE, Lombard CJ, Harris AM. The frontal sinus and mandibular growth prediction. Am J Orthod Dentofacial Orthop 1991;10096):542–6.
Alkofide EA. The shape and size of the sella turcica in skeletal class I, class II, and class III Saudi subjects. Eur J Orthod 2007;29(5):457–63.
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(1):70–4.
Bonneville JF, Dietemann JL. Radiology of the sella turcica. Springer Science & Business Media; 2012.
Houston WJ, Lee RT. Accuracy of different methods of radiographic superimposition on cranial base structures. Eur J Orthod 1985;7(2):127–35.
Kjaer I. Sella turcica morphology and the pituitary gland-a new contribution to craniofacial diagnostics based on histology and neuroradiology. Eur J Orthod 2012;37(1):28–36.
Björk A. Cranial base development: a follow-up x-ray study on the individual variation in growth occurring between the ages of 12 and 20 years and its relation to brain case and face development. Am J Orthod. 1955;41(3):198–225.
Luong HM, Ahn JH, Bollu P, Chenin D, Chaudry K, Pourhamidi J. Sella turcica variations in skeletal class I, class II and class III adult subjects: a CBCT study. J Dent Oral Biol 2016;1(3):1–6.
Abdel-Kader HM. Sella turcica bridges in orthodontic and orthognathic surgery patients. a retrospective cephalometric study. Aust Dent J 2007;23(1):30–5.
Meyer-Marcotty P, Reuther T, Stellzig-Eisenhauer A. Bridging of the sella turcica in skeletal class III subjects. Eur J Orthod 2010;32(2):148–53.
Yaşa Y, Büyük SK, Benkli YA, Arslan A, Topbaşı NM. The size and shape of the sella turcica in adolescent orthodontic patients with different vertical growth patterns. Clin Dent Res 2017;41(1):3–9.
Steiner CC. Cephalometrics in clinical practice. Angle Orthod 1959;29:8–29.
Silverman FN. Roentgen standards fo-size of the pituitary fossa from infancy through adolescence. Am J Roentgenol Radium Ther Nucl Med 1957;78(3):451–60.
Axelsson S, Storhaug K, Kjær 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(6):597–604.
Cordero DR, Brugmann S, Chu Y, Bajpai R, Jame M, Helms JA. Cranial neural crest cells on the move: their roles in craniofacial development. Am J Medical Genet A 2011;155A(2):270–9.
Chin A, Perry S, Liao C, Yang Y. The relationship between the cranial base and jaw base in a Chinese population. Head Face Med 2014;10:31.
Kerr WJ, Adams CP. Cranial base and jaw relationship. Am J Phys Anthropol 1988;77(2):213–20.
Jarvinen S. Saddle angle and maxillary prognathism: a radiological analysis of the association between the NSAr and SNA angles. Brit J Orthod 1984;11(4):209–13.
Soakar PC, Nawale S. The comparative study of size of sella turcica in different skeletal types in local population-an in vitro study. Indian J Appl Res 2014;4(10):160–2.
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(3):e16059.
Shah AM, Bashir U, Ilyas T. The shape and size of the sella turcica in skeletal class I, II and III in patients presenting at Islamic International Dental Hospital, Islamabad. Pak Oral Dent J 2011;31(1):104–10.
Moslemzadeh SH, Moghaddam N, Moghaddam SF, Rafighi A, Ghojazadeh M, Rasouli F. Relationship between bridging and dimensions of sella turcica and antero-posterior skeletal malocclusions in children. Iran J Orthod 2016;11(2):e5738.
Rohria R, Jain S. Sellar dimension in skeletal class II subjects with different growth patterns. J Pierre Fauchard Acad 2015;29(1):26–31.
Jones RM, Faqir A, Millett DT, Moos KF, McHugh S. Bridging and dimensions of sella turcica in subjects treated by surgical-orthodontic means or orthodontics only. Angle Orthod 2005;75(5):714–8.
Marşan G, Öztaş E. Incidence of bridging and dimensions of sella turcica in class I and III Turkish adult female patients. World J Orthod 2009;10(2):99–103.
Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal class III children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993;15(3):211–21.
Sankey WL, Buschang PH, English J, Owen AH 3rd. Early treatment of vertical skeletal dysplasia: the hyperdivergent phenotype. Am J Orthod Dentofacial Orthop 2000;118(3):317–27.