The frequency of ponticulus posticus in orthodontic patients in turkish society and its relationship with skeletal malocclusion, dental anomalies, and hyoid bone position

Ponticulus Posticus (PP) is an anatomical variant of the first cervical vertebra (atlas, C1). Since this structure may carry potential signs of underlying pathology, it is crucial to carefully examine the anatomical variants in routine lateral cephalometric radiographs taken for orthodontic diagnosis. This study aims to investigate the relationship between the presence of Ponticulus Posticus and clinical factors such as gender, skeletal malocclusion, dental anomalies, and hyoid bone position. A total of 477 orthodontic patients (290 females, 187 males; average age 17.3 ± 5.88) were analyzed through lateral cephalometric and panoramic radiographs. Ponticulus Posticus was classified into three groups: 'Incomplete PP,' 'Complete PP,' and 'No PP.' The results showed that PP was absent in 82.6% of the patients, present as complete in 10.7%, and incomplete in 6.7%. Statistical analysis revealed that PP was not associated with gender, skeletal malocclusion, or dental anomalies. One of the most noteworthy findings of the study was the observed relationship between PP and hyoid bone position, with patients having incomplete PP showing a lower position of the hyoid bone compared to those without PP.