Sella Turcica Bridging – An Orthodontic Perspective

Background: Sella turcica bridge is a developmental anomaly formed as a result of calcification of the interclinoid ligaments. Its detection at an early age could foretell impending palatal canine impactions, tooth transpositions and other dental anomalies as also other craniofacial deviations, syndromes and underlying endocrinological disorders. The objective of the study was therefore to use published data to highlight the importance of sella turcica bridging and its correlation with dental anomalies and skeletal malocclusions.

Methods: Pertinent articles pertaining to anatomy, morphology, topography, radiology & prevalence of sella turcica bridging and its association with dental anomalies, skeletal malocclusions and congenital syndromes were extensively searched in bibliographic databases and perused, with the salient points conclusively delineated and highlighted.

Results: A correlation of sella turcica bridging and its occurrence with dental anomalies especially impending palatal canine impactions and concomitant occurrence with skeletal malocclusions and craniofacial deviations was found to be reported widely in literature. Though lateral cephalograms were accurate in diagnosing partial bridging and no bridging, CBCT was more accurate in diagnosing partial and complete bridging. Though visualized in a 2-D lateral cephalogram, greater clarity and visibility of the same is best achieved with imaging with the 3-D cone-beam computed tomography.

Conclusion: Detection of sella turcica bridging at an early age could foretell impending palatal canine impactions, tooth transpositions, maxillary lateral incisor, second premolar and third molar agenesis and occurrence of various other dental anomalies, thereby serving as an invaluable screening tool for the practising orthodontists as also aid the neurosurgeons who perform complex surgical procedures in this critical area characterized with rich vascular and neuronal elements.