Relationship between sella turcica morphology and dentofacial anomaly – a three-dimensional analysis

TL;DR

This study explores how the shape of the sella turcica relates to dentofacial anomalies using 3D imaging in adults.

Contribution

The study introduces a 3D analysis of sella turcica morphology in relation to dentofacial anomalies, revealing correlations with skeletal classes.

Findings

Sella turcica volume and dimensions differ significantly across skeletal classes.

Vol_A correlates with Wits appraisal, suggesting a link between sella morphology and skeletal class.

3D diagnostics of sella turcica can inform about underlying dentofacial anomalies.

Abstract

This cohort study aimed to evaluate the relationship between sella turcica (ST) morphology and dentofacial anomalies three-dimensionally (3D).

Cone beam computed tomograms (CBCTs) and computed tomography scans (CTs) of 90 adults (46 women; age 28.1 ± 11.3 years) were analyzed. Dentofacial anomalies were evaluated (1) sagittally regarding skeletal classes (Wits appraisal), (2) vertically regarding the inclination of the jaws (maxillomandibular plane angle), and (3) transversally regarding skeletal symmetry (menton deviation from midsagittal plane). Sella morphology was assessed (a) linearly by ST-length, -width, -height, -diameter, and position to nasofrontal suture (CB); and (b) volumetrically by total, anterior, and posterior volume (Vol_T, Vol-A, Vol_P). Five porcine skulls were scanned by CBCT, CT, and micro-CT for method validation.

CBCT and CT both underestimated the ST volume compared to the volume measured with micro-CT. ST morphology differed significantly between the skeletal classes. Individuals with skeletal class I showed higher ST length than participants with skeletal class II (p = .024). Vol_T and Vol_A were higher in class II than in class III (p = .047; p = .019). Vol_A correlated with the Wits appraisal (r = .337, p < .001). Vertical and transversal jaw relation showed no correlation with ST variables. ST-width and CB were significantly higher in men than women (p = .004; p < .001).

3D-diagnostics of ST morphology enabled conclusions about underlying dentofacial anomalies. Vol_A seemed to be a relevant marker based on its correlation and class-specific volumes. Future research could help to identify this as prognostic factor of developing anomalies.

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