Sella turcica variations in lateral cephalometric radiographs and their association with malocclusions

Objectives: Classification of the skeletal facial types is performed using certain reference points and planes in lateral cephalometric radiographs to plan orthodontic treatments. One of these reference points is sella turcica which is closely associated with craniofacial bone development. The aim of this study was to identify the association between the sella turcica variations and skeletal Class I, II, and III malocclusions. Methods: This study retrospectively evaluated 94 orthodontic patients (48 males and 46 females) between 14–26 years of age. Lateral cephalometric radiographs of the patients with skeletal Class I, II, and III malocclusions were classified into six groups according to sella turcica morphology: normal sella turcica, oblique anterior wall, double contour of the floor, sella turcica bridge, irregularity in the posterior part, and pyramidal shape of sella turcica. The length, depth, and diameter of sella turcica were measured. Sella turcica variations and radiographs of patients with Class I, II, and III malocclusions were compared statistically. Results: The correlation between the sella turcica variations and skeletal sagittal classification was statistically significant (p=0.017). 36.8% of the radiographs, which were classified as normal sella turcica were classified as Class I patients. There were no statistically significant differences between the skeletal Class I, II, and III malocclusions and sella turcica variations in terms of the length, depth, and diameter. Conclusion: For adequate patient referral and management, orthodontists should recognize sella turcica variations in lateral cephalometric radiographs, and these findings should arise an index of suspicion for associated pathologies, especially of the hypophyseal gland.