Prevalence of Ponticulus Posticus and Migraine in 220 Orthodontic Patients: A Cross-Sectional Study

SIMPLE SUMMARY: The vertebral artery passes through the first cervical vertebra (or atlas). Around 20% of patients carry an atlas mutation in the presence of ponticulus posticus, an additional bony ridge over the vertebral artery groove that compresses or irritates the artery with its sympathetic periarterial plexus and suboccipital nerve. Early atlas mutation identification is essential for accurate diagnosis in patients affected by unexplainable symptoms, such as headache, neck pain, vertigo, visual disturbances, problems with speech and swallowing, neurosensory hearing loss, vertebrobasilar insufficiency, dizziness, postural muscle tone loss, shoulder pain, etc. Our cross-sectional study aimed to assess the prevalence and morphologic features of ponticulus posticus and its association with migraine using cone beam CT scans. We confirmed in a homogeneous population (220 Italian adults) the association between migraine and ponticulus posticus. ABSTRACT: Background: Ponticulus posticus (PP) is a medical term that describes an anomaly of the atlas (C1), which has a complete or partial bone bridge over the vertebral artery (VA) groove. The purpose of the study is to estimate the prevalence of PP in patients with a diagnosis of migraine. Methods: Cone beam CT (CBCT) scans (n = 220) were reviewed for the detection of PP in the University “G. D’Annunzio” of Chieti in the Department of Medical, Oral and Biotechnological Sciences. The sample included 220 Italian patients between 18 and 87 years. Pearson chi-square analysis (p < 0.05 and 95% CI) was used to establish an association between migraine and PP. Results: The present study found a prevalence of PP of 20.9% and a prevalence of migraine of 12.272%. The association between migraine and PP was confirmed by the chi-square statistic, since the p-value was 0.008065 (significant at p < 0.05). PP was more frequent in the migraine without aura group, without a statistical difference relative to the migraine with aura group. Conclusions. The study concluded that PP is positively associated with migraine.