Dimensions and morphology of sella turcica in different skeletal malocclusions: a systematic review and network meta-analysis

Abstract

This systematic review and meta-analysis aimed to determine whether the morphology and linear dimensions of sella turcica differ by the different skeletal malocclusions. PubMed, Scopus, EMBASE, and Google Scholar were comprehensively searched for the relevant articles published until 21 May 2024 using combinations of the following terms: sella turcica, lateral cephalometric, skeletal malocclusion, and morphology. Observational studies that assessed sella turcica in different skeletal malocclusions in systemically healthy subjects were included. Data analysis was accomplished using R. Twenty-six studies were included and subjected to quantitative analysis. The length and diameter of sella turcica in Class III were higher compared to Class I [Mean Difference (MD) = 0.42, 95% CI: 0.18-0.67, p value < 0.001; and MD = 0.29, 95% CI: 0.05-0.53, p value = 0.0197, respectively], and compared to Class II (MD = 0.48. 95%CI: 0.23-0.73, p value ≤ 0.001, and MD = 0.4, 95%CI: 0.14-0.65, p value = 0.002, respectively). The depth of sella turcica in Class III was also higher than that of Class II (MD = 0.29, 95%CI: 0.03-0.56, p = 0.03. Furthermore, Class III showed the highest rates of bridge and notch shape of sella turcica compared to Class I (Risk Ratio (RR) = 1.42, 95%CI: 1.13-1.79, p value = 0.0026; and RR = 1.55, 95%CI: 1.11-2.17, p value = 0.011, respectively), and compared to Class II regarding the bridge shape (RR = 1.35, 95%CI: 1.07-1.71, p value = 0.012. The Class III malocclusion showed larger dimensions of sella turcica, and higher prevalence of bridging, notching, and double shape in sella turcica. The present findings do not provide direct diagnostic evidence for orthodontic clinical practice.

Keywords: Dimensions; Lateral cephalometric; Morphology; Sella turcica; Skeletal malocclusion.