The Relationship Between Orthodontic Malocclusion and Morphological Features of Sella Turcica Bridging and Ponticulus Posticus

<i>Background and Objectives</i>: Recent years have been marked by a search for new relationships between malocclusions and the morphological features of the cranial base and upper cervical spine. The aim of this study was to evaluate the relationship between skeletal orthodontic malocclusions and the morphological features of sella turcica bridging (STB) and ponticulus posticus (PP). <i>Materials and Methods</i>: The study sample consisted of 300 randomly selected pre-orthodontic treatment patients aged 7-40 years. Cephalometric analysis was performed twice by two researchers. The patients were divided into three groups according to the type of skeletal malocclusion. Statistical analysis was performed using SPSS 29.0 software. <i>Results</i>: The prevalence of incomplete PP was 40%, and the prevalence of complete PP was 11.33% and was significantly more common in males (56.7%). STB had a prevalence of 52.67% (15.67% complete, 37.0% partial), with a significantly higher prevalence in females (60.1%, <i>p</i> < 0.001). PP and STB were more common in Class II patients, followed by Class I and Class III. However, only PP showed a statistically significant difference (<i>p</i> = 0.042). According to logistic regression, men were twice as likely to have an open groove of PP (<i>p</i> = 0.015), while females had higher odds of partial and complete STB (<i>p</i> < 0.05). Class II malocclusion increases the odds of type 2 and type 4 PP as well as partial STB. However, it was not statistically significant (<i>p</i> > 0.05). <i>Conclusions</i>: The morphological features of sella turcica bridging and ponticulus posticus were related to sex and the orthodontic skeletal pattern. Ponticulus posticus was more prevalent in males, while sella turcica bridging was more prevalent in females; both conditions were more common in patients with a Class II skeletal pattern. Males were more likely to have an open groove of ponticulus posticus, whereas females were twice as likely to have both forms of sella turcica bridging.