Evaluation of Pneumatization in the Articular Eminence and Roof of the Glenoid Fossa with Cone-Beam Computed Tomography

Abstract

Background: Detection of air cavities, so called pneumatizations, nearby to the temporomandibular joint (TMJ) area is important, as they represent sites of minimal resistance and facilitate the spread of various pathologies into the joint as inflammation, tumor or fractures and serve as a possible complicating factor in TMJ surgery. Aims: To determine the prevalence of pneumatization of the articular eminence (PAT) and roof of the glenoid fossa (PRGF) using cone-beam computed tomography (CBCT). Study Design: Cross-sectional study. Methods: Acquired images of 111 patients (222 TMJs) were evaluated. The presence of pneumatization was recorded at the articular eminence and roof of the glenoid fossa. Age and gender were recorded for all patients and type (unilocular or multilocular) and laterality were noted for the cases of pneumatization. Results:The mean age of the study group was 48.86±18.31 years. Among all the patients, 73 (65.8%) had PAT, while 13 (11.7%) had PRGF. Forty-two (37.8%) of the patients had PAT bilaterally; whereas 3 of them (2.7%) presented PRGF bilaterally. The percentage of PAT was higher for females (73.6%) than males (51.3%) (p<0.05). Conclusion: CBCT images are an accurate and reliable means of detection of the exact size and type of pneumatization and the relationship of pneumatization to the adjacent tissues. This is especially significant before a surgical intervention is planned in this region, in order to make a sound diagnosis.

Pneumatized Articular Tubercle and Pneumatized Roof of Glenoid Fossa on Cone Beam Computed Tomography: Prevalence and Characteristics in Selected Iranian Population

“…(6,12,18) The age range of patients with PAT and PRGF was 21 to 81 years (mean age: 47.92) and 25 to 66 years (mean age: 45.07), respectively, similar to that the ranges of 43.0-48.86 years reported in other studies. (4,5,17,19) Pediatric patients were excluded from the present study, consistent with previous work. (4,9,10,17) Pneumatization of the mastoid process is often complete by the age of five years, while pneumatization of zygomatic process begins at 9 years of age.…”

“…(9,10,12,17) The reported prevalence of PAT on CBCT images varies in the literature, from 8% (12) to 21.3% (4) to 51.8%. (5) Panoramic radiographs imply inherent problems, such as superimposition of adjacent structure, distortion, and low resolution. CBCT or CT is considered the modality of choice for the assessment of bony structures.…”

“…Differing prevalence rates were reported by Laderia et al (38.3%) (4) , Groell et al (51%) (23) and İlgüy et al (11.7%). (5) This difference might be attributed to various factors, including sample size, type of sample, and composition of the populations.…”

“…(1)(2)(3) .When these exist in the zygomatic process of the temporal bone, they are known as the pneumatized articular tubercle (PAT) and the pneumatized roof of the glenoid fossa (PRGF). (4,5) This asymptomatic radiolucency in the zygomatic process is similar to mastoid air cells. (6) PAT is also called Zygomatic Air Cell Defects (ZACDs).…”

“…A unilocular ZACD appears as a single radiolucent oval defect with well-defined borders; the multilocular type appears as numerous radiolucent small cavities, which look like mastoid air cells. (5,7) In previous studies, panoramic radiography has typically been used to evaluate these defects. Owing to the anatomical complexity of the temporo-mandibular joint (TMJ), this technique is inadequate for assessing this region.…”