CBCT Assessment of Pneumatization of the Articular Tubercle and the Roof of the Glenoid Fossa: a retrospective study

Abstract

Objectives: To determine the prevalence of the pneumatization of the articular tubercle (PAT) and glenoid fossa (PGF) concerning the sex, laterality and locularity in a sample of Egyptian population using CBCT images.Subjects and methods: 210 CBCT scans (74 males and 136 females) were assessed retrospectively by an oral and maxillofacial radiologist. The presence of pneumatization was identified bilaterally on a serial of reformatted sagittal cuts at the articu lar tubercle and the roof of the glenoid fossa. Age and sex for all patients were recorded as well as the type and laterality for the pneumatiza tion cases.Results: 19.1 % of the scans exhibited PAT and 35.24% exhibited PGF. Of the scans found with PAT, 50% were unilateral (20% on the right and 30% on the left) and 50% were bilateral. Moreover, 15 of the PAT cases were unilocular and 28 were multilocular with 3 cases showing different locularity between sides. For PGF, 41.9% of the PGF cases were unilateral (13.5% on the right and 28.4% on the left) and 58.1% were bilateral. Only 16 of the PGF cases were unilocular, while 61 were multilocular with 3 cases also showing different locularity between sides. There was no significant difference between both sexes regarding the PAT or PGF prevalence, laterality or locularity. Conclusion:In the studied sample, the prevalence of PAT and PGF was 19.1 and 35.24% respectively. The prevalence was not linked to sex or laterality or locularity.

Pneumatization of the articular eminence in cone-beam computed tomography: prevalence and characteristics — literature review

“…All studies included in the meta-analysis assessed the presence of articular tubercle pneumatization using cone-beam computed tomography. Most studies showed no statistically significant differences in the incidence of PAT between males and females [4,6,[13][14][15][16][17][18][19][20][21][22][23][24]. One study [1] showed a statistically significant difference between the incidence of PAT in females (73,6%) and males (51,3%; p<0,05).…”

“…In the study by ElBeshlawy [21], out of 40 CBCT scans with diagnosed pneumatization, 20 PATs were unilateral (50%) (8 on the right side and 12 on the left side) and 20 cases (50%) had bilateral PATs (1:1 ratio). There was no statistically significant difference between unilateral and bilateral or right/left incidence.…”

“…PAT is completely asymptomatic and is usually diagnosed incidentally on radiographs [21] as a well-demarcated translucency within the zygomatic process and the articular tubercle that does not extend beyond the zygomaticotemporal region [13]. Nowadays, threedimensional imaging methods, such as CT and CBCT, are considered the gold standard for the evaluation of pneumatized cranial air spaces because they provide valuable information for better understanding the nature and character of these rare lesions [21].…”

“…PAT is completely asymptomatic and is usually diagnosed incidentally on radiographs [21] as a well-demarcated translucency within the zygomatic process and the articular tubercle that does not extend beyond the zygomaticotemporal region [13]. Nowadays, threedimensional imaging methods, such as CT and CBCT, are considered the gold standard for the evaluation of pneumatized cranial air spaces because they provide valuable information for better understanding the nature and character of these rare lesions [21]. These modalities decrease the problem of overlapping structures that is inherent in conventional panoramic radiographs, however this X-ray may be the first to take clinician's notice of the problem of PAT because of the high prevalence of these examinations in dental practice [13].…”

“…PAT may resemble some pathological conditions such as aneurysmal bone cyst, vascular malformations, acidophilic granuloma, cancer metastasis, early type of fibrous dysplasia. To facilitate differentiation, clinical and radiographic signs of bone destruction by the above-mentioned lesions should be considered in comparison to asymptomatic pneumatization [21].…”