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

Abstract

Background: The articular tubercle is a site prone to pneumatization within the cranial bones. Knowledge of the anatomical variations of pneumatization adjacent to the temporomandibular joint (TMJ) is an important issue. Air cells exhibit decreased resistance to trauma, facilitate the spread of various pathologies in the TMJ, such as inflammation, tumours or fractures. Articular tubercle pneumatization may cause complications during TMJ surgery. Information of possible location allows to detect and conduct differential diagnosis of pneumatization of the articular tubercle (PAT) during cone-beam computed tomography (CBCT) examinations. The aim of this study is to determine the prevalence and characteristics of PAT, with respect to age, gender, location and type through assessment in CBCT images.

Materials and methods: Articles were selected through database search (PubMed, Scopus, Google Scholar), in which the main objective was to assess the prevalence of articular tubercle pneumatization using CBCT. Search strategies included the following keywords: "pneumatized articular eminence" and "CBCT", "pneumatized articular tubercle" and "CBCT" and "zygomatic air cell defect" and "CBCT". A meta-analysis of prevalence using a random effects model was performed.

Results: Fifteen studies met the selection criteria. The results showed that an overall prevalence of articular tubercle pneumatization was 25.22% (n = 6393; 95% confidence interval [CI] 15.84-35.94). The occurrence of PAT in females was 25.14% (n = 3064; 95% CI 14.96-36.94). The frequency of PAT in males was 25.81% (n = 2671; 95% CI 15.30-37.99).

Conclusions: There was no correlation between the frequency, location or type of PAT with age and gender.

Keywords: air cells; articular tubercle; cone-beam computed tomography; pneumatization; pneumatized articular eminence; pneumatized articular tubercle; zygomatic air cell defect.