Comparison of cone beam computed tomography and panoramic imaging for the detection of pneumatization of the articular eminence.

Abstract

Pneumatization of the articular eminence (PAE) and pneumatization of the glenoid fossa (PGF) refer to the presence of air cells in the zygomatic process of the temporal bone, according to their location. These air cells are asymptomatic and do not necessitate treatment; however, their identification is crucial in specific situations, particularly during temporomandibular joint (TMJ) surgery. The aim of this study was to assess the diagnostic efficacy of panoramic radiography in detecting PAE compared to cone beam computed tomography (CBCT). The study included 400 individuals who underwent panoramic and CBCT imaging in the same calendar year. The examination of PAE was first conducted using CBCT, and this was followed by a comparative analysis with panoramic imaging. The prevalence of PAE was determined to be 17.3% on CBCT and 9.8% on panoramic imaging. Compared to CBCT imaging, the specificity of panoramic images to identify cases without PAE was 99.5% for the right side and 98% for the left side; sensitivity, on the other hand, was only 40.6% and 49.1% for the right and left sides, respectively. In comparison to CBCT imaging, panoramic imaging demonstrated a low sensitivity, despite its high specificity. Therefore, a three-dimensional examination is recommended prior to TMJ surgery.