The prevalence, radiographic appearance, and characteristics of zygomatic air cell defects (ZACDs) in symptomatic temporomandibular joint disorder patients in North Indian population

Abstract

Although the incidence of zygomatic air cell defects (ZACDs) is significantly low in general population, still they pose as a risk factor during surgical procedures like eminectomies and eminoplasties because there is a risk of spread of infection intracranially. Furthermore, such procedures are more common in TMD patients. With this fact in mind, this study was designed to find out the prevalence, radiographic appearance, and characteristics of zygomatic air cell defects in diagnosed symptomatic temporomandibular joint disorder patients. The study comprised of evaluation of panoramic radiographs of 70 temporomandibular joint disorder (TMD) patients in the age range of 18-30 years selected on the basis of Research Diagnostic Criteria (RDC/TMD). The radiographs were evaluated regarding the presence, variations, and characteristics of ZACDs. Groups were compared by χ (2) analysis. ZACDs were identified in 21 TMD subjects out of 70, giving an overall prevalence of 30 %. Out of 21 ZACDs, nine were in males (42.8 %) and 12 were in females (52.38 %). ZACDs were unilateral in ten TMD patients (47.61 %) and were bilateral in 11 patients (52.38 %). It can be concluded that the number of ZACDs is surprisingly more in diagnosed TMD patients. This strengthens the need for thorough preoperative imaging evaluation of ZACDs in such patients. Further longitudinal studies are required to find out the long-term effect of ZACDs on symptomatic as well as non-symptomatic TMD subjects. This may prove helpful to appreciate that whether ZACDs have any role in the development TMDs and vice versa. As with many TMD studies, caution should be exercised in interpreting these results until further studies have been carried out on this topic. Ideally, some prospective randomised evaluations with "hard" evidence of the diagnosis with MRI support.