Cone beam computed tomography evaluation of pterygoid hamulus

Abstract

Introduction: The hamular process topographically arises from the terminal part of the medial bone lamina and it is a sickle or hook-shaped process located distal and medial to the maxillary tuberosity. Its morphology is very varied as well as its size and its terminal portion can be thin or bulbous. In the literature, the average length and width are 5.3 mm and 1.6 mm, respectively. It commonly has a lateral deviation in the coronal plane and a posterior deviation in the sagittal plane. The present study aimed to analyze the morphology and morphometry of hamular processes in Cone Beam Computed Tomography (CBCT) slices. Cone-beam computed tomography slices of 200 patients (100 male and 100 female) were analyzed. A field of view of 80 mm by 80 mm and an isotropic voxel size of 200 µm. Images obtained were viewed and analyzed with Romexis software 4.4.0.R. where Hamular processes measurements were taken. In the different slices, the Hamular processes were observed as cortical bone hyperdense images. They presented an average length of 5.42mm and an average width of 1,80 mm. The deviations of the hamulus laterally outwards in the coronal plane presented an average angle of 32°. In the sagittal slices, hamular processes presented a posterior deviation (85%). In our study, the morphology and size of these bone processes presented similar values to those reported in the literature. Knowledge of the statistically most frequent morphological and morphometric characteristics of hamular processes allows the dental professional to diagnose different pathological alterations, such as their abnormal deviation or their elongation that may be a cause of different disorders such as obstructive sleep apnea or hamular process syndrome.