CBCT-based evaluation of morphological variations of pterygoid plates and their association with age and gender: a retrospective cross-sectional study

The pterygoid plates of the sphenoid bone are important anatomical structures in the pterygomaxillary region and exhibit considerable morphological variations. These variations are clinically relevant in oral and maxillofacial surgery, implant procedures, trauma assessment, and radiological interpretation. Cone Beam Computed Tomography (CBCT) allows accurate three-dimensional evaluation of these structures. A retrospective cross-sectional radiological study was conducted on 128 archived CBCT scans of individuals aged 13–60 years. Only scans with clear visualization of the pterygoid plates were included. The lengths of the medial and lateral pterygoid plates were measured bilaterally on axial CBCT images using standardized reference points. The morphology of the pterygoid fossa was classified as U-shaped, V-shaped, or W-shaped. Statistical analysis was performed using IBM SPSS Statistics version 27. As the data were not normally distributed, the Mann–Whitney U test, Kruskal–Wallis test, Pearson’s Chi-square test, and Fisher–Freeman–Halton exact test were used, as appropriate. A p value < 0.05 was considered statistically significant. The V-shaped pterygoid fossa was the most common morphology (52.3%), followed by the U-shaped (36.8%) and W-shaped (10.9%) patterns. Males showed significantly greater medial and lateral pterygoid plate lengths than females on both sides ( p < 0.001). A significant increase in pterygoid plate length with advancing age was observed, with the highest values in the 41–60 years age group ( p < 0.001). Pterygoid fossa morphology showed a significant association with age ( p = 0.007) but not with gender ( p = 0.818). CBCT evaluation demonstrated significant age- and gender-related differences in the length of the medial and lateral pterygoid plates. The V-shaped pterygoid fossa was the most commonly observed morphological pattern, and its distribution showed a significant association with age but not with gender. These findings highlight the value of CBCT in accurate radiographic assessment and preoperative evaluation of the pterygomaxillary region.