Pituitary Tumors in Maxillofacial Radiology and Daily Practice: A Scoping Review.

Background

Lateral cephalometric radiographs and large-field cone-beam computed tomography (CBCT) routinely used in orthodontics and maxillofacial radiology can reveal incidental pituitary tumors in the sellar region. Given the regular use of these imaging modalities, a structured overview of how pituitary tumors present on dental radiographs and how often they occur is clinically relevant.

Methods

A scoping review was conducted according to PRISMA-ScR. MEDLINE via PubMed, Livivo, and Google Scholar were searched up to 20 January 2026 using MeSH terms and keywords for pituitary tumors and dental radiology. Human studies in English or German reporting on radiological presentation, clinical manifestation and epidemiology of pituitary tumors in the context of dental imaging were included. Study selection was performed independently by two reviewers.

Results

Of 150 records, 15 studies were included: 2 case-control studies, 5 observational studies, 6 case reports, 1 questionnaire-based study and 1 neurosurgical guideline. Pituitary tumors most frequently presented with enlargement, deformation, or double contour of the sella turcica; growth hormone-producing adenomas additionally showed cephalometric changes such as mandibular and frontal sinus enlargement. The evidence is largely descriptive and does not permit robust estimates of prevalence or diagnostic accuracy but consistently identifies radiological "red flags" and recurrent clinical constellations, especially in acromegaly or unexplained craniofacial changes.

Conclusions

Pituitary tumors, among the most common brain tumors, may first be suspected on routine dental radiographs. Distinct radiographic abnormalities combined with suggestive clinical features should prompt timely endocrine and neuroradiological evaluation, underscoring the need for heightened awareness among dental professionals.