Evaluation of the upper airways in dentistry: protocol in cone-beam computed tomography

Catarina Fonseca*, Francisca Manata Cavadas, Patrícia Fonseca

*Corresponding author for this work

Research output: Working paperPreprint


Background: The upper airways are formed by the nasal cavities, pharynx, and larynx. There are several radiographic methods that allow to evaluate the craniofacial structure. The upper airway analysis in CBCT (Cone Beam Computed Tomography) may be useful in assisting to diagnose some pathologies such as the Obstructive Sleep Apnea Syndrome (OSAS). In some individuals with OSAS the upper airway is compromised and narrowed. Nowadays, CBCT is widely used in dental medicine by clinicians. Its use for upper airways assessment would be an advantage for screening some abnormalities related to an increased risk of pathologies like OSAS. There is an urgent need to standardize the protocol for the upper airways measurement to help clinicians to identify at-risk patients. Objective: The main aim is to create a standard protocol for upper airways evaluation in CBCT. Methods: To measure and evaluate the upper airways the data is obtained through Planmeca® ProMax 3D (Planmeca, Helsinki, Finland). The exposure corresponds to 90 kV, 8 mA and 13,713 s. The software used for upper airway analysis is Romexis® version 5.1.O.R (Planmeca, Helsinki, Finland). The images are exhibited according to the field of view of 20.1 x 17.4 cm, size 502 x 502 x 436 mm and the voxel of 400 μm. Results: The described and illustrated protocol presented in this article for evaluation of the upper airways in CBCT allows to automatically calculate the total volume of the pharyngeal airspace, its area of greatest narrowing, its location and the smallest anteroposterior and laterolateral dimensions of the pharynx. The measurement is done automatically by the imaging software whose reliability is proven by the existing literature. In this way we reduce the possible bias of manual measurement, aiming at data collection. Conclusions: The use of this protocol by dentists will allow to standardize the measurements and contribute to the detection of respiratory and upper airways related pathologies such as OSAS in patients visiting the clinics with CBCT equipment.
Original languageEnglish
Number of pages13
Publication statusPublished - 13 Jul 2022


  • Cone-Beam computed tomography
  • Three dimensional image
  • Airway obstructions
  • Sleep medicine specialty
  • Dentistry
  • Obstructive sleep apnea


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