Upper airway volumetry using CBCT: a critical review of methodological inconsistencies and open-source software applications

Habumugisha J, Ida S, Nakamura M, Kono K, Uchida K, Moriya T, et al. Clinical prediction models for upper airway volume based on soft palate and airway lumen dimensions in adults with varying vertical skeletal patterns. Int Dent J. 2025. https://doi.org/10.1016/j.identj.2024.09.023.

Article  PubMed  Google Scholar 

Rajkumar B, Parameswaran R, Sanjana M, Boovaraghavan S, Vijayalakshmi D. Evaluation of pharyngeal airway volume three-dimensionally in various sagittal skeletal patterns: a systematic review. Indian J Dent Res. 2023;34(2):209–15. https://doi.org/10.4103/ijdr.ijdr_338_22.

Article  PubMed  Google Scholar 

Jadhav M, Bhosale V, Patil A, Shinde S. Comparison of volumetric dimensions of pharyngeal airway for different dentofacial skeletal patterns using cone-beam computed tomography. Folia Med (Plovdiv). 2020;62(3):489–96. https://doi.org/10.3897/folmed.62.e48930.

Article  Google Scholar 

Celikoglu M, Bayram M, Sekerci AE, Buyuk SK, Toy E. Comparison of pharyngeal airway volume among different vertical skeletal patterns: a cone-beam computed tomography study. Angle Orthod. 2014. https://doi.org/10.2319/121913-930.1.

Article  PubMed  PubMed Central  Google Scholar 

Süküt Y, Yurdakurban E, Duran GS. Accuracy of deep learning-based upper airway segmentation. J Stomatol Oral Maxillofac Surg. 2025. https://doi.org/10.1016/j.jormas.2024.102048.

Article  PubMed  Google Scholar 

Ghoneima A, Kula K. Accuracy and reliability of cone-beam computed tomography for airway volume analysis. Eur J Orthod. 2013. https://doi.org/10.1093/ejo/cjr099.

Article  PubMed  Google Scholar 

Fonseca C, Cavadas F, Fonseca P. Upper airway assessment in cone-beam computed tomography for screening of obstructive sleep apnea syndrome: development of an evaluation protocol in dentistry. JMIR Res Protoc. 2023. https://doi.org/10.2196/41049.

Article  PubMed  PubMed Central  Google Scholar 

Di Carlo G, Fernandez Gurani S, Pinholt EM, Cattaneo PM. A new simple three-dimensional method to characterize upper airway in orthognathic surgery patient. Dentomaxillofac Radiol. 2017. https://doi.org/10.1259/dmfr.20170042.

Article  PubMed  PubMed Central  Google Scholar 

Zhang R, Shi HM, Li QH, Yan J, He JD, Li H, et al. A novel protocol for three-dimensional reconstruction of pharyngeal airway on computed tomography. J Craniofac Surg. 2013. https://doi.org/10.1097/SCS.0b013e3182997740.

Article  PubMed  Google Scholar 

Orhan K, Shamshiev M, Ezhov M, Plaksin A, Kurbanova A, Ünsal G, et al. AI-based automatic segmentation of craniomaxillofacial anatomy from CBCT scans for automatic detection of pharyngeal airway evaluations in OSA patients. Sci Rep. 2022. https://doi.org/10.1038/s41598-022-15920-1.

Article  PubMed  PubMed Central  Google Scholar 

Steegman RM, Renkema AM, Schoeman A, Kuijpers-Jagtman AM, Ren Y. Volumetric changes in the upper airway on CBCT after dentofacial orthopedic interventions: a systematic review. Clin Oral Investig. 2023. https://doi.org/10.1007/s00784-023-05207-8.

Article  PubMed  PubMed Central  Google Scholar 

El H, Palomo JM. Measuring the airway in 3 dimensions: a reliability and accuracy study. Am J Orthod Dentofac Orthop. 2010. https://doi.org/10.1016/j.ajodo.2010.01.014.

Article  Google Scholar 

Guo J, Fu R, Pan L, Zheng S, Huang L, Zheng B, He B. Coarse-to-fine airway segmentation using multi-information fusion network and CNN-based region growing. Comput Methods Programs Biomed. 2022. https://doi.org/10.1016/j.cmpb.2021.106610.

Article  PubMed  Google Scholar 

Dos Santos LF, Albright DE, Dutra V, Bhamidipalli SS, Stewart K, Polido WD. Is there a correlation between airway volume and maximum constriction area location in different dentofacial deformities? J Oral Maxillofac Surg. 2020. https://doi.org/10.1016/j.joms.2020.03.024.

Article  PubMed  Google Scholar 

Grauer D, Cevidanes LSH, Styner MA, Ackerman JL, Proffit WR. Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology. Am J Orthod Dentofac Orthop. 2009. https://doi.org/10.1016/j.ajodo.2008.01.020.

Article  Google Scholar 

Anandarajah S, Abdalla Y, Dudhia R, Sonnesen L. Proposal of new upper airway margins in children assessed by CBCT. Dentomaxillofac Radiol. 2015. https://doi.org/10.1259/dmfr.20140438.

Article  PubMed  PubMed Central  Google Scholar 

Weissheimer A, Menezes LM, Sameshima GT, Enciso R, Pham J, Grauer D. Imaging software accuracy for 3-dimensional analysis of the upper airway. Am J Orthod Dentofac Orthop. 2012;142(6):801–13. https://doi.org/10.1016/j.ajodo.2012.07.015.

Article  Google Scholar 

Asymal A, Priaminiarti M, Suryonegoro H, Kiswanjaya B, Bachtiar-Iskandar HH. Comparison of open-source software performance as a measurement tool in CBCT: a literature review. J Int Dent Med Res. 2022;15(4):1787–97. https://doi.org/10.7107/j.jidmr.2022.15.4.1787.

Article  Google Scholar 

Pinheiro LR, Ruellas ACO, et al. Volumetric reconstruction and determination of minimum cross-sectional area of the pharynx in patients with cleft lip and palate: comparison between open-source and commercial software. J Appl Oral Sci. 2018;26:e20170499. https://doi.org/10.1590/1678-7757-2017-0499.

Article  CAS  Google Scholar 

Torres HM, Evangelista K, Torres EM, Estrela C, Leite AF, Valladares-Neto J, Silva MAG. Reliability and validity of two software systems used to measure the pharyngeal airway space in three-dimensional analysis. Int J Oral Maxillofac Surg. 2020;49(5):602–13. https://doi.org/10.1016/j.ijom.2019.09.008.

Article  CAS  PubMed  Google Scholar 

dos Inocentes JG, de Souza JG, et al. Three-dimensional analysis of upper airway dimensions in treacher Collins syndrome patients compared with nonsyndromic individuals. Int J Dent. 2024;2024:1–8. https://doi.org/10.1155/2024/11221962.

Article  Google Scholar 

Templier A, Cevidanes LHS, et al. Accuracy of upper airway volume measurements in CBCT: a systematic review of software reliability. Orthod Craniofac Res. 2023;26(3):335–44. https://doi.org/10.1111/ocr.12573.

Article  Google Scholar 

Coppelson K, Summersgill I, Hatcher D, Nguyen G, Pada H, Stewart H, et al. Does head and neck posture affect cone-beam computed tomography assessment of the upper airway? J Oral Maxillofac Surg. 2023;81(6):721–33. https://doi.org/10.1016/j.joms.2023.01.016.

Article  PubMed  Google Scholar 

Lenza MG, Lenza MMO, Dalstra M, Melsen B, Cattaneo PM. An analysis of different approaches to the assessment of upper airway morphology: a CBCT study. Orthod Craniofac Res. 2010;13(2):96–105. https://doi.org/10.1111/j.1601-6343.2010.01482.x.

Article  CAS  PubMed  Google Scholar 

Aksoz G, El H, Palomo JM. Correlation between different boundaries used in upper airway assessment. BMC Oral Health. 2025. https://doi.org/10.1186/s12903-024-05402-3.

Article  PubMed  PubMed Central  Google Scholar 

Salerno S, Gagliardo C, Vitabile S, Militello C, La Tona G, Giuffrè M, et al. Semi-automatic volumetric segmentation of the upper airways in patients with Pierre Robin sequence. Neuroradiol J. 2014. https://doi.org/10.15274/NRJ-2014-10067.

Article  PubMed  PubMed Central  Google Scholar 

Chen H, van Eijnatten M, Wolff J, de Lange J, van der Stelt PF, Lobbezoo F, et al. Reliability and accuracy of three imaging software packages used for 3D analysis of the upper airway on cone beam computed tomography images. Dentomaxillofac Radiol. 2017. https://doi.org/10.1259/dmfr.20170043.

Article  PubMed  PubMed Central  Google Scholar 

Souza KRS, Oltramari-Navarro PVP, Navarro RL, Conti ACCF, Almeida MR. Reliability of a method to conduct upper airway analysis in cone-beam computed tomography. Braz Oral Res. 2013. https://doi.org/10.1590/S1806-83242013000100009.

Article  PubMed  Google Scholar 

Alhammadi MS, Almashraqi AA, Halboub E, Almahdi S, Jali T, Atafi A, et al. Pharyngeal airway spaces in different skeletal malocclusions: a CBCT 3D assessment. Cranio. 2021. https://doi.org/10.1080/08869634.2019.1583301.

Article  PubMed  Google Scholar 

Zambon CE, Ceccheti MM, Utumi ER, Pinna FR, Machado GG, Peres MPSM, et al. Orthodontic measurements and nasal respiratory function after surgically assisted rapid maxillary expansion: an acoustic rhinometry and rhinomanometry study. Int J Oral Maxillofac Surg. 2012;41:1120–6. https://doi.org/10.1016/j.ijom.2011.12.037.

Article  CAS  PubMed  Google Scholar 

Zambon CE, Cherobin GB, Utumi ER, Machado GG, Vasconcellos FAF, Peres MPSM, et al. Computational fluid dynamics and NOSE scale to assess nasal respiratory function, and correlation with linear maxillary measurements after surgically assisted rapid maxillary expansion. Int J Oral Maxillofac Surg. 2022;xx:1–10.

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