3-D IMAGING
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| Figure 13. In these CAT scan views, the lateral cervical view (upper right) shows the small airway caused by the posterior position of a large tongue. The lower right image is the same individual with the FBS appliance in place. |
Figure 14. These images show the increase in the size of the airway achieved with the FBS appliance. Compare the pretreatment image (upper right) with the post-treatment (lower right) image. Again, note the tongue depressing effect of the tail to depress the tongue and open the airway. |
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Figure 15. In the upper right, the superior posterior tip of the tail is touching the soft palate and can be a cause of discomfort. Also, the tail needs to be repositioned downward to better control the tongue. The lower right image shows the changes made to the appliance and the increased airway. |
The tail, which is the key to successfully treating the patient, is incrementally elongated and thickened in depth until the snoring is eradicated. The elongation of the tail with acrylic is done by adding a little length and slowly increasing the depth inferiorly, gauging clinical success by the lack of snoring. The pace of addition is based on the comfort/tolerance of the patient with each addition.
The most efficient and precise method of increasing tail size is provided by one of dental radiology’s new diagnostic tools, 3-D cone beam. 3-D imaging allows detailed viewing of appliance tail placement, tongue position, and the size of the airway. It also makes precise adjustments possible to maximize the airway opening. We can easily analyze how and where we should add acrylic to the tail to maximize the opening of the airway. We are able to observe the original restricted airway, and then to see the improved airway with use of the FBS appliance. 3-D dental imaging clearly illustrates the ability of the appliance’s tail to control the tongue and open the airway (Figures 13 to 15)