Orthotown November 2022 - 52

Fig. 13
Fig. 14
or lack thereof on the upper incisors. Our
goal is explained as upright incisors without
entrapment of the lower lip. If necessary,
an on-the-fly Wits evaluation is performed
easily, drawing a line through the occlusal
plane and dropping and raising lines from
A and B point to this creation. Once again,
the Angle Classification of the molars is
highlighted.
The CBCT software is opened for
evaluation and it is explained that this
low-dose new technology is replacing the
impressions and casts of years ago.
The first section screen (Fig. 13) is
Fig. 15
utilized to view the airway, noting tongue
position and evaluating lip to upper incisors.
If the cross-section airway is found to be
smaller than 50 square millimeters, more
questions regarding sleep, snoring and
behavior are made, along with a referral
to medical specialists if necessary. Many
times, patients that have been identified as
having a degree of tongue tie are found to
have the dorsal surface of the tongue not in
contact with the palate, a finding I believe
contributes to a narrow palate.
The TMJ tab in the software (Fig. 14)
Fig. 16
is used to identify gross abnormalities and
assess the symmetrical positioning of the
condyles in the fossa, while the Volume tab
(Fig. 15), used to assess crowding, impaction
and relative jaw relationships, gets the most
reaction from the parents and children.
Lastly, the section screen (Fig. 16) is
again used to measure the distance between
palatal surfaces of the first upper molars. It
is also in this tab that cross-sections of the
nasal cavity are viewed to ascertain the size
and shape of the turbinates, nasal septum,
etc. This last finding and measurement is
the key to proceeding with early treatment
or medical referrals involving expansion,
52 NOVEMBER 2022 // orthotown.com
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Orthotown November 2022

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