GAP Australasian-Dentist Issue 80 Jul-Aug 19

Category 70 AustrÀlÀsiÀn Dentist DISCLAIMER The information contained in this white paper is for educational purposes only. The implementation and use of the information and recommendations contained in this white paper are at the discretion of the reader. The mention of commercial products, services, their sources, or their use in connection with the information reported herein is not to be construed as either an actual or implied endorsement of such products by the author or Sleep Architects, Inc. This white paper was developed by the author and Sleep Architects, Inc. However, the contents herein may not necessarily represent the views of Sleep Architects, Inc. EXECUTIVE SUMMARY Àecently, there has been an increased awareness and desire to understand how we sleep at night, to such extent that in 2016, Arianna Huffington published a Àew York Àimes Bestseller on the subject: The Sleep Revolution 1 . Àn fact, the global sleep apnoea devices market is expected to generate more than $6 billion in annual revenue by 2023. 2 More importantly, however, in 2014, the Centers for Disease Control and Prevention categorized insufficient sleep as “a public health epidemic.” 3 And, in October 2017, the American Dental Association adopted an 11-point policy addressing the role of the dental practitioner in identifying and treating patients that suffer from sleep-related breathing disorders. 4 With much attention on the topic of sleep and how dentistry plays a role in this arena, Cone Beam Computed Àomography (CBCÀ) manufacturers have rushed to develop software and manufacturemachines that can accurately document the condition of the upper airway and the adjunct structures. With more than 20 years in the market, CBCÀ has been found to be an invaluable tool to evaluate the maxillofacial area. Àhe more recent CBCÀ devices are low cost and produce a lower radiation dose when compared to computed tomography (CÀ). 5 Although various peer-reviewed articles have been published, showing the accuracy and reliability of upper airway analysis using CBCÀ, 6,7 the purpose of this white paper is to help the dental clinician consider the most ideal field of view when selecting what CBCÀ to purchase or what type of CBCÀ scan to order from an imaging center. Àhe ideal field of view should provide the clinician with enough data to properly identify, treat and manage patients with sleep-related breathing disorders ( BD). PROPER FIELD OF FIEW One of the various options to consider when selecting a new CBCÀ or obtaining an image from an independent imaging center is the Field of View (FOV). Àhe FOV is the area of interest that will be captured during the CBCÀ scan. When identifying, treating and managing patients that may suffer from sleep-related breathing disorders, doctors are encouraged to perform an appropriate upper airway analysis of the patient using a CBCÀ by capturing – at minimum – all of the following landmarks: Àemporomandibular joints and the entire upper airway 8 (nasal cavity, oral cavity, pharynx, and larynx). C and Sleep Disorders Proper use of Cone Beam Imaging for Upper Airway Analysis and Management of Sleep-Related Breathing Disorders n aÀ By Sal Rodas, MBA, ÀleepArchiÀx™ Fig. 1. Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". Figure 2. Patient with compromised nasal cavity; high-vaulted palate.