# Ten Years of Cone-Beam CT Airway Studies on Their Relationship with Different Anteroposterior Skeletal Patterns: A Systematic Review

## TL;DR

This review finds that no high-quality studies have confirmed a clear link between skeletal patterns and upper airway shape using CBCT, due to inconsistent methods.

## Contribution

The paper systematically reviews ten years of CBCT airway studies to assess their methodological quality and evidence for skeletal pattern correlations.

## Key findings

- Nine studies were analyzed, but none were of high methodological quality.
- Results were inconsistent, showing no strong evidence of a direct correlation between skeletal patterns and airway morphology.
- Inconsistent CBCT protocols were identified as a major limitation.

## Abstract

Objectives: Given the widespread adoption of CBCT in clinical and research activity, it seems reasonable to critically evaluate the evidence produced on the investigations over the relationship between upper airway morphology and skeletal malocclusions patterns. Methods: The analysis method and inclusion criteria were pre-specified and documented in a protocol to minimize the risk of post hoc selective bias. A methodological quality grading system was used to identify the most valuable studies. Results: The nine selected articles, published between 2009 and 2020, involved subjects recruited from existing databases. The average methodological quality grading assessment score was 18.6 (range: minimum 16, maximum 23). Methodological quality scores ranged from 36.1% to 63.8% of the maximum possible score, with an average quality score of 51.1%. No high-quality studies were found in the sample. Conclusions: This systematic review revealed that no high-quality studies have compared upper airway morphology with skeletal patterns using cone-beam computed tomography. The heterogeneity of the results did not confirm strong evidence of a direct correlation between skeletal patterns and upper airway morphology. This appears to be due to a lack of consistency in CBCT protocols.