CBCT Before and After Cranial and SOT Treatment

Before & After CBCT: Resolving Headaches, Jaw Pain and Neck Issues

After about seven visits, our patient's headaches, jaw pain and neck issues had resolved, and her follow-up 3D scan showed why her jaw joints finally had room to breathe. In this post we walk through her before and after CBCT (cone beam CT) images side by side.

Where she started

She came to us with a familiar cluster of symptoms: recurring headaches, pain in her jaw joints and ongoing neck tension. These problems often travel together. The jaw joints (TMJs) sit just in front of the ears, share muscles and nerves with the head and upper neck, and depend on how the skull and jaw are positioned relative to each other.

Her first CBCT scan gave us a 3D picture of that relationship before we began care. The second scan, taken after treatment, let us measure exactly what changed.

How a CBCT superimposition works

A superimposition lays the "after" scan directly on top of the "before" scan so any movement shows up in millimeters. Both scans are lined up on structures that should not change, in this case the cranial base and upper jaw. Her registration was stable to within 0–0.5 mm, so the differences we see in the lower jaw are real changes rather than a difference in how the scans were taken.

In the 3D models, white is the original position and blue is the new one. On the color map, blue means little change and yellow to red means up to about 4 mm of movement.

Before vs. after: what changed

The biggest change was in her jaw joints: the space above each condyle (the ball of the jaw joint) more than doubled, and her lower jaw settled down and forward. The rest of the scan shows the same story from different angles.

Measurement	Before	After
Superior joint space, right TMJ	1.43 mm	3.63 mm
Superior joint space, left TMJ	1.20 mm	3.73 mm
Narrowest joint space, right / left	0.94 / 0.88 mm	2.83 / 3.14 mm
Condyle position	Pushed up and back (posterosuperior)	Decompressed
Lower jaw position	Normal	Down and forward (1–2 mm body, 4 mm at the chin)
Lower facial height	Below normal	Increased
Airway volume	25.1 cc	32.8 cc (+31%)
Narrowest airway cross-section	305.8 mm²	354.6 mm² (+16%)
Atlanto-occipital space, right / left	2.82 / 3.07 mm	2.97 / 2.96 mm
Skeletal class	Class I, Class II tendency	Class I

The jaw joints

Before care, both condyles were seated up and back in their sockets, leaving well under 1 mm of space at the tightest point. That kind of compression is commonly associated with joint pain, clicking and muscle guarding. After care, the joint spaces measured roughly 3–4 mm on both sides, and the condyles sat in a decompressed position.

The lower jaw

The superimposition shows the whole mandible moving slightly down and forward, about 1–2 mm through the body of the jaw and about 4 mm at the chin. The color map is mostly blue through the joints and jaw angles, with the warmer colors concentrated at the front teeth and chin, where the movement is largest. Her skeletal pattern also moved from a Class II tendency to a solid Class I.

The airway

With the jaw forward, her airway space appears to open up. Total airway volume rose from 25.1 cc to 32.8 cc, and the narrowest point grew by 16%. Her airway went from narrowed to within the normal range. This has to be taken with a grain of salt since airway cannot be properly assessed via CBCT.

The upper neck

The space between the skull and the first vertebra (atlanto-occipital space) became nearly even side to side, from 2.82 / 3.07 mm to 2.97 / 2.96 mm. A more balanced upper neck fits with the relief she reported in her neck tension.

How we treated her

We saw her about seven times, combining four approaches that work on the skull, spine and jaw together:

•      Cranial therapy — gentle, hands-on work to improve motion and balance between the bones of the skull, which form the sockets the jaw joints sit in.

•      Sacro Occipital Technique (SOT) — a chiropractic system that addresses the relationship between the pelvis, spine and skull, supporting the neck and head as a single unit.

•      Vector Point — targeted adjustments to specific points to guide the cranium and jaw toward better alignment.

•      Cranial orthotic — a custom oral appliance that holds the jaw in its new, decompressed position so the joints and muscles can adapt between visits. It also acts to maintain the maxilla in a level position.

The hands-on work helped the skull and neck reorganize, and the orthotic maintained the cranial alignment and provided the jaw a stable place to land.

The result, and what comes next

Her headaches, jaw pain and neck issues all resolved over the course of care. Her scans now show decompressed jaw joints, a more forward jaw position and a more open airway.

There is one more step. Her jaw has a new home and her maxilla is more level, but her teeth were shaped to fit the old position. The scan shows this clearly: her upper front teeth are tipped back (U1-SN 86.49° / 84.61° against a norm of about 110°), and her bite plane is now steeper (7.42° before, 10.04° after). Right now the orthotic holds the jaw in place.

Her next step is working with her orthodontist to bring her bite up to meet her new cranial and jaw position. The goal is for her teeth to support the decompressed joints on their own, so the result holds long-term without depending on the appliance. Her before and after CBCT data gives her orthodontist a clear, measured target to work toward.

Living with headaches, jaw pain or neck tension?

If these symptoms sound familiar, the cause may be in how your skull, jaw and neck fit together. A CBCT scan lets us see that relationship in 3D and measure what changes with care. Contact our office to schedule a consultation.