Download the oxford dental college - Rajiv Gandhi University of Health Sciences

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1.
NAME OF THE CANDIDATE AND
ADDRESS:
DR.DINESH G
POST GRADUATE STUDENT,
DEPARTMENT OF ORAL AND
MAXILLOFACIAL SURGERY,
THE OXFORD DENTAL COLLEGE
HOSPITAL & RESEARCH CENTER,
BANGALORE- 560068
THE OXFORD DENTAL COLLEGE
HOSPITAL & RESEARCH CENTER,
BANGALORE - 560068
2.
NAME OF THE INSTITUTION:
3.
COURSE OF THE STUDY AND
SUBJECT:
MASTER OF DENTAL SURGERY IN
ORAL AND MAXILLOFACIAL
SURGERY
4.
DATE OF ADMISSION TO COURSE:
10. 06. 2013
5.
TITLE OF THE TOPIC:
COMPARISON OF 3 DIMENSIONAL AIRWAY VOLUME IN CLASS I PATIENTS,
CLASS II AND CLASS III SKELETAL DEFORMITIES.
6.
BRIEF RESUME OF INTENDED WORK
6.1. NEED FOR THE STUDY: To compare three dimensional Oropharyngeal and Nasal passage volumes of
patients with normal naso-respiratory functions having Class I , and Class II, Class III skeletal
deformities , and The correlations between different variables and the airway
6.2. REVIEW OF LITERATURE:A study had been conducted to evaluate the nasal passage and oropharyngeal
volumes of patient with different dentofacial skeleton patterns. The study sample consist of
140 patients(70boys & 70 girls),divided into 3 groups as Class I (1≤ANB≤3), Class II
(ANB>3) ,and further divided them into 4 groups as SNA≥80°, SNA<80°, SNB≥78° ,
SNB<78° to evaluate how the positional changes in the maxilla and the mandible affect the
oropharyngeal and nasopharyngeal variables. The study concluded that the oropharyngeal
airway volumes of Class II patients were smaller when compared with Class I and Class III ,
and also mandibular position with respect to cranial base had an effect on the oropharyngeal
airway volume.
A study had been conducted on 91 patients to assess nasopharyngeal soft-tissue
patterns in patients with ideal occlusion. Lateral cephalograms were digitized, and linear and
area measures were made to define the airway pattern. The study concluded that nasal fossa,
cranial base, and adenoid tissue are larger in men than women. Cranial-base length is
statistically related to different variables that define the airway, mainly nasal fossa length and
lower airway thickness. Nasal fossa length is also statistically related to upper airway
thickness.
A study had been conducted to evaluate relationship of the functional oropharynx to
craniofacial morphology in 70 subjects(31 males & 39 females) at age of 10-13yrs to
investigate association between functional oropharyngeal airway and craniofacial morphology
using 16 craniofacial variables taken from lateral cephalometric radiographs. The study
concluded that oropharyngeal airway size was positively correlated with (1) the length of the
mandible, (2) the distance between the third cervical vertebra and the hyoid bone , and (3) the
cranial base angle.
A study had been conducted on upper and lower pharyngeal airways in subjects with
Class I and Class II malocclusions and different growth patterns. His study comprise of 80
subjects divided into 2 groups: 40 Class I and 40 Class II, subdivided according to growth
pattern into normal and vertical growers to assess the upper and lower pharyngeal airways.
The study concluded that subjects with Class I and Class II malocclusions and vertical growth
patterns have significantly narrower upper pharyngeal airways than those with Class I and
Class II malocclusions and normal growth patterns.
A study had been conducted to evaluate human airway using cone-beam
computerized tomography in 10 patients to define and measure human airway space with
radiographic volumetric 3 dimensional imaging and digital reconstruction of pharynx using
cone beam computerized tomography. The study concluded that 8 of the 10 subjects
demonstrated a region of maximum constriction near the oropharynx level. The most restricted
cross-sectional area varied from 90mm² to 360mm².
6.3. OBJECTIVES OF THE STUDY: To evaluate the airway volume for different dentofacial skeletal patterns.
 To compare Nasopharyngeal airway and Oropharyngeal airway in classI patients ,
classII and class III skeletal deformities respectively.
 The cross-sectional area at palatal plane (ANS-PNS) extending to the posterior wall of
the pharynx.(pp)
 The cross-sectional area at plane parallel to palatal plane that passes from the most
anterioinferior point of second cervical vertebrae.(2cv)
 The cross-sectional area at the last slice before the nasal septum fused with the
posterior wall of the pharynx.(uNP)
7
MATERIAL & METHODS:
7.1. SOURCE OF DATA:The patients who report to The Oxford Dental College & Hospital, Bangalore with different
dentofacial skeletal pattern.
7.2. METHOD OF COLLECTION OF DATA:Cone Beam Computerized Tomographic images of the patients.
INCLUSION CRITERIA : Patients with Class I , Class II and Class III dentofacial skeletal pattern.
EXCLUSION CRITERIA : Transverse deficiencies
 Severe hypodivergent growth pattern
 Severe hyperdivergent growth pattern
 Obese subjects according to their bodymassindex (BMI)
 Congenital craniofacial deformities,pharyngeal pathology,nasal obstruction , history of
adenoidectomy and scans showing incomplete imaging of airway.
EQUIPMENTS TO BE USED :
Cone beam computerized tomographic imaging.(KODAK 9300C)
PROCEDURE:The study includes 30 patients between the age group of 20 – 35yrs both male and
female. After obtaining informed consent from patient,they will be divided into 3 groups,each
group containing 10 patients of class I(1≤ANB≤3) ,class II(ANB >3) and class III (ANB<1)
respectively.
All the patients will be advised cone beam computerized tomographic imaging of
Nasopharyngeal airway and oropharyngeal airway and then compare the values between
Class I, Class II, and Class III patients.
The volume of the pharynx between palatal plane (ANS-PNS) extending to the posterior
wall of the pharynx(pp) and the plane parallel to palatal plane that passes from the most
anterioinferior point of second cervical vertebrae(2cv) is taken as Oropharyngeal volume. The
inferior limit of the Nasopharyngeal airway was the superior limit of the Oropharyngeal
airway and the superior limit was the last slice before the nasal septum fused with the
posterior wall of the pharynx(uNP).
Using CS3D imaging software version 3.2.9 the three dimensional airway volume of
Nasopharynx and Oropharynx are calculated.
7.3. DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS
TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR OTHER
ANIMALS?
YES, Cone beam computerised tomograph on patients
7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION
IN CASE OF 7.3?
YES
8.
LIST OF REFERNCES:
1.
Haken El, Juan Martin Palomo. Airway volume for different-dentofacial skeletal
patterns. American Journal of Orthodontics and Dentofacial Orthopedics
2011;139(6):e511-e521
9.
10.
11.
2.
Oscar Martin, Leonor Muelas, M Jose Vinas. Nasopharyngeal cephalometric study
of ideal occlusions. American Journal of Orthodontics and Dentofacial Orthopedics
2006;130(4):436.e1-436.e9
3.
Michael J Trenouth, Donald J Timms. Relationship of the functional oropharynx to
cranial morphology. The Angle Orthodontist 1999;69(5):419-423
4.
Marcos Roberto De Freitas, Nadyr Maria Penteado Virmond Alcazar, Guitherme
Janson, Karina Maria Salvatore de Freitas, Jose Fernando Castanha Henriques.
American Journal of Orthodontics and Dentofacial Orthopedics 2006;130(6):742-745
5.
Hung Hsiag Tso, BS, Janice S Lee,John C Huang, Koutaro Maki, David Hatcher ,
Arthur J Miller. Evaluation of the human airway using cone-beam computerized
tomography.Oralsurgery Oralmedicine Oral Pathology Oral radiology and
Endodontology nov 2009;108(5):768-776
SIGNATURE OF THE CANDIDATE:
REMARKS OF THE GUIDE:
NAME AND DESIGNATION OF
11.1. GUIDE:
11.2. SIGNATURE:
DR. RAMDAS BALAKRISHNA,
PROFESSOR,
DEPARTMENT OF ORAL AND
MAXILLOFACIAL SURGERY,
THE OXFORD DENTAL COLLEGE
HOSPITAL & RESEARCH CENTER,
BANGALORE- 560068.
11.3. CO-GUIDE:
11.4. SIGNATURE:
11.5.HEAD OF THE DEPARTMENT:
11.6. SIGNATURE:
12.
12.1.REMARKS OF THE CHAIRMAN
AND PRINCIPAL:
12.2. SIGNATURE:
DR. JAYAPRASAD N. SHETTY,
HEAD OF THE DEPARTMENT,
DEPARTMENT OF ORAL AND
MAXILLOFACIAL SURGERY,
THE OXFORD DENTAL COLLEGE
HOSPITAL & RESEARCH CENTER,
BANGALORE- 560068.