Download Dr. PAVITHRA. US MDS

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.
NAME OF THE CANDIDATE
AND ADDRESS
(IN BLOCK LETTERS)
DR.BRIJESH.S
POST GRADUATE STUDENT
DEPARTMENT OF ORTHODONTICS
AND DENTOFACIAL ORTHOPAEDICS
SRI HASANAMBA
DENTAL COLLEGE
AND HOSPITAL, HASSAN-573201
2.
NAME OF THE INSTITUTION
SRI HASANAMBA DENTAL COLLEGE
AND HOSPITAL, HASSAN-573201
3.
COURSE OF STUDY AND
MASTER OF DENTAL SURGERY IN
SUBJECT
ORTHODONTICS AND DENTOFACIAL
ORTHOPAEDICS
4.
DATE OF ADMISSION TO
15/04/2011
COURSE
5.
TITLE OF THE TOPIC
“EVALUATION OF SKELETAL, DENTAL
AND SOFT TISSUE PARAMETERS IN
PATIENTS HAVING
HYPODIVERGENT
AND HYPERDIVERGENT JAWS WITH
CLASS I
AND
CLASS
II SKELETAL
PATTERN- A CEPHALOMETRIC STUDY”
6.
BRIEF RESUME OF THE INTENDED WORK:
6.1 Need for the study:
Facial growth and development is always a concern for the clinicians, as the
amount and direction of growth significantly alters the nature of orthodontic
biomechanics. The treatment plan for hypodivergent and hyperdivergent skeletal
differs from each other1.
Soft tissue response to orthodontic tooth movement has been investigated under
various conditions and it is difficult to evaluate effects of growth and treatment on
the facial profile. There has been recent speculation in the literature that changes in
mandibular position with increase or decrease in the anterior facial heights may
have an effect on soft tissue profile2.
Many authors have investigated the different skeletal parameters in
hypodivergent and hyperdivergent growth patterns, but no study has been
conducted so far to evaluate the dental and soft tissue parameters of the same. Very
few studies have been mentioned in the literature regarding it’s correlation with
Class I and Class II malocclusions. Hence the objective of this study is to evaluate
the skeletal, dental and soft tissue parameters in patients having hypodivergent and
hyperdivergent jaws with Class I and Class II skeletal pattern.
6.2 Review of Literature :
1. A cephalometric study was conducted with 110 subjects to evaluate
mandibular morphology in different facial types.The sample was divided
into normodivergent, hypodivergent and hyperdivergent subgroups and
various parameters were evaluated. The authors came to the conclusion that
the mandible with the vertical growth pattern was associated with a
symphysis with large height, small depth, small angle, decreased ramus
height and width, smaller mandibular depth, increased gonial angle, and
decreased mandibular arc angle in contrast to mandible with a horizontal
growth pattern. Sexual dichotomy was found with mean symphysis height
and depth in the female sample being smaller than in the male sample, but
symphysis ratio was larger in the female sample; males having greater
ramus height, width and mandibular depth than females. The mandible
seemed to have retained its infantile characteristics with all its processes
underdeveloped in hyperdivergent group.1
2. The author conducted a cephalometric study to evaluate relationships
between soft tissue profile changes, changes in mandibular position and
changes in anterior dental area using 39 non growing subjects with steep
mandibular plane
angle. He
concluded that there was a significant
correlation of 5% between a change in soft tissue profile & upper incisor
tooth movement, a 1 % correlation between changes in soft tissue profile
and changes in total facial height, lower facial height & upper incisor
retraction and no correlation between magnitude of mandibular plane angle
changes and amount of anterior tooth movement.2
3. A study was conducted to evaluate the relationship between vertical and
anterio-posterior growth as related to function and treatment. It was found
that anterio-posterior angles were indicators of vertical height. When the
angles were too high there is more chance for anterior open bite. It was
concluded that vertical dimension was most important dimension to a
clinical orthodontist for planning the treatment and that vertical dysplasia.3
4. The authors conducted a study to assess skeletal factors associated with
development of vertical facial disproportions. The progressive reduction of
angles in skeletal open bite reduced or maintained the magnitude of
imbalance, while the reduction of angles accentuated the skeletal deep bite
with age. The inclination of the palatal plane and its constancy suggested the
downward and backward rotation of the mandible in open bite subjects is
precommitted in response to dentoalveolar compensatory changes with
center of rotation at molars.4
5. A study was conducted to evaluate the longitudinal changes in adult
craniofacial complex were studied in an age group between 18-42 years
and who had class I or end-end molar relation and with no excessive
protusion. Authors came to conclusion that in males there was an `increase
in nose dimensions and soft tissue thickness of pogonion and that the
profile became more straight with age. In females there was an increase of
nose dimension but no straightening of profile, the lower lip slightly
thickened with age at labrale inferious. There was good correlation between
sagittal growth in maxilla in both males and female.5
6.3 Objectives of the study :
 Evaluation of skeletal, dental and soft tissue parameters with hypodivergent
jaws in class I and class II skeletal patterns.
 Evaluation of skeletal, dental and soft tissue parameters with hyperdivergent
jaws in class I and class II skeletal patterns.
MATERIALS AND METHODS:
7.1 Source of Data: The materials for this study will be collected from case
records of 80 patients available in the Department of Orthodontics and Dentofacial
Orthopaedics at Sri Hasanamba Dental College and Hospital, Hassan.
MATERIALS:
1. Lateral cephalogram
2. Digital vernier caliper
3. Tracing table
4.
0.3mm lead pencil
5. Set squares
INCLUSION CRITERIA:
1. Patients case record from dept of orthodontics
2. Patients with age between 18-27yrs
3. Patients with Class I & Class II skeletal pattern
4. Patient with intact teeth (OPG/Study models).
5. No history of previous orthodontic treatment (Case records).
EXCLUSION CRITERIA:
1. Incomplete case record
2. Previous Orthodontic treatment
3. Patients with facial asymmetry
4. Presence of any systemic disease
5. Presence of craniofacial disorders
7.2 Method :
Lateral cephalometric radiograph of 80 patients (40males and 40females) fulfilling
the inclusion criteria will be selected
from the case records available in the
Department of Orthodontics and Dentofacial Orthopaedics, Sri Hasanamba Dental
College, Hassan.
The sample will be divided into four groups –

Group A:-Class I skeletal with hypodivergent pattern- 20subjects (10males
and 10females).

Group B:-Class I skeletal with hyperdivergent pattern- 20subjects (10males
and 10females).

Group C:-Class II skeletal with hypodivergent pattern -20subjects (10males
and 10females).

Group D:-Class II skeletal with hyperdivergent pattern-20subjects (10males
and 10females).
Samples with mandibular plane angle (SN-Go-GN) less than 28° will be taken as
hypodivergent and those with mandibular plane angle (SN-Go-GN) greater than 32°
will be taken as hyperdivergent facial skeletal pattern. Samples with ANB of 1-2°
will be taken as skeletal Class I and samples with ANB greater than 2° will be taken
as skeletal Class II. All the cephalometric tracings will be done by a single
examiner.
The following 27 Skeletal,6 dental and 3 soft tissue parameters will be measured.
-
Skeletal parameters

Lower facial height(ANS & Me)

Anterior facial height (N & Me)

Posterior facial height (S &Go)

Posterior-anterior.Face height ratio(S-Go & N-Me)

Ramus height;( distance b/w Ar &Go)

Ramus width ;(distance b\w anterior and posterior border of ramus at
height of occlusal plane)

Mandibular depth ;(distance between Ar and Pog)

Antegonial notch depth

Frankfort Mandibular plane angle(:angle formed b/w FH-Go-Me)

Symphysis angle .(Posterior superior angle formed by the line through
Me & Point B and Mandibular Plane)

Gonial angle (angle formed by pt Ar,Go & Me at Go)

Upper gonial angle (angle formed by pt Ar,Go & N at Go)

Lower gonial angle(angle formed by pt N,Go & Me at Go)

Mandibular arc angle(:Postero superior angle formed by points Dc,Xi
pm at Xi)

Saddle angle

Articular angle

Sum of the posterior angles

Angle of inclination

Pn to Mandibular plane

Basal plane angle

Upper Basal plane angle

Lower Basal plane angle

Y-axis

SNA

SNB

ANB

Beta angle
Dental Parameters

1 to SNplane

1 to Mandibular plane

Upper 6 to NF

Lower 6 to MP

Upper 1 to NF

Lower 1 to MP
Soft tissue Parameters

Upper lip length

Nasolabial angle

Soft tissue thickness of chin
.
STATISTICAL ANALYSIS :

An analysis of variance (ANOVA) followed by Tucky’s post Hoc test or
Bonferroni will be applied to evaluate the males and females in different subgroups.

t-test will be used for intergroup comparison.
7.3 Does the study require any investigation to be conducted on patient (or)
Other human (or) animals? If so please describe briefly.
No,
Previously recorded cephalometric radiograph will be utilized for the study .
7.4 Has ethical clearance been obtained from your institution in case of 7.1?
Yes
List of References:
1. Mangla R, Singh N, Dua V, Padmanabhan P, Khanna M. Evaluation of
mandibular morphology in different facial types. Contemp Clin Dent 2011;
2:200-6.
2. Pike JP. A Cephalometric investigation of facial profile changes in high
angle non growing case. Angle Orthod 1975; 45:15-124.
3. Schudy FF. Vertical growth versus anteroposterior growth as related to
function and treatment. Angle Orthod 1964; 34:75-93.
4. Nanda SK. Growth patterns in subjects with long and short faces. Am J
Orthod Dentofacial Orthop 1990; 98:247-58.
5.
Formby WA, Nanda RS, Currier GF. Longitudinal changes in the adult
facial profile. Am J Orthod Dentofacial Orthop 1994; 105:464-76.
6. Aki T, Nanda RS, Currier GF and Nanda SK. Assessment of symphysis
morphology as a predictor of the direction of mandibular growth. Am J
Orthod Dentofacial Orthop 1994; 106:60-69.
SIGNATURE OF THE CANDIDATE
(Dr. BRIJESH.S)
REMARKS OF THE GUIDE
NAME & DESIGNATION OF
(IN BLOCK LETTERS)
11.1 GUIDE
Dr. AJITH R.GOWDA M.D.S,
M. Orth RCS(Edin.)
ASSOCIATE PROFESSOR
DEPARTMENT OF ORTHODONTICS AND
DENTOFACIAL ORTHOPAEDICS,
SHDCH, HASSAN – 573201.
11.2 SIGNATURE
.
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE DEPARTMENT
.
Dr. PAVITHRA. U.S M.D.S.,
PROFESSOR AND HOD
DEPARTMENT OF ORTHODONTICS AND
DENTOFACIAL ORTHOPAEDICS,
SHDCH, HASSAN – 573201.
11.6 SIGNATURE
12.1 REMARKS OF THE CHAIRMAN &
.
THE PRINCIPAL
12. 2 SIGNATURE
Dr. S. RAVINDRA M.D.S.
PRINCIPAL and HEAD
DEPT OF PERIODONTICS,
SRI HASANAMBA DENTAL COLLEGE
AND HOSPITAL,
HASSAN – 573201.