Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA ANNEXURE II PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION 1. Name of the candidate Dr .Abdul Kareem Address Post Graduate Student, Department of Orthodontics and Dentofacial Orthopedics, KLE Society’s Institute Of Dental Sciences, # 20,Yeshwantpur Suburb, Tumkur Road , Bangalore -22 2. Name of the institution KLE Society’s Institute of Dental Sciences Bangalore -22 3. Course of the study and subject Master of Dental Surgery in Orthodontics and Dentofacial Orthopedics. 4. Date of admission of course 5. Title of the topic: 20th April 2009 Dental Arch Width And Vertical Facial Morphology Correlation –A Cephalometric and Study Model Analysis in Untreated Adults. 1 6 BRIEF RESUME OF INTENDED WORK 6.1 NEED FOR THE STUDY Each individual is a different person in this world, no one is similar with the other in any way, and so is the case with facial morphology. Facial morphology is influenced by various factors like genetic, racial, ethnic geographical etc. But each type of face has a proportion of its own, intern the facial morphology is closely related to the size and shape of the dental arches. Hence in orthodontics for proper diagnosis and treatment planning it is necessary to know the facial morphology of each patient which intern can influence the treatment plan. There is a proportion between each dimension of the face , as the long face individual has narrower transverse dimensions (dolichofacial) and a short face individual has wider transverse dimensions (brachyfacial).1 In daily clinical practice, preformed arch wires are routinely used by many orthodontists. So there is a need to correlate different arch width with vertical facial morphology. The relationship of the Dental arch width and the vertical facial morphology in male and female subjects will help in using better treatment mechanics for stable treatment results 2. The purpose of the present study is to correlate the dental arch widths and vertical facial morphology as determined by the percentage of posterior facial height(S- Go) to anterior facial height (Na-Me)3 and to examine the differences in dental arch widths and vertical facial morphology between male and female untreated adults. 2 6.2 REVIEW OF LITERATURE: 1. Wei SH 4 conducted a study in 1970 to obtain a data of variations in craniofacial dimensions in Chinese population; he used posteroanterior cephalograms of Chinese adults and noted gender differences in maxillary and mandibular intercanine widths. 2. Isaacson J R, Isaacson R J, Speidel T M, Worms F W 5 in 1971 conducted a study to know the extreme variations in vertical facial growth and associated variation in skeletal and dental variations. They reported that subjects with longer faces presented with a decrease in maxillary intermolar width. However, they did not distinguish between males and females. 3. Nasby J A , Isaacson R J , Worms F W , Speidel T M 6 in 1972 conducted a study to evaluate the relationship between facial skeletal patterns and dental occlusion. They reported that the mean maxillary and mandibular arch circumference and mandibular intermolar width were greater in subjects with low MP – SN angles when compared with those with high MP – SN angles. In their study, the subjects were adolescents without discussion of gender and ethnicity. 4. Schendel SA, Eisenfeld J, Bell WH, Epker BN, Mishelevich DJ 7 in 1976 they studied 31 patients with long face syndrome .On the basis of the clinical summary ofs this syndrome, an analysis of esthetics, skeletal morphology, and occlusion was undertaken. They concluded that the basic dentofacial deformity is associated with excessive vertical growth of the maxilla. Dental open and closed bite are two variants of the syndrome. An increased mandibular ramus height is associated with the closed-bite group. 5. Christie T E 8 in 1977 evaluated orthodontic records of 82 white adults (43 women, 39 men) with normal untreated occlusions and found that short-face men had greater maxillary and mandibular widths than normal men. However, no differences in width were found between short-face and normal women. They did not provide data on long-face subjects because the sample size was too small (only 4). 3 6. Tsunori M , Mashita M , Kasai K 9 in 1998 reported that, when compared with average and long-face persons, short-face subjects had larger intermolar widths and greater buccal cortical bone thicknesses in the molar area of the mandible. They suggested a possible link between the development of the maxillofacial complex in the vertical and transverse dimensions and measures of increased muscularity. 7. Eröz UB, Ceylan I, Aydemir S 10 in 2000 has done a study to investigate the mandibular morphology in different vertical facial growth patterns. Mandibular morphology was investigated on lateral cephalometric head films and dental casts of 60 subjects (30 females and 30 males) who had different vertical facial growth patterns. The sample had a mean age of 13.5 years, with a range of 11 to 15.5 years. The subjects were divided into three groups with regard to vertical facial growth by using the SN/GoGn angle to define low-angle, normal, and high-angle groups. In addition, each group was divided into two subgroups according to sex. The effects of the SN/GoGn angle and gender on mandibular morphology were investigated by means of analysis of variances. Than Go, IMPA, SL, and EL measurements were found to be related to SN/GoGn, and the measurements of Go-Gn, Symphysis depth, and Intermolar width to be related to sex. 8. Chun-Hsi Chung, Wallace W. Wong 11 in 2002 conducted a longitudinal study to investigate the craniofacial growth in untreated skeletal class II subjects. They concluded that the low-angle group displayed significantly more facial flattening and more mandibular forward rotation than did the high-angle group. Moreover, the mandibular incisors became more retroclined in the low-angle group and more proclined in the high-angle group with age. Comparisons between males and females showed similar skeletal growth patterns in angular measurements. However, a significant sex difference was noted in some linear measurements. 4 9. Chung CH, Mongiovi VD12, conducted a longitudinal study in 2003 to investigate the craniofacial growth in untreated skeletal class I subjects with low, average, and high MP_SN angles. Results showed that, for boys and girls at age 9, the low-angle groups exhibited significantly larger SNA angle, SNB angle, facial taper, PFH, PFH:AFH, and ramus height, and the high-angle groups showed significantly larger ANS-Me and gonial angle. From ages 9 to 18, all the male and female low-, average-, and high-angle groups showed an increase in SNA and SNB angles, and PFH: AFH, and a decrease in ANB angle, convexity (more flattened face), MP-SN angle, and gonial angle (mandibular forward rotation). The dental measurements showed few changes with growth in all groups. In terms of skeletal measurements from ages 9 to 18, similar growth changes were found between the sexes in most angular measurements, but males had larger values in linear measurements than females. 10. Dawn M. Wagnera and Chun-Hsi Chung13 in 2005 conducted a study on 81 untreated white girls with low, average and high MP-SN angels to investigate the maxillary and mandibular transverse growth longitudinally from ages 6 to 8 years. For each subject, longitudinal posteroanterior cephalograms at different ages (from ages 6 to 18) were traced, and the widths of maxilla and mandible were measured. They concluded that the vertical facial patterns (with low or high mandibular plane angles) might play a strong role in the transverse growth of the maxilla and the mandible. 5 11. C. Matthew Forster, Elaine Sunga and Chun-Hsi Chung2 in 2008 conducted a study to know the relationship between dental arch width and vertical facial morphology in untreated adults. Lateral cephalograms and dental casts were obtained from 185 untreated Caucasians (92 males, 93 females) between 18 and 68 years of age with no crossbite, minimal crowding, and spacing. MPSN angle is measured.Dental casts were used to obtain comprehensive dental measurements including maxillary and mandibular intercanine, interpremolar, and intermolar widths, as well as the amount of crowding or spacing.. Regression analysis was used to determine the statistical significance of the relationships between MP – SN angle and dental arch width and crowding or spacing. The results showed that male arch widths were significantly larger than those of females. For both males and females, there was a trend that as MP – SN angle increased, arch width decreased. It was concluded that dental arch width is associated with gender and facial vertical morphology. Thus, using individualized archwires according to each patient’s pre-treatment arch form and width is suggested during orthodontic treatment. 6.3 AIMS AND OBJECTIVES OF THE STUDY: The objectives of this study is to 1. Correlate between dental arch width and the vertical facial pattern. 2. Evaluate the differences in dental arch widths and vertical facial morphology between male and female untreated adults 6 7 MATERIALS AND METHODS 7.1 Source of data: Data will be collected from the patients reported to Department of Orthodontics and Dentofacial Orthopedics, K.L.E society’s Institute of Dental Sciences Bangalore. Venue: This study will be conducted in Department of Orthodontics and Dentofacial Orthopedic, KLE society’s institute of dental sciences Bangalore. 7.2 Method of collection of data: Type of study - Descriptive study Sample size - 100 Age Group - 18-25 Sampling Method - Sample will be Randomly selected ,and for descriptive purposes, the subjects will be classified into three different groups according to percentage Facial height ratio3: 1. hypo divergent 64-80% 2. neutral 59-63% 3. Hyper divergent 54-58%. INCLUSION CRITERIA 2 Full dentition with / or without third molars. Dentition with good periodontal health. No history of previous orthodontic treatment EXCLUSION CRITERIA 2 Previous orthodontic treatment. Edentulous spaces. History of trauma. Significant cuspal wear. Extensive restorations or prosthetics Anterior and posterior cross bites Severe crowding or spacing. 7 MATERIALS: Pre-treatment lateral cephalogram . Pre-treatment Maxillary and mandibular dental casts. MEASUREMENTS: For each subject following cephalometric and study cast measurement will be done . CEPHALOMETRIC MEASURMENTS 1. Anterior facial height (AFH ) measured from Nasion to Menton (N-Me) 3 2. Posterior facial height ( PFH ) measured from Sella to Gonion(S-Go)3 3. Ramus height is measured from Condylion to Gonion (Go-Co)5 4. Palatal height is a perpendicular measurement from occlusion plane through the mesial cusp of maxillary molor to inferior cortex of the palate (Op-Pp)5. 5. Facial height ratio (PFH/AFH) 3 6. Ratio of Ramus height to palatal height. DENTAL CAST MEASUREMENTS Will be performed using a digital caliper accurate to 0.01mm. The following maxillary and mandibular dimensions will be measured 1. Intercanine width (cusp tip and widest labial aspect)2. 2. First and second interpremolar widths (buccal cusp tip and widest buccal aspect)2. 3. First intermolar widths (mesiobuccal cusp, central fossa, widest buccal, and narrowest lingual aspect)2. 8 STATISTICAL TESTS THAT WILL BE USED Descriptive statics, including mean and SD, will calculated for all measurements. A student’s two tailed t test will be use to determine if the differences in male and female groups are significant. Regression analyses will be used to determine the percentage to which Facial height ratio variation will be predicted by dental arch width in male and females separately. 7.3 Dose the study require any investigation or interventions to be conducted on Patients or other humans or animals? If so please describe briefly No 7.4 Has ethical clearance be obtained from your institution in case of 7.3? Not applicable 9 LIST OF REFERENCES 1. Ricketts R M , Roth R H , Chaconas S J , Schulhof R J , Engel G A 1982 Orthodontic diagnosis and planning . Rocky Mountain Data Systems , Denver 2. Foster C.M, Sunga E Chung CH :Relationship between dental arch width and vertical facial morphology in untreated adults. Eur J Orthod 30 (2008) 288–294. 3. Siriwat PP, Jarabak JR 1985; maloclussion and facial morphology is there a relationship? Angle Orthod 55: 127-138 4. Wei S H 1970 Craniofacial width dimensions. Angle Orthod 40 : 141 – 147 5. Isaacson J R , Isaacson R J , Speidel T M , Worms F W 1971 Extreme variation in vertical facial growth and associated variation in skeletal And dental variations. Angle Orthod 41 : 219 – 230 6. Nasby J A , Isaacson R J , Worms F W , Speidel T M 1972 Orthodontic Extractions and facial skeletal pattern . Angle Orthod 42 : 116 – 122 7. Schendel S , Einsfeld J , Bell W 1976 The long face syndrome: vertical Maxillary excess. Am J Orthod 70 : 398 – 408 8. Christie T E 1977 Cephalometric patterns of adults with normal occlusion. Angle Orthod 47 : 128 – 135 9. Tsunori M , Mashita M , Kasai K 1998 Relationship between facial types and tooth and bone characteristics of the mandible obtained by CT Scanning. Angle Orthod 68 : 557 – 562 10 10 Eroz U B , Ceylan I , Aydemir S 2000 An investigation of mandibular Morphology in subjects with different vertical facial growth patterns. Aust Orthod J 16 : 16 – 22 11. Chung C-H , Wong W W 2002 Craniofacial growth in untreated in Class II subjects: a longitudinal study Am J Orthod Dentofacial Orthop122 : 619 – 626 12. Chung C-H , Mongiovi V D 2003 Craniofacial growth in untreated Skeletal Class I subjects with low, average, and high MP-SN angles: a longitudinal Study. Am J Orthod and Dentofacial Orthop 124 : 670 – 678 13 Wagner D C , Chung C-H 2005 Transverse growth of the maxilla and mandible in untreated girls with low, average, and high MP-SN angles: a longitudinal study. Am J Orthod and Dentofacial Orthop 128 : 716 – 723 14. Proffi t W R 2000 Contemporary orthodontics. Mosby , St. Louis 11 9. SIGNATURE OF CANDIDATE 10. REMARKS OF THE GUIDE 11. Satisfactory NAME AND DESIGNATION OF DR.B.C KARUNAKARA PROFESSOR DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS. (IN BLOCK LETTERS) 11.1 GUIDE 11.2 SIGNATURE DR.S.E.SHEKAR PRINCIPAL , PROFESSOR & HOD DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS. 11.3 CO-GUIDE (IF ANY) 11.4 SIGNATURE 11.5 HEAD OF THE DEPARTMENT DR.S.E.SHEKAR PRINCIPAL , PROFESSOR & HOD DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS. 11.6 SIGNATURE 12. 12.1 REMARKS OF THE Can be done CHAIRMAN AND PRINCIPAL 12.2 SIGNATURE 12 13