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1. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. NAME OF THE CANDIDATE
AND ADDRESS (in block
letters)
Dr. SHARAD ACHARYA
POST GRADUATE STUDENT,
DEPARTMENT OF PROSTHODONTICS,
BAPUJI DENTAL COLLEGE AND HOSPITAL,
DAVANGERE – 577 004,
KARNATAKA.
2. NAME OF THE INSTITUTION BAPUJI DENTAL COLLEGE AND HOSPITAL,
DAVANGERE-577004.
3. COURSE OF STUDY AND
SUBJECT
MASTER OF DENTAL SURGERY
IN PROSTHODONTICS INCLUDING CROWN
AND BRIDGE AND IMPLANTOLOGY
4. DATE OF ADMISSION TO
COURSE
24-04-2008
5. TITLE OF THE TOPIC “A COMPARATIVE STUDY OF
CONDYLAR GUIDANCE SETTING
OBTAINED FROM INTEROCCLUSAL
RECORDS AND PANORAMIC
RADIOGRAPHS IN BOTH DENTULOUS
AND EDENTULOUS PATIENTS”.
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2. 6. BRIEF RESUME OF THE INTENDED WORK :
6.1: Need for the study:
An analogue of the condylar guidance on an articulator is considered to be a
necessary requisite in prosthodontics1
. The condylar guidance in a patient is governed
by a number of factors so its exact and accurate determination is highly difficult.
When the patient’s casts are mounted in a semiadjustable articulator by use of a
facebow and intra-oral or extra-oral records to adjust the condylar guidance, a close
approximation of the patient’s mandibular movements and occlusal relationships can be
obtained2
. Studies have shown the unreliability of recording and reproducing the
condylar guidance on these instruments.1
In clinical practice,the method most often used to determine the inclination of the
sagittal path of the condyles consists of employing intra oral wax records and then
calculating the angle in the articulator.This method produces different results.3
On the
other hand, the outline of the articular eminence of the temporal bone may be seen on a
panoramic radiograph.If the panoramic radiographic image accurately represents the
outline of the articular eminence, it may be used as an aid in setting the condylar
guidance inclination of a semiadjustable articulator.1
Hence, this study is intended to compare the condylar guidance values obtained by
using interocclusal records in a semiadjustable articulator and tracings from panoramic
radiographic images in dentulous and edentulous patients.
2
3. 6.2 Review Of Literature:
A study was done on 16 patients to compare condylar control settings obtained
from wax interocclusal records and simplified mandibular motion analysis. It was found
that the wax interocclusal records produced a protrusive condylar pathway angle that
averaged 17 degrees less than the Whip-Mix analyser and 6 degrees less than the
Panadent analyser.Also, the protrusive condylar pathway recorded by the two analysers
varied by an average of 11 degrees.4
A similar study was carried out in 30 subjects to determine the accuracy of different
methods of measuring condylar inclination from graphical recordings of the
condylar paths. The results showed clear variations in the values of the
condylar angles and variation between right and left sides within the same
individual.5
A clinical study on 56 edentulous patients was done to determine statistically the
inclination of the condylar path and to assess the reliability of evaluators using
the tangential method of measuring and comparing the data . It was interesting
to observe that there was considerable angular variations between left and right
sides ranging from 0 to 25 degrees. It was concluded that the inclination of the
condylar path is highly variable.3
Another study was conducted on 10 dentate subjects, free of signs and symptoms of
temporomandibular disorder, chosen at random having most of their maxillary
and mandibular teeth present. The condylar guidance setting obtained from a
wax record was compared with extra-oral tracing. Within the limitations of this
study, measurement of the extra-oral tracing of the sagittal protrusive condylar
path gave higher values with less variation than the intra-oral wax protrusive
method.2
3
4. Recently, an in vitro study was conducted on 25 dry human skulls to determine
the correlation between the anatomic shape of the articular eminence and the
corresponding panoramic radiographic image. A significant correlation was found
between the sagittal inclination of the anatomic articular eminence outline and
corresponding panoramic radiographic image with a mean difference in inclination
of only 7 degrees.1
6.3 : Objectives of the study :
1. To compare the condylar guidance values obtained by interocclusal
protrusive records with those obtained by tracing panoramic radiographic
images of dentulous patients.
2. To compare the condylar guidance values obtained from interocclusal
record method with those obtained by tracing panoramic radiographic
images of edentulous patients.
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5. 7. MATERIAL AND METHODS:
7.1 Source of data:
Interocclusal records and panoramic radiographs of dentulous and edentulous
patients.
7.2 Method of collection of data :
20 dentulous patients aged between 18 to 30 years and 20 completely
edentulous patients aged between 45 to 75 years will be involved in this cross-
sectional descriptive type of study. Predefined proforma will be used to record
relevant information (patients data, criteria of selection) from each individual
patient selected.
Criteria for selecting dentulous patients :
1. Presence of all the teeth excluding third molars.
2. Overjet and overbite should not be more than 2-3 mm.
3. No history of previous orthodontic treatment.
4. No history of previous craniofacial surgery/ trauma.
5. No signs and symptoms of temporomandibular disorder,facial asymmetries
and congenital facial defect.
Criteria for selecting edentulous patients:
1. Class I ridge relationship.
2. Preferably younger age group.
3. Good neuromuscular control.
4. No Signs and symptoms of TMJ disorder.
5. No history of Craniofacial surgery/trauma.
6. No Facial asymmetries
7. No bony abnormalities.
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6. Determination of condylar guidance by interocclusal records:
For dentulous patients, stone cast of each patient will be obtained by use of
irreversible hydrocolloid impression material. The casts will be mounted on a
semiadjustable articulator (Hanau articulator Model Wide-Vue) with a face
bow transfer (springbow;Teledyne) .For all patients, the protrusive records will
be made when the mandible moved straight forward approx 4-6 mm.The
interocclusal record will then be used to set the articulator for measurement of
condylar guidance.
For edentulous patients, the protrusive interocclusal records will be taken by
using Tracing device(Hanau High Tracer CAT no.28-0 Teledyne) asking the
patients to protrude the mandible by 6 mm.This record will be transferred to the
semiadjustable articulator for the determination of condylar angles.
Determination of Condylar Guidance by panoramic Radiographs:
Each patient will be asked to stand straight in panoramic radiographic unit
(Orthoralix 9200; GENDEX DENTAL SYSTEMS, Milan, Italy) with head
properly stabilized and patient was strictly instructed not to move during the
radiographic exposure.
Tracings from the panoramic radiographic images of the inner inclines of
the Glenoid fossa and outer inclines of the articular eminence will be made on
transparent tracing paper. Horizontal reference lines will be drawn parallel to
the upper border of the radiograph, passing through the most superior and
inferior points of each curve.
6
7. These two points will be connected by a straight line representing the mean
curvature line. Angles made by the intersection of the mean curvature line and the
horizontal reference plane which is the campers plane will be measured.
The condylar guidance readings of both dentulous and edentulous patients
obtained from the interocclusal records and those by tracing panoramic
radiographic images will be compared by Mann Whitney U test.
7.3: Does the study require any investigations or interventions to be conducted
on patients or other humans or animals? If so, please describe briefly
Yes
Measurements of condylar guidance will be determined in both dentulous and
edentulous patients using interocclusal records and by taking panoramic
radiographs.
7.4 : Has ethical clearance been obtained from your institution in case of 7.3?
Yes
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8. 8. LIST OF REFERENCES:
1. Gilboa I, Cardash HS, Israel K, Martin DG. Condylar Guidance : Correlation
between articular morphology and Panoramic Radiographic images in Dry
human skulls. J Prosthet Dent 2008;99:477-482.
2. Jose DS, Stanley N, Thomas N. Comparison of Condylar Guidance setting
obtained from a wax record versus an extra oral tracing: A pilot study.
J Prosthet Dent 2003;89:54-59.
3. Zamacona JM, Otaduy E, Aranda E. Study of the sagittal condylar path in
edentulous patients. J Prosthet Dent 1992 ;68 :314-318.
4. Garry AE, Charles JG, Roland WD. A comparison of condylar control settings
obtained from wax interocclusal records and simplified mandibular motion
analyzers. J Prosthet Dent 1984;51:404-406.
5. El-Gheriani AS, Winstanley RB. Graphic tracings of condylar paths and
measurements of condylar angles. J Prosthet Dent 1989;61:77-87
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9. 9. SIGNATURE OF CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME & DESIGNATION OF
(in block letters)
11.1 GUIDE
Dr.GAUTAM SHETTY., M.D.S.,
PROFESSOR,
BAPUJI DENTAL COLLEGE AND
HOSPITAL,
DAVANGERE-577 004.
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF
DEPARTMENT
Dr. NANDEESHWAR D.B., M.D.S.
PROFESSOR AND HEAD,
DEPARTMENT OF PROSTHODONTICS,
BAPUJI DENTAL COLLEGE AND
HOSPITAL,
DAVANGERE-577 004.
11.6 SIGNATURE
12. 12.1 REMARKS OF THE
CHAIRMAN &
PRINCIPAL
12. 2 SIGNATURE
9
10. 9. SIGNATURE OF CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME & DESIGNATION OF
(in block letters)
11.1 GUIDE
Dr.GAUTAM SHETTY., M.D.S.,
PROFESSOR,
BAPUJI DENTAL COLLEGE AND
HOSPITAL,
DAVANGERE-577 004.
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF
DEPARTMENT
Dr. NANDEESHWAR D.B., M.D.S.
PROFESSOR AND HEAD,
DEPARTMENT OF PROSTHODONTICS,
BAPUJI DENTAL COLLEGE AND
HOSPITAL,
DAVANGERE-577 004.
11.6 SIGNATURE
12. 12.1 REMARKS OF THE
CHAIRMAN &
PRINCIPAL
12. 2 SIGNATURE
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