02 d003 5256 (1)

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02 d003 5256 (1)

  1. 1. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,BANGALORE, KARNATAKA.ANNEXURE – IIPROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION1. NAME OF THE CANDIDATEAND ADDRESS (in blockletters)Dr. SHARAD ACHARYAPOST 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 ANDSUBJECTMASTER OF DENTAL SURGERYIN PROSTHODONTICS INCLUDING CROWNAND BRIDGE AND IMPLANTOLOGY4. DATE OF ADMISSION TOCOURSE24-04-20085. TITLE OF THE TOPIC “A COMPARATIVE STUDY OFCONDYLAR GUIDANCE SETTINGOBTAINED FROM INTEROCCLUSALRECORDS AND PANORAMICRADIOGRAPHS IN BOTH DENTULOUSAND EDENTULOUS PATIENTS”.1
  2. 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 anecessary requisite in prosthodontics1. The condylar guidance in a patient is governedby 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 afacebow and intra-oral or extra-oral records to adjust the condylar guidance, a closeapproximation of the patient’s mandibular movements and occlusal relationships can beobtained2. Studies have shown the unreliability of recording and reproducing thecondylar guidance on these instruments.1In clinical practice,the method most often used to determine the inclination of thesagittal path of the condyles consists of employing intra oral wax records and thencalculating the angle in the articulator.This method produces different results.3On theother hand, the outline of the articular eminence of the temporal bone may be seen on apanoramic radiograph.If the panoramic radiographic image accurately represents theoutline of the articular eminence, it may be used as an aid in setting the condylarguidance inclination of a semiadjustable articulator.1Hence, this study is intended to compare the condylar guidance values obtained byusing interocclusal records in a semiadjustable articulator and tracings from panoramicradiographic images in dentulous and edentulous patients.2
  3. 3. 6.2 Review Of Literature:A study was done on 16 patients to compare condylar control settings obtainedfrom wax interocclusal records and simplified mandibular motion analysis. It was foundthat the wax interocclusal records produced a protrusive condylar pathway angle thataveraged 17 degrees less than the Whip-Mix analyser and 6 degrees less than thePanadent analyser.Also, the protrusive condylar pathway recorded by the two analysersvaried by an average of 11 degrees.4A similar study was carried out in 30 subjects to determine the accuracy of differentmethods of measuring condylar inclination from graphical recordings of thecondylar paths. The results showed clear variations in the values of thecondylar angles and variation between right and left sides within the sameindividual.5A clinical study on 56 edentulous patients was done to determine statistically theinclination of the condylar path and to assess the reliability of evaluators usingthe tangential method of measuring and comparing the data . It was interestingto observe that there was considerable angular variations between left and rightsides ranging from 0 to 25 degrees. It was concluded that the inclination of thecondylar path is highly variable.3Another study was conducted on 10 dentate subjects, free of signs and symptoms oftemporomandibular disorder, chosen at random having most of their maxillaryand mandibular teeth present. The condylar guidance setting obtained from awax record was compared with extra-oral tracing. Within the limitations of thisstudy, measurement of the extra-oral tracing of the sagittal protrusive condylarpath gave higher values with less variation than the intra-oral wax protrusivemethod.23
  4. 4. Recently, an in vitro study was conducted on 25 dry human skulls to determinethe correlation between the anatomic shape of the articular eminence and thecorresponding panoramic radiographic image. A significant correlation was foundbetween the sagittal inclination of the anatomic articular eminence outline andcorresponding panoramic radiographic image with a mean difference in inclinationof only 7 degrees.16.3 : Objectives of the study :1. To compare the condylar guidance values obtained by interocclusalprotrusive records with those obtained by tracing panoramic radiographicimages of dentulous patients.2. To compare the condylar guidance values obtained from interocclusalrecord method with those obtained by tracing panoramic radiographicimages of edentulous patients.4
  5. 5. 7. MATERIAL AND METHODS:7.1 Source of data:Interocclusal records and panoramic radiographs of dentulous and edentulouspatients.7.2 Method of collection of data :20 dentulous patients aged between 18 to 30 years and 20 completelyedentulous patients aged between 45 to 75 years will be involved in this cross-sectional descriptive type of study. Predefined proforma will be used to recordrelevant information (patients data, criteria of selection) from each individualpatient 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 asymmetriesand 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 asymmetries7. No bony abnormalities.5
  6. 6. Determination of condylar guidance by interocclusal records:For dentulous patients, stone cast of each patient will be obtained by use ofirreversible hydrocolloid impression material. The casts will be mounted on asemiadjustable articulator (Hanau articulator Model Wide-Vue) with a facebow transfer (springbow;Teledyne) .For all patients, the protrusive records willbe made when the mandible moved straight forward approx 4-6 mm.Theinterocclusal record will then be used to set the articulator for measurement ofcondylar guidance.For edentulous patients, the protrusive interocclusal records will be taken byusing Tracing device(Hanau High Tracer CAT no.28-0 Teledyne) asking thepatients to protrude the mandible by 6 mm.This record will be transferred to thesemiadjustable 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 headproperly stabilized and patient was strictly instructed not to move during theradiographic exposure.Tracings from the panoramic radiographic images of the inner inclines ofthe Glenoid fossa and outer inclines of the articular eminence will be made ontransparent tracing paper. Horizontal reference lines will be drawn parallel tothe upper border of the radiograph, passing through the most superior andinferior points of each curve.6
  7. 7. These two points will be connected by a straight line representing the meancurvature line. Angles made by the intersection of the mean curvature line and thehorizontal reference plane which is the campers plane will be measured.The condylar guidance readings of both dentulous and edentulous patientsobtained from the interocclusal records and those by tracing panoramicradiographic images will be compared by Mann Whitney U test.7.3: Does the study require any investigations or interventions to be conductedon patients or other humans or animals? If so, please describe brieflyYesMeasurements of condylar guidance will be determined in both dentulous andedentulous patients using interocclusal records and by taking panoramicradiographs.7.4 : Has ethical clearance been obtained from your institution in case of 7.3?Yes7
  8. 8. 8. LIST OF REFERENCES:1. Gilboa I, Cardash HS, Israel K, Martin DG. Condylar Guidance : Correlationbetween articular morphology and Panoramic Radiographic images in Dryhuman skulls. J Prosthet Dent 2008;99:477-482.2. Jose DS, Stanley N, Thomas N. Comparison of Condylar Guidance settingobtained 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 inedentulous patients. J Prosthet Dent 1992 ;68 :314-318.4. Garry AE, Charles JG, Roland WD. A comparison of condylar control settingsobtained from wax interocclusal records and simplified mandibular motionanalyzers. J Prosthet Dent 1984;51:404-406.5. El-Gheriani AS, Winstanley RB. Graphic tracings of condylar paths andmeasurements of condylar angles. J Prosthet Dent 1989;61:77-878
  9. 9. 9. SIGNATURE OF CANDIDATE10. REMARKS OF THE GUIDE11. NAME & DESIGNATION OF(in block letters)11.1 GUIDEDr.GAUTAM SHETTY., M.D.S.,PROFESSOR,BAPUJI DENTAL COLLEGE ANDHOSPITAL,DAVANGERE-577 004.11.2 SIGNATURE11.3 CO-GUIDE (IF ANY)11.4 SIGNATURE11.5 HEAD OFDEPARTMENTDr. NANDEESHWAR D.B., M.D.S.PROFESSOR AND HEAD,DEPARTMENT OF PROSTHODONTICS,BAPUJI DENTAL COLLEGE ANDHOSPITAL,DAVANGERE-577 004.11.6 SIGNATURE12. 12.1 REMARKS OF THECHAIRMAN &PRINCIPAL12. 2 SIGNATURE9
  10. 10. 9. SIGNATURE OF CANDIDATE10. REMARKS OF THE GUIDE11. NAME & DESIGNATION OF(in block letters)11.1 GUIDEDr.GAUTAM SHETTY., M.D.S.,PROFESSOR,BAPUJI DENTAL COLLEGE ANDHOSPITAL,DAVANGERE-577 004.11.2 SIGNATURE11.3 CO-GUIDE (IF ANY)11.4 SIGNATURE11.5 HEAD OFDEPARTMENTDr. NANDEESHWAR D.B., M.D.S.PROFESSOR AND HEAD,DEPARTMENT OF PROSTHODONTICS,BAPUJI DENTAL COLLEGE ANDHOSPITAL,DAVANGERE-577 004.11.6 SIGNATURE12. 12.1 REMARKS OF THECHAIRMAN &PRINCIPAL12. 2 SIGNATURE9

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