The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The document summarizes the Schwarz analysis and WITS appraisal methods for evaluating lateral cephalometric radiographs. Schwarz analysis divides measurements into craniometry (skeletal base and profile) and gnathometry (dentition). It describes various angular and linear measurements used to assess skeletal and dental relationships. The WITS appraisal relates points A and B to the occlusal plane to measure anteroposterior jaw relationships, less influenced by rotations than ANB angle. Both methods provide diagnostic information but have limitations and should be interpreted along with other parameters.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Indics /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Schwarz analysis divides the evaluation into craniometry (skeletal) and gnathometry (dental) using reference lines and planes. Craniometry assesses the skeletal base and profile using angles like J angle, F angle, and TMJ position. Gnathometry evaluates the dentition using angles like B angle, gonial angle, and axial tooth inclinations. Linear measurements include anterior cranial base, ascending ramus, maxillary base, and soft tissue thickness. The analysis provides metrics to assess the skull, jaws, dentition, and facial profile.
GENETICS & MALOCCLUSION - II /orthodontic courses by Indian dental academy Indian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses utility arches, which are orthodontic appliances used to apply light forces in the dental arch. It provides details on:
- The historical background and development of utility arches based on biomechanical principles.
- Common wire dimensions and materials used, including stainless steel, nickel titanium, and beta titanium alloys.
- The standard design components of utility arches, including molar, vertical, and incisal segments.
- Different types of utility arches like passive arches, intrusion arches, and retraction/protrusion arches and how they are activated to apply specific orthodontic forces.
Friction less mechanics in orthodontics /certified fixed orthodontic course...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The document summarizes the Schwarz analysis and WITS appraisal methods for evaluating lateral cephalometric radiographs. Schwarz analysis divides measurements into craniometry (skeletal base and profile) and gnathometry (dentition). It describes various angular and linear measurements used to assess skeletal and dental relationships. The WITS appraisal relates points A and B to the occlusal plane to measure anteroposterior jaw relationships, less influenced by rotations than ANB angle. Both methods provide diagnostic information but have limitations and should be interpreted along with other parameters.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Indics /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Schwarz analysis divides the evaluation into craniometry (skeletal) and gnathometry (dental) using reference lines and planes. Craniometry assesses the skeletal base and profile using angles like J angle, F angle, and TMJ position. Gnathometry evaluates the dentition using angles like B angle, gonial angle, and axial tooth inclinations. Linear measurements include anterior cranial base, ascending ramus, maxillary base, and soft tissue thickness. The analysis provides metrics to assess the skull, jaws, dentition, and facial profile.
GENETICS & MALOCCLUSION - II /orthodontic courses by Indian dental academy Indian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses utility arches, which are orthodontic appliances used to apply light forces in the dental arch. It provides details on:
- The historical background and development of utility arches based on biomechanical principles.
- Common wire dimensions and materials used, including stainless steel, nickel titanium, and beta titanium alloys.
- The standard design components of utility arches, including molar, vertical, and incisal segments.
- Different types of utility arches like passive arches, intrusion arches, and retraction/protrusion arches and how they are activated to apply specific orthodontic forces.
Friction less mechanics in orthodontics /certified fixed orthodontic course...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The document discusses factors that should be considered in the finishing and detailing stage of orthodontic treatment. It covers 17 factors identified by Dougherty, including correcting overjet/overbite, establishing correct tip and torque of anterior teeth, coordinating arch widths, establishing marginal ridge relationships and contact points. It also discusses esthetic procedures like gingival zenith and missing laterals, as well as periodontal procedures like supracrestal fibrotomy. The document provides guidelines for finishing based on ABO requirements, including overjet of 1-3mm and buccolingual tooth inclinations within 1mm of a straight edge. Positioners are also discussed for settling the occlusion at the finishing stage.
This document provides an overview of frictionless mechanics in orthodontics. It discusses various loop and spring configurations that can be used for space closure without tooth movement along the archwire. Advantages include control of tooth movement and known force levels. Disadvantages include more complex mechanics and potential patient discomfort. Factors like loop height and geometry determine the moment-to-force ratio and type of tooth movement achieved. The document defines key terms and principles of biomechanics relevant to frictionless orthodontic tooth movement.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses various types of intrusion arches used in orthodontics to correct deep overbites. It begins by defining intrusion and describing the biomechanics and principles involved. It then covers 9 specific intrusion arch designs: 1) Rickett's Utility Arch 2) Tipback Springs 3) Burstone's Continuous Intrusion Arch 4) Burstone's Three Piece Intrusion Arch 5) K-SIR 6) Connecticut Intrusion Arch 7) PG Retraction Spring 8) Translation Arch 9) Lingual Arch for intruding lower incisors. For each type, it provides details on materials, design, and mechanics of intrusion.
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Indian dental academy
This document discusses various methods for space closure during orthodontic treatment. It begins by stating that space closure is dictated by treatment objectives and can be achieved through different mechanisms. The goals for any space closure method are then outlined, including differential tooth movement control and producing an optimal biological response. Key determinants of space closure like the amount of crowding, anchorage, and tooth inclinations are also discussed. The document then goes on to compare sliding/friction mechanics versus loop/frictionless mechanics. It provides details on considerations for various anchorage situations and techniques for individual canine retraction. In summary, the document provides an overview of factors to consider for space closure and compares different mechanical approaches.
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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Biomechanics of headgears in orthodontics /certified fixed orthodontic course...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
in Orthodontics, Torque is a vital ingredient in the achievement of optimal esthetics, function and health of teeth and surrounding tissues, as also in stability of the treatment results
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides an overview of posteroanterior cephalometric analysis. It defines the setup and landmarks used in PA cephalometry. It then summarizes several common PA cephalometric analyses including Ricketts analysis, Grummons analysis, and Grayson analysis. Ricketts analysis measures dental, skeletal, and jaw relationships. Grummons analysis uses planes, volumes, asymmetries, and ratios to compare sides. Grayson analysis constructs midlines in different frontal planes to analyze asymmetry in 3 dimensions.
The document provides information about the MBT bracket system. Some key points:
- MBT was developed by Dr. Richard McLaughlin, Dr. John Bennett, and Dr. Hugo Trevisi to address limitations of previous pre-adjusted edgewise appliances.
- MBT utilizes light, continuous forces with sliding mechanics principles. Torque is incorporated fully into the bracket bases.
- Bracket tip and torque specifications are designed to achieve ideal tooth positions and occlusion. Canine torque values were modified from original straight wire appliance prescriptions.
- MBT treatment philosophy emphasizes accuracy of bracket placement, group tooth movement, anchorage control, and awareness of tooth size discrepancies.
Ceramic orthodontic brackets/certified fixed orthodontic courses by Indian de...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The document summarizes the first stage of Begg's appliance in orthodontic treatment. Stage I objectives include closing spaces, correcting crowding, overcorrecting rotations, overjet, and overbite. Anterior teeth undergo labial/lingual, intrusive, and retractive movements. Posterior teeth are maintained upright or overcorrected distally. Characteristic archwires include plain or looped 0.016" wires. Class II or III elastics are used. Bracket placement and archwire details such as offsets are described.
This document provides an overview of evidence-based orthodontics. It defines evidence-based orthodontics as integrating the best available research evidence with clinical expertise and patient values. The need for evidence-based orthodontics is that it allows practitioners to provide the currently best care available to patients. Evidence-based orthodontic practice differs from traditional practice by regularly accessing new evidence, identifying risk factors, and providing continuous, patient-centered, and efficient care. Systematic reviews are used to summarize research evidence in an unbiased manner to inform clinical decision making.
Psycological management of orthodontic patients /certified fixed orthodontic...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1. The document discusses the relationship between naso-respiratory function, growth, sleep apnea and dentofacial deformities.
2. Animal studies found that nasal obstruction led to rhythmic activity in additional craniofacial muscles involved in respiration. This induces changes in neuromuscular function.
3. Studies in humans found that the sagittal depth of the nasopharynx increases steadily up to age 16 in females and age 20 in males, with the highest growth between ages 12-14 in males. There is great variation between individuals. Sagittal depth is relatively independent of other facial dimensions.
The document discusses factors that should be considered in the finishing and detailing stage of orthodontic treatment. It covers 17 factors identified by Dougherty, including correcting overjet/overbite, establishing correct tip and torque of anterior teeth, coordinating arch widths, establishing marginal ridge relationships and contact points. It also discusses esthetic procedures like gingival zenith and missing laterals, as well as periodontal procedures like supracrestal fibrotomy. The document provides guidelines for finishing based on ABO requirements, including overjet of 1-3mm and buccolingual tooth inclinations within 1mm of a straight edge. Positioners are also discussed for settling the occlusion at the finishing stage.
This document provides an overview of frictionless mechanics in orthodontics. It discusses various loop and spring configurations that can be used for space closure without tooth movement along the archwire. Advantages include control of tooth movement and known force levels. Disadvantages include more complex mechanics and potential patient discomfort. Factors like loop height and geometry determine the moment-to-force ratio and type of tooth movement achieved. The document defines key terms and principles of biomechanics relevant to frictionless orthodontic tooth movement.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses various types of intrusion arches used in orthodontics to correct deep overbites. It begins by defining intrusion and describing the biomechanics and principles involved. It then covers 9 specific intrusion arch designs: 1) Rickett's Utility Arch 2) Tipback Springs 3) Burstone's Continuous Intrusion Arch 4) Burstone's Three Piece Intrusion Arch 5) K-SIR 6) Connecticut Intrusion Arch 7) PG Retraction Spring 8) Translation Arch 9) Lingual Arch for intruding lower incisors. For each type, it provides details on materials, design, and mechanics of intrusion.
Space closure by frictionless mechanics 2 /certified fixed orthodontic course...Indian dental academy
This document discusses various methods for space closure during orthodontic treatment. It begins by stating that space closure is dictated by treatment objectives and can be achieved through different mechanisms. The goals for any space closure method are then outlined, including differential tooth movement control and producing an optimal biological response. Key determinants of space closure like the amount of crowding, anchorage, and tooth inclinations are also discussed. The document then goes on to compare sliding/friction mechanics versus loop/frictionless mechanics. It provides details on considerations for various anchorage situations and techniques for individual canine retraction. In summary, the document provides an overview of factors to consider for space closure and compares different mechanical approaches.
Roth philosophy /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Biomechanics of headgears in orthodontics /certified fixed orthodontic course...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
in Orthodontics, Torque is a vital ingredient in the achievement of optimal esthetics, function and health of teeth and surrounding tissues, as also in stability of the treatment results
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides an overview of posteroanterior cephalometric analysis. It defines the setup and landmarks used in PA cephalometry. It then summarizes several common PA cephalometric analyses including Ricketts analysis, Grummons analysis, and Grayson analysis. Ricketts analysis measures dental, skeletal, and jaw relationships. Grummons analysis uses planes, volumes, asymmetries, and ratios to compare sides. Grayson analysis constructs midlines in different frontal planes to analyze asymmetry in 3 dimensions.
The document provides information about the MBT bracket system. Some key points:
- MBT was developed by Dr. Richard McLaughlin, Dr. John Bennett, and Dr. Hugo Trevisi to address limitations of previous pre-adjusted edgewise appliances.
- MBT utilizes light, continuous forces with sliding mechanics principles. Torque is incorporated fully into the bracket bases.
- Bracket tip and torque specifications are designed to achieve ideal tooth positions and occlusion. Canine torque values were modified from original straight wire appliance prescriptions.
- MBT treatment philosophy emphasizes accuracy of bracket placement, group tooth movement, anchorage control, and awareness of tooth size discrepancies.
Ceramic orthodontic brackets/certified fixed orthodontic courses by Indian de...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The document summarizes the first stage of Begg's appliance in orthodontic treatment. Stage I objectives include closing spaces, correcting crowding, overcorrecting rotations, overjet, and overbite. Anterior teeth undergo labial/lingual, intrusive, and retractive movements. Posterior teeth are maintained upright or overcorrected distally. Characteristic archwires include plain or looped 0.016" wires. Class II or III elastics are used. Bracket placement and archwire details such as offsets are described.
This document provides an overview of evidence-based orthodontics. It defines evidence-based orthodontics as integrating the best available research evidence with clinical expertise and patient values. The need for evidence-based orthodontics is that it allows practitioners to provide the currently best care available to patients. Evidence-based orthodontic practice differs from traditional practice by regularly accessing new evidence, identifying risk factors, and providing continuous, patient-centered, and efficient care. Systematic reviews are used to summarize research evidence in an unbiased manner to inform clinical decision making.
Psycological management of orthodontic patients /certified fixed orthodontic...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1. The document discusses the relationship between naso-respiratory function, growth, sleep apnea and dentofacial deformities.
2. Animal studies found that nasal obstruction led to rhythmic activity in additional craniofacial muscles involved in respiration. This induces changes in neuromuscular function.
3. Studies in humans found that the sagittal depth of the nasopharynx increases steadily up to age 16 in females and age 20 in males, with the highest growth between ages 12-14 in males. There is great variation between individuals. Sagittal depth is relatively independent of other facial dimensions.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Nasal airway and malocclucion /certified fixed orthodontic courses by Indian ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1. The study examined the growth of the sagittal depth of the bony nasopharynx in relation to other facial variables in 260 children between ages 6-20 years.
2. The results showed that in males the sagittal depth of the nasopharynx increased steadily up to age 20 years, with the fastest growth between ages 12-14 years. In females, growth peaked between ages 6-12 years and then slowed after age 12.
3. There was significant variation between individuals in the timing and rate of nasopharyngeal growth. The sagittal depth was found to be most strongly correlated with total cranial base length, and only weakly correlated with maxilla length.
Upper airway constiction and its effects on growth & develop /certified fixe...Indian dental academy
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formats.
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Bridge,rotary endodontics,fixed orthodontics,
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Upper airway constiction and its effects on growth & developmentIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Human beings are normally nasal breathers. The nasal and oral cavities serve as pathways for respiratory airflow.
Ordinarily, the inspiratory and expiratory airstreams are channeled through the nose because the mouth is usually closed.
However, in some individuals, because of nasal airway inadequacy or habit, the oral cavity becomes the predominant route for the passage of respiratory airflow.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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The document discusses the relationship between nasal airway obstruction and malocclusion. It reviews literature over 100 years old linking nasal obstruction to malocclusion. Tests to diagnose nasal obstruction and mouth breathing are discussed, including cephalometric analysis, spirometry, oximetry, and rhinomanometry. Effects of nasal obstruction include changes to head posture, mandibular rotation, increased facial height and dental arch collapse. Treatment options aim to address etiological factors through tonsillectomy, adenoidectomy, RME, and orthodontics. Further research is still needed to better understand these relationships and prevent obstructed airways.
1. The McNamara analysis method relates craniofacial structures including teeth, jaws, and cranial base to evaluate skeletal and dental relationships.
2. For the patient, the analysis found a retrusive maxilla, decreased mandibular length and anteroposterior differential, reduced vertical proportions, and protrusive incisors.
3. The airway measurements were within normal limits, but other findings indicate the patient has a skeletal Class II malocclusion with a vertical growth pattern.
This document discusses various types of breathing circuits and airway management devices. It describes Mapleson breathing circuit classifications and notes that the Magill and Bain systems are efficient for spontaneous and controlled ventilation, respectively. The Jackson Rees or Type F circuit has a larger reservoir bag, allowing for assisted or controlled ventilation, especially in children. The document also outlines various airway assessment techniques, predictors of difficult intubation/mask ventilation, and management strategies and devices for securing the airway, including oral/nasal airways, face masks, laryngeal mask airways, and tracheal intubation equipment.
Age characteristics of the larynx in infants during the first year of lifeLía Castillo Canave
This study investigated the anatomy of the larynx in 30 infants during their first year of life through morphological and histological analysis. Measurements were taken of the length, width, and thickness of the larynx to determine size. A correlation was found between larynx size and body length. Histological analysis found that cartilage structure changes with age. The goal was to establish characteristics that can determine a child's age to aid in choosing appropriate endotracheal tubes and prevent laryngeal damage during intubation.
Airway assessment is important for identifying patients at risk of a difficult airway. Several tests can be used including Mallampati scoring, mouth opening, neck mobility, and thyromental distance. A difficult airway is when facemask ventilation or intubation is not possible using conventional methods. It is important to prepare for difficult airway scenarios by having proper equipment and involving senior help. Identifying difficult airway risks pre-operatively allows time for planning alternative strategies to ensure patient safety.
Orthodontic diagnostic procedures part 3 Maher Fouda
This document discusses various diagnostic procedures used in orthodontics, including examining muscle function, breathing patterns, facial morphology, tongue posture, and radiographs. Specific findings are described that are indicative of issues like hyperactivity of the mentalis muscle, mouth breathing, adenoid size, and tongue position. Differential diagnosis is important to determine if breathing problems are due to nasal obstruction or oral breathing habits. Myofunctional exercises and oral screens can be used to help patients transition from oral to nasal breathing. A functional analysis form is presented to record joint and muscle findings, occlusal relationships, dysfunctions, and respiratory patterns.
The document discusses the influence of various functional factors on orofacial development, including respiration, tongue posture and function, chewing, swallowing, speech and oral habits. Mouth breathing is associated with increased facial height and mandibular plane angle. Tongue thrusting can cause spacing and proclination of the anterior teeth. Diagnosis involves clinical examination, tests to assess breathing mode, and sometimes cephalometric or rhinomanometric analysis. Treatment may involve addressing nasal obstructions surgically and using orthodontic appliances to correct malocclusions and discourage abnormal oral functions.
This document discusses various methods for objectively measuring nasal patency and airflow, which is important for accurately assessing complaints of nasal obstruction. It describes rhinomanometry, which measures nasal resistance, and acoustic rhinomanometry, which provides anatomical data on nasal cross-sectional area. Several other tests are also mentioned, including peak nasal inspiratory flow, body plethysmography, and questionnaires. Overall, the document provides an overview of existing objective methods for evaluating nasal function and structure to help diagnose the cause of a blocked nose.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Similar to Naso respiratory function and growth sleep apnea /certified fixed orthodontic courses by Indian dental academy (20)
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Naso respiratory function and growth sleep apnea /certified fixed orthodontic courses by Indian dental academy
1. NASO-RESPIRATORY FUNCTION
AND GROWTH, SLEEP APNEA
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
1
3. CONTENTS
Introduction
Anatomy
Mechanism of Breathing
Diagnosis
Animal studies
Human studies
Relationships between dentofacial
deformities and nasal airway inadequacy
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3
4. Introduction
Nasal and oral cavities serve as pathways
for respiratory airflow.
Inspiratory and expiratory air streams are
channeled through nose.
Nasal airway inadequacy – oral breathing
results.
Conflicting views regarding close
relationship b/n dentofacial deformities and
nasal inadequacy.
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4
9. RESPIRATORY PHYSIOLOGY
Pulmonary alveoli and respiratory tract.
Function
Exchange of O2 and CO2 between environment and
body cells.
O2 – intercellular metabolism.
CO2 – End product.
Exchange through alveoli
Alveolar membrane permits O2 and CO2
transport.
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9
11. Rhythmic activity – alters the level of gases
– alveoli and pulmonary capillaries - ↓
pressure gradients.
Respiratory tract results in transfer between
alveoli and environment.
Respiratory tract – nasal and oral passages
which connect pharynx, larynx and trachea.
Trachea – Bronchi
Bronchioles
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11
14. Airway Resistance
Changes in dimensions of respiratory tract - ↓
airflow e.g. enlarged adenoids and tonsils.Solow(79)
Compensatory mechanisms
Respiratory muscles – increased work –change in
intrapulmonary pressure.
Modification of respiration by sensory feed back.
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14
18. Diagnosis
Nasal breathers – lips touch lightly at rest
Nares dilate on command inspiration.
Mouth breathers – lips parted at rest
nares maintain size
Use of a two surface steel mirror
Use of a cotton butterfly.
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25. ELECTROMYOGRAPHY
It is a test that measures muscle response to
nervous stimulation(electrical activity
within muscle fiber)
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25
27.
To summarize rhythmic activity correlated with
respiration is normally present in five craniofacial
muscles – control animals.
Experimental animals – adapt to oral respiration –
four additional muscles involved.
This reflexivity induces changes in neuromuscular
function of craniofacial muscles.
inducing periodicity in discharge
initiating a sustained tonic discharge
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27
28. Growth in the sagittal depth of bony nasopharynx in
relation to some other facial variables
Sten Linder - Aronson
Size of nasopharynx important – mode of
breathing
Lymphoid tissue – posterior wall of
nasopharynx.
Adenoid vegetations
Size of adenoids – crucial
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29.
Difference of opinions
Rosenberger 1934 – nasopharynx ↑ in conjunction
with growth of the cranial base.
Brodie 1941 – depth established during the first
year or two of life – constant afterwards.
King 1952 – examined nasopharyngeal
dimensions from 3 months to 16 years – similar
views.
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30.
In contrast Subtelny 1957 – Serial
cephalometric study of 30 subjects →
- Nasopharynx ↑ from 3 years to 17 years
- First 11 years periods of apparent increase
/ decrease
- After 12 years – steady increase
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31. Handelman and Osborne 1976 –
nasopharyngeal depth constant in females
In Males increased moderately from 3
years, 9 months to maturity.
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32.
Materials – longitudinal
study – 6 to 20 years
children.
140 boys and 120 girls –
Burlington Growth
Center.
Method
variables measured:
- Ba-S
- S-N
- Ba-ptm
- Ba-N
- Ptm-Sn
- Sn-Gn
- N-Sn www.indiandentalacademy.com
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33.
Results
Males – steady increase in sagittal depth
of nasopharynx – 6-20 yrs
6-12 yrs – 2.4mm
12-18 yrs – 4.7mm
Females – Growth of nasopharynx after
16 years negligible.
6-12 yrs – 3.5mm
12-18 yrs – 1.6mm
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34. Correlations done
Results – Highest
correlation coefficient b/n
depth of nasopharynx and
length of total cranial base
–
r = 0.63 - 0.75
.
Very weak correlation b/n
depth of nasopharynx and
length of maxilla
r=0.18 – 0.40
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35. No correlation b/n depth of nasopharynx and facial heights
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36. In earlier investigations – Linder Aronson
1972- sagittal depth of bony nasopharynx
influenced by mode of breathing.
Mouth breathers nasopharynx smaller.
Nasopharynx normalized – following
change to nose breathing.
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38. Summary
1.
Sagittal depth of nasopharynx ↑ in small steady
increments upto 16 yrs of age in females and 20
yrs in males.
2.
The velocity of sagittal depth ↑ peaked – 12 to
14 yrs in males –
3.
In females – ↓ after 12 yrs of age
4.
There was great variation among individual
velocity curves in both the age at which it
peaked and magnitude of growth increments.
5.
Sagittal depth of bony nasal pharynx is
relatively independent of other cephalometric
dimensions of the facial complex.
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40. Relationships between dentofacial
deformities and nasal airway inadequacy
-
Most prevalent view – mouthbreathing –
associated with
Retrognathic mandible
Protruding maxillary anterior teeth
High palatal vault
Constricted maxillary arch
Flaccid and short upper lip.
Dull appearance
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40
41.
Angle 1907 –
– “This form of malocclusion is always accompanied and
atleast in its early stages, aggravated, if indeed not
caused by mouth breathing due to some form of nasal
obstructions”.
Hunter 1971 – Did not find a relationship b/n allergic
rhinitis and malocclusion.
Linder Aronson, Aschan – Enlarged adenoids - Adenoid
facies
Moffat 1963 – Related protrusion of maxillary incisors to
mouth breathing.
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41
42. Relationships between dentofacial
deformities and nasal airway inadequacy
Harvold 1973 – Palatal anatomy and impaired
nasal breathing related.
Korkhaus 1960 – Maxillary arch form important
in determining nasal cavity size and hence
breathing mode
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42
43. Relationships between dentofacial deformities
and nasal airway inadequacy
Derichsweiler 1956 – contradicts nasal obstruction
as a primary etiologic factor in dentofacial
deformity.
Choanal atresia
Watson 1968 – mouth breathing – not always
associated with skeletal deformity.
23% of mouth breathers due to habit rather
than physiologic need.
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44. Relationships between dentofacial
deformities and nasal airway inadequacy
To summarize
- Malocclusion may or may not be associated
with an inadequate nasal airway.
- Certain nasal or nasopharyngeal
abnormalities may produce a mouth
breathing pattern.
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45. Maxillary expansion and nasal airway
resistance
-
Hershey et al 1976 – 45% reduction in nasal
airway resistance after RME
Turby fill – 1976 – 53% decrease in airway
resistance in 17 subjects.
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45
46. Craniocervical angulation and nasal
respiratory resistance
Solow Thompson – Changed craniofacial
morphology – due to changed head posture
.
Schwarz 1926 – Head bent backwards i.r.t.
neck in nasal obstruction.
Ricketts 68, Koski 75, Quinn and Pickrell
78 – similar views.
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46
47. Head posture and craniofacial
morphology
Bjork 1961 –
– Retrognathic facial type – head in extended position.
– Prognathic facial type – head in lower position
Bench 1963 – neck -curved in square faces
Straight – long faces.
Sallow and Tallgren 1976 – of the posture variables
the craniocervical angulation showed the most
comprehensive correlation with craniofacial
morphology.
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48.
Extended head position –
- Large inclination
of mandible
Small post and large ant
facial heights
Facial retrognathism
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49.
Average craniofacial morphology in
persons who had a large craniocervical
angulation resembled to those persons who
had a large mandibular plane angle.
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50. Soft tissues stretching hypothesis
Solow and Kreiborg 1977 – posturally
induced stretching of the facial soft tissue
layer might influence craniofacial
morphological development.
Extension of head – entails a passive
stretching of the facial soft tissue layer
draping the face and the neck.
Slight backward and downward forces
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52. Conclusions
1.
2.
Before adenoidectomy a large craniocercival
angulation was seen in connection with a
large nasalrespiratory resistance.
After adenoidectomy reduction of the
craniocervical angulation occurred in children
in whom nasal respiratory resistance was
reduced.
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52
53. Nasorespiratory function and
Craniofacial growth-Linder Aronson
Distinction between mouth and nose
breathers
Mouth breathing
» Refers to those individuals who have a certain
degree of nose breathing capacity but, for one
reason or another, breathe mainly through the
mouth.
Conditions - E.g. Bilateral Chonanalatresi, alea nasi
insufficiency – pure mouth breathers.
Reduced nasal respiratory function – pts with enlarged
adenoidal masses
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54. Effects of reduced nasal respiratory function on the
development of facial skeleton and occlusion
Last 100 yrs – lot of research
Wilhelm Meyer 1868 – patients with reduced nasal
respiration – poor hearing & poor general health.
Tomes 1872 – mouth breathers- narrow dental arches (vshape).
Nordlund 1918 – theory of compression
- Disturbance of balance b/n tongue and cheek musculature
Korner 1891 – mouth breathing
1. Narrow dental arches.
2. Underdevelopment of nasal cavity.
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3. Reduced maxillary size.
54
55. Woodside 1968 – Obstructed nasal ventilation –
Class II malocclusion.
Harvold et al 1973-79 – Animal experiments
--change to mouth breathing
narrowing of the maxilla.
post rotation of mandible
.
Nordlund, Brash et al
Reduced nasal breathing result of existing facial
and dental morphology.
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56. Adenoid faces
Associated with long history of mouth breathing.
C/F:
–
–
–
–
–
–
–
–
–
Open mouth posture.
Flattened nose.
Pinched nostrils.
Short upper lip.
Voluminous and pouting lower lip.
Vacant facial expression.
Proclined upper incisors.
V-shape upper jaw – high palatal vault.
Skeletal Class II relationship.
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58. Effects on the dentition& facial skeleton
of a change from mouth to nose
breathing-Linder Aronson
1973
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59. 5 yr follow up study of children undergone
adenoidectomies to clear obstructed nasal
passages.
Purpose – Examine effects of a change in the
mode of breathing on
1. U/L incisal inclination
2. Upper arch width
3. Sagittal depth of nasopharynx.
4. Anterior facial height.
5. Inclination of the maxilla to mandible.
Sample: 41 children – changed from mouth to nose
breathing.
54 children – control
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61. Results
Upper incisal
inclination
- Relatively greater
increase in upper incisor
inclination.
- Normalization of upper
incisor inclination to SNduring the five year
postop period
.
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62. Results
Inclination of the lower
incisors
Greater change during
first year post-op
Next 4yrs no significant
change
Normalization of lower
incisors inclination occur
during the 1st year post-op
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62
63. Results
Changes in arch
width
1st year greatest change 0.
9mm – statistically
significant.
Normalization of arch
width took place
following adenoidectomy
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66. Mechanisms of change in dentition &
facial morphology
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67. Changes in head posture
Mouth breathers – unconsciously maintain an
extended head posture.
16 pts – undergone adenoidectomy
16 pts – controls
Method:
Inclination of SN – measured relative to a vertical
reference line.
SN / vert angle – decreased in extended head
posture.
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69. Patients evaluated – before and 1 month
after surgery.
Pt in a relaxed position infront of mirror –
outside the cephalostat.
Light cross as a reference
Pencil mark following the horizontal line of
light cross.
.
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70. Results:
Significant differences
in the size of SN/Vert
angle before
adenoidectomy.
No difference after
adenoidectomy b/n
two groups
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73. The role of tonsils and adenoids
in the obstruction of respiration
Tonsillectomy and adenoidectomy - in
combination or separately
1 Recurrent or chronic throat infection.
2 Hypertrophy
3 Recurrent attacks of acute otitis media.
Chronic otitis media with effusion.
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74. Prevalence
Upper resp infection – peaked – 1 & 6 years and
significantly ↓ thereafter.
Hypertrophy of tonsils and adenoids – more common in
boys – under 6 yrs
.
Hypertrophy tonsils –twice in adult female.
Otitis media – 2nd common disease in childhood.
All these conditions - ↓ - after 6 yrs.
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75. Urgent indications for surgery:
-Alveolar hypoventilation
-Tonsil enlargement – difficulty in swalowing.
Tonsillectomy –– foll conditions
1) Recurrent tonsillitis
2) Chronic tonsillitis
Adenoidectomy indicated in –
persistent nasal obstruction
recurrent otitis media with effusion.
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76. Factors influencing the degree of
obstruction
Degree of obstruction is primarily related to the
size of the tonsils and adenoids relative to their
surr compartment.
Recurrent chronic inflammation – ↑ the degree of
obstruction.
Acute rhinitis – moderately obstructing adenoids marked ↓ in nasal airflow.
Body position –
Recumbency in general – ↑ upper airway
obstruction
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77. Anatomic factors –
–Affect the degree of obstruction
–Syndromes – e.g. Downs syndrome – extreme
form – respiratory compromise.
-Anatomic variation –
pedunculated tonsils
-Deformity of nasal cavity
e.g. septal deviation, Choanal stenosis
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78. Methods of assessing degree of
respiratory obstruction
Thorough history & physical examination –
Sleeping habits
Snoring
Mouth breathing
Distortion of speech
Hypersomnia
Headaches
Lethargy
Weight gain
Nightmares
Difficulty in awakening
Physical examination – head neck, chest & abdomen areas
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79. Adenoid inspection:
1) Direct inspection through the nasal cavities
Topical decongestant
2) Right angle telescope
3) Flexible fibreoptic nasopharyngoscope
Tonsil inspection
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80. Classification
1 ± tonsils not visible behind the ant pillar
2 ± tonsils visible just beyond the pillar
3 ± tonsils are almost touching
4 ± tonsils meet in the midline
Radiographic films – lateral,
posterioanterior & submento vertex
views
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81. Mandibular growth direction following
adenoidectomy – Linder Aronson – AJO 1989
Materials: 38 Swedish children – 38 controls
Age: 7-12 yrs
After adenoidectomy
Method:
Serial cephalometric study
Post-operative assessment
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82. Results
Experimental group – initially – steeper MP
angles, longer lower face heights
5 yrs postoperative – more horizontal
growth pattern
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82
83. Association of lip posture & the dimensions of tonsils
and sagittal air way with facial morphology
- Trotman et al – Angle Orthod 1997
Method: clinical & ceph data – 207 children
(adenoid or tonsil problems)
Conclusions:
–
More open lip posture - backwardly rotated
face & ↑ lower face height.
– Reduced airway size – backward relocation of
max & mand.
.
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83
84. Effects of maxillary protraction on craniofacial
structures and upper airway dimensions –
Shigetoshi et al – Angle Orthod 2002
Aim: To examine the effect of max. protraction
appliance on upper airway dimensions.
Material: - 25 pts – mean age 9.8yrs
Class III malocclusion
Method:
Lateral cephalogram evaluation
Conclusions:
The max growth had significant positive effect
on the superior airway dimension.
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84
85. Conclusions
1.
2.
3.
↑ in max growth
Inhibition of mand growth
Clockwise rotation of mandible.
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85
86. Does the timing & method of RME have an effect
on the changes in nasal dimension – Karaman,
Bascifti – Angle Orthod 2002
Aim: To assess the effects of RME on
nasopharyngeal area
Sample:
30 pts – perm dent.
Max. constriction and post crossbite
Method:
Lateral & frontal cephalograms – before &
after RME
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86
87. Results
Respiratory area ↑
Nasal cavity width & max. width - ↑
Decrease in nasal airway resistance
MP suture seperated - ↑ in the internasal
volume
Nasal resistance decreased & respiratory
area ↑ after RME
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87
88. Comparison of nasopharyngeal endoscopy & lateral
cephalometric radiography in diagnosis of
nasopharyngeal airway obstruction –
Daniel Filho – AJO 2001
Aim:
2 methods of diagnosing nasopharyngeal
airway obstruction were compared
Material:
30 orthodontic pts – 7-12 yrs
Mouth breathers
Method : Nasopharyngeal endoscopy &
radiographic examination – same day
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89.
Conclusions
Lateral cephalometric radiography – sufficiently
reproducible for diagnosing hypertrophy of the middle
and inferior turbinates
.
Lateral cephalometric radiography – overestimates
turbinate hypertrophy – false positive findings.
Nasopharyngeal videoendoscopy – more suitable in
diagnosing obstruction of nasopharyngeal origin.
Nasal septal deviations
Hypertrophy of the inferior & middle turbinates
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89
90. Cleft palate studies
12 yr old female – submucous cleft, nasal
speech.
Velopharyngeal flap – to reduce
nasopharyngeal leakage.
5 yrs postop change from nose to mouth
breathing.
Marked opening overbite & increase in
lower face height
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91. Subtelny 1978 –
Pharyngeal flap surgery – 24 children
Results:
Chin position downward & backward
No difference in growth of mandible
Warren 1975 –velopharyngeal flap surgery
Increased resistance to nose breathing
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91
92. Comparison of the sizes of adenoidal tissues
and upper airways of subjects with and
without CLCP - Imawaru
Shigetoshi
AJO Aug 2002
Sample
1. 90 juvenile with CLP(CLP/J)
90 controls – control/J
2. 40 adolescents with CLP – CLP/A
40 controls – control/A
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93. Method – measurements using Lat. Ceph
Results – Adenoid tissue
significantly larger in CLP/J than in
control/J
no significant difference betn CLP/A &
control/A
adenoids smaller in CLP/A than in CLP/J
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94. Upper Airway
Significantly smaller in CLP/J than in
control/J
Significantly smaller in CLP/A than in
control/A
CLP/A- increased airway than CLP/J
Control/A larger than control/J
Larger adenoids in CLP/J group decreased
to a smaller size with aging
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95. Sleep Apnea
Defn – It is defined as an intermittent
cessation of air flow at the nose and mouth
during sleep.
10 sec duration – imp.
Sleep apnea syndrome – refers to a clinical
disorder that arises from recurrent apneas
during sleep.
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95
96. Etiology
Loss of muscle tone
Obstruction of nasal passages
Large tonsils
Large tongue
Retrognathic mandible
Obesity
Alcohol
Sedative medications
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100. Clinical features
Behavioral disturbances
Fragmentation of sleep
Nocturnal cerebral hypoxia
Excessive day time sleepiness
Intellectual impairment
Memory loss
Impotence – in men
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100
110. Modified functional appliance for
treatment of sleep apnea
Sleep apnea – sleep with mouth open
Reduced tonicity of genioglossal mucsletongue sucked back
Diagnosis - best by pulmonologist
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111. New appliance – NAPA
Nocturnal airway patency appliance
Mechanism –
– Posturing the tongue more anteriorly
– Inhibiting wide jaw opening
– Assuring adequate air intake when nasal
obstruction exists
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113. Case report
5 OSA patients – polysomnography
Results – substantial reduction in no. of
apneas/hr
All 5 ptns – improvement in sleep
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114. summary
Mandible was protruded to advance the
tongue to the posterior pharyngeal wall
Genioglossus originates from the inner
surface of the mandibular symphysis
¾ distance b/w centric occlusion and full
protrusion was selected
5-7 mm of protrusion
Oral breathing beak – ptns with nasal
congestion
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115.
Ptns – clench their teeth 3 times for 5 secs
every morn. – relaxes the lat.pty muscle
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115
116. Removable Herbst appliance for
treatment OSA – Ernest A.Rider
16 SA ptns
Plunger mechanism
Sustained pharyngeal patency
Advancement
– Edge to edge position
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118. Therapeutic efficacy of an oral
appliance in the treatment of OSA –
2 yr follow up
Purpose – the long term efficacy of
Karwetzky activator
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118
119. Thank you
For more details please visit
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