DISSERTATION SYNOPSIS

DR. VARUN GOYAL

POST GRADUATE STUDENT

DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL

ORTHOPAEDICS

A.B. SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES,

DERALAKATTE, MANGALORE 575 018
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
4th BLOCK, JAYANAGAR, BANGALORE, KARNATKA

ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION

1. DR. VARUN GOYAL

NAME OF THE
POST GRADUATE STUDENT,
CANDIDATE AND
DEPT. OF ORTHODONTICS AND
ADDRESS
DENTOFACIAL ORTHOPAEDICS
A.B.SHETTY MEMORIAL INSTITUTE OF
DENTAL SCIENCES.
DERALAKATTE- MANGALORE 575 018

2. NAME OF THE A.B.SHETTY MEMORIAL INSTITUTE OF

DENTAL SCIENCES.
INSTITUTION
DERALAKATTE MANGALORE 575 018

3. COURSE OF THE STUDY MASTER OF DENTAL SURGERY

AND SUBJECT ORTHODONTICS AND DENTOFACIAL
ORTHOPAEDICS
BRANCH V
4. DATE OF ADMISSION
TO COURSE 31/05/ 2008

5. TITLE OF TOPIC
RELATIONSHIP BETWEEN ARCH WIDTH AND VERTICAL FACIAL
MORPHOLOGY IN UNTREATED ADULTS OF KERALA POPULATION
6. BRIEF RESUME OF THE INTENDED STUDY:

6.1 NEED FOR THE STUDY:

Factors such as age, sex, and ethnic group are important in making a
proper orthodontic treatment plan; another important factor is the facial
growth pattern and its several clinical characteristics 1. It is generally accepted
among orthodontists that a relationship exists between vertical facial morphology and the
dental arch width. A long-face individual usually has narrower transverse
dimensions (dolichofacial) and a short-face individual has wider
transverse dimensions (brachyfacial). Although several studies have
addressed this topic, but their results were inconclusive for example most
of these studies used MP-SN angle as a measure of vertical facial pattern
but due to natural cranial variation, there may be variation in the anterior
cranial base (SN), which may tip up or down 2. Jarabaks ratio is the ratio between
posterior face height (PFH, S-Go) and anterior face height (AFH, Na-Me) and is another
measurement for vertical facial morphology not based on the mandibular
plane. A subject with a high Jarabaks ratio tends to have a longer face, and one with a low
Jarabaks ratio (flat MP) often has a shorter face.

The purpose of the present study was to investigate if dental

arch widths are correlated with vertical facial types ( Jarabaks ratio) and
an attempt will made to find out a definite relationship between vertical
facial pattern and dental arch width. Relationship between vertical facial
morphology and arch width has been found for different ethnic and racial groups
previously .Most investigators have concluded that there are significant differences between
the diverse ethnic and racial groups, and many standards have been developed for different
ethnic groups. All these studies indicate that normal measurements for one group should not
be considered normal for every other race or ethnic group3. This will help in making
individualized arch wires according to each patients pre-treatment arch form and width for
this population type.

6.2 REVIEW OF THE LITERATURE

A study was conducted to study the development of alveolar process and inter molar palatal
width to vertical facial morphology as determined by MP-SN plane. It was concluded that
growth of the alveolar process decreased with decrease in MP-SN angle. But the width of the
palate in the molar region increased as MP-SN angle decreased4.

Another study was conducted to correlate the amount of tooth material and arch
circumference present. It was seen that tooth material was independent of growth pattern but
arch circumference decreased in the high plane group as compared to the low plane group.
Hence it was concluded that high plane syndrome patients have a higher tendency of
crowding5.

In a longitudinal cephalometric study longitudinal growth changes were studied from

posteroanterior cephalometric radiographs of male subjects from 4 to 25 years of age and
female subjects from 4 to 20 years of age. There were gender differences in all variables at
18 years of age. Also it was found that maxillary and mandibular intermolar widths were
significantly correlated with ramus height and total anterior facial height6.

Buccolingual inclination of teeth in subjects with different skeletal patterns was studied. It
was concluded from the study that the maxillary molars and premolars of subjects with a
vertical pattern had a statistically significant greater buccal inclination than those in subjects
with a horizontal pattern1.

Another study was conducted to investigate maxillary and mandibular transverse growth in
untreated female subjects with low, average, and high mandibular plane angles
longitudinally from ages 6 to 18. It was seen that maxillary width was more in subjects with
low and average mandibular plane angle and its growth stopped in all the 3 groups at the age
of 14 years. The mandibular width was also more in subjects with decreased MP-SN angle
but mandibular width kept on increasing for four more years in subjects with average and
low MP-SN angles7.

A study was done to determine whether Kuwaiti adolescents differ from Caucasian
adolescents with respect to their cephalometric values which included anterior and posterior
facial height. The results show that there were significant differences between the Kuwaiti
population and the Caucasian population for the majority of the variables and vertical
growth pattern is more common in Kuwaiti population with decreased posterior height3.

A study was conducted to study if a relationship exists between dental arch width and the
vertical facial pattern determined by the steepness of the mandibular plane and to examine
the differences in dental arch widths between male and female untreated adults. 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 morphology2.

6.3 OBJECTIVES OF THE STUDY

1. The purpose of the present study is to investigate if dental arch widths are correlated
with vertical facial types ( Jarabaks ratio).

2. To find the standard norms and relationship between arch width and facial pattern for
the population under study.
7. MATERIALS AND METHODS
7.1 SOURCE OF THE DATA

The study is set up in A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte,
Mangalore. This study will include 150 untreated adults of Kerala population aged between
18 to 48 years of age and having angle class I malocclusion visiting the Department Of
Orthodontics And Dentofacial Orthopaedics and the subjects will be included in the study as
per the inclusion and exclusion criterias.

INCLUSION CRITERIA
a) Angle class I malocclusion
b) Full dentition except third molars
c) Pre-treatment lateral cephalogram and maxillary and mandibular dental casts
available.
d) Individuals between 18-48 years of age

EXCLUSION CRITERIA

a) Previous orthodontic treatment

b) Edentulous spaces, history of trauma,
c) Significant cuspal wear
d) Extensive restorations or prosthetics
e) Anterior and posterior crossbites
7.2 METHOD OF COLLECTION OF DATA

Lateral Cephalograms will be taken and study casts will be made for each individual using a
standardized and specified technique. Cephalograms will be traced onto .003 inch acetate
paper.

CEPHALOMETRIC ANALYSIS
For each subject the following two cephalometric parameters will be measured and Jarabaks
ratio will be calculated
a) Anterior facial height ( AFH , Na-Me)
b) Posterior facial height ( PFH, S-Go )

DENTAL CAST ANALYSIS

Upper and lower impressions will be made for each subject and dental cast measurements
will be performed using a digital calliper accurate to 0.01 mm. The following maxillary and
mandibular dimensions will be measured and following measurements will be calculated

a) Intercanine width ( from cusp tip of canine of the right side to canine cusp tip of the
left side)
b) Intermolar width ( from Mesiobuccal cusp tip of the first molars of the right side to
the mesiobuccal cusp tip of the molar of the left side )
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS
TO BE CONDUCTED IN PATIENTS OR OTHER HUMANS OR ANIMALS

Yes the study requires the informed consent of the individual / parents / guardian for study
models and lateral cephalometric radiographs.

7.4
HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION :
Yes the ethical clearance letter is enclosed
8. LIST OF REFERENCES

1. Guilherme J , Bombonatti R , Cruz K S , Hassaunuma C Y , Del Santo Jr M 2004

Buccolingual inclinations of posterior teeth in subjects with different facial patterns .
American Journal of Orthodontics and Dentofacial Orthopedics 125 : 316 322

2. C. Matthew Forster , Elaine Sunga and Chun-Hsi Chung 2008 Relationship between
dental arch width and vertical facial morphology in untreated adults. European
Journal of Orthodontics 30: 288294

3. Faraj Behbehani, E.Preston Hicks, Cynthia Beeman, G.Thomas Kluemper , Mary K.

Rayens 2006 Racial Variations in Cephalometric Analysis between Whites and
Kuwaitis. Angle Orthodontist,Vol 76: 406-411
4. 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
Orthodontist 41 : 219 230

5. Nasby J A , Isaacson R J , Worms F W , Speidel T M 1972 Orthodontic extractions

and facial skeletal pattern . Angle Orthodontist 42 : 116 122

6. Stephen F Snodell, Ram S. Nanda, G. Frans Currier 1993 A longitudinal

cephalometric study of transverse and vertical craniofacial growth. American Journal
of Orthodontics and Dentofacial Orthopaedics ;104 :471-483

7. 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 .
American Journal of Orthodontics and Dentofacial Orthopedics 128 : 716 723
9. Signature of the candidate

10. 10.1 Remarks of the guide THE STUDY IS FEASIBLE.

10.2 Name and designation of
Guide( in block letters)
10.3 Signature
DR. DHEERAJ SHETTY
READER
DEPARTMENT OF ORTHODONTICS AND
DENTOFACIAL ORTHOPAEDICS
A.B.SHETTY MEMORIAL INSTITUTE OF
DENTAL SCIENCES, DERALAKATTE,
MANGALORE-575018.

11. 11.1 Co-guide PROF. (DR.) U.S. KRISHNA NAYAK

DEAN(ACADEMICS)
HEAD OF DEPARTMENT
DEPARTMENT OF ORTHODONTICS AND
DENTOFACIAL ORTHOPEDICS.
11.2 SIGNATURE

12. 12.1 Head of the department
12.2 Signature
PROF. (DR.) U.S. KRISHNA NAYAK
DEAN(ACADEMICS)
HEAD OF DEPARTMENT
DEPARTMENT OF ORTHODONTICS AND
DENTOFACIAL ORTHOPEDICS.

13. 13.1 Remarks of the chairman

and principal
13.2 Principal of the institution
PROF.(DR.) B.RAJENDRAPRASAD
PRINCIPAL AND DEAN,
A.B.SHETTY MEMORIAL INSTITUTE OF
DENTAL SCIENCES, DERALAKATTE,
MANGALORE- 575018

13.3 Signature