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Jayan B, Krishnan M, Saraswathy S, Gupta S, Agarwal M, Sahai K. Multicentric evaluation of conventional dosimetry vs bio-dosimetry over a period of two years for a three-point contact. Med J Armed Forces India 2023; 79:378-385. [PMID: 37441291 PMCID: PMC10334216 DOI: 10.1016/j.mjafi.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background Dental radiology represents the best model for evaluating the effects of low-dose ionizing radiation. Therefore, this study evaluated the awareness on radiation hygiene among dental ancillary personnel through a questionnaire and their absorbed doses by physical and biologic dosimetry. Methods The multicentric study included two groups. Group I (N = 30) consisted of dental staff involved in dental radiology. An equal number of personnel who were not related to radiology formed the control group. Knowledge (K), attitude (A), and practice (P) of participants were assessed using a KAP questionnaire. Radiation exposure was evaluated by physical dosimetry at 3 time periods: at the beginning of the study (T1), after 10 months (T2), and at the end after 20 months (T3). Similarly, biologic dosimetry was also carried out at 3 time points by dicentric chromosome aberration assay. The data were compared using percentage analysis, analysis of variance (one-way analysis of variance), and Student's t- test. Results The KAP survey demonstrated enhanced understanding of radiation protection measures and its sound practice by the participants. Physical dosimetry showed a significant increase in absorbed dose at 3 time points: T1, T2, and T3. However, no chromosomal aberrations were observed in blood lymphocytes for any of the participants in the optimized 4-day biodosimetry protocol. Conclusion Good radiation protection protocols-safe distance from the radiation source and wear of lead aprons and thyroid collars-ensured low absorbed doses. The 4-day protocol is an important step toward developing biodosimetry laboratories in the Armed Forces Medical Services for clinical and national radiation countermeasure strategies.
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Affiliation(s)
- Balakrishnan Jayan
- Commandant, Army Dental Centre, (Research & Referral), Delhi Cantt, India
| | - Manu Krishnan
- Commanding Officer & Classified Specialist (Orthodontics), 17 Corps Dental Unit, C/o 99 APO, India
| | - Seema Saraswathy
- Faculty (Biochemistry), Army College of Medical Sciences (ACMS), Delhi, India
| | - Shilpi Gupta
- Senior Research Fellow (Dental Research & Implantology), Institute of Nuclear Medicine & Allied Sciences (INMAS), Defence Research & Development Organization (DRDO), Timarpur, Delhi, India
| | - Manisha Agarwal
- Associate Professor (Lab Sciences), Command Hospital (Eastern Command), Kolkata, India
| | - Kavita Sahai
- Deputy Commandant, Command Hospital (Northern Command), C/o 56 APO, India
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Mathur P, Sharma M, Jayan B, Chaudhary D, Jain V. Letter to the Editor. Angle Orthod 2022; 92:151. [PMID: 34929036 DOI: 10.2319/1945-7103-92.1.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Prateek Mathur
- Department of Orthodontics and Dentofacial Orthopedics, Government Dental Center, Research and Referral, New Delhi, India
| | - Mohit Sharma
- Department of Orthodontics and Dentofacial Orthopedics, Government Dental Center, Research and Referral, New Delhi, India
| | - Balakrishnan Jayan
- Department of Orthodontics and Dentofacial Orthopedics, Government Dental Center, Research and Referral, New Delhi, India
| | - Dinesh Chaudhary
- Department of Orthodontics and Dentofacial Orthopedics, Government Dental Center, Research and Referral, New Delhi, India
| | - Vipul Jain
- Department of Orthodontics and Dentofacial Orthopedics, Government Dental Center, Research and Referral, New Delhi, India
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Affiliation(s)
- Vipul Jain
- Department of Orthodontics, Army Dental Centre Research and Referral, Delhi Cantt, New Delhi, India
| | - Dinesh Chaudhary
- Department of Orthodontics, Army Dental Centre Research and Referral, Delhi Cantt, New Delhi, India
| | - Mohit Sharma
- Department of Orthodontics, Army Dental Centre Research and Referral, Delhi Cantt, New Delhi, India
| | - B Jayan
- Department of Orthodontics, Army Dental Centre Research and Referral, Delhi Cantt, New Delhi, India
| | - Prateek Mathur
- Department of Orthodontics, Army Dental Centre Research and Referral, Delhi Cantt, New Delhi, India
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Singh S, Jayan B. Comparative Evaluation of Periodontally Accelerated Osteogenic Orthodontics (PAOO) Versus Conventional Orthodontic Tooth Movement in Adult Patients with Bimaxillary Dentoalveolar Protrusion. INT J PERIODONT REST 2019; 39:571-577. [PMID: 31226197 DOI: 10.11607/prd.3771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The aim of the study was to comparatively evaluate periodontally accelerated osteogenic orthodontics (PAOO) and conventional fixed orthodontic mechanotherapy in the management of bimaxillary dentoalveolar protrusion in adults. The selected patients were grouped into two groups: Group I: PAOO procedure followed by orthodontic fixed mechanotherapy; Group II: orthodontic fixed mechanotherapy alone. The total treatment time, the quantum of root resorption, and the periodontal status of Group I and Group II were compared. Group I had a shorter treatment time and stable overall periodontal health, both of which were statistically significantly different compared to Group II. Within the limitations of this study, significant statistical differences were found in the clinical and radiographic parameters among the patients treated with PAOO along with conventional fixed orthodontic therapy as compared to the patients treated with orthodontic therapy alone.
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Jayan B, Kadu A. Airway-Focused Orthodontics. J Indian Orthod Soc 2019. [DOI: 10.4103/jios.jios_51_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Balakrishnan Jayan
- Commandant and Airforce Dental Advisor, Air Force institute of Dental Sciences, Bengaluru, Karnataka
| | - Abhijeet Kadu
- Graded Specialist Orthodontics, 12 Corps Dental Unit, Jodhpur, Rajasthan, India
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Affiliation(s)
- Balakrishnan Jayan
- Commandant and Airforce Dental Advisor, Air Force institute of Dental Sciences, Bengaluru, Karnataka
| | - Abhijeet Kadu
- Graded Specialist Orthodontics, 12 Corps Dental Unit, Jodhpur, Rajasthan, India
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Maurya R, Jayan B, Mitra R, Nakra O, Kamat U. Quality control in the orthodontic department of a Tertiary Military Dental Centre: A decade clinical audit. Med J Armed Forces India 2019; 75:318-324. [PMID: 31388237 DOI: 10.1016/j.mjafi.2018.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 09/02/2018] [Indexed: 11/30/2022] Open
Abstract
Background The objective of the study was to analyze the quality control of the treatment within the orthodontic department by determining the workload, type of treatment, and quality of outcome. Method Two hundred eighty patients were selected from departmental archives, who underwent orthodontic treatment since January 2010 and assessed using index of complexity, outcome and treatment need. Descriptive statistics was performed by SPSS, version 21 (IBM, USA). Mann-Whitney U test was applied to assess the difference between complexity and improvement grade. Result Orthodontic treatment was provided to 56.43% of female and 43.57% male patients with a mean age of 16.91 years. Angle's class I type malocclusion was the highest with 35.71%. Preadjusted edgewise metal appliance with 95% dominated the mechanics. About 12.14% and 3.57% patients got benefited with myofunctional and orthopedic treatment, respectively. Ten percent of patients were treated with orthognathic surgery. The mean duration of treatment was 31.19 months with a range of minimum of 17 months to a maximum of 46 months. Among 87.14% patients treated by faculty, 47.95% had difficult complexity grading and 22.95% had very difficult complexity grading. Residents had provided treatment with 63.88% difficult and 19.44% very difficult grade. Mann-Whitney U test of overall complexity and improvement grade showed Z score of -9.25715 which was highly significant. Conclusion The present study concludes that fair quality control is being maintained by the department considering the number of patients, its severity, and excellent outcomes. However, being the premier institute of Indian Armed Forces, regular clinical audit should be conducted to fulfill demand and supply ratio in appropriation.
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Affiliation(s)
- Rajkumar Maurya
- Assistant Professor, Department of Orthodontics, Army Dental Centre (R & R), Delhi, India
| | - B Jayan
- Commandant & Dental Adviser (Air), Army Dental Centre (R & R), Delhi, India
| | - Rajat Mitra
- Associate Professor, Department of Orthodontics, Army Dental Centre (R & R), Delhi, India
| | - Oonit Nakra
- Assistant Professor, Department of Orthodontics, Army Dental Centre (R & R), Delhi, India
| | - Uday Kamat
- Professor, Department of Orthodontics, Army Dental Centre (R & R), Delhi, India
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Bhatia S, Jayan B, Chopra SS. Effect of retraction of anterior teeth on pharyngeal airway and hyoid bone position in Class I bimaxillary dentoalveolar protrusion. Med J Armed Forces India 2016; 72:S17-S23. [PMID: 28050064 DOI: 10.1016/j.mjafi.2016.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/21/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND To test the hypothesis that the retraction of anterior teeth has no effect on the dimensions of pharyngeal airway and to evaluate the retraction of anterior teeth on each parameter of pharyngeal airway. METHODS Twenty-two adult patients of Class I bimaxillary protrusion requiring first premolar extractions with maximum anchorage requirements were selected. The pharyngeal airway and dentofacial parameters of the patients were compared using pre- and post-treatment lateral cephalograms with the help of Student's paired t-test (P < 0.05). The relationship between airway size and dentofacial parameters was also evaluated using Pearson correlation coefficient. RESULTS The upper and lower lips were retracted by 2.25 and 5.4 mm after retraction of the incisors. The tips of upper and lower incisors were retracted by 7.75 and 7.15 mm, respectively. There was a statistically significant decrease in SPP-SPPW (P < 0.05), U-MPW (P < 0.001), TB-TPPW (P < 0.001), and change in HRGN (P < 0.01). A significant correlation was observed between the amount of retraction of lower incisor and decrease in the pharyngeal airway posterior to soft palate (r = 0.102), tongue (r = 0.322), and change in HRGN (r = 0.265). CONCLUSIONS The size of the pharyngeal (velopharyngeal and glossopharyngeal) airway reduced and hyoid bone position changed after retraction of the incisors in extraction space in bimaxillary protrusive adult patients.
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Affiliation(s)
- S Bhatia
- Classified Specialist (Orthodontics), 33 Corps Dental Unit, C/O 99 APO, India
| | - B Jayan
- Consultant (Orthodontics & Dentofacial Orthopedics), Army Dental Centre (R&R), Delhi Cantt 10, India
| | - S S Chopra
- Commanding Officer & Corps Dental Adviser, 3 Corps Dental Unit, C/O 99 APO, India
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Kochar GD, Londhe S, Jayan B, Chopra SS, Kohli S, Verma M, Thapa A. Management of Tooth Size Arch Size Discrepancy (TSASD) in Patients with Sleep Disorder Breathing. Int J Orthod Milwaukee 2016; 27:9-13. [PMID: 29799696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This case report describes the interdisciplinary management of an adult patient with sleep disorder breathing i.e. snoring. Treatment involved combined ortho-surgical management. Marked improvement in general health, good esthetic results, and dental relationships were achieved by the treatment.
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Agarwal SS, Chopra SS, Kumar P, Jayan B, Nehra K, Sharma M. A radiographic study of external apical root resorption in patients treated with single-phase fixed orthodontic therapy. Med J Armed Forces India 2016; 72:S8-S16. [PMID: 28050063 DOI: 10.1016/j.mjafi.2016.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 04/16/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND External apical root resorption (EARR) is one of the most common iatrogenic consequences of orthodontic tooth movement. Many factors like gender, duration, orthodontic force and duration of orthodontic treatment have been implicated to cause EARR. METHODS Pre- and post-treatment OPGs of 60 orthodontic patients (30 males and 30 females) who had undergone treatment with a single phase of fixed orthodontic therapy were randomly selected from institutional archives. The root apices were evaluated for EARR by a single operator on an radiograph viewing box at a standardized source of light using a four-grade ordinal scale. Anterior EARR was measured on the maxillary and mandibular canines. Posterior EARR was measured on premolars, mesiobuccal and distobuccal roots of maxillary first molars and mesial and distal roots of mandibular first molars. The results were compiled and subjected to statistical analysis. RESULTS The cases in which the patients underwent therapeutic extraction had a relatively higher amount of EARR compared to the cases in which the patients were treated by non-extraction therapy (P < 0.001). Odds ratio indicated that extraction cases had two-fold increased risk of EARR than non-extraction cases (P < 0.001). No statistically significant difference was observed in the distribution of EARR based on gender or duration of orthodontic treatment (P > 0.05). CONCLUSION Therapeutic extraction is an important determinant of post-treatment EARR. Gender and duration of orthodontic treatment may not be important variables in the causation of EARR according to the findings of this study. However, longitudinal studies with larger sample size are required to validate the results of this study.
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Affiliation(s)
- S S Agarwal
- Graded Specialist (Orthodontics), 4 Corps Dental Unit, C/O 99 APO, India
| | - S S Chopra
- Classified Specialist (Orthodontics), Army Dental Centre (R&R), New Delhi, India
| | - Prasanna Kumar
- Associate Professor (Orthodontics), Dept of Dental Surgery, Armed Forces Medical College, Pune 411040, India
| | - B Jayan
- Consultant (Orthodontics), Army Dental Centre (R&R), New Delhi, India
| | - K Nehra
- Assistant Professor (Orthodontics), Dept of Dental Surgery, Armed Forces Medical College, Pune 411040, India
| | - Mohit Sharma
- Assistant Professor (Orthodontics), Dept of Dental Surgery, Armed Forces Medical College, Pune 411040, India
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Kochar G, Chakranarayan A, Kohli S, Kohli V, Khanna V, Jayan B, Chopra S, Verma M. Effect of surgical mandibular advancement on pharyngeal airway dimensions: a three-dimensional computed tomography study. Int J Oral Maxillofac Surg 2016; 45:553-9. [DOI: 10.1016/j.ijom.2015.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/31/2015] [Accepted: 10/07/2015] [Indexed: 12/01/2022]
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Agarwal SS, Jayan B, Sahoo NK, Thapa A. Stabilisation of cleft maxilla using modified technique during bi-jaw orthognathic surgical procedures with simultaneous use of two stage surgical splints. Med J Armed Forces India 2016; 71:S415-7. [PMID: 26843758 DOI: 10.1016/j.mjafi.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/01/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- S S Agarwal
- Resident (Orthodontics), Dept of Dental Surg, Armed Forces Medical College, Pune 411040, India
| | - B Jayan
- Consultant (Orthodontics), Army Dental Centre (R&R), Delhi Cantt, India
| | - N K Sahoo
- Professor & Head, Dept of Dental Surg, Armed Forces Medical College, Pune 411040, India
| | - Amrit Thapa
- Graded Specialist (Orthodontics), Command Military Dental Centre (Central Command), Lucknow, India
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Sahoo NK, Jayan B, Roy ID, Desai A. Evaluation of the hard and soft tissue changes after maxillary advancement with rigid external distractor in unilateral cleft lip and palate induced maxillary hypoplasia. Med J Armed Forces India 2016; 71:S355-61. [PMID: 26843750 DOI: 10.1016/j.mjafi.2013.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Midfacial growth retardation in cleft lip and palate (CLP) cases, is seen in all the three dimensions. Conventionally these cases are managed by orthographic surgery which has a high rate of relapse. The application of the distraction osteogenesis (DO) has revolutionized the management protocol. The aim of the study was to evaluate the efficacy of rigid external distractor (RED) in management of cleft induced maxillary hypoplasia. METHODS Ten cases of unilateral CLP between 11 and 20 years of age having gross midfacial deficiency and those who have undergone presurgical orthodontic treatment were included in the study. The cases were operated for Le Fort 1 osteotomy and application of RED. DO was carried out through transnasal traction wires. Clinico-radiological evaluation of presurgical and 1, 6 and 12 months post distraction parameters were statistically analysed by application of paired 't'-test. RESULT There were 4 males and 6 females with a mean age of 15.1 years. The mean distraction carried out was 14.95 mm. There was a significant improvement in all the hard and soft tissue parameters except SNB. Facial profile improvement and stable occlusion was achieved in all the cases. CONCLUSION Midfacial DO using RED is a versatile procedure where the maxilla can be moved in multiple planes to achieve a functional, aesthetic and occlusal balance. Keeping in view of the significant relapse rate the clinicians are required to plan 15-20% excess amount of distraction.
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Affiliation(s)
- N K Sahoo
- Professor & Head, Dept of Dental Surgery, Armed Forces Medical College, Pune 411040, India
| | - B Jayan
- Associate Professor, Dept of Dental Surgery, Armed Forces Medical College, Pune 411040, India
| | - I D Roy
- Senior Specialist, Dept of Dental Surgery, Armed Forces Medical College, Pune 411040, India
| | - Ajay Desai
- Assistant Professor, Army Dental Centre (R&R), Delhi Cantt 110010, India
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Kochar GD, Jayan B, Chopra SS, Mechery R, Goel M, Verma M. Interdisciplinary Management of Patient with Advanced Periodontal Disease. Int J Orthod Milwaukee 2016; 27:51-56. [PMID: 27319043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This case report describes the interdisciplinary management of an adult patient with advanced periodontal disease. Treatment involved orthodontic and periodontal management. Good esthetic results and dental relationships were achieved by the treatment.
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Abstract
Objective
The aim of this study was to find an association between the patients with obstructive sleep apnea (OSA) and with cervical vertebral anomalies and any further correlation between various anomalies with varying severities of OSA.
Materials and Methods
The sample consisted lateral cephalograms of 70 subjects who were diagnosed with OSA and 70 other orthodontic patients who were selected as a control group. The lateral radiographs of both cases and controls were traced and findings were recorded.
Results
In total, 21.42% of subjects in the OSA group and 8.57% in the control group were affected with cervical vertebrae anomalies. The statistical analysis reveals that the number of subjects affected with cervical vertebrae anomalies in OSA group is highly significant. A number of cases of fusion were higher than posterior arch deficiency in OSA group and equal in the control group. However, in both the groups, the number of cases with two vertebrae fusion was higher. Further, the higher number of two vertebrae fusion cases in OSA group was found to be statistically significant. The findings of one-way ANOVA for OSA cases reveals the number of cases affected with cervical vertebrae anomalies were statistically highly significant (P < 0.01) in severe cases of OSA.
Conclusion
Patients of cervical vertebral anomalies may be at higher risk of developing OSA, and the possibility of the presence of cervical vertebral anomalies may increase with the increase in the severity of OSA. The most common vertebral anomaly was found to be two vertebral fusions.
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Affiliation(s)
- Saugat Ray
- Department of Orthodontics and Dentofacial Orthopedics, FDC, Fort, Mumbai, Maharashtra, India
| | - Sanjeev Datana
- Department of Orthodontics and Dentofacial Orthopedics, R&R, Delhi Cant., New Delhi, India
| | | | - Amit Jain
- Department of Orthodontics and Dentofacial Orthopedics, CMDC, Pune, Maharashtra, India
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Kadu A, Chopra SS, Gupta N, Jayan B, Kochar GD. Effect of the personality traits of the patient on pain perception and attitude toward orthodontic treatment. J Indian Orthod Soc 2015. [DOI: 10.1177/0974909820150207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Abhijeet Kadu
- Senior lecturer, Department of Orthodontics and Dentofacial Orthopedics, Army Dental Centre, Research and Referral
| | - Sukhbir S Chopra
- Senior Specialist, Commanding Officer and CORPS Dental Advisor, 3 CORPS Dental Unit, C/O 99 APO
| | - Neetu Gupta
- Resident, Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research Centre, Faridabad, Haryana
| | - Balakrishnan Jayan
- Consultant, Department of Orthodontics and Dentofacial Orthopedics, Division of Orthodontics, Army Dental Centre, Research and Referral, Dhaula Kuan, Delhi Cantonment, Delhi
| | - Gagan Deep Kochar
- Senior Lecturer, Graded Specialist (Orthodontics), Military Dental Centre, Jabalpur, Madhya Pradesh, India
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Agarwal SS, Jayan B, Kumar S. Therapeutic efficacy of a hybrid mandibular advancement device in the management of obstructive sleep apnea assessed with acoustic reflection technique. Indian J Dent Res 2015; 26:86-9. [PMID: 25961623 DOI: 10.4103/0970-9290.156820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Obstructive sleep apnea (OSA) is one of the most common forms of sleep-disordered breathing. Various treatment modalities include behavior modification therapy, nasal continuous positive airway pressure (CPAP), oral appliance therapy, and various surgical modalities. Oral appliances are noninvasive and recommended treatment modality for snoring, mild to moderate OSA cases and severe OSA cases when patient is not compliant to CPAP therapy and unwilling for surgery. Acoustic reflection technique (ART) is a relatively new modality for three-dimensional assessment of airway caliber in various clinical situations. The accuracy and reproducibility of acoustic rhinometry and acoustic pharyngometry assessment are comparable to computerized tomography and magnetic resonance imaging. This case report highlights the therapeutic efficacy of an innovative customized acrylic hybrid mandibular advancement device in the management of polysomnography diagnosed OSA cases, and the treatment results were assessed by ART.
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Affiliation(s)
- S S Agarwal
- Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, Maharashtra, India
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Kadu A, Chopra SS, Gupta N, Jayan B, Kochar GD. Effect of the personality traits of the patient on pain perception and attitude toward orthodontic treatment. J Indian Orthod Soc 2015. [DOI: 10.4103/0301-5742.162260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Abhijeet Kadu
- Senior lecturer, Department of Orthodontics and Dentofacial Orthopedics, Army Dental Centre, Research and Referral
| | - Sukhbir S Chopra
- Senior Specialist, Commanding Officer and CORPS Dental Advisor, 3 CORPS Dental Unit, C/O 99 APO
| | - Neetu Gupta
- Resident, Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research Centre, Faridabad, Haryana
| | - Balakrishnan Jayan
- Consultant, Department of Orthodontics and Dentofacial Orthopedics, Division of Orthodontics, Army Dental Centre, Research and Referral, Dhaula Kuan, Delhi Cantonment, Delhi
| | - Gagan Deep Kochar
- Senior Lecturer, Graded Specialist (Orthodontics), Military Dental Centre, Jabalpur, Madhya Pradesh, India
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Thapa A, Jayan B, Nehra K, Agarwal SS, Patrikar S, Bhattacharya D. Pharyngeal airway analysis in obese and non-obese patients with obstructive sleep apnea syndrome. Med J Armed Forces India 2014; 71:S369-75. [PMID: 26843752 DOI: 10.1016/j.mjafi.2014.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 07/01/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sleep disorders are a group of disorders characterized by abnormalities of respiration during sleep. OSA (Obstructive Sleep Apnea) is characterized by the repetitive episodes of complete or partial collapse of the upper airway during sleep, causing a cessation or a significant reduction of airflow. METHOD The study population consisted of 30 control patients (AHI ≤ 5) events per hour, 74 patients with OSAS, including 34 Obese (BMI ≥ 27) and 40 non-obese (BMI ≤ 27). Polysomnography and measurements of 21 cephalometric variables were carried out for all patients with OSAS. RESULTS Obese patient with OSAS showed significant difference in following cephalometric parameters: (1) PAS (2) MPT (3) MPH (4) PNS-P (5) SAS. In addition, obese patient had longer tongue (TGL), more anteriorly displaced hyoid bones (H-VL) and more anterior displacement of mandible (G-VL) when compared with control groups. The findings of non-obese patients when compared to controls showed all the findings of obese patients and in addition to that narrow bony oropharynx were significant. Step wise regression analysis showed the significant predictors for all patients were MPH, PNS-P, bony nasopharynx (PNSBa), MPT, and palatal length (ANS-PNS) for AHI. The significant predictors for obese OSA (obstructive sleep apnea) group were MAS while for non-obese OSA group ANS-PNS was significant predictor for AHI (apnea-hypopnea index). CONCLUSION Craniofacial landmarks such as increase in hyoid distance, longer tongue and soft palate with increased thickness and narrowing of superior pharyngeal, oropharyngeal and hypopharyngeal airway space may be important risk factors for development of OSAS.
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Affiliation(s)
- Amrit Thapa
- Graded Specialist (Orthodontics), Command Military Dental Centre (Central Command), Lucknow, India
| | - B Jayan
- Consultant (Orthodontics), Army Dental Centre (R&R), Delhi, India
| | - K Nehra
- Assistant Professor (Orthodontics), Dept of Dental Surg, Armed Forces Medical College, Pune 411040, India
| | - S S Agarwal
- Graded Specialist (Orthodontics), Command Military Dental Centre (Central Command), Lucknow, India
| | - Seema Patrikar
- Lecturer (Statistics & Demography), Dept of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - D Bhattacharya
- Senior Advisor (Pulmonary and Sleep Medicine), Military Hosp (Cardio Thoracic Centre), Pune 411040, India
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Sahoo NK, Jayan B, Thakral A, Nagpal V. Skeletal relapse following sagittal split ramus osteotomy advancement. J Maxillofac Oral Surg 2014; 14:357-62. [PMID: 26028858 DOI: 10.1007/s12663-014-0640-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 06/14/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Sagittal split ramus osteotomy (SSRO) is an accepted and standard procedure to address mandibular corpus deficiency. The relapse following the mandibular advancement has a negative impact both on clinician and patient. PURPOSE To analyse the hard tissue changes and to investigate relapse following SSRO advancement procedure. MATERIALS AND METHODS A retrospective review of 21 patients treated by bilateral SSRO advancement at our institute was conducted. Lateral cephalograms obtained at pre-treatment (T1), pre-surgery (T2), 2 months (T3) and 2 years post-surgery (T4) were evaluated by an independent investigator. The data T2-T3 revealed immediate postoperative changes, and T3-T4 revealed skeletal relapse following surgery after 2 years. RESULTS Twelve females and nine males with age ranging from 16 to 24 years underwent mandibular advancement. The mean follow-up period was 2 years 7 months ± 4 months. The mean mandibular advancement at pogonion was 5.1 ± 1.25 mm with significant improvement in SNB, ANB, CoGn, maxillo-mandibular differential and SN:GoPg ratio following surgery. Comparison of the outcomes following surgery revealed that the mean relapse at pogonion was 0.2 ± 0.44 mm. B point, mandibular corpus length, anterior and posterior facial height remained stable with no significant relapse following mandibular advancement. CONCLUSION Sagittal split ramus osteotomy within the range of mandibular advancement is a stable procedure.
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Affiliation(s)
- Nanda Kishore Sahoo
- Department of Dental Surgery, Armed Forces Medical College, Pune, 411040 Maharashtra India
| | - Balakrishnan Jayan
- Department of Dental Surgery, Armed Forces Medical College, Pune, 411040 Maharashtra India
| | - Ankur Thakral
- 15 Corps Dental Unit, C/O 56 APO, Pune, 903515 India
| | - Vishvaroop Nagpal
- Department of Dental Surgery, Armed Forces Medical College, Pune, 411040 Maharashtra India
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Panwar M, Jayan B, Arora V, Singh S. Orthodontic management of dentition in patients with periodontally compromised dentition. J Indian Soc Periodontol 2014; 18:200-4. [PMID: 24872629 PMCID: PMC4033887 DOI: 10.4103/0972-124x.131325] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 10/11/2013] [Indexed: 11/13/2022] Open
Abstract
Background: An increasing number of adult patients are seeking orthodontic treatment to improve their dental appearance. However, special attention must be given to the periodontal status of the adults as periodontal disease and its sequel, such as pathologic migration of anterior teeth, result in esthetic and functional problems. In such adult patients, an interdisciplinary approach often offers the best option for achieving a predictable outcome to solve complex clinical problems. Materials and Methods: A prospective study was carried out on 20 adult patients [mean age = 33.3 ± 4.52 (SD), 11 females and nine males] with periodontally compromised and malaligned dentition. Loe and Silness Gingival Index (GI), Ramfjord's Periodontal Disease Index (PDI) and Dental Aesthetic Index (DAI) were recorded at the start and after completion of treatment. Results: Comparison of GI, PDI and DAI before and after completion of treatment showed statistically significant differences, indicating the relevance of combined orthodontic–periodontic treatment in periodontally compromised dentition (P < 0.01). Conclusion: The outcome of the study showed that an interdisciplinary approach is a simple solution for complex clinical problems arising as a sequel to periodontitis, such as pathological tooth migration, restoring function, esthetics and periodontal health.
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Affiliation(s)
- Mohinder Panwar
- Adjutant General's Branch, IHQ, MOD (Army), New Delhi, India
| | - B Jayan
- Department of Dentistry, AFMC, Pune, Maharashtra, India
| | - Vimal Arora
- Adjutant General's Branch, IHQ, MOD (Army), New Delhi, India
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Jayan B, Prasad B, Dhiman RK. Role of Oral Appliances in the Management of Sleep Disorders. Med J Armed Forces India 2011; 65:123-7. [PMID: 27408216 DOI: 10.1016/s0377-1237(09)80123-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 12/17/2008] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND A study was undertaken with the aim to evaluate the therapeutic and clinical efficacy of oral appliances in the management of upper airway sleep disorders like snoring and obstructive sleep apnea (OSA). METHODS Oral appliances were prescribed in eight cases of non - apneic snoring and 42 polysomnography (PSG) diagnosed cases of OSA. The cases were assessed on Epworth Sleepiness Scale (ESS) and Apnea - Hypopnea Index (AHI). RESULT 62.5% of the non - apneic snoring cases reported gross reduction/cessation of snoring. In the OSA cases, the mean AHI and ESS scores decreased from 51.48 ± 23.70 to 32.78 ± 18.06 and 12.50 ± 3.57 to 7.20 ± 2.917 respectively. A statistically significant (p<0.0001) improvement in AHI and ESS scores was observed. CONCLUSION Short term therapeutic efficacy of oral appliances therapy in non-apneic snoring and OSA cases was observed.
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Affiliation(s)
- B Jayan
- Classified Specialist (Orthodontics), Army Dental Centre, Army Hospital (R&R), Delhi Cantt 10
| | - Bnbm Prasad
- Consultant (Medicine and Respiratory Medicine), MH (CTC), Pune
| | - R K Dhiman
- Classified Specialist (Prosthodontics), Commanding Officer, Military Dental Centre Allahabad
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Panwar M, Jayan B, Mandlik VB, Jha AK. Combined Periodontal and Orthodontic Treatment of Pathologic Migration of Anterior Teeth. Med J Armed Forces India 2011; 66:67-9. [PMID: 27365709 DOI: 10.1016/s0377-1237(10)80100-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- M Panwar
- Classified Specialist (Periodontics), Army Dental Centre, (R&R) Delhi Cantt-10
| | - B Jayan
- Commanding Officer, 3 Corps Dental Unit, C/o 99 APO, Pune-40
| | - V B Mandlik
- Commanding Officer, 10 Corps Dental Unit, C/o 56 APO, Pune-40
| | - A K Jha
- Reader, Department of Dental Surgery, AFMC, Pune-40
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Roy Chowdhury SK, Menon PS, Vasant MR, Jayan B, Dhiman RK, Karkun S. Secondary and Delayed Bone Grafting in Alveolar and Anterior Palatal Clefts. Med J Armed Forces India 2006; 62:231-5. [PMID: 27365684 PMCID: PMC4922870 DOI: 10.1016/s0377-1237(06)80007-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2005] [Accepted: 12/26/2005] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Surgical repair with suitable bone graft / substitutes plays an important role in rehabilitation of individuals with residual anterior palatal or alveolar defects associated with an oronasal fistula. METHODS 52 cases were treated by secondary or delayed bone grafting of the alveolar defects in isolation or associated with defects of the anterior palate from July 2002 - Nov 2004. Dimension and the extent of the defects were assessed with the help of radiographs & maxillofacial CT. Cephalometric analysis, presurgical orthodontics and dentofacial orthopedics preceded surgical repair with cancellous graft from the iliac crest, followed by post surgical orthodontics and prosthetic rehabilitation. RESULT Satisfactory results were achieved in 49 cases with three cases showing failure of graft acceptance. Postoperative clinical and radiological evaluation for all the patients was done at an interval of one, three and six months. Bone density and trabeculation was comparable to the adjacent bone within six months. CONCLUSION Recreating the bony continuity of the maxillary arch followed by orthodontic correction of dental discrepancies achieves a comprehensive orthosurgical correction.
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Affiliation(s)
| | - P S Menon
- Associate Professor (Oral & Maxillofacial Surgery), AFMC, Pune-40
| | - M R Vasant
- Classified Specialist (Orthodontics), MDC (BEG), Kirkee, Pune
| | - B Jayan
- Classified Specialist (Orthodontics), Delhi Cantt
| | - R K Dhiman
- Classified Specialist (Prosthodontics), Delhi Cantt
| | - S Karkun
- Classified Specialist (Oral & Maxillofacial Surgery), Army Dental Centre (R & R), Delhi Cantt - 110010
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