ViVan Ratio for Maxillomandibular Tooth Material Discrepancy.

According to the guidelines of the American and Indian Boards of Orthodontics, it is essential to include second molars, while managing an orthodontic case. Therefore, the present study was planned to determine maxilla-mandibular tooth material discrepancy.METHODSThe study sample consisted of study casts of 300 subjects in the age range of 18-30 years. Samples having a full complement of teeth with Angle’s Class I molar and canine relationships, good intercuspation, normal overjet and overbite and minimal crowding and spacing were included in the study. Tooth dimensions were measured using digital vernier caliper (accurate to 0.01 mm) and overall ratio was calculated. The data was statistically analysed for range, mean, standard deviation and coefficient of variation.RESULTSViVan ratio was found to be 90.79 with standard deviation of 3.13, variance of 9.81 and range was 83.55 - 95.82.CONCLUSIONSIdeal tooth proportions play an important role in achieving good occlusion at the end of orthodontic treatment. The ViVan ratio obtained in the study included second molars and this would benefit the orthodontist in proper treatment planning. This ratio will add importance for improved results at the finish of orthodontic treatment.

Comparison of Bolton s Ratio for Evaluation of Tooth Size Discrepancy between Maxillary and Mandibular Arches in Vidarbha Population

Bolton’s ratio is an indispensable parameter used in orthodontic diagnosis to evaluate the tooth size discrepancy. However, these norms have been established for Caucasian population and population variations necessitate the evaluation of these ratios for Vidarbha population. The objectives of the present study were to determine Bolton’s ratio for Vidarbha population, compare them with original Bolton’s ratios and determine the clinical significance of these differences.METHODSThe study sample consisted of study casts of 300 subjects in the age range of 18-30 years, all belonging to Vidarbha population, having a full complement of teeth. Tooth dimensions were measured using digital vernier caliper and Bolton’s overall ratio and anterior were calculated. The data calculated was statistically analysed for range, mean, standard deviation and coefficient of variation. Unpaired t-test was applied to draw a difference between the results of this study and the results from Bolton’s study.RESULTSBolton’s overall and anterior ratio norms for Vidarbha population sample were found to be 88.15 and 78.50, respectively, with standard deviation of 3.27 and 3.19, respectively. The range of overall ratio noted was 80.36–98.44, and the range of anterior ratio was 67.74–89.70.CONCLUSIONSIn general, the values obtained from this study for the Vidarbha population differ from the data of Caucasian population. So, it can be inferred that the established Bolton’s values for Caucasians cannot be used for the Vidarbha population. Hence, population specific standards are necessary for clinical assessment.

Establishment of Cephalometric Norms for UCLP Cases from Central India Population Falling Under Goslon 1 and 2 Based on Burstone Analysis.

This study was done as there is a need to evaluate separate hard and soft tissue parameters for UCLP as we cannot compare the deformity with normal. A study by Abhilasha Yadav has defined the Burstone norms for class I subjects in Central India as compared to Caucasians. The objective is to derive norms for UCLP itself as the pattern of growth and development of bone, muscle is not normal that can be compared with any population and needs to treated, based on specific norms.METHODS75 cases of UCLP from Central India, with an age range of 18-25 yrs. were selected for the study. The COGS analysis values for Central Indian UCLP cases (falling under GOSLON 1 and 2) was established and compared with class I Caucasians and class I Central Indian subjects. The cephalograms were traced, analysed and interpreted using the landmarks and values established in Burstone analysis (cephalometric analysis for orthognathic surgery). The mean, standard deviation and Z values were calculated to compare the values between three groups.RESULTSThe Central Indian UCLP cases demonstrated decreased anterior cranial base length, upper third height of face, decreased anteroposterior maxillary length, decreased upper and lower incisor height as well as molar height, retroclined upper anterior, significantly decreased facial convexity, nasolabial angle and reduced maxillary prognathism while mandible showed prognathism.CONCLUSIONSThe study reported significant differences in certain cephalometric parameters of UCLP cases from central India population with that of Caucasian and class I central Indian population. The results obtained for central India’s UCLP cases can be used as cephalometric norms for planning orthognathic surgery specifically for cleft cases.

ViVan Formula- A Modified Formula for Estimating the Mesiodistal Width of Maxillary Central and Lateral Incisor

It is a frequent occurrence that teeth especially maxillary incisors are either completely avulsed or fractured due to trauma in facial region. Replacement of these missing teeth always possess a challenge if there are no prior dental records of the patient. Also, maxillary lateral incisors are frequently smaller in size – “Peg shaped” or congenitally absent. Aesthetic correction or/and replacement of this tooth also poses a problem when prior records are missing.METHODSTotally, 300 study casts were taken from the patients and digital vernier caliper was used to measure the mesiodistal width of maxillary central and lateral incisors and mandibular lateral incisors on both the sides. The mean and the standard deviations of the width was assessed. Similarly, the proportion between the widths of the maxillary lateral incisor and mandibular lateral incisor was also assessed and based on the proportions, the ViVan formula was derived.RESULTSBased on the proportions, ViVan Formula for Central Incisor and Lateral Incisor is derived.CONCLUSIONSViVan ratio determined the mesiodistal width of central and lateral incisor with the help of mandibular lateral incisor. This formula provides results accurately and with minimum error. One of the important diagnostic tools is the use of diagnostic model for estimation of tooth size. Tooth size must be proportionate to jaw size so as to avoid tooth size arch length discrepancy.

A Review on Evolution and Controversies Regarding Surgical Methods and Timing of Palatoplasty in UCLP Cases

To establish speech, growth and development of maxillofacial region and hearing etc. towards normal is the aim of every professional working for cleft care. With a quest to attain and normalize the growth and development in CLP since ages, researchers and workers have invented and still inventing newer technique to treat them. The procedure of surgeries has evolved over a period of time. Controversies concerning speech and maxillofacial growth have challenged many surgeons who have come up with different views in surgical methods. Studies suggest that the palate repair is the main cause of the maxilla and growth disturbance that later is responsible for speech impairment due to fibrous tissue in anterior palate and constricted tissue in uvula due to repair. Many authors have noted that delayed hard palate repair has more positive effects on maxillary growth than that of early hard palate repair, but studies have also proved that late palate repair impair the speech with due respect. This unsolved controversy whether to opt for late/ early palatoplasty w.r.t to the improvement in speech is still unsolved controversy. The purpose of this article is to review the history of cleft palate surgery, its evolution, various surgical methods and optimal timing of cleft palate repair.

Clinicoepidemiological profile and predictors of severe illness in young infants (< 60 days) reporting to a hospital in North India.

OBJECTIVES: To describe the clinical and epidemiological profile of young infants reporting to a hospital and assess previously proposed simple clinical signs for their value in enabling health workers to detect young infants with severe illness warranting hospital admission. METHODS: Observational study of infants less than 2 months of age presenting consecutively to a large public hospital in South Delhi who were evaluated by a health worker (nurse), on a standardized list of signs and symptoms, and the ability of these were evaluated against the need for hospital admission which was assessed by an independent pediatrician. RESULTS: Of the 1624 young infants triaged, 878 were enrolled into the study. Of these 100 (11%) were below 7 days of age, for whom the common reasons for seeking care were jaundice (52%), not feeding well (6%) and fever (5%). The remaining 778 (89%) were 7-59 days of age with respiratory symptoms as the main presenting complaints (29.1%). The primary clinical diagnoses in infants with serious illness needing admission to hospital in the age group <7 days (n = 66) were hyperbilirubinemia (56%) and sepsis (21%). In those between 7-27 days of age (n = 60), primary diagnoses were sepsis (27%), pneumonia (13%), diarrhea, dysentery or dehydration (10%), while in the age group 28-59 days of age (n = 47) pneumonia (40%), sepsis (19%) and diarrhea or dehydration (13%) were the common primary diagnoses. Signs that had at least a prevalence of 5% and were strong predictors for all the age categories studied were history of difficult feeding (OR 6.8 for 0-6 days, 15.1 for 2-27 days and 6.2 for 28-59 days age groups), not feeding well on observation (OR 13.7, 27.6 and 20.9 respectively for the 3 age groups), temperature > 37.5C (OR 21.8, 14.6 and 30.0 respectively for the 3 age groups) and respiratory rate > 60 per minute (OR 6.8, 15.1 and 21.0 respectively for the 3 age groups). Additional strong predictors with > 5% prevalence were history of convulsions (OR 7.9, only in 0-6 day age group), lethargy (OR 26.1, only in 7-27 day age group), and history of diarrhea (OR 3.0 for 2-27 days and 2.2 for 28-59 days age groups). CONCLUSIONS: Simple clinical signs are useful in hands of health worker for identifying neonates with serious illness warranting hospital admission. These will be of use in the further development of clinical algorithms for the national integrated management of childhood illnesses.

Management of carcinoma breast with conservative surgery and radiation therapy-experience in a developing country.

Between 1980 and 1987, 14 patients with breast cancer who refused mastectomy were treated at the V.N. Cancer Centre, Coimbatore, with excision of the lump, followed by radiation therapy and adjuvant chemotherapy/hormonal therapy. No attempt was made to boost the tumour bed with interstitial implants or electron beam for want of these facilities. No patient developed local or loco-regional disease or distant metastases during the period of follow-up which ranged between 10 and 76 months. Ten of the 14 patients have been followed up for more than two years. Most published data on breast-conserving treatment for cancer breast are from the U.S., UK and Europe. There are not many papers published from the developing countries. This paper gives an insight into this subject in the developing countries.