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TRANSCRIPT
Poster No.
Department Presenting
Author Designation Abstract Title Authors
SR-15 CDER Priyanka Ravi
Senior Resident
Analysis of the existing mobile applications for oral health promotion in India
Ravi Priyanka, Priya Harsh, Kharbanda OP
SR-16 CDER Shailendra singh Rana
senior Resident
Influence of tongue volume, oral cavity volume and their ratio on upper airway: A Cone Beam Computed tomography study
Rana SS, Kharbanda OP
SR-18 CDER Jitender Senior Resident
Quantitative evaluation of Pentraxin-3 levels in peri-miniscrew implant crevicular fluid before and after orthodontic force application
Machawal J, Kharbanda OP, Duggal R, Chauhan SS
SR-19 CDER Anuradha Yadav
Senior Resident
Development of Radiation Dose Reductionprotocol forvarious CBCT applications in CDER:An Institutional Based Study
Shalini Gupta, Anuradha Yadav, Swati Dahiya, Sheetal Sharma
SR-20 CDER Ivaturi Anupama
Senior Resident
Influencers of tobacco cessation in a tertiary dental hospital: A study on the adjuncts to behavioral intervention
Ivaturi Anupama, Prof.Kharbanda OP, Harsh Priya, Ravi Priyanka
SR-21 A, B
CDER Rajiv B Fellow
Abstract A: CollabDDS: Collaborative Digital Diagnosis System for Dental Education and Oral Healthcare Abstract B: Indigenization of Cephalometric Systems: AutoCEPH
Balachandran Rajiv, Kharbanda OP, Davar Savita, RajkhowaMridu Pobon
SR-22 CDER Orthodontics
Karthik S Senior Resident
Three dimensional quantitative assessment ofbone thickness at infrazygomatic crest area for placement of orthodontic bone anchors in unilateral cleft lip and palate patients.
Karthik S, Kharbanda OP
SR-131 CDER Nisha Singh
Senior Resident
Efficacy of Clarithromycin in treating gum disease (periodontitis): A systematic review of randomized controlled trials
Bhatia Anu, Singh Nisha, Dhingra Kunaal
SR-144 CDER Kamalpreet Kaur
MDS Research Fellow
Does Ilizarov's procedure or growth centre transplantation in temporomandibular joint ankylosis treatment leads to neocondylogenesis
Kamalpreet Kaur, AjoyRoychoudhury, OngkilaBhutia, AshuSeith Bhalla, Rahul Yadav, R.M. Pandey, Ragavi
SR-15
TITLE:“Analysis of the Existing Mobile Applications for Oral Health Promotion in India”
Name of Authors:Dr. Ravi Priyanka1, Dr. PriyaHarsh
2, Prof. KharbandaOP
3
Affiliation:
1. Senior Resident, Department of Public Health Dentistry, Centre for Dental Education and
Research, AIIMS, New Delhi.
2. Assistant Professor, Department of Public Health Dentistry, Centre for Dental Education
and Research, AIIMS, New Delhi
3. Professor & Chief, Centre for Dental Education and Research, AIIMS, New Delhi
Presenting Author:
Name- Dr. Priyanka R
Email – [email protected]
Corresponding Author:
Name- Dr. Priyanka R
Email –[email protected]
ABSTRACT BODY:
Introduction:The development of smartphones has led to a proliferation of software
applications (app) in mobiles. They offer a relatively new and promising approach to behavioral
lifestyle interventions. Newer emergence of mobile health (mhealth) has been used in various
sectors of health promotion like mcessation and Mera Aspatal in India. Oral health related
mobile apps hold promise in helping individuals to self-regulate their oral health behaviors.Very
little is known about the extent to which oral health related mobile apps incorporate the
established behavior change theories to promote oral health.Hence this study was conceptualized
to evaluate if the apps are incorporating theory-based strategies aimed at promoting oral health
behavioral change.
Aims:To analyze the content of the mobile applications on oral health promotion in India.
Objectives:
1. To identify the oral health promotion mobile apps available in the Apple App and Google
Play store.
2. To evaluate the content of the mobile apps based on the constructs of self-regulation aspect
of Bandura’s social cognitive theory i.e., self-observation/monitoring, judgment process,
and self-reaction.
Materials and Methods:We analyzed the oral health promotion focused mobile apps that were
designed for Android or iOS. Inclusion criteria were the applications available in English
language, and those targeting the adult only, apps downloaded at least 100 times or more andfree
downloading apps. Exclusion criteria were the mobile apps targeting the dental, medical or
paramedical professionals, apps targeting the children or tobacco quitting, the apps developed by
individual dental chains/ tooth brush manufactures/ insurance companies with no oral health
promotion content.Key words such as oral hygiene, oral care, teeth cleaning, brush teeth, quit
tobacco and stop tobacco were used.
Results:A total of 64 mobile applications were analyzed, out of which 33 were android, 15 were
iOS and 16 were found both in android and iOS.The contents were analyzed based on Self-
regulation aspect of Bandura’s social cognitive theory which involves three main processes self-
observation/ self-monitoring, judgment process and self-reaction. Tooth brush timer (29.5%),
tips for better oral hygiene (68.5%), oral health education content (73.5%), oral hygiene alerts or
reminders (26.5%) and tracking of dental appointments (23.5%) features were commonly found
in the oral health apps in India.One app provided misleading oral health information on the home
remedies such as clove, salt and turmeric for treating dental caries.
Conclusion:Mobile applications play a significant role in oral health promotion. Regulating and
providing a more evidence based contents might help the app users in improving and maintaining
their oral health.With the increase in the number of mobile users in the country a good mobile
application with evidence based content will help in improving the oral health of the mobile app
users.
SR-16
Title: Influence of tongue volume, oral cavity volume and their ratio on upper airway: A Cone Beam
Computed tomography study
Name of Authors: SS. Rana1, O P Kharbanda2
Affiliation:1Fellow in cleft orthodontics, Division of Orthodontics and Dentofacial Deformities,
CDER, AIIMS
2Professor and Head, Division of Orthodontics and Dentofacial and Dentofacial
Deformities,CDER, AIIMS.
CHIEF –CDER, AIIMS
Presenting Author- RanaShailendraSingh1
Email: [email protected]
Corresponding Author: Dr. O P Kharbanda2
Professor, Division of Orthodontics and Dentofacial Deformities, CDER,AIIMS
Email: [email protected]
Abstract
Introduction-Oral cavity volume and tongue volume could be a significant predictor of obstructive sleep
apnea and could have a relationship with upper airway. This study aimed to measure the tongue volume
(TV), oral cavity volume (OCV), and their ratio (TV/OCV) using CBCT. The data were analyzed for their
relationship with upper airway.
Material and method- The volume of oral cavity, tongue and upper airway were obtained by the manual
process of segmentation of CBCT data of 15 subjects. The mean age of the sample was 21.86 years
(range 15–33 years). Segmentation of the upper airway, tongue and oral cavity was performed manually
using MIMICS software at different thresholds for air and the tongue. The Hounsfield units (HU) for
airway volume of the different facial region ranged from -1024 to -500. For tongue volume, Hounsfield
units (HU), ranging from -200 to 200 was calculated.
Results-A significant negative correlation between TV/OCV and oropharynx ( r = − 0.51; P = 0.04), oral
cavity airway volume ( r = − 0.74; P = 0.002) was found. There was a significant and a positive
correlation with TV/OCV and tongue volume (r = 0.65; P = 0.009).
Conclusion- A significant negative correlation established between TV/OCV, oropharynx and oral cavity
airway volume. This finding indicates an influence tongue volume, oral cavity volume and their ratio in
effecting patency of the upper airway and hence development of OSA. Our sample was adult non OSA
subjects and further studies can be done in OSA subjects to know the ratio of TV/OCV and its effect on
upper airway.
SR-18
Title
Quantitative evaluation of Pentraxin-3 levels in peri-miniscrew implant crevicular fluid
before and after orthodontic force application
Name of Authors- Machawal Ja, Kharbanda OP
b, Duggal R
c, Chauhan SS
d
Affiliation: aSeniorResident, Division of Orthodontics and Dentofacial Deformities, CDER,
AIIMS
bProfessor and Head, Division of Orthodontics and Dentofacial Deformities, CDER, AIIMS
CHIEF- CDER, AIIMS
cProfessor, Division of Orthodontics and Dentofacial Deformities, CDER, AIIMS
dProfessor, Department of Biochemistry, AIIMS
Presenting Author- Dr. Jitender
Email- [email protected]
Corresponding Author- Prof. OP Kharbanda
Email- [email protected]
Abstract
Introduction: Peri-implantitis accounts for about 30% of miniscrew failures. Biomarkers are
detected in peri-miniscrew implant crevicular fluid (PMICF) following peri-implantitis. The
level of Pentraxin-3 (PTX-3) is shown toincreaseduring initial phases oforthodontic tooth
movement. This study was undertaken with the aim to evaluate PTX-3 levels in PMICF at
miniscrew site, before and after application of orthodontic forces.
Aims and Objectives:The specific objective of the study was to evaluate the role of PTX-3 as
inflammatory indicator and prognostic marker for stability of miniscrew implant.
Materials and Methods: The study was performed on patients requiring first premolar
extractions followed by space closure using miniscrew as anchorage. PMICF was obtained from
crevices around 40 miniscrewimplant sites using periopaper.Miniscrew implant were loaded at
3 weeks after placement, using 200-g nitinol closed coil springs of 9-mm length. PMICF were
collected after implant placement (T1) and at 24 hours (T2) and prior to miniscrew implant
loading (T3) followed by one hour (T4), 24 hours (T5), one week (T6), 3weeks (T7) and 6 weeks
(T8) after loading of miniscrew implants. Peri-miniscrew tissue was examined for signs of
inflammation, and also, miniscrewimpalnt mobility were assessed. PTX-3 levels were
determined using a commercial ELISA kit.
Results: The mean values of the PTX-3 in maxilla and mandible, as compared to baseline (T3),
T1, T4, T5, T6 (p-value=0.0000) were statistically significant. Statistically, T1, T4 and T6 were
not significant to each other.
Conclusion: The initial rise in the level of PTX3 in PMICF after MSI placement is due to trauma
caused during insertion which could have probably led to the release of TNF-α, macrophages
around peri-implant site. The subsequent increase in level of PTX3 in PMICF after MSI loading
could be correlated to the periodontal remodeling induced by the orthodontic force application.
SR-19
Title: Development of Radiation Dose Reductionprotocol forvarious CBCT applications in
CDER:An Institutional Based Study
Name of Authors: Dr. Shalini Gupta, Dr. Anuradha Yadav, Dr Swati Dahiya, Dr Sheetal
Sharma
Affiliation: Oral Medicine & Radiology
CDER
AIIMS New Delhi
Presenting Authors: Dr. Anuradha Yadav ([email protected])
Dr Swati Dahiya ([email protected])
Dr Sheetal Sharma ([email protected])
Corresponding Author: Dr. Shalini Gupta ([email protected])
Introduction-
Cone Beam Computed Tomography CBCT promises a low radiation dose and high quality accurate 3-
dimensional representation of the osseous elements of maxillofacial skeleton compared to Conventional
CT. However the radiation dose is very high compared to conventional dental radiography like IOPA,
OPG etc.With its diverse applications, this results in patient receiving high radiation doses and concerns
regarding radiation-associated risks have to be addressed. Each CBCT machine has its unique set of
exposure parameters and software; hence the radiation dose varies between machines. There are no
standard protocols for CBCT applications, which can be universally adopted to justify principle of
ALADA (as low as diagnostically achievable).A customized protocol for each CBCT application, which
gives optimal diagnostic image quality at lowest possible radiation dose, needs to be developed.
Aims –
To develop a radiation dose reduction protocol for various CBCT applications in CDER.
Objectives-
1) To investigate the relationships between radiation dose(Dose Area Product) and subjective image
quality at different Voxel size, Field of Views and Exposure time in CBCT machine at CDER.
2) To develop a practicable low- radiation dose protocol with optimal diagnostic image quality for
various CBCT applications.
Methodology –
A retrospective observational study where 1000 DICOM image datasets of patients undergoing CBCT
examination in Oral Medicine & Radiology (OMR) CDER AIIMS wereanalyzed. Patient’s informed
consent was obtained prior to CBCT examination and analysis.
Inclusion criteria was all consecutive patients referred to OMR for undergoing CBCT examination for
evaluation of dental implants, oral and maxillofacial trauma, pathology, craniofacial developmental
disorders, endodontic failures etc. CBCT image datasets acquired by i- CAT (Imaging Sciences
International Hatfield PA USA) with field of view (FOV) ranging from 8X8 to 17X 23 cms and Voxel
sizes ranging from 0.125 to 0.4 mm for various indicationswere selected. The images were visualized on
the monitor of i-CAT (Imaging Sciences International Hatfield PA USA in a dimmed room at a distance
of 60 cm from the diagnostic viewing screen. The evaluation was done by four experienced calibrated
oral and maxillofacial radiologists after undergoing two training sessions prior to the final observations.
Each observer was required to give information using a pro forma to answer a standard set of questions
related to overall image quality and diagnostic confidence with respect to the visualization and delineation
of anatomical structures such as jaw bone morphology, mandibular canal, maxillary sinus, nasal cavity,
mental foramina, alveolar bone height and width etc, localization of dental and maxillofacial pathologies
like dental caries, tooth fractures, impacted supernumerary teeth, internal / external root resorption,
periodontal /periapical pathologies, maxillofacial fractures, bony neoplasms and cysts, development
disorders like dentoalveolar clefts, hyper/ hypoplastic jaw bones , temporomandibular joint anomalies etc.
Diagnostic difficulties posed by metal artifacts were also recorded. A four point rating scale (1= very
poor/ very doubtful; 2= poor / doubtful, unsure; 3= acceptable/ confident; 4= excellent/ very confident)
was used for the CBCT images. The radiation dose (Dose Area Product DAP) was recorded for each scan
which was provided by the CBCT machine. The voxel size, field of view and exposure time for a scan
with average rating score of 3/4 and the corresponding DAP for a particular diagnostic task was tabulated.
A protocol for each CBCT application at lowest DAP and optimal diagnostic image quality was selected.
Conclusion –
The 8X8 field of view, which is the smallest in the i-CAT CBCT machine, suffices most dental
applications. 0.3 voxel size gives optimal image quality for most dental applications. 0.125 voxel size
which is the smallest in the i-CAT CBCT machine gives the highest radiation dose and is required for a
few applications like vertical root fractures with root canal fillings. 8.9 seconds of exposure time gives
optimal image quality without motion artifacts. The present study demonstrated that the radiation dose
could bedecreased while maintaining the optimal diagnostic image quality for various CBCT applications
by selection of optimal voxel size, field of view and exposure time.
SR-20
Title: Influencers of tobacco cessation in a tertiary dental hospital: A study on the adjuncts to behavioral
intervention
Dr.Ivaturi Anupama1, Prof.Kharbanda OP2, Dr.Harsh Priya3, Dr. Ravi Priyanka4
1. Senior Resident, Public Health Dentistry, CDER AIIMS New Delhi 2. Professor and Chief, CDER AIIMS New Delhi 3. Assistant Professor, Public Health Dentistry, CDER AIIMS New Delhi 4. Senior Resident, Public Health Dentistry, CDER AIIMS New Delhi
Presenting Author
Dr. Ivaturi Anupama
Corresponding Author
Dr. Ivaturi Anupama
Abstract Body
Introduction
Tobacco misuse is an endemic habit in South East Asia and widely prevalent in India. About 266.8 million
adults in India consume either smoking or smokeless forms of tobacco. Oral Health issues are
commonplace among tobacco misusers which include staining of teeth, gum problems,. GATS 2017
indicates that more than half of the tobacco misusers intend to quit tobacco. Tobacco Cessation services
not standalone and are generally integrated along with Psychiatry, Pulmonology, Medicine or Dentistry
departments. The footfall in these facilities is closely linked to the referral mechanism of a health facility.
Aims and Objectives
1. To explore the influencers of tobacco cessation among the patients referred for counselling from various departments in CDER, AIIMS New Delhi
2. To identify adjuncts to brief behavioral intervention for tobacco cessation.
Materials and Methods
Tobacco cessation is a service being provided at the Centre for Dental Education and Research, AIIMS
New Delhi. Patients with a history of tobacco misuse are referred from various departments of the
Centre for cessation advise. A detailed interview is conducted as a part of the counseling session during
which data pertaining to triggers for initiation, family history of tobacco misuse, level of dependence,
concomitant risk behaviors like added salt and sugar consumption, physical inactivity and reactance to
photographs of lesions in their oral cavity, if any, is recorded. A month wise cohort of data is maintained.
Analysis of the data recorded from 253 individuals was done and results computed.
Results
The footfall new patients at various departments in CDER OPD in the months of January and February
2019 was 18,322. Out of this, 1.38% reported to the tobacco cessation service. No data on the actual
number of tobacco users visiting the dental OPD exists. Of these 65% reported a positive family history
of tobacco misuse as a cue for initiation. Peer influence, stress and environmental factors were the
other identified influencers. The concomitant risk behaviors-Added sugar in in diet was consumed by
43.75% individuals, 35.9% consumed added salt in diet and 27% do regular physical activity. 35% did not
know about the harms of tobacco misuse until they initiated and 95% never performed self-examination
of the oral cavity. Reactance to the photograph of a lesion in their mouth has triggered an immediate
urge to quit tobacco in 85% of the individuals. The response to cessation advise was better in individuals
referred for dental clearance. However, likelihood of visit to tobacco cessation clinic is positively
correlated to the diagnosis.
Conclusion
Behavioral intervention for tobacco cessation is influenced by multiple determinants and it is significant
to ensure these are addressed not just during cessation, but also during the treatment procedures.
Orientation of the clinicians to the aspect of tobacco cessation being complementary and not
subordinate to any treatment procedures is pivotal for the success of a cessation programme.
SR-21A
Title: CollabDDS: Collaborative Digital Diagnosis System for Dental Education and Oral Healthcare
Name of the Authors: Balachandran Rajiv1, Kharbanda Om Prakash1, Davar Savita2,
RajkhowaMridu Pobon2
Affiliations: 1Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and
Research, All India Institute of Medical Sciences, 2 National informatics Centre, New Delhi, India
Presenting Author:
Name: Rajiv Balachandran
Fellow Cleft and craniofacial Orthodontics
Division of Orthodontics and Dentofacial Deformities, CDER
All India Institute of Medical Sciences
New Delhi-110029, INDIA
Email: [email protected]
Corresponding author
Name: Om P Kharbanda
MDS (Lucknow), M. Orth RCS (Edinburgh), M MEd (Dundee)
CHIEF: Centre for Dental Education and Research
All India Institute of Medical Sciences
New Delhi-110029, INDIA
Professor and Head
Division of Orthodontics and Dentofacial Deformities
All India Institute of Medical Sciences
New Delhi-110029, INDIA
Email: [email protected]
Abstract body
Introduction:CollabDDS (Collaborative Digital Diagnosis System) is one of the pioneer software
programs, which was developed to address the logistic issues in quality oral health care delivery
and dental education in rural/remote areas. It is indigenous software, which provides an integrated
online environment to visualize medical and dental images for diagnosis and treatment planning.
This was developed in 2012 by the synergy of specialists from varied disciplines and knowledge
domains. Since inception, it has evolved into various versions latest being version 2.4 introduced in
Aug, 2018. CollabDDS allows real-time collaboration at two or more remote locations utilizing high
bandwidth and low latency of National Knowledge Network (NKN)
Aims & Objective:To evaluate the efficiency and effectiveness of remote diagnosis using clinical
pictures & radiographs, and its contribution to repository of teaching files for education using
CollabDDS software.
Material and methods: The pilot implementation of CollabDDS was tested between Division of
orthodontics and Dentofacial Deformities, CDER, AIIMS, New Delhi (Expertcentre) and three dental
centres from rest of the country. The three participating centres areGovernment Dental College and
Hospital, Ahmedabad, Government Dental College, Goa and King George's Medical University,
Lucknow. The collaborative session was conductedon weekly basis with each centre. The feedback
from each centre was collected at the end of session regarding the impact of real-time collaboration
on diagnosis and treatment planning, and ease& speed of establishing the network connectivity.
Results:Total 52 cases were discussed through CollabDDSin 31 session with three dental colleges
in 18 months. These cases covered a wide range of modalities including X-rays, CT, MRI and
Scanned images of X-Rays and of specialties in dentistry. At the same time feedback of the software
was collected from each institute to enhance the CollabDDS Software using online questionnaire.
The cases included different domains like Orthodontics, Oral and Maxillofacial Surgery,
Maxillofacial Prosthodontics, Conservative Dentistry and Endodontics, Oral Medicine and Radiology
and Oral Pathology and covered most of the imaging modalities.
Conclusion:The online feedback system showed that 75% case discussion using CollabDDS found
the collaboration helpful in their diagnosis and treatment planning. Nearly all the cases (96.1%)
showed agreement between remote clinician and expert at AIIMS. Ease and speed of connection
were satisfactory in more than 90% of occasions.
The next step is to “roll out” the applications to selective dental/medical colleges to ascertain the
usefulness of such applications. The ultimate goal is to roll out PAN INDIA to provide quality oral
health care to all the citizens of INDIA.
Further developments are in progress which includes enhancing automated dental/orthodontic
cephalometric analysis (AutoCEPH), 3D surface dental scans, statistical shape models of selected
bone anatomies of the Indian population, based on CT data sets and algorithms for reconstruction
of approximate 3-D models from two X-Ray images.
SR-21B
Title: Indigenization of Cephalometric Systems: AutoCEPH
Name of the Authors: Kharbanda Om Prakash,1 Sardana Harish K2, Sardana Viren2
Affiliations: 1Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and
Research, All India Institute of Medical Sciences, 2 Central Scientific Instruments Organisation,
Chandigarh, India.
Presenting Author:
Name: Om P Kharbanda
MDS (Lucknow), M. Orth RCS (Edinburgh), M MEd (Dundee)
CHIEF: Centre for Dental Education and Research
All India Institute of Medical Sciences
New Delhi-110029, INDIA
Professor and Head
Division of Orthodontics and Dentofacial Deformities
All India Institute of Medical Sciences
New Delhi-110029, INDIA
Email: [email protected]
Corresponding author
Name: Om P Kharbanda
Email: [email protected]
AutoCEPH - Cephalometric radiography is a valuable tool in diagnosis, treatment planning and
evaluation of treatment/growth in patient with skeletal/dental malocclusion and craniofacial
anomalies. The traditional manual cephalometric method was, for a long time, the only method
used for obtaining cephalometric measurements. The major disadvantage of this method lies in the
fact that it is relatively time-consuming and cumbersome. Continuous technological advances in
computation and artificial intelligence (AI) combined with scientific advances in dental radiology
resulted in development of computer programs designed to perform cephalometric tracings and
measurements. Presently these analyses are being performed manually or using expensive
imported software.
While, tertiary centres continue to use state of the art technologies available globally for
cephalometric analysis, there lies a need to develop a cheaper and cost effective solution which
could be utilized at smaller centres. To address this problem and provide quality healthcare at
an affordable cost, the team at CSIR-CSIO collaboration with Division of Orthodontics and
Dentofacial Deformities, Centre for Dental Education and Research (CDER), AIIMS, New Delhi,
has developed an indigenous software “AutoCEPH” in an effort towards full filling these lacunae.
AutoCEPH is capable of carrying out standard 15 lateral cephalometric analysis, PA analysis and
superimposition of serial cephalograms.
Also, this AutoCeph software have been incorporated in the CollabDDS (Collaborative Digital
Diagnosis System) software program which developed by the same team in collaboration with NIC,
New Delhi and IIT-B, Mumbai for real-time collaboration.
One more step ahead of this, an automatic cephalometric tracing and landmark plotting algorithm
was developed by applying advances in artificial intelligence, which is being incorporated in the
current application
SR-22
Title: Three dimensional quantitative assessment ofbone thickness at infrazygomatic crest
area for placement of orthodontic bone anchors in unilateral cleft lip and palate patients.
Name of the authors: S. Karthik*, Kharbanda OP**
Affiliation:
*Senior Resident (Non-Acad.)
Division of Orthodontics & Dentofacial Deformities
Centre for Dental Education and Research
All India Institute of Medical Sciences, New Delhi
** CHIEF, CDER
Professor & HOD
Division of Orthodontics & Dentofacial Deformities
Centre for Dental Education and Research
All India Institute of Medical Sciences, New Delhi
Presenting author:
Name: Dr. Karthik S.
Email : [email protected]
Corresponding author:
Name: Dr. OP Kharbanda
Email : [email protected]
Introduction:
Orthodontic bone anchors comprise mainly ofminiplates, mini-implants and palatal implants.The
bone thickness and density are important factors for attaining primary stability and influence the
success rate of bone anchors.Miniplates placed in the infrazygomatic crest area would help to
perform maxillary protraction and wide range of orthodontic tooth movements.The surgical
placement of miniplate in the infrazygomatic crestencounters anatomic limitations like close
proximity to the lateral wall of maxillary sinus and the root tip of permanent molars. Hence it is
necessary to evaluate the bone thickness prior to the placement of miniplates.
Aims &objectives:The retrospective study was conducted to assess the bone thickness at
infrazygomatic crest area for placement of orthodontic bone anchors in cleft lip ad palate patients
using CBCT.
Material & Method:The sample consisted of 16 (Male: 10, Female: 6)surgically operated
unilateral cleft lip and palate (UCLP) patients. The mean age group of patients was 12.37 years
(9-15 years). The CBCT was collected from the archives of Orthodontic department, CDER,
AIIMS. Measurements were made using Dolphin imaging software (Version 11.9 Premium). The
bone thickness at the infra zygomatic crest area was measured in the multiplanar view at
different levels with the reference being the distobuccal root of permanent molars.To verify
theagreement among different measurementsthe same procedure was repeated at two
differenttime periods (T1 and T2) with a two week interval by the same operator.
Results:
ICC revealed a good agreement between the measurements performed during two different time
periods. Mean thickness of infrazygomatic crest (L1: 3.7 - 3.9mm, L2: 2.4 - 2.5mm, L3: 1.8 -
1.9mm) is less than the length of commonly used mono-corticalminiscrews (5 - 7mm). The
difference in bone thickness between cleft and non-cleft side and between genders were not
statistically significant (p>0.05).
Conclusion:
The placement of miniplates into the infrazygomatic crest while staying clear of the molar roots,
the perforation of the maxillary sinus can be expected and the risks should be informed to the
patient in prior to the procedure. Bone thickness varies considerably between individuals. Hence
it is recommended that assessment of the risk–benefit ratio on an individual basis is required
before placement of bone anchors.
SR-131
Title: Efficacy of Clarithromycin in treating gum disease (periodontitis): A systematic review of
randomized controlled trials
Name of the authors:
1. Bhatia Anu
2. Singh Nisha
3. Dhingra Kunaal
Affiliation: Periodontics Division, Centre for Dental Education and Research, AIIMS, New Delhi
Presenting Author:
Name: Dr. Anu Bhatia (Senior Resident, Periodontics Division, Centre for Dental Education and Research, AIIMS, New Delhi) Email: [email protected] Corresponding Author:
Name: Dr. Kunaal Dhingra (Asst. Professor, Periodontics Division, Centre for Dental Education and
Research, AIIMS, New Delhi)
Email: [email protected]
ABSTRACT:
Introduction: Periodontitis (severe gum disease) is multifactorial chronic inflammatory disease that
occurs due to dysbiotic plaque biofilm, which leads to progressive destruction of tooth supporting
apparatus. Use of local or systemic antimicrobials as an adjunct to scaling and root planing (SRP) has
demonstrated statistically significant improvements in the clinical outcomes of periodontitis patients.
Despite such positive findings, the long-term benefits of adjunct antimicrobial therapy are still unclear,
and the evidence for this is still controversial. Clarithromycin (CLM), a macrolide class of antimicrobial
agent, is effective against upper and lower respiratory tract infections, skin and soft tissue infections and
H.pylori infections associated with duodenal ulcers.
CLM has shown broad antimicrobial spectrum against some periodonto-pathogens such as A.
actinomycetemcomitans, P.gingivalis, Prevoltella spp. and F.nucleatum. CLM is an antimicrobial with a
short regimen (three days), favorable tissue distribution, better bioavailability and low incidence of
adverse drug reactions, which could positively impact patient’s compliance to the treatment.
Aims & Objectives: The aim of this systematic review was to evaluate whether the use of local or
systemic clarithromycin would improve the clinical results of non-surgical periodontal therapy for
periodontitis patients.
Materials and methods: Literature search was conducted using electronic databases (PubMed,
Cochrane Central Register of Controlled Trials, Web of Science and EMBASE) and manual searching of
articles published up to December, 2018. Randomized controlled trials (RCTs) evaluating the clinical
efficacy of clarithromycin (local/systemic administration) when used as an adjunct to SRP, were included
in this systematic review. Changes in clinical periodontal parameters viz. probing pocket depth, clinical
attachment level, bleeding on probing, and microbiological parameters along with occurrence of
adverse events were analyzed. Two reviewers independently extracted data regarding characteristics of
study population, interventions, outcomes, and length of follow-up. The assessment of quality of
reporting for included trials was carried out using the elaborated Consolidated Standards of Reporting
Trials (CONSORT) checklist for reporting of RCTs. According to the Cochrane handbook for systematic
reviews of interventions, an overall estimation of plausible risk of bias (low, uncertain or high) was
performed within each study and across all selected studies. The quality of evidence was appraised for
the clinical outcomes separately, across the studies, according to the Grades of Recommendation,
Assessment, Development and Evaluation (GRADE) approach.
Results: The seven included RCTs, limited by their study design and conduct, demonstrated improved
clinical and microbiological outcomes with local (0.5% gel applied subgingivally) and systemic
clarithromycin (500 mg b.i.d. for 3 days) as an adjunct to SRP in periodontitis patients. The detailed
results of meta-analysis and quality of reporting and evidence generated will be presented in the AIIMS
Research day platform presentation. Many important and trivial details of study design and conductance
were lacking in these trials, and therefore, the quality of reporting and methods was generally flawed
with unclear risk of bias.
Conclusion: Although clinical trials revealed some promising results, the evidence concerning the clinical
use of clarithromycin as an adjunct to SRP in treatment of periodontitis is currently lacking and needs
further reinforcement with high quality randomized controlled trials.
SR-144
Title:
Does Ilizarov's procedure or growth centre transplantation in temporomandibular joint
ankylosis treatment leads to neocondylogenesis?
Name of the authors and Affiliation:
Kamalpreet Kaur, M.D.S., Research fellow, Division of Oral and Maxillofacial Surgery, CDER,
All India Institute of Medical Sciences.
AjoyRoychoudhury, M.D.S., Consultant, Division of Oral and Maxillofacial Surgery, CDER, All
India Institute of Medical Sciences.
OngkilaBhutia, M.D.S., Consultant, Division of Oral and Maxillofacial Surgery, CDER, All
India Institute of Medical Sciences.
AshuSeith Bhalla, M.D., Consultant, Department of Radiodiagnosis, All India Institute of
Medical Sciences.
Rahul Yadav, M.D.S., Consultant, Division of Oral and Maxillofacial Surgery, CDER, All India
Institute of Medical Sciences.
R.M. Pandey, Consultant, Department of Biostatistics, All India Institute of Medical Sciences.
Ragavi, B.D.S., Junior Resident, Division of Oral and Maxillofacial Surgery, CDER, All India
Institute of Medical Sciences.
Presenting author:
Ragavi
Corresponding author:
AjoyRoychoudhury
Abstract
Introduction
Both growth centre transplantation i.e., costochondral graft (CCG) interpositional arthroplasty
andIlizarov’sprodecure i.e., transport disc distraction osteogenesis (TDDO) stand mention in
literature for autogenous reconstruction of ramus condyle unit (RCU) in temporomandibular joint
(TMJ) ankylosis surgery, but there has been noprospective study on human beings on comparison
between these modalities. So arandomised prospective study was planned to provide evidence on
comparison of success rate between these modalities.
Aims and Objectives
Aim:To evaluate success rate of TDDO versus CCGinterpositional arthroplasty in non-
recurrantTMJ ankylosis patients in terms of growth, mouth opening and reankylosis.
Objectives:
Primary:
1. To compare neocondylogenesis in patients treated with CCG with that in patients treated with TDDO after treatment of TMJ ankylosis.
Secondary:
2. To compare the two groups formouth opening, reankylosis, occlusion,laterotrusion/ protrusion, chin deviation and midline shift at follow-up.
3. To compare atatleast six months postoperatively, if the new disc formation has occurred in the two groups.
Materials and methods
This randomized controlled clinical trial included 3- 16 years old unilateral, non-recurrent TMJ
ankylosis patients. Patients were randomly enrolled in CCG (n=12) and TDDO (n=12) groups.
Clinical parameters (mouth opening, reankylosis, occlusion, ipsilateral/ contralateral laterotrusion,
protrusion) and radiographic parameters (increase in RCU length, chin deviation, midline
deviation, facial asymmetry) were recorded. Magnetic resonance imaging (MRI) was done at
atleast 6-12 months postoperatively for evaluation of neodisc (n=11). Modification ofKaban’s
protocol for TMJ ankylosis was followed. Patients were followed up for average 15.5 months
(range 8- 23 months). p < 0.05 was considered as statistically significant for all parameters.
Results
Trauma was the most common etiology and male predominance was noticed with mean age of
10.32 +/- 2.85 years. Both groups have shown neocondyle formation. Both group patients have
shown improvement for all parameters; however, inter-group comparison has been non-
significant statistically suggesting both treatment modalities as effective. No reankylosis or
openbite was seen in any group. 3 hour delayed gadolinium enhanced MRI provided best neodisc
interpretation; this technique has not been used in literature for neodisc evaluation in TMJ
ankylosis patients.
Conclusion
TDDO provides successful neocondyle formation, comparable to that achieved with the
considered gold standard treatment modality CCG.TDDO seems to be a better modality as it has
no donor site morbidity, no intermaxillary fixation required, facial symmetry achieved earlier and
neo-disc formation occurs. However, individualized approach, depending on patient preference
and compliance, is important.