Journal of Pierre Fauchard Academy (India Section)

Sanjeev Datana ¹, Shiv Shankar Agarwal ¹, S. K. Bhandari ², Deepak Chauhan ¹

Affiliations
1 Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune – 411040, Maharashtra, IN
2 Department of Oral and Maxillofcial Surgery, Armed Forces Medical College, Pune – 411040, Maharashtra, IN

Abstract

Introduction: It is imperative to have a sound knowledge of causes and various aspects of facial asymmetry. Objectives: To evaluate asymmetry in the lower third of face, correlate the asymmetry with morphological features of the mandible, to correlate the dental and skeletal asymmetry in the mandible and to determine a correlation between these parameters and skeletal asymmetry at point menton using CBCT. Methods: Pre-treatment records of 15 patients (07 males and 08 females, aged 16.93 ± 2.19 years) with asymmetry of lower third of face due to unknown aetiology and chin deviated to right (Group A, study group) were compared with 15 patients (07 males and 08 females, aged 16.12 ± 2.06 years) presenting with no gross facial asymmetry (Group B, control group). Multiplanar Reformation view of CBCT data in sagittal plane was used to assess condylar height, ramus length and mandibular body length in both groups. Results: The mean condylar heights on both sides were similar in Group B (P-value > 0.05). The condylar height on right side in Group A was smaller compared to the left side condyles in both groups (P-value < 0.001). No significant difference was observed in mean ramus and body length between the 02 groups (P-value > 0.05). The skeletal midline deviation was higher compared to the dental midline deviation towards right in Group A (P-value < 0.001). Conclusion: Condylar height is an important factor responsible for asymmetry of the lower third of the face and deviation of chin in adolescent patients with asymmetry of unknown aetiology.

Keywords

CBCT, Condylar Height, Facial Asymmetry

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Varun Govindraj ¹, Sanjeev Datana ¹, Mohit Sharma ², Shiv Shankar Agarwal ¹, Deepak Chauhan ¹

Affiliations
1 Department of Orthodontics and Dentofacial Orthopaedics, AFMC, Dental Unit, Pune - 411010, Maharashtra, IN
2 Department of Orthodontics and Dentofacial Orthopaedics, ADC (R&R), Delhi – 110010, Delhi, IN

Abstract

Aim: To assess improvement of soft tissue profile and upper airway dimensions in skeletal Class II adolescent patients treated with Forsus Fatigue Resistant Device (FRD). Material and Methods: This prospective observational study was planned with a sample size of 15 subjects (5 male & 10 female) diagnosed with mandibular hypoplasia as a cause of Class II malocclusion, requiring fixed functional therapy, with the inclusion criteria of age of 16-25 yrs with the ANB value range of 4°+2° with a non-extraction treatment plan. Pre-functional records were recorded once the leveling and alignment phase was complete and Forsus FRD attachments were placed. Treatment continued till the desired objectives were achieved. Post functional records were made at the end of functional therapy, after removal of Forsus FRD. Along with soft tissue analysis on lateral cephalogram, Acoustic Pharyngometry (AP) was recorded for each patient (Eccovision®” (sleep group solutions Florida, US) for airway changes before and after Forsus FRD. Results: Post functional treatment indicated statistically significant changes in nasolabial angle, upper lip position, upper lip strain, H angle and mento-labial sulcus. On evaluation of upper airway dimensions of the subjects by pharyngometry , there were statistically significant changes in mean upper airway volume and area. Conclusion: Study concluded that Forsus FRD is an effective method for correction of skeletal Class II malocclusion among adolescent patients, enhancing marked improvement in soft tissue profile of the patients, along with significant increase in volume and area of hypopharyngeal and oropharyngeal spaces, thus improving the upper airway patency.

Keywords

Acoustic Pharyngometry, Forsus FRD, Soft Tissue Profile, Upper Airway.

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