The aim of this paper is to determine the presence or absence of ossification of adductor sesamoid bone, which indicates if a child has attained puberty or not along with other physiological parameters of indicators of growth, using a... more
The aim of this paper is to determine the presence or absence of ossification of adductor sesamoid bone, which indicates if a child has attained puberty or not along with other physiological parameters of indicators of growth, using a computerized, automatic method of assessment. The Greulich and Pyle method is used in medical and dental sciences as a gold standard for assessment of skeletal age. This study describes the implementation of a computerized and automatic method for the identification of adductor sesamoid, using the numerical computing environment MATLAB. The input is the hand–wrist radiographic image, and the output is a Boolean true or false value indicating the presence of the adductor sesamoid bone in the input radiographic image. The onset of the appearance of adductor sesamoid indicates the onset of puberty which is important to diagnose for growth modification treatment in medicine and orthodontics.
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To describe qualitatively and quantitatively the directions and magnitudes of rotations of permanent maxillary central incisors and first molars in the mixed dentition in repaired complete unilateral cleft lip and palate (UCLP) and study... more
To describe qualitatively and quantitatively the directions and magnitudes of rotations of permanent maxillary central incisors and first molars in the mixed dentition in repaired complete unilateral cleft lip and palate (UCLP) and study their associations with absence of teeth in their vicinity. Dental casts and orthodontic records taken prior to orthodontic preparation for alveolar bone grafting of 74 children with repaired UCLP (53 male, 21 female; aged 8.9 ± 1.0 years) were studied. Directions and magnitudes of permanent maxillary central incisor and first molar rotations were recorded. Tooth absence was confirmed from longitudinal radiographic records. Incisor and molar rotations were analyzed in relation to the absence of teeth in their vicinity. Distolabial rotation of the permanent maxillary central incisor was noted in 77.14% on the cleft side, while distopalatal rotation was noted in 82.19% on the noncleft side. Incisor rotation was greater when a permanent tooth was prese...
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Objective : To study the change in the sagittal depth of the bony nasopharynx in patients with unilateral cleft lip and palate (UCLP), following maxillary protraction using reverse headgear. Methods : Nineteen patients (14 male, five... more
Objective : To study the change in the sagittal depth of the bony nasopharynx in patients with unilateral cleft lip and palate (UCLP), following maxillary protraction using reverse headgear. Methods : Nineteen patients (14 male, five female; aged 9.36 ± 2.89 years) with repaired complete UCLP underwent maxillary protraction with a Delaire type reverse headgear at a tertiary-care referral teaching hospital. Control data were taken from five patients (four male, one female; aged 8.25 ± 2.25 years) who did not receive any orthopedic/orthodontic treatment for a similar duration of time as the treated patients. Average treatment/observation period was 11.71 ± 3.39 months for the treated patients and 12.40 ± 2.60 months for the untreated subjects. Changes in the sagittal bony nasopharynx depth were measured by comparing pretreatment (T1) and posttreatment (T2) lateral cephalograms. Correlations between the changes in the bony nasopharynx depth and in other variables measured in the treate...
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One hundred and twenty-five consecutive patients with obstructive jaundice were prospectively studied by ultrasonography to determine the level and cause of obstruction. These were diagnosed precisely in 80 (72%) and 52 patients (41.6%)... more
One hundred and twenty-five consecutive patients with obstructive jaundice were prospectively studied by ultrasonography to determine the level and cause of obstruction. These were diagnosed precisely in 80 (72%) and 52 patients (41.6%) respectively. The results were compared with cholangiography. The final diagnosis was established at surgery (97 cases) and fine needle aspiration cytology (28 cases). While US is an excellent screening modality in distinguishing obstructive and non-obstructive jaundice, cholangiography is still the gold standard for determining the precise anatomic level and cause of obstruction.
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This clinical report describes the simultaneous use of functional and fixed appliances to modify the pattern of dentofacial development and align teeth in preparation for prosthodontic habilitation of a growing child with hypohidrotic... more
This clinical report describes the simultaneous use of functional and fixed appliances to modify the pattern of dentofacial development and align teeth in preparation for prosthodontic habilitation of a growing child with hypohidrotic ectodermal dysplasia. The treatment objective was to create a more favorable starting point for the prosthodontic phase of habilitation by improving the sagittal and vertical skeletal relationships and facial esthetics. This was accomplished through growth modification with functional appliances conducted simultaneously with eruption of maxillary and mandibular molars, dental arch expansion, alignment, and space management using fixed orthodontic appliances. Orthodontic retention was accomplished by means of removable partial dentures. A second phase of orthodontics conducted closer to the age of skeletal maturation will aim at definitive tooth alignment in preparation for dental implant-supported restorations.
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The detection of cervical lymph nodal metastasis and carotid artery invasion by metastatic lymph nodes is an important issue in the management of head and neck malignancies. This study compared the evaluation of metastasis by palpation,... more
The detection of cervical lymph nodal metastasis and carotid artery invasion by metastatic lymph nodes is an important issue in the management of head and neck malignancies. This study compared the evaluation of metastasis by palpation, ultrasonography (USG) and computed tomography (CT) in patients with known head and neck malignancies.Twenty-five consecutive patients with head and neck malignancy were prospectively evaluated for the presence of cervical lymphadenopathy and carotid artery invasion. All patients underwent clinical examination (palpation), USG and CT examination. A modified CT criteria was employed which yielded acceptable results for the detection of metastatic nodes. Radical neck dissection was performed for 26 neck sides, and the results of pre-operative evaluation were confirmed by the surgical and histopathological findings.Palpation, ultrasound and CT have comparable sensitivity in the determination of metastasis involving cervical lymph nodes. Thus palpation sh...
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The role of tongue thrust has often been suspected, long debated and largely dispelled as a primary etiological factor of malocclusion. However, tongue thrust may contribute to poor occlusal intercuspation both during and after treatment.... more
The role of tongue thrust has often been suspected, long debated and largely dispelled as a primary etiological factor of malocclusion. However, tongue thrust may contribute to poor occlusal intercuspation both during and after treatment. A tongue thrust may also develop during orthodontic mechanotherapy as a result of the transient creation of intra and interarch spaces and this little recognized phenomenon was found to occur in many randomly followed cases. In many instances, this seemingly adaptive and secondary response of the tongue posture and function may persist and thereafter impede the resolution of intra and interarch problems.
Research Interests: Dentistry, Orthodontics, Medicine, Humans, Malocclusion, and 4 moreMandible, Posture, Tongue, and Tooth Eruption
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This is a case report of a 20-year-old woman with a hyperdivergent Class III malocclusion, infected mandibular incisors, maxillary midline diastema, and a mild tongue thrust. Extraction of the infected incisors and orthodontic treatment... more
This is a case report of a 20-year-old woman with a hyperdivergent Class III malocclusion, infected mandibular incisors, maxillary midline diastema, and a mild tongue thrust. Extraction of the infected incisors and orthodontic treatment involving partial mesial movement of the remaining mandibular teeth produced a well-intercuspated Class III occlusion. After successful orthodontic treatment, a 4-unit bridge with pontics for the mandibular central incisors completed the rehabilitation and met the functional, esthetic, and occlusal treatment goals. Occlusal stability of the treatment result has been excellent in the 3-year follow-up.
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Purpose: Percutaneous nephrostomy (PCN) is an effective method for achieving temporary drainage of the obstructed urinary system and is usually performed under fluoroscopic guidance alone or more commonly under combined sonographic and... more
Purpose: Percutaneous nephrostomy (PCN) is an effective method for achieving temporary drainage of the obstructed urinary system and is usually performed under fluoroscopic guidance alone or more commonly under combined sonographic and fluoroscopic guidance. We undertook a retrospective analysis of 273 PCNs performed solely under ultrasound (US) guidance with the aim of evaluating the technique and the safety and efficacy of the procedure. Material and Methods: A total of 273 PCN procedures in 267 patients were performed under real-time US guidance using the Seldinger technique. the indications for PCNs comprised benign (n=215) and malignant (n=46) urinary obstruction, and urinary fistulae (n=6). Results: PCN was successful in 269 of the 273 attempts (98.5%). Satisfactory catheter placement was achieved in 245 of the 269 procedures (91.1%) under US guidance. Fluoroscopic assistance for catheter repositioning was required in 24 PCNs owing to the unsatisfactory position of the catheter tip. Major complications occurred in 15 patients (5.6%). Catheter dislodgement and catheter blockage was seen in respectively 12.6% and 3.3% of procedures. Conclusion: in most patients, PCN can be performed safely using real-time sonographic guidance.
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Objectives (1) To evaluate quantitative differences in presurgical presentations of alveolar alignment and nostril anatomy of infants with BCLP treated with nasoalveolar molding (NAM) from those treated with maxillary infant orthopedics... more
Objectives (1) To evaluate quantitative differences in presurgical presentations of alveolar alignment and nostril anatomy of infants with BCLP treated with nasoalveolar molding (NAM) from those treated with maxillary infant orthopedics only (I0) and (2) to detect interrelationships between presurgical nasoalveolar anatomy, age at lip surgery, age of commencing, and durations of alveolar and nasal molding. Methods A retrospective analysis was conducted on nasal-alveolar measurements and presurgical treatment records of infants with BCLP who received lip repair by a single surgeon in a tertiary-care, referral teaching hospital consecutively from 2000 to 2009 after undergoing NAM (n = 29; 51 nostrils) or IO (n = 17; 32 nostrils). Paired t tests analyzed nostril and alveolar symmetry in each group. Intergroup comparisons were made by linear mixed-model regression analyses. Pearson's correlation tests were conducted to detect significant interrelationships within groups. Results Sig...