RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA
BANGALORE
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / Name of the candidate[In block letters] / DR. KANEEZ FATIMA
Permanent address / DEPARTMENT OF PROSTHODONTICS, H.K.E. Society’s S.N Institute of Dental Sciences & Research, Gulbarga, Karnataka
2. / Name of the Institution / H.K.E. Society’s S.N Institute of Dental Sciences & Research, Gulbarga-585105, Karnataka
3. / Course of the study and subjects / PROSTHODONTICS AND CROWN BRIDGE AND IMPLANTOLOGY
4. / Date of admission to the course / 15th MAY 2012
5. / Title of the Topic / QUALITATIVE ESTIMATION OF BONE DENSITY IN DIFFERENT SEGMENTS OF PARTIALLY EDENTULOUS PATIENTS IN INDIAN POULATION
6. / Brief Resume of the Intended work
6.1 / NEED FOR THE STUDY
Oral implant success is mainly influenced by bone quality and bone quantity. Bone quality is an important factor for achieving primary implant stability.1Many methods to measure the quantity and quality of bone were introduced for clinicians, however they would reflect the exact bone situation at the planned implantation site for an individual patient. Determination of local bone mineral density (BMD) may offer a comprehensive description of the bone, therefore it would be a helpful information for the operater. Qualititative computed tomography (Q-CT) i.e. [qualitative interpretation of values derived from Hounsfield Unit (HU) with a suitable calibiration procedure] is one of the choices to determine BMD.2 Nackerts et al.3 demonstrated that density profiles of conventional CT showed stable HU values whereas intensity values in CBCT images are not reliable because the values are influenced by the device used, imaging parameters, and positioning. Accordingly, Naitoh et al.4 found that the trabecular bone volume per total tissue volume using CBCT images was closely correlated with HU values generated from conventional CT images.
The primary aim of this study is to: evaluate bone quality in different segments of partially edentulous jaws by using computed tomography (CT) in Indian population, and to compare if there exists a correlation between bone density measurement with caucasians population.
6.2 / REVIEW OF LITERATURE
1. HIASA K, ABE Y, OKAZAKI Y, NOGAMI K, MIZUMACHI W, AKAGAWA Y1
In that study, the mean HU bone density in the 4 jaw regions decreased in the following order: anterior mandible, anterior maxilla, posterior mandible, and posterior maxilla, which was similar to reported reference values. Furthermore, the mean bone densities predicted to maximize acquired primary implant stability, as assessed by HU, were in the optimal range proposed in the literature. CT using HU was therefore a suitable assessment tool for bone densities prior to dental implantation.
2. Shapurian T, Damoulis PD, Reiser GM, Griffin TJ Rand WM.5
The study evaluated bone quality in different segments of the edentulous jaw and correlate it with demographic data and (2) establish a quantitative and objective assessment of bone quality based on the Hounsfield scale. For that one hundred one randomly selected computerized tomographic (CT) scans were used for the analysis. Edentulous segments ranging from 10 to 30 mm were selected for evaluation and the findings were analyzed and correlated to demographics. This study concluded that knowledge of the Hounsfield value as a quantitative measurement of bone density can be helpful as a diagnostic tool.
3. Schwarz MS, Rothman SLG, Rhodes ML, Chaftez N. 6
Computed tomography has been shown to be a e specially designed reformatted computed radiographic examination adds significantly to information available to the surgeon prior to entering the operation theater. Cross section images perpendicular to the alveolar ridge provide the best information regarding the ridge height and mineralization and the position of the inferior alveolar nerve.
4. Pocek EM, Orlacchio A. 7
The authors are proposing the use of computerized tomography for the evaluation of osseous structures of the maxilla and mandible before installation of titanium fixtures. The results indicate that the CT scan can give information about the structure and the bone density. The height and the width of the alveolar osseous crests and the relationship with the incisive canal and the mandibular canal are clearly demonstrated. The CT scan can facilitate the measurement of the space available in order to install the titanium fixtures.
5. Turkylmaz I, Tumer C, Ozbec EN, Tozum TF.8
They designed a study to determined the relationship between bone densities,insertion torque,and implant stability at implant placement.They concluded that bone density values from preoperative CT Examination may produce an objective assessment of bone quality and significantly correlation between bone density and Implant stability parameters.2007
6.Lindh C, Nilsson M, Linge BK, Petersson A.9
They concluded study to evaluate the potential use of quantitative computed tomography for the assessment of bone mineral density of the edentulous mandible prior to Implant placement. They concluded that computed tomography provides a site related measures of the bone mineral density in the mandible and appears potentially useful as a non invasive method to determine a parameter that may reflect bone quality prior to Implant placement.
6.3 / OBJECTIVES OF THE STUDY
The primary aim of this study is to evaluate bone quality in different segments of partially edentulous jaw in Indian population.
7 / MATERIALS AND METHODS
Total 40 partially edentulous patients will be taken, these 40 patients will be divided into two groups, group A (20 males) and group B (20 females). For the estimation of bone density in four different regions i.e. anterior mandible, anterior maxilla, posterior mandible and posterior maxilla by using computed tomography. The bone density values will be compared with the values of Caucasian population.
7.1 / SOURCE THE DATA
Patients visiting to the HKES SN DENTAL COLLEGE & HOSPITAL GULBARGA.
7.2 / METHOD OF COLLECTION OF DATA
To evaluate the bone density of each partially edentulous patient, a CT scanner (Phillips multi slice MDCT Brilliance CT scanner) will be used. Bone density will be measured in HU in four different regions i.e. anterior mandible, anterior maxilla, posterior mandible and posterior maxilla.
7.3 / Does the study require any investigation or intervention to be conducted on patients or other humans or animals? If so please describe briefly.
YES The study requires investigation on patient’s CT scan.
7.4 / Has ethical clearance have been obtained from your institution in case of 7.3?
YES
8. / LIST OF REFERENCES
1. Hiasa K, Abe Y, Okazaki Y, Nogami K, Mizumachi W, Akagawa Y. Preoperative Computed Tomography-Derived Bone Densities in Hounsfield Units at Implant Sites Acquired Primary Stability. International Scholarly Research Network Dentistry 2011, 5: 1-5.
2. Tschabitscher M et al. Bone mineral density measurement with dental quantitative CT prior to dental implant placement in cadaver mandibles: pilot study. Radiology 2002; 224: 247-52.
3. Bhat S, Shetty S, Shenoy KK. Imaging in implantology. J Indian Prosthodont Soc 2005; 5 : 10-3.
4. Almog DM, Torrado E, Moss ME, Meitner SW, LaMar F. Use of imaging guides in preimplant tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 93 : 483-7.
5. Shapurian T, Damoulis PD, Reiser GM, Griffin TJ, Rand WM. “Quantitative evaluation of bone density using the Hounsfield index,” International Journal of Oral and Maxillofacial Implants 2006; 21:290–297
6. Schwarz MS, Rothman SLG, Rhodes ML, Chaftez N. Computed tomography: Part Preoperative assessment of the mandible for endosseous implants surgery. Int J Oral Maxillofac Implants 1987; 2 : 137-41
7. Pocek EM, Orlacchio A. Role of computerize tomography in endosseous implantology. Monteseni L, Fanucci Dent Cadmos 1991;59:44-9.
8. Turkyilmaz I, T¨oz¨um TF, Tumer C. “Bone density assessments of oral implant sites using computerized tomography,” Journal of Oral Rehabilitation2007;34:267–272.
9. 9.Lindh C, Petersson A, Rohlin M. “Assessment of the trabecular pattern before endosseous implant treatment Diagnostic outcome of periapical radiography in the mandible,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 1996: 82:335–343.
9. / Signature of The Candidate
10. / Remarks of the Guide / Forwarded to university for registration.
11. / Name and Designation
[In block letters]
11.1 / Guide / DR. SUDHINDRA MAHOORKAR
MDS
PROFESSOR,
DEPARTMENT OF PROSTHODONTICS
11.2 / Signature
11.3 / Co-guide
11.4 / Signature
12 / 12.1 / Head Of The Department / DR. ARVIND MOLDI
MDS
PROFESSOR AND HEAD
DEPARTMENT OF
PROSTHODONTICS
12.2 / Signature
13 / 13.1 / Remarks of Chairman and Principal
13.2 / Signature