Upper Airway Volume in Orthodontic Patients Undergoing Premolar Extraction using MRI

Not yet recruiting

Conditions: Other specified disorders of teethand supporting structures,

Registration Number: CTRI/2025/06/089724

Lead Sponsor: All India Institute of Medical Sciences Bibinagar ,Hyderabad

Brief Summary: This study aims to evaluate the changes in airway volume using MRI following orthodontic treatment with premolar extraction in Bimaxillary protrusion patients.A total of n=32 patients in the age group of 19-28 yrs with Bimaxillary protrusion indicated for fixed orthodontic treatment with extraction of all the first four premolar teeth will be recruited. Pre-treatment intra-extraoral photographs, study models, Magnetic Resonance Imaging (MRI) will be recorded. MRI will be taken in two stages using 3-Tesla Magnetom VIDA system pretreatment before bonding (T0) and immediately after debonding (T1) to assess the volumetric changes in airway and to correlate with arch perimeter. T1 weighted (T1-w) images will be acquired. The standardised procedure will be followed by stabilising head with foam pads keeping Frankfort horizontal plane (FHP) perpendicular to floor in awake patients with supine position and head in neutral anatomical position. Participants will be instructed to breathe normally through their nose, rest their tongue on the back of the front teeth with teeth lightly touching, and refrain from swallowing. Midsagittal and axial views of airway (T1-w images) will be analysed though software Syngo.via siemens (Siemens Medical Solutions USA). The landmarks identification will be done by the senior orthodontist. Extraction of all first premolars willl be done followed by placement of 0.022 ×0.028-inch slot MBT bracket for the fixed appliance therapy. Interradicular titanium miniscrews ( 1.8x8mm) will be inserted immediately after extraction between second premolar and first molar in both the jaws to preventing mesial drift of posterior teeth during levelling and alignment. Post alignment retraction of anterior teeth will be done by enmass retraction using NiTi closed coil spring (9mm with 250 gm force) by anchorage from MS1.The force range of 250-300grams will be used during the entire course of the procedure. Finishing and detailing will be done till 0.021x0.025 TMA wire. Post-treatment MRI of patient will be recorded immediately after debonding and before placement of fixed retainers.Post-treatment records will be obtained.The data will be analyzed using SPSS v29. The inter-operator and intra-operator reliability assessment will be calculated using inter-class coefficient. Normality of data will be assessed using Shapiro-wilk test. Descriptive statistics will be calculated based on population parameters. Pre (T0) and post-treatment (T1) changes in upper airway volume will be analysed with Paired t-test (Mean + SD) and Post-hoc test will be conducted to evaluate for any co-relation with change in arch-length.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 32

Inclusion Criteria

Bimaxillary protrusion (Upper central incisor to Sella Nasion plane to 120 to 135 degree) Age ranging from 19 to 28 years All teeth should be present till the second molar Average growth pattern (Angle Sella Nasion to Gonion Gnathion plane 28 degree to 35 degree) Participants (or Guardian,if minor) must provide written informed consent Body mass index (BMI) within normal limits (18.5 to 23.9kg-m2).

Exclusion Criteria

1. Children/Individuals less than 18 years.
1. Any history of adenoidectomy/tonsillectomy, pharyngeal pathology, nasal 3) Obstruction, snoring, obstructive sleep apnea, claustrophobia, previous orthodontic/orthognathic treatment 4) Dental prosthesis that may have caused safety problems during an MRI scan /pacemaker.
1. Patients not indicated for surgical procedures such as extraction (Bleeding or clotting disorders) 6) Supernumerary or missing teeth till second molar.
1. Periodontally compromised patients.
1. Any systemic disorders, syndromic conditions.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Three-dimensionally assess change in airway volume following orthodontic treatment by extraction mechanics	Baseline and 18 months

Secondary Outcome Measures

Name	Time	Method
To correlate the change in arch perimeter with the airway volume

Trial Locations

Locations (1): All India Institute of Medical Sciences, Bibinagar, Telangana
🇮🇳
Hyderabad, TELANGANA, India
All India Institute of Medical Sciences, Bibinagar, Telangana
🇮🇳Hyderabad, TELANGANA, India
Dr Sabi S Kumar
Principal investigator
6238748362
drsabiaiimsbbnagar@gmail.com