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Dr Mohan Z Mani

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On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Research Protocol
Year : 2022 | Month : December | Volume : 16 | Issue : 12 | Page : ZK04 - ZK07 Full Version

Assessment of a New Regression Equation for Mixed Dentition Space Analysis in Paediatric Population of Wardha, Maharashtra, India- A Research Protocol


Published: December 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/58051.17306
Rutuja Purushottam Ragit, Punit Ratnakar Fulzele, Nilima Thosar

1. Postgraduate Student, Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India. 2. Professor, Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India. 3. Professor and Head, Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India.

Correspondence Address :
Rutuja Purushottam Ragit,
Postgraduate Student, Department of Paediatric and Preventive Dentistry, Sharad Pawar Dental College, Sawangi, Wardha, Maharashtra, India.
E-mail: rutujaragit25@gmail.com

Abstract

Introduction: Prediction of the mesiodistal crown width of unerupted canines and premolars in mixed dentition analysis is crucial. When Tanaka-Johnston’s equations, the most popular approach, are applied to diverse ethnic groups, their accuracy is questioned.

Aim: To derive a new regression equation of mixed dentition space analysis for predicting the size of unerupted canines and premolars teeth among paediatric population of Wardha, Maharashtra, India.

Materials and Methods: The study will be conducted in two phases. The study design for First phase is observational and second phase is interventional. Dental study casts of 400 patients aged 11-18 years will be selected in the first phase. A Digital Vernier Caliper (DVC) will be used to measure the mesiodistal crown dimension of all erupted permanent teeth up to first molar. Between four mandibular incisors and the canine-premolar segments of both arches, correlation and linear regression equations will be created. In the second phase, 30 children aged 6-11 years will be randomly selected. Analysis of Tanaka-Johnston’s equations, Huckaba GW equation and the proposed equation will be compared and further statistical analysis will be carried out.

Results: New derived regression equation will allow the closer prediction of the size of unerupted canines and premolars in the paediatric population of Wardha.

Conclusion: This new equation will allow an accurate prediction of the width of unerupted canines and premolars at an earlier age in the said population.

Keywords

Canine, Children, Huckaba’s analysis, Mesiodistal width, Permanent, Premolar, Tanaka-Johnston’s analysis, Unerupted

The study of mixed dentition is a significant part of an orthodontic diagnosis. In this analysis, mesiodistal width of unerupted permanent canines and premolars are predicted and space that is available is assessed if there is sufficient space for unerupted teeth. Treatment can be planned according to this prediction ranging from simple and conservative procedures that include constant follow-up and observation, space maintenance, eruption guidance, expansion and regaining space to a more complicated treatment plan that is serial extraction (1),(2).

The earliest attempt to predict the tooth size was done by GV Black. However, due to high individual variability in tooth size the data was unreliable clinically (3). A significant linear correlation between the mesiodistal size of the permanent canines and premolars and the mesiodistal size of the lower permanent incisors was observed by Carey CW (4). Many attempts have been made since then to evaluate the sizes of unerupted permanent teeth (4),(5),(6).

Among various methods of mixed dentition space analysis, Tanaka-Johnston’s method is the most commonly used in which the regression equation is based on the erupted permanent mandibular incisors (7). The advantage of the method proposed by Tanaka and Johnston’s method (1974) is that it does not require a radiograph. It is based on a prediction equation derived from mesiodistal width of erupted permanent teeth during the period of mixed dentition. However, the size of unerupted teeth is likely to be overestimated by this method (8). The other method, which involves radiographs, has the advantage of being able to measure unerupted teeth and providing more precise results, but it exposes patients to ionising radiation and necessitates extra radiographs and expenditures (8).

Huckaba GW introduced the radiographic method in 1964. In this method, he used an equation related to the measurement of teeth that are erupted to their radiographic images to get proportionate sizes of unerupted teeth to overcome the effect of radiographic distortion (8).

Among different populations and civilizations, it was found that mesiodistal width of teeth varies considerably because of environmental and genetic factors. Moreover, according to some studies sexual dimorphism was seen in tooth sizes (9),(10),(11),(12). Therefore, accuracy may be uncertain in the published norms when they are applied to different ethnicities. Therefore, for each ethnic group, particular predictive data may be necessary. However, a good association between the dimension of canines and premolars and the dimension of permanent lower incisors is based on some predictive equation methods (13). While, in a survey of the Syrian population, Nourallah AW et al., observed that there was an improvement in survey results when the sum of the width of upper first molars and lower central incisors as predictors was applied as compared to the total width of permanent mandibular four incisors (2).

As mandibular incisors are the first teeth to erupt in the permanent teeth and if their dimensions could perhaps be used for predicting the width of unerupted teeth, then it may be advantageous for analysis of mixed dentition at an early age (13). The concept of regression equations was suggested by different authors and was often applied to estimate the sizes of unerupted canines and premolars teeth. But these methods tend to overestimate or underestimate the size of tooth width, and a new regression equation need to be proposed for a more accurate prediction of these teeth (8).

Objectives

1. To derive a new regression equation for space analysis of mixed dentition for predicting the size of unerupted permanent canines and premolars teeth among paediatric population of Wardha, Maharashtra, India.
2. To assess the accuracy of the new regression equation by comparing the prediction values of the mesiodistal width of unerupted canines and premolars calculated by the Tanaka and Johnston’s method and the Huckaba method.

Material and Methods

The study will be conducted in two phases. The study design of first phase will be a retrospective observational in which cast selection of the 400 patients who reported to the Department of Paediatric and Preventive Dentistry for the treatment will be done. The study design of second phase will be cross-sectional in which 30 children will be selected. There will be random selection of the patient according to selection criteria. Total time period required for the study will be two years. Ethical approval for the study was obtained from the Institutional Ethics Committee (Ref ID no. IEC/2022/758).

Phase-I

A retrospective observational phase in which first cast selection will be done. The dental study casts of 400 patients aged 11-18 years who will report to the Sharad Pawar Dental College for treatment will be chosen according to the selection criteria. An informed consent will not be taken in first phase. All casts should fulfill the selection criteria and will be included in the study.

Inclusion and Exclusion criteria: All the permanent teeth fully erupted in both jaws (upto first permanent molar on both sides) will be included in the study. All restorations or interproximal caries, previous orthodontic treatment, attrition, and changes in tooth shape, size, or number will be excluded from the study.

Sample size calculation:

Sample size (N)=Z1-α/2σ2/d2

Primary variable: Mandibular incisors Mean Score=23.20 Standard deviation= 1.52 (13).

Z1-α/2 at 5%=1.96
Margin for error d %=10% of mean=2.320
Minimum samples required=(1.96 * (1.52)^2)/2.320=385

Methodology: The highest mesiodistal widths of the crown of permanent teeth (including incisors, canines, premolars, and first molars) in both the upper and lower arches will be measured. The mesiodistal width of the teeth will be measured with a Digital Vernier Caliper (DVC) with a 0.01 mm repeatability, 0.02 mm accuracy, and 0.01 mm resolution (manufacturer standard). As a result, the interproximal contact points of the tooth’s maximal width will be measured right angle to the tooth’s long axis and parallel to the occlusal surface.

To check the reliability, the plaster casts will be measured by two investigators who will be blinded to the subjects and each other. The primary investigator (AB) will measure five pairs of models twice, separated by 24 hours, as part of the intraexaminer calibration method. The intraexaminer calibration will be done against a team of expert doctors who will measure the five model pairs twice, separated by 24 hours. Only 10 plaster casts will be measured and chosen at random. To determine measurement consistency, the intra-class correlation coefficient will be employed (14). To generate equations, the linear regression method will be used for predicting the sum of the width of the canines and premolars in either jaw. The regression equation will be expressed as:

Y=a+bx
Where,

• Y is dependent variable which indicates the predicted sum of the mesiodistal widths (in millimetres) of the permanent canines and premolars on both sides.
• X is independent variable which indicates the sum of the m-d widths of the four mandibular permanent incisors.
• The constants ‘a’ and ‘b’ will be obtained for both genders from the population together as well as separately.

The Standard Errors of the Estimates (SEE), correlation coefficients (r), and coefficients of determination (r2) will also be calculated. The regression equation’s prediction accuracy for Y based on X values is represented by r2 values. Otherwise, r2 values represent the regression models’ power (13).

To predict the total mesiodistal widths of premolars and canines, new regression equations based on the total mesiodistal widths of four mandibular permanent incisors will be used. These teeth will be used as a reference due to their earlier eruption. Standard errors, correlation coefficients (r), and coefficients of determination (r2) will also be determined.

Statistical analysis: To determine measurement consistency and interexaminer calibration, unpaired and paired t-tests will be performed. An unpaired t-test will be employed for the determination of right/left side and sex differences. The actual and predicted total width of permanent premolars and canines will also be compared using a paired t-test (15).

Phase-II

This phase will be cross-sectional in which 30 children (6-11 years old) with mixed dentitions (with the exception of 2nd and 3rd molars) will be randomly chosen from the Department of Paediatrics and Preventive dentistry of Dental College and written informed consent will be taken from the parents regarding participation in the study. Patients will be screened for the selection criteria.

Inclusion and Exclusion criteria: All patients with mixed dentition arch, which includes the four permanent mandibular incisors and complete record (including cast and periapical radiographs) were included in the study. All partially erupted mandibular incisors, congenital craniofacial anomalies and previous orthodontic treatment were excluded from the study.

Sample size calculation:

Sample size by correlation formula


Dependent variable=The predicted sum of the m-d widths (in millimetres) of the permanent canine and premolars on both sides.
Independent variable=The sum of the mesiodistal widths of the four mandibular permanent incisors.

The predicted sum of the mesiodistal widths (in millimetres) of the permanent canine and premolars versus sum of the mesiodistal widths of the four mandibular permanent incisors; Pearson correlation (r)=0.7 (13). Minimum sample size required N=14.

Methodology: High-quality alginate will be used for all impressions and study casts will be obtained. All the dental models will be made of high-grade orthodontic dental stone. The plaster models of mandibular and maxillary dental arches of 30 individuals aged 6-11 years old (both genders) will be fabricated. The first investigator will measure the required space using the two methods considered. The measurements will be repeated after 15 days, with each one being repeated twice in order to determine the reproducibility and repeatability conditions, as well as the random and systematic errors for each method. The present study will be conducted to determine the reliability of the actually derived formula, Tanaka and Johnston’s method (based on the sum of permanent lower incisors), and the radiographic technique of Huckaba.

I) Tanaka-Johnston’s space analysis: To anticipate tooth size, no additional radiographs or tables are required. It can be applied to both the arches (7).

• Mesiodistal width of unerupted mandibular canines and premolars will be calculated according to Tanaka-Johnson’s method by the ‘Sum of Half the Mesiodistal width of four lower incisors with 10.5 is equal to the Mesiodistal width of maxillary canines and premolars in one quadrant’ (16).
• Mesiodistal width of unerupted maxillary canines and premolars will be calculated according to Tanaka-Johnson’s method by the ‘Sum of Half the mesiodistal width of four lower incisors with 11 is equal to the mesiodistal width of mandibular canines and premolars in one quadrant’ (16).

II) Huckaba space analysis: The DVC will be used to measure the mesiodistal width of teeth. The Enlargement Ratio is calculated for each unerupted permanent tooth by first measuring the closest erupted tooth in the mouth and then in the radiograph (8).

Subsequently, the below-mentioned equation will be used (16):

X=X’Y/Y’

Where,
Y’ represents the Width of a primary tooth on IOPA,
X’ represents the Width of its underlying successor on IOPA,
Y represents the Width of a primary tooth on the cast and
X represents the Width of an unerupted permanent tooth
X-ray mesiodistal width of deciduous×Real mesiodistal width of deciduous.
X-ray mesiodistal width of the permanent Real mesiodistal width of the permanent

III) The new regression equation: Linear regression will be used to derive equations to predict the sum of the mesiodistal widths of the canines and premolars in either jaw. Individual regression equations for maxilla and mandible will be made based on the sum of incisors.

The regression equation will be expressed as Y=a+bX.

Calculation of R-value (Correlation coefficient): The linear relationship between different tooth-type combinations and the total of the unerupted canines and premolars will be evaluated by means of the Pearson correlation coefficient (17). To compare the actual values of these teeth with the values generated from the prediction tables, a Student t-test, and correlation coefficients will be calculated. The size of each side’s canines and premolars will be compared between sexes using a Student t-test (18).

Statistical Analysis

For phase II all analyses will be performed on Statistical Package for Social Sciences (SPSS,Chicago: SPSS Inc) version 16.0 software. Data will be summarised as mean±Standard Deviation (SD). Analysis Of Variance (ANOVA) of the regression equations will be performed while independent groups will be compared by Independent student’s t-test. A simple linear regression will be used to assess the relative association between the variables considering the sum of all three values, the independent variable (X) and the actual width as the dependent variable (Y) (14),(19).

Results

Expected outcome: New derived regression equation will allow the closer prediction of the size of unerupted canines and premolars in the paediatric population of Wardha.

Discussion

Based on mixed dentition analysis, two regression equations and their applicability was evaluated by Bhatnagar A et al., and a New Regression Equation (NRE) for predicting the size of unerupted permanent canines and premolars teeth in school children utilising the permanent mandibular incisors and first molars as predictors was proposed and evaluated. Dental study casts of 100 children aged 11-14 years (50 males and 50 females) from Moradabad, Uttar Pradesh, India, were used. An electronic DVC was used to measure the mesiodistal widths of mandibular and maxillary first molars, canines and premolars and permanent incisors. The intraexaminer calibration was done. The analysis of Bernabe Flores-Mir, Tanaka Johnston, and the proposed equation was verified on the casts. Bernabe’s Flores-research Mir and Tanaka Johnston’s analysis tended to overestimate the canines and premolars mesiodistal crown width. The proposed equation was overstated as well, although the mean difference was closer to the actual observed values than the other two equations (14).

In an Iranian population, Toodehzaeim MH et al., created an NRE in mixed dentition, to calculate the mesiodistal width of the crown of unerupted canines and premolars. A total of 120 Iranian patients with complete permanent teeth were chosen and dental casts were made. A digital caliper was used to calibrate mesiodistal widths of teeth. The study began with the development of correlation and linear regression equations between the C-PM segments of both upper and lower arches and four mandibular incisors (modified Tanaka-Johnston equation). The second portion of the study generated correlation and linear regression equations between the total of maxillary first molars, canines and premolars segments, and mandibular central incisors as a novel technique. The correlation coefficients between the sum of maxillary first molars- mandibular central incisors and the mandibular and maxillary canine-premolars segments were more than the correlation coefficients between the four mandibular incisors and maxillary and mandibular canines and premolars segment. New linear regression equations were derived. The sum of upper first molars and lower central incisors was found to be a stronger predictor of unerupted canines and premolars than the sum of maxillary first molars and central incisors of the mandibular arch. This unique method allows for early estimation of the width of unerupted canines and premolars (13).

In the Bengali population, Dasgupta B et al., conducted a comparison of the two mixed dentition space analyses. Dental casts of mandibular and maxillary arches with permanent dentitions were made for a total of seventy Bengali children. The mesiodistal crown measurements of all erupted canines and premolars and incisors were calibrated using a digital caliper. For a certain number of mandibular incisors, Tanaka-mixed Jhonson’s dentition arch analysis and Moyer’s analysis were performed, followed by statistical analysis. The mean, standard deviation, minimum and maximum values, correlation coefficient “r” and unpaired t-tests were all calculated and summed together as descriptive statistics. The mesiodistal width of permanent canines and premolars were underestimated by Tanaka and Johnston’s regression formulae. In the Bengali population, however, no statistically significant variations were found between actual canines and premolars mesiodistal widths and predicted widths using the Moyers formula at the 50% level for the maxillary and mandibular arches. With slight changes to their regression models, both Moyer’s and Tanaka-Johnston’s mixed dentition arch analyses were found to be relevant in the Bengali population (7).

Limitation(s)

The study limited to a small geographic area with smaller sample size in interventional group.

Conclusion

A new regression equation will be proposed for better representation of the size of unerupted canines and premolars in the population of Wardha. The study will also assess the validity of the new regression equation in comparison with Tanaka Johnston’s and Huckaba’s analysis.

References

1.
Al-Bitar ZB, Al-Omari IK, Sonbol HN, Al-Ahmad HT, Hamdan AM. Mixed dentition analysis in a Jordanian population. Angle Orthod. 2008;78(4):670-75. [crossref] [PubMed]
2.
Nourallah AW, Gesch D, Khordaji MN, Splieth C. New regression equations for predicting the size of unerupted canines and premolars in a contemporary population. Angle Orthod. 2002;72(3):216-21.
3.
Black GV. Descriptive anatomy of human teeth. 4 th ed, Philadelphia: S.S. White Dental Manufacturing; 1897. pp.16.
4.
Carey CW. Linear arch dimension and tooth size: An evaluation of the bone and dental structures in cases involving the possible reduction of dental units in treatment. Am J Orthod. 1949;35(10):762-75. [crossref] [PubMed]
5.
Ballard ML, Wylie WL. Mixed dentition case analysis, estimating size of unerupted permanent teeth. Am J Orthod. 1947;33(11):754-59. [crossref] [PubMed]
6.
Hixon EH, Oldfather RE. Estimation of the sizes of unerupted cuspid and bicuspid teeth. Angle Orthod. 1958;28(4):236-40.
7.
Dasgupta B, Zahir S. Comparison of two non-radiographic techniques of mixed dentition space analysis and evaluation of their reliability for Bengali population. Contemp Clin Dent. 2012;3(Suppl 2):S146-50. [crossref] [PubMed]
8.
Cruz BS da, Rothier EKC, Vilella B de S, Vilella O de V, Nascimento RR do. Evaluation of two methods for mixed dentition analysis using the method error. Braz J Oral Sci. 2014;13:163-67. [crossref]
9.
Lee-Chan S, Jacobson BN, Chwa KH, Jacobson RS. Mixed dentition analysis for Asian-Americans. Am J Orthod Dentofacial Orthop. 1998;113(3):293-99. [crossref] [PubMed]
10.
Uysal T, Basciftci FA, Goyenc Y. New regression equations for mixed-dentition arch analysis in a Turkish sample with no Bolton tooth-size discrepancy. Am J Orthod Dentofacial Orthop. 2009;135(3):343-48. [crossref] [PubMed]
11.
Schirmer UR, Wiltshire WA. Orthodontic probability tables for black patients of African descent: Mixed dentition analysis. Am J Orthod Dentofacial Orthop. 1997;112(5):545-51. [crossref] [PubMed]
12.
Jensen E, Kai-Jen Yen P, Moorrees CF, Thomsen SO. Mesiodistal crown diameters of the deciduous and permanent teeth in individuals. J Dent Res. 1957;36(1):39-47. [crossref] [PubMed]
13.
Toodehzaeim MH, Aghili H, Shariatifar E, Dehghani M. New regression equations for mixed dentition space analysis in an Iranian population. J Contemp Dent Pract. 2013;14(6):1156-60. [crossref] [PubMed]
14.
Bhatnagar A, Sinha AA, Chaudhary S, Manuja N, Kaur H, Chaitra TR, et al. Accuracy and evaluation of a new regression equation in predicting the width of unerupted permanent canines and premolar teeth. Eur Arch Paediatr Dent Off J Eur Acad Paediatr Dent. 2017;18(1):31-37. [crossref] [PubMed]
15.
Mittal S, Pathak A, Mittal K, Pathania V. Predicting the mesiodistal width of unerupted canine and premolars by using width of the permanent mandibular incisors and first molar in the Himachal population. J Indian Soc Pedod Prev Dent. 2016;34(3):204. [crossref] [PubMed]
16.
Mathewson REPRJ. Fundamentals of Paediatric Dentistry, 3 rd Edition. Indian edition. Quintessence India; 2014.
17.
Bernabé E, Flores-Mir C. Are the lower incisors the best predictors for the unerupted canine and premolars sums? An analysis of a Peruvian sample. Angle Orthod. 2005;75(2):202-07.
18.
de Paula S, Almeida MA, Lee PC. Prediction of mesiodistal diameter of unerupted lower canines and premolars using 45 degrees cephalometric radiography. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 1995;107(3):309-14. [crossref] [PubMed]
19.
Talebi M, Parisay I, Sarraf A, Mazhari F. Regression equations for predicting the size of unerupted canines and premolars in an Iranian population: a pilot study. J Contemp Dent Pract. 2010;11(5):033-40. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2022/58051.17306

Date of Submission: May 27, 2022
Date of Peer Review: Aug 19, 2022
Date of Acceptance: Oct 27, 2022
Date of Publishing: Dec 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 01, 2022
• Manual Googling: Aug 18, 2022
• iThenticate Software: Oct 18, 2022 (10%)

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