I.T.
S DENTAL COLLEGE, HOSPITAL & RESEARCH CENTRE
GREATER NOIDA, UTTAR PRADESH, INDIA
CERTIFICATE BY THE HEAD OF INSTITUTION
This is to certify that the dissertation entitled “Prevalance Of Sleep Disordered Breathing In
Orthodontic Patients And Its Effect On Quality Of Life And Craniofacial Morphology” is a
bonafide work done by Dr. Rukh Baiz for the award of the degree of Master of Dental
Surgery in the specialty of Department of Orthodontics & Dentofacial Orthopedics.
Prof. Dr. Sachit Anand Arora
Principal
I.T.S Dental College, Hospital & Research Centre, Greater Noida
47, Knowledge Park III, Greater Noida
Date: Place: Greater Noida
I.T.S DENTAL COLLEGE, HOSPITAL & RESEARCH CENTRE
GREATER NOIDA, UTTAR PRADESH, INDIA
CERTIFICATE BY THE GUIDE, CO-GUIDE & HOD
This is to certify that the Dissertation titled “Prevalance Of Sleep Disordered Breathing In
Orthodontic Patients And Its Effect On Quality Of Life And Craniofacial Morphology”,
submitted to Chaudhary Charan Singh University, Meerut, in partial fulfillment of the
requirements for the degree of Master of Dental Surgery in „Department of Orthodontics &
Dentofacial Orthopedics‟, has been completed by Dr. Rukh Baiz.
Dr. Amrita puri Dr. Anil Miglani
Guide Co-Guide
B.D.S, M.D.S B.D.S, M.D.S
Professor Professor & Head
Department of Orthodontics Department of Orthodontics
& Dentofacial Orthopedics & Dentofacial Orthopedics
I.T.S Dental College, Hospital I.T.S Dental College, Hospital
& Research Centre, Greater Noida & Research Centre, Greater Noida
Dr. Anil Miglani
B.D.S, M.D.S, Professor & Head
Department of Orthodontics & Dentofacial Orthopedics
I.T.S Dental College, Hospital & Research Centre, Greater Noida
Date: Place: Greater Noida
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation entitled “PREVALANCE OF SLEEP
DISORDERED BREATHING IN ORTHODONTIC PATIENTS AND ITS
EFFECT ON QUALITY OF LIFE AND CRANIOFACIAL
MORPHOLOGY” is a bonafide and genuine research work carried out by me
under the guidance of “Dr. Amrita Puri”, Prof, Department of Orthodontics
& Dentofacial Orthopedics at I.T.S Dental College, Hospital & Research
Centre, Greater Noida.
Date: Signature of the Candidate
Place: Greater Noida Dr. Rukh Baiz
COPYRIGHT
DECLARATION
I hereby declare that the Chaudhary Charan Singh University, Meerut shall have
all the rights to preserve, use & disseminate this dissertation in print of
electronic format for academic/research purpose.
Date: Signature of the Candidate
Place: Greater Noida Dr. Rukh Baiz
ACKNOWLEDGEMENT
I am grateful to Allah for giving me the opportunity, strength and ability to understand , learn
and complete my MDS dissertation, Alhumdulliah !
I would like to extend thanks to many people, who so generously contributed to the work
presented in this MDS dissertation.
A profound gratitude goes to my Principal Dr. Sachit Anand Arora for his constant faith in
my work.
I am hugely appreciative to our Head of department, Dr. Anil Miglani, for sharing his
expertise so willingly, and for being so dedicated to his role as a mentor.
I would also thank my Guide, Dr. Amrita Puri . Working with her on this dissertation has
been an amazing experience.
Special mention to Dr. Anil K. Chandna, for his tremendous support, but also for giving me
constant motivation and for nurturing my enthusiasm for the MDS dissertation
I would like to thank my knowledgeable staffs, Professor Dr. Anshul Singla, Associate
Professor Dr.Vishal Singh and senior lecturer Dr. Shruti Premsagar, for their support and
encouragement in the making of this MDS Dissertation.
I am especially grateful to our Ex. principal Dr.Akshay Bhargava for encouraging me in all
my pursuits and inspiring me to follow my dreams. Also, for challenging my thinking by
helping me question assumptions and view issues from multiple perspectives.
I am overwhelmed in all humbleness and gratefulness to acknowledge my BDS mentor
Dr.Shalaj Bhatnagar and my high school guide Mrs. Shafia shafi for inspiring me with
their vision, sincerity and knowledge.
I would also like to extend my deepest gratitude to my batchmates Dr. Devansh Kumar, Dr.
Anushriya Dutta , Dr. Anjali singh and Dr. Shruti Sharma for listening, offering me
advice and supporting me through this entire process and my senior Dr. Abhinav Bhardwaj
for his encouragement and never ending motivation.
I also want to express my sincere gratitude to my seniors Dr. Ravi Sachdeva, Dr. Nidhi ,
Dr. Rhimjhim and Dr. Nikita. I am ineffably indebted to them for conscientious guidance
and encouragement
Special mention goes to my juniors Dr. Nikhil Mahajan, Dr. Rakshita Kathia, Dr. Srishti
Sureka, Dr. Juganta Jyoti Gogoi, Dr.AtikaTulsyan, Dr. Mathew Koshy Vaidyan, Dr.
Sheetal, Dr. Arshi Talat, Dr. Neel Lalmani Maurya and Dr. Ayushi Nagar for their
constant days of love and support.
I also acknowledge with deep sense of reverence, my gratitude towards my parents and
members of the family, my grandfather Late Shaikh Abdul Ahad, my father Mr. Manzoor
Anjum Shah , mother Mrs. Rubeena, my brother Zameer, my sister Taqwa Qadri and my
aunt Shamshad Nuzhat for their unbelievable support and prayers. Words are inadequate to
express my feeling of gratitude towards them. Their love, support, trust and motivation kept
me focused at all times. They are the most important people in my life and I dedicate this
library dissertation to them.
Dr. Rukh Baiz
LIST OF ABBREVATIONS
S.NO ABBREVATION FULL FORM
1. SDB Sleep disordered breathing
2. OSA Obstructive sleep apnea
3. WHO World
LIST OF QUESTIONNAIRES
S.NO TITLE PAGE NO.
1. Pediatric Sleep Questionnaire 32-35
PSQ-22
(English and Hindi)
2. Quality of Life Questionnaire 36-37
OSA-18
LIST OF FIGURES
S.NO TITLE PAGE NO.
1. Selected measurements of the 38
oral cavity
2. Selected measurements of 39
maxilla and mandible
3. Selected measurements of 40
hyoid bone
4. Selected measurements of 41
uvula
5. Selected measurements of 42
pharyngeal airway
LIST OF TABLES
S.NO TITLE PAGE NO.
1. Prevalence of sleep disorders and sex 47
distribution
2. Distribution of study population according 48
to Risk as assessed by OSA-18
3. Overall cephalometric analysis result 49-51
4. ANS to point B comparison 52
5. Go to PNS comparison 53
6. PNS to point B comparison 54
7. Go to point B comparison 55
8. ANS-PNS to GoGn comparison 56
9. Go to Gn comparison 57
10. N to point B comparison 58
11. Ar to Go comparison 59
12. S to Go comparison 60
13. Go to PhW comparison 61
14. Go to H comparison 62
15. Gn to H comparison 63
16. Phw to H comparison 64
17. S to H comparison 65
18. Go-Gn to H comparison 66
19. S-N to Ar-H comparison 67
20. Ulength comparison 68
21. Uwidth comparison 69
22. T point comparison 70
23. P point comparison 71
LIST OF GRAPHS
S.NO TITLE PAGE NO.
1. Prevalence of sleep disorders 47
2. Distribution of study population 48
according to Risk as assessed by OSA-18
3. Overall cephalometric analysis result 49-51
4. ANS to point B comparison 52
5. Go to PNS comparison 53
6. PNS to point B comparison 54
7. Go to point B comparison 55
8. ANS-PNS to GoGn comparison 56
9. Go to Gn comparison 57
10. N to point B comparison 58
11. Ar to Go comparison 59
12. S to Go comparison 60
13. Go to PhW comparison 61
14. Go to H comparison 62
15. Gn to H comparison 63
16. Phw to H comparison 64
17. S to H comparison 65
18. Go-Gn to H comparison 66
19. S-N to Ar-H comparison 67
20. Ulength comparison 68
21. Uwidth comparison 69
22. T point comparison 70
23. P point comparison 71
ABSTRACT
Introduction: Our objective was to evaluate the prevalence of sleep disordered breathing
(SDB) and quality of life with its corelation with altered craniofacial development.
Methods: The sample included 300 healthy children between the ages of 9 and 17. High risk
of SDB was assessed using the Paediatric Sleep Questionnaire, a validated instrument that
consists of 22 questions, and high risk is defined as positive answers to 33% or more of the
questions answered. High risk patients were further evaluated for their quality of life using
OSA-18 questionnaire. Pre-treatment lateral cephalogram was taken in high risk group for
measuring their alteration in craniofacial development.
Results: The percentage of patients who were screened as high risk was 12% who were
categorized into 34% major, 58% moderate and 8% small group on the basis of OSA-18
questionnaire. An altered craniofacial morphology was observed in high risk patients.
Conclusion: There is an increased risk of sleep disordered breathing in children with an
affected quality of life and craniofacial morphology.
CONTENTS
S.NO TITLE PAGE NO.
1. INTRODUCTION 1-4
2. AIM AND OBJECTIVE 5
3. REVIEW OF LITERATURE 6-29
4. MATERIAL AND METHOD 30-43
5. STATISTICAL ANALYSIS 44-46
6. RESULTS 47-71
7. DISCUSSION 72-78
8. SUMMARY AND CONCLUSION 79
9. REFERENCES 80-91
10. ANNEXURE 92-96
LIST OF ANNEXURES
S.NO DESCRIPTION PAGE NO.
1. ANNEXURE I (SIGNATURE OF 92
GUIDE/CO GUIDE/PRINCIPAL)
2. ANNEXURE II (PATIENT 93
INFORMATION SHEET- ENGLISH)
3. ANNEXURE II -A (PATIENT 94
INFORMATION SHEET-HINDI)
4. ANNEXURE III(PATIENT CONSENT 95
FORM -ENGLISH)
5. ANNEXURE III-A (PATIENT CONSENT- 96
HINDI)
