DR SHALU RAI
@agdc.tripura.gov.in
Principal Department of Oral Medicine and Radiology
Agartala Government Dental College , West Tripura
EDUCATION
BDS,MDS,FICD
RESEARCH, TEACHING, or OTHER INTERESTS
Dentistry, General Dentistry, Radiology, Nuclear Medicine and imaging, Oral Surgery
Scopus Publications
Scopus Publications
Shalu Rai, Deepankar Misra, Akansha Misra, Ankit Jain, Priyanka Dabas, Qaiser Ali, and Manish Kumar
Medknow
ABSTRACT Background: The aim of this study is to evaluate the location and radio morphometric features of the posterior superior alveolar artery (PSAA) in patients undergoing rehabilitation of posterior maxilla and other sinus augmentation surgical procedures by cone-beam computed tomography (CBCT). Materials and Methods: A total of 816 CBCT scans were included. Various radio morphometric measurements were done to assess the PSAA location, diameter, and distances to the sinus floor and alveolar crest. Results: The PSAA was mostly intraosseous in the maximum in the age group 31–51 years (56%), in males (53.4%), and in dentate patients (57.4%). The artery tends to be wider in older patients. Distances to the sinus floor or the alveolar crest tend to be shorter in women. Conclusions: This study suggests that CBCT is a valuable pre-surgical tool and the evaluation of the PSAA on CBCT images could reduce the likelihood of excess bleeding during surgery in the maxillary posterior region.
Somya Sharma, Shalu Rai, Deepankar Misra, Akansha Misra, Shalini Sharma, Anusuya Sharma, and Manish Singh Prayasi
Medknow
Abstract Aim: Urine as a biofluid has been rarely used as a diagnostic fluid in oral diseases. The article aims to systematically review the utility of human urinary carcinogen metabolites as an approach for obtaining important information about tobacco and cancer. Materials and Methods: The following article reviews the use of urine and its metabolites as biomarkers in various lesions of the oral cavity including oral squamous cell carcinoma and as a screening method in evaluating tobacco and its components. A bibliographic comprehensive search was carried out in the main databases: PUBMED, SciELO, Google Scholar, VHL, and LILACS for articles that were published from 1985 to 2020. The inclusion criteria were “urinary metabolites,” “oral cancer/HNSCC,” “body fluids,” “tobacco,” and “metabolomics.” A total of 55 articles were collected which included laboratory studies, systematic reviews, and literature of urinary metabolites in tobacco users. Results: Most of the studies carried out show accurate results with high sensitivity of urinary metabolite biomarkers in individuals with tobacco-based habits and lesions caused by them. Conclusion: The review indicates that urinary metabolite analysis demonstrates its applicability for the diagnosis and prognosis of disease. Urine is a remarkable and useful biofluid for routine testing and provides an excellent resource for the discovery of novel biomarkers, with an advantage over tissue biopsy samples due to the ease and less invasive nature of collection.
Shalu Rai, Deepankar Misra, Akansha Misra, Sahil Kidwai, Suman Bisla, Ankit Jain, and Purwa Gangwal
Elsevier BV
Shalu Rai, , , Deepankar Misra, , Akansha Misra, , Ankit Jain, , Ashish Verma,et al.
S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L
Mucopolysaccharidosis VI is a genetic disorder affecting multiple organs with sundry clinical presentations. The main etiological factor reflects the disturbances in mucopolysaccharide metabolism leading to deposition of acid mucopolysaccharide in various tissues. The pathognomonic features of the disease include a large head, short neck, corneal opacity, open mouth associated with an enlarged tongue, enlargement of the skull, and long anteroposterior dimension with unerupted dentition, dentigerous cyst-like follicles, condylar defects, and gingival hyperplasia. An 18-year-old boy with Maroteaux-Lamy syndrome (mucopolysaccharidosis type VI) is described in this article, emphasizing the oral manifestations and radiographic illustration of lesions in the jaws. It also emphasizes the essential role of cone-beam computed tomography to identify and analyze multicentric pathologies in the jaws.
Shalu Rai, Deepankar Misra, Akansha Misra, Ankit Jain, and Suman Bisla
Medknow
The innumerable special needs and challenges faced by geriatric patients in healthcare has attracted the attention of the modern world. Various basic oral functions contribute to good physical and psychological health and are likely to deteriorate with frailty. The aim of the study was to examine effects of aging on oral health related quality of life (OHRQoL) and assess importance of dental care amongst older persons. An electronic search in PubMed Central's database was performed. The search strategy was limited to human studies (single and double-blinded trials, cross-sectional and case-control studies), full-text English articles published from first of January 2010 until the end of April 2021. Irrelevant articles or articles with inadequate information were omitted. Data was searched and analyzed using following MeSH terms/keywords: Geriatric Assessment, Oral Health Related Quality of Life. 43 studies were included. In most of the studies it was identified geriatric assessment is essential to avoid comorbidities in such patients. Furthermore judicious use of polypharmacy is advocated in such patients. An association between OHRQoL and dental care of older people was found. This indicates prevention and early intervention with treatment modalities in the increasing elderly population with an apparent solicitousness of their health needs
Shalu Rai, Deepankar Misra, Akansha Misra, Mansi Khatri, Sahil Kidwai, Suman Bisla, and Prerna Jain
Medknow
Introduction: Oral rehabilitation in maxillary anterior region has increased concerns in the dental fraternity to have detailed morphological examination in treatment planning. The nasopalatine canal (NPC) along with its contents plays an important role in determining the prognosis of implants and their associated surgeries. The present study was performed to evaluate morphometric anatomic variations of the NPC using focused small field of view on cone-beam computed tomography (CBCT). Materials and Methods: The study included 250 participants. CBCT examination was conducted using standard exposure and patient positioning protocols. Sagittal, coronal, and axial sections were reviewed to determine NPC morphology and dimensions. Results: Single, round, incisive foramen with mean mesiodistal diameter of 3.23 (±1.00) mm, and mean anteroposterior dimension of 3.03 (±0.96) mm was found. Single Stenson's foramen along with funnel shaped, slanted NPC with mean angulation of 81.97 (±42.19), and mean length of 12.67 (±2.69) mm was found. Mean mesiodistal diameter at nasal fossa of NPC was 3.27 (±1.75) mm, at mid-level was 2.23 (±1.02) mm, at palate was 3.46 (±1.12) mm. At least one additional foramen was found. Discussion: Anatomy of the NPC is highly variable. Age-wise and gender-wise correlations revealed statistically significant results for different parameters. The present study highlighted significance of NPC along with its variations. Therefore, a methodical three-dimensional presurgical assessment is mandatory before any surgical intervention in this region.
Shalu Rai, Deepankar Misra, and Akansha Misra
Medknow
Background: The density of cortical and cancellous bone is a key reason for implant anchorage which might be severely affected during diabetes. Aim: The aim of the study was to establish the role of cone-beam computed tomography (CBCT) using grayscale values in determining bone density in different jaw sites and in comparing the values in healthy with diabetic patients. Materials and Methods: Bone densities in 322 possible implant sites in healthy and diabetic patients were evaluated using NewTomGiano CBCT machine. Cross-sections obtained were assessed for bone densities in terms of Hounsfield Unit on different sites using New Net Technologies software version 6.1. Statistical Analysis: Data were statistically analyzed using SPSS software (version 19.0). Results: Age-wise cortical and cancellous bone densities were compared and no statistical significance was obtained. Gender-wise bone density was compared and significant results were found in males. Jaw-wise bone density was compared and was found to be significantly high in the mandible. The mean cortical bone density in control group was 1608.572 (±380.36), whereas in diabetic group was 1395.368 (±296.97), and the mean cancellous bone density in control was 906.918 (±185.40) and in diabetic was 559.868 (±128.16). Teeth wise in cortical bone significant values were found at premolar region (P = 0.046) and in cancellous bone significant values were found at canine and premolar region (P = 0.012) and highly significant values were found at molar region (P = 0.001). Conclusion: CBCT unveils a distinct pattern of cortical and cancellous bone density. A high degree of concordance between different regions of the mouth in cortical and cancellous bones was obtained in different study groups. CBCT could be used for bone density analysis.
Shalu Rai, Deepankar Misra, Mansi Khatri, Tarun Vyas, Poulomi Bhakta, and Priyank Mallick
Medknow
Background: This study aims to evaluate alveolar height, buccal, and palatal cortical bone thickness using cone beam computed tomography (CBCT) useful for radiological pre-assessment for various surgical procedures of maxillary anterior region. Materials and Methods: Maxillary central and lateral incisors and canines were bilaterally evaluated in 200 selected patients. Images were obtained with New Tom CBCT and traced with New Net Technologies software. Alveolar height and cortical bone thickness at 3 mm, 6 mm, and 9 mm above the cemetoenamel junction were measured and statistically analyzed. Results: Significant differences in alveolar height were found genderwise and agewise and were found to be highest in age groups of 51–60 years and lowest in 11–20 years. Buccal thickness at 3 mm, 6 mm, 9 mm was highest in right central incisor, right central incisor and left central incisor and lowest in right canine, left canine and left canine, respectively. Palatal thickness at 3 mm, 6 mm, 9 mm was highest in right central incisor, left central incisor and left central incisor and lowest in left canine, left canine, and left canine, respectively. Bucco-palatal thickness at 3 mm, 6 mm, 9 mm was highest in left canine, right central incisor and left central incisor and lowest in right lateral incisor, respectively. Agewise and genderwise significant differences in buccal and palatal bone were found at different levels. Conclusion: Buccal bone is thinner than palatal bone; thus, require careful radiological appraisal in orthodontic tooth movement and any surgical procedure in this region.
Shalu Rai
Medknow
Shalu Rai, Deepankar Misra, Mukul Prabhat, Ankit Jain, and Prerna Jain
Medknow
Hybrid ameloblastoma has a variable clinical, radiological, and histopathological presentation. They contain two or more different histologic types and their biologic comportment is still arguable. We herein present a case of a hybrid variant of desmoplastic ameloblastoma which is the first of its kind to have ever been reported due to its unusual location in the maxillary anterior region, along with systematic review of clinicopathologic features of reported cases immunohistochemical markers may act as an adjunct in the accurate diagnosis of these lesions.
Shalu Rai, Deepankar Misra, Mukul Prabhat, Mansi Khatri, Priyank Mallick, and Ayush Dhawan
Medknow
Introduction: Cone beam computed tomography (CBCT) has revolutionized the field of oral radiology. With the detailed three-dimensional views of dental tissues, incidental findings which were once considered abnormalities present outside the area of interest can now be recognized. Here, we report various incidental findings found on CBCT. Materials and Methods: This retrospective study consisted of 1500 CBCT scans. Different fields-of-view ranging from 5 × 5 to 11 × 13 were selected. Age group of the subjects included in the study was 5 to 89 years. All incidental findings were categorized in seven groups according to the area and nature of pathology – dento-alveolar region, cysts and tumors, nasal and sinus pathologies, supernumerary and impacted teeth, artifacts, temporomandibular joint (TMJ) region, and miscellaneous. Results: Out of 1500 patients, 723 (48.2%) were males and 777 (51.8%) were females. Mean age of patients referred for CBCT was 47.08 years. Most frequently referred patient age group was 60–69 years (19.75%). Eighty-nine percent of the subjects showed incidental findings. Total number of incidental findings was 2734. The most common area showing incidental findings was dento-alveolar area (44.3%), the least number of findings were seen in the TMJ area (0.4%). Most common finding was mucositis/mucous retention cyst (83.4%) whereas the least finding found was odontogenic keratocyst cyst and coronoid hyperplasia (0.6%). Conclusion: The full CBCT dataset should be fully examined and interpreted by Oral Maxillofacial Radiologists. Correct identification of various potentially pathological lesions outside the area of interest on CBCT scan should be reported and documented.
Shalu Rai, Deepankar Misra, Ayush Dhawan, Kuber Tyagi, Mukul Prabhat, and Mansi Khatri
Medknow
Background: This questionnaire study aims to assess the precise knowledge of dental radiography along with cone beam computed tomography (CBCT) in dental fraternity. Materials and Methods: The data in questionnaire were completely filled by 500 participants including Master of Dental Surgery and Bachelor of Dental Surgery (BDS) working as faculty and/or general practitioners, interns, and postgraduates. It consisted of multiple choice questions on CBCT. Overall assessment of answers obtained for each part was analyzed category-wise, specialty-wise, and qualification-wise. Results: A definite gap in knowledge of CBCT applications exists between different categories of dental specialists. Dental students should be provided with appropriate CBCT education supported by practical experience and guidance of oral medicine and maxillofacial radiologists. It is also recommended that all the CBCT scans should be performed under the guidance of an oral radiologist and the interpretation of these scans should be done by a trained oral and maxillofacial radiologist only. Conclusion: From the study it is evident dental practices are positively affected by high-end quality practice. More efforts for spreading awareness about this imaging modality, through inclusion of CBCT in curriculum of BDS and through lectures/Continuing Dental Education CDEs, should be undertaken to ensure better knowledge among dentists.
Shalu Rai, Deepankar Misra, Akansha Misra, Ankit Jain, Prerna Jain, and Ayush Dhawan
Medknow
Mucormycosis is an acute, fulminating, fungal disease that frequently involves oral, cranial, and facial structures. It is an opportunistic fatal infection which occurs in debilitating and immunosuppressive states. This report documents a rare case of localized maxillary mucormycosis in a patient with uncontrolled diabetes, with emphasis on early and prompt diagnosis of the same.
Shalu Rai, Deepankar Misra, Kuber Tyagi, Mukul Prabhat, and Purwa Gangwal
Medknow
The forensic examination of dead bodies is very helpful in order to identify the person, cause of death, gender, and solving the mysterious cases. It includes a number of techniques, out of which autopsy is the primary investigation that is performed in every medicolegal case. Because of mutilation technologies, traditional autopsy technique is most disturbing in terms of emotions and rituals of relatives. The use of radiology in forensic science comprises performance, interpretation, and reporting of radiographs that is helpful in detecting those changes that are not clinically visible. Forensic radiology plays an important role for identification of humans in mass disasters, criminal investigations, and evaluation of cause of death. The introduction of radiological modalities in autopsy techniques is a complementary tool for forensic identification and is known as virtual autopsy. The advance imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) is used in virtual autopsy in order to visualize and reconstruct the internal organs to know the site, type, and depth of injury. This review elaborates the role of maxillofacial imaging in image-guided virtual autopsy.
Akansha Misra, Shalu Rai, and Deepankar Misra
Medknow
Cell death appears to be a basic biological phenomenon which is maintained by the human body. The term apoptosis, also known as programmed cell death, is characterized by several unique morphological and biochemical features. Apoptosis and its different forms are essential for tissue homeostasis. Alteration in molecular mechanisms involved in apoptotic signaling contributes to a vast range of oral diseases. An understanding of the regulation of apoptosis has led to the development of many therapeutic approaches and better management of oral diseases. The review updates us the correlation between apoptosis in normal oral tissues and oral diseases.
Deepankar Misra, Sapna Panjwani, Shalu Rai, Akansha Misra, Mukul Prabhat, Prashant Gupta, and SubrataK Talukder
Medknow
Background: To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns. Materials and Methods: In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS. Results: Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes. Conclusion: Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.
Sapna Panjwani, Shalu Rai, Deepanakar Misra, and Akansha Misra
Medknow
Danta Swasthya (oral health) is important for the general kausalya (well being) and relates to the quality of Jivana (life) that extends beyond the functions of the craniofacial complex. Danta Amivacatana (oral diseases) continues to be a major health problem worldwide. In mainstream Ausadha (medicine), new medical treatments are assumed to be ineffective, until they are proved to be useful. In addition, the adverse effects associated with mainstream medicine makes their use less desirable and less reliable by the population. Traditional medicine is a socioeconomic and sociocultural heritage, serving approximately 80% of the population of developing countries. Heterogeneity, easy availability, enduring recognition, popularity and fewer adverse side effects are some of the key lineaments of traditional Ausadha. This review attempts to introduce several widely used traditional medicines and plant extracts for treating oral diseases, with a highlight on tooth soap, one of the most unrevealed herbal alternative to tooth paste.
Shalu Rai, Vikash Ranjan, Deepankar Misra, and Sapna Panjwani
Georg Thieme Verlag KG
ABSTRACTObjective: The present comparative study was aimed to determine the effectiveness of Th US and TENS in the management of myofascial pain in TMD patients. Materials and Methods: The present randomized comparative study was on 90 patients who were further assigned in three different groups each having 30 patients; Group I was healthy control patients, Group II was receiving Th US therapy, and Group III was receiving TENS therapy. All the 90 patients were further evaluated for maximum inter incisor subjective evaluation regarding muscle pain, impediment to daily life, massage impression on visual analog scale (VAS) scale, and intensity and duration used in Th US massage. Results: The masseter muscle thickness in control group was 12.00 (standard deviation [SD] ±1.1) mm when compared with TMD patient of 13.00 (SD ± 1.1) mm before treatment. Statistical significant findings on VAS score of muscle pain, impediment to daily life, and massage impression were observed in Th US. After treatment, the anechoic areas disappeared or were reduced in Th US group by 95.6% and in TENS by 74.4%. Conclusion: Th US appeared to be subjectively better which was related to VAS score of massage impression, muscle pain, and impediment to daily life after treatment as well as sonographically related to existence of anechoic areas.
Shalu Rai, Akshay Sharma, Vikash Ranjan, Deepankar Misra, and Sapna Panjwani
Medknow
Introduction: This study was undertaken to assess the levels of malondialdehyde (MDA), superoxide distmutase (SOD), beta carotene, and vitamin E in oral submucous fibrosis (OSMF), oral leukoplakia (OL), and oral cancer patients. Though several studies have been done on the levels of antioxidants in these disorders, there are very few available reports in patients with various histological staging of these disorders. Materials and Methods: Blood samples were collected from 40 patients who were divided into three groups: Group I as control with 20 normal individuals, group II with histopathologically confirmed different stages of OSMF and OL, and group III with histopathologically confirmed different stages of oral squamous cell carcinoma (OSCC). Standard methods for estimation of serum values were used and statistical comparisons were performed using SPSS software 16.0 version and the level of significance was calculated. Results: The mean levels of vitamin E, beta carotene, MDA, and SOD among Group I subjects were 9.89 ± 0.75, 112.10 ± 11.97, 2.92 ± 0.36, and 189.45 ± 14.17, respectively. In group II patients with OL having mild dysplasia, serum vitamin E, beta carotene, MDA, and SOD levels were found to be 7.89 ± 0.87, 70.75 ± 2.82, 9.89 ± 0.92, and 119.63 ± 24.97, respectively. In moderate dysplasia, these values were 7.16 ± 0.55, 69.80 ± 5.54, 10.56 ± 0.46, and 115.20 ± 23.03, respectively. Serum vitamin E, beta carotene, MDA, and SOD levels were 7.70 ± 0.57, 70.50 ± 3.54, 9.81 ± 0.11, and 115.00 ± 8.49, respectively, in grade I OSMF and 7.32 ± 0.29, 69.67 ± 3.43, 9.76 ± 0.38, and 113.67 ± 8.32, respectively, in grade II OSMF. In group III patients with well-differentiated squamous cell carcinoma (WDSCC), serum vitamin E, beta carotene, MDA, and SOD levels were 7.01 ± 0.36, 64.32 ± 3.42, 12.98 ± 0.67, and 59.22 ± 4.01, respectively, and in patients with moderately differentiated squamous cell carcinoma (MDSCC), the values were 6.54 ± 0.41, 61.87 ± 2.03, 13.34 ± 0.42, and 58.43 ± 2.26, respectively. The P-value was calculated and the results were highly significant. Conclusion: A decrease in the levels of antioxidants like beta carotene, vitamin E, and SOD and an increase in MDA level in these disorders have been previously reported in the literature.
Deepankar Misra, Shalu Rai, Sapna Panjwani, Vikash Ranjan, Mukul Prabhat, Kanika Bhalla, Puneet Bhatnagar, and Akansha Misra
Medknow
Context: Admantinoma is second most common benign odontogenic tumor which clinically appears as an aggressive odontogenic tumor, often asymptomatic and slow growing, associated with symptoms such as swelling, dental malocclusion, pain, and paresthesia of the affected area. The radiographic appearance may vary from unilocular to multilocular radiolucencies, imparting a characteristic honey comb, soap bubble appearance or may resemble a caricature of spider. Case Report: This report highlights the importance of conventional and advanced imaging in the diagnosis of large and invasive lesions. Patient reported with complaint of swelling in jaw, which progressively increased; and was found to be bony hard, both intra- and extraorally. Radiographs revealed large multilocular radiolucency on left body and ramus of mandible with soap bubble pattern and knife edged root resorption. Computed tomographic examination evaluated the extent of the lesion, internal structure, and relation to adjacent structures; further a reconstructed image was obtained to evaluate extent of destruction in three dimensions. Conclusion: Computed tomography has an important role in the diagnosis and treatment planning is imperative as it is superior in revealing the cortical destruction and extension into the neighboring soft tissues than conventional radiography.
Shalu Rai, Subhankar Dasgupta, Vikash Ranjan, Deepankar Misra, and Sapna Panjwani
Medknow
Introduction: The inferior alveolar canal is described as a dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone. Conventionally, preoperative assessment is performed by orthopantomogram (OPG). Spiral computed tomography (CT), allows the clinician to localize and determine the relation of the impacted tooth and the inferior alveolar neurovascular canal (IANC) in three dimensions. Objectives: To describe the anatomical and morphologic variation of IANC as it appears in digital OPG and to correlate its relation with IANC on the CT. Materials and Methods: 100 patients were subjected to OPG and were studied for anatomic and morphologic variation. Eleven patients with mandibular impacted third molar in close proximity to the IANC were further subjected to CT examination. Results: Linear type was the commonest on the left side (39.5% in females and 41.9% in males) and elliptical type on the right side (52.6% in females and 45.2% in males). Morphologic variation showed bifid canal present in only 1 (1.6%) male on the left side. On the left side, narrowing of canal was seen in 4 (100%) teeth on OPG, in which 3 (75%) teeth showed 0 mm with cortical break in the CT. Three (100%) teeth showing interruption of white line (superior radiopaque border of IANC) on the OPG also showed 0 mm with cortical break in the CT. On the right side, 2 (100%) teeth showing narrowing of canal on the OPG correlated with 0 mm with cortical break in the CT and 1 (100%) tooth showed interruption of white line which correlated with 0 mm with cortical break in the CT. Conclusion: The comparison between the OPG patients and the CT patients (selected using the Roods criteria from the OPG patients) showed statistically significant value for narrowing of canal and interruption of white line with 0 mm loss of cortication in CT.
Shalu Rai, Sandeep Kaur, Abhishek Sinha, Vikas Ranjan, Deepankar Mishra, and Sapna Panjwani
Medknow
Introduction: The airway is assumed to play a role in dentofacial development. So, several studies tried to correlate patients with normal nasorespiratory functions with different malocclusions and airway dimensions. A narrow upper airway is associated with obstructive sleep apnea (OSA). Currently neck size and obesity are considered to be the most important physical characteristics of patients with sleep apnea. Aim: To study the interaction between craniofacial structures and pharyngeal airway space along with soft palate and tongue in patients with different anteroposterior skeletal patterns using lateral cephalogram. The correlation of upper airway and soft-tissue measurements with neck circumference (NC) and body mass index (BMI) was elucidated to evaluate the predictors on lateral cephalogram, in order to determine the etiology of OSA. Materials and Methods: Lateral cephalograms of 45 subjects were used to measure the pharyngeal airway and were divided into three groups (each group included 15 subjects) according to ANB angle: Class I (ANB angle 2°-4°), Class II (ANB angle >4°), and Class III (ANB angle <2°). Velar morphology along with its length was also analyzed and categorized into different types. The NC and BMI of all the patients were also calculated. Student′s t-test for paired samples was used to compare the mean values of the study variable vital parameters. Results: Significant reduction was found in pharyngeal airway in ANB group II. The soft palate and tongue size increased with increasing BMI and NC. Conclusion: Sagittal skeleton pattern had a close association with the dimensions of pharyngeal airway passage. The correlation of NC with increase in soft-tissue size (soft palate and tongue) suggested that obesity mediates its effects in OSA through fat deposition in the neck.