Tiempo empleado para estimar edad dental en niños peruanos comparando el método de Demirjian y el cuadro integral del enfoque de Demirjian: un estudio piloto / Time spent to estimate dental age in peruvian children comparing the demirjian method and the comprehensive chart based on demirjian method: a pilot study

El objetivo de este estudio fue comparar el tiempo empleado al estimar la edad dental (ED) entre el método propuesto por Demirjian et al. y el cuadro integral del enfoque de Demirjian (DAEcc) utilizando radiografías panorámicas digitales de individuos peruanos de 5 a 13 años residentes en Lima. Se realizó un estudio no experimental, comparativo, transversal y retrospectivo. Se utilizaron 100 radiografías panorámicas digitales que presentaban siete dientes permanentes mandibulares izquierdos. Una odontóloga forense capacitada y calibrada determinó el tiempo utilizado en evaluar la maduración dental y la estimación de ED con dos métodos (Demirjian y DAEcc). La unidad de medida utilizada fue los minutos (min.). No hubo diferencias en el tiempo de evaluación del estadio de maduración dental entre ambos métodos (p<0,05). El tiempo para estimar ED fue estadísticamente inferior con DAEcc (2,09 min) que con Demirjian (4,19 min). La diferencia del tiempo total de evaluación resultó estadísticamente significativa entre ambos métodos (Δ2,1 min.; 2,05-2,11; p=0,000). La aplicación del DAEcc redujo en 50 % el tiempo empleado en estimar ED en comparación con los cuadros propuestos por Demirjian. Aunque la odontología forense se centra en el estudio de la eficacia de estimación de la edad, es necesario abordar también su uso práctico.

SUMMARY: The objective of this study was to compare the time used to estimate dental age (DA) between the method proposed by Demirjian et al., and the comprehensive chart for dental age estimation (DAEcc) using digital panoramic radiographs of Peruvian individuals aged 5 to 13 years residing in Lima. A non- experimental, comparative, cross-sectional and retrospective study was carried out. 100 digital panoramic radiographs showing seven mandibular left permanent teeth were used. A trained and calibrated forensic odontologist determined the time used to assess tooth maturation and DA estimation with two methods (Demirjian and DAEcc). The unit of measurement used was minutes (min.). There were no differences in the evaluation time of the dental maturation stage between both methods (p<0.05). The time spent to estimate DA was statistically less with DAEcc (2.09 min) than with Demirjian (4.19 min). The difference in total evaluation time was statistically significant between both methods (Δ2.1 min; 2.05-2.11; p=0.000).The application of DAEcc reduced by 50 % the time spent estimating DA compared to the method proposed by Demirjian. Although forensic odontology focuses on the study of the effectiveness of age estimation, its practical use needs to be addressed as well.

Age Estimation by Modified Demirjian's Method in a Hospital-Based Population: A Radiographic Study

ABSTRACT Objective: To test the modified Demirjian's method of dental age estimation on the South Indian population and correlate it with the patient's chronological age. Material and Methods: This retrospective radiographic study was performed on digital panoramic radiographs taken during a one-year duration. Radiographs of patients in the age range from 8 to 18 years were included in the study. The radiographs were examined and according to the stage of the crown and root status of the left side mandibular teeth. The stage of calcification was observed for eight teeth in the mandibular arch and was recorded in a specially designed proforma. Each rated tooth with stage was converted into a score using a conversion table specified for girls and boys. Results: 224 digital panoramic radiographs were retrieved from the radiologic database. Out of total study sample, 49.5% (n=111) were boys and 50.5% (n=113). The mean chronological and estimated dental age using dental maturity scores resulted in an overestimation of 3 years and eight months. Also, it was noted that there was a strong positive association between chronological (real) and dental age. Conclusion: It was observed that there was a strong correlation between chronological and dental age. A new formula for determining the chronological age from the estimated dental age was derived. Further studies on a larger population may prove the reliability of this age estimation method.

Correlación entre la edad cronológica y dental con los estadios de maduración vertebral en pacientes de 5 a 15 años / Correlation between the chronological and dental age with the vertebral maturation stages in patients from 5 to 15 years old

El uso de un método rápido y efectivo para la estimación de la maduración esquelética de los pacientes pediátricos es fundamental para la aplicación oportuna de tratamientos ortopédicos/ortodónticos. En Odontología Pediátrica, la toma de una radiografía panorámica, como método diagnóstico de rutina, puede servir para estimar con precisión el estadio de maduración en estos pacientes, mediante el cálculo de la edad dental. El objetivo del presente trabajo fue determinar la correlación entre las edades cronológica y dental con los estadios de maduración esquelética de las vértebras cervicales, a través del método estadístico no paramétrico con Rho de Spearman. Se utilizó un diseño observacional, transversal y analítico. La muestra consistió en 516 expedientes de pacientes entre los 5 y 15 años de edad, sistémicamente sanos, con radiografías panorámica y lateral de cráneo, tomadas en la misma fecha. Se determinó la edad cronológica de cada paciente según su historia clínica. Se realizó el cálculo de la edad dental de cada paciente con el método de Demirjian, y se determinó el estadio de maduración de vértebras cervicales con el método de Lamparski. Se determinó una correlación de 72 % entre la edad cronológica y la maduración ósea vertebral; una correlación del 66 % entre la edad dental y la maduración ósea, y una correlación del 86 % entre la edad cronológica y la dental. De acuerdo con estos resultados, tanto la edad cronológica y dental presentan una alta correlación con la edad de maduración vertebral. Se concluye así que la edad dental y cronológica son indicadores apropiados para estimar el estadio de maduración esquelética de los pacientes pediátricos.

The use of fast and effective methods for estimating the skeletal maturity for pediatric patients, is fundamental for the opportune application of orthopedic/orthodontic treatments. In pediatric dentistry, the panoramic radiography as a routine diagnostic method, can be used to estimate the stage of maturation in these patients, through the calculation of dental age. The aim of the present study is to determine the correlation between the chronological and dental ages, with the cervical vertebrae stages of skeletal maturity, through the non-parametric Spearman statistical method. An observational, transversal, and analytical design was employed. The sample consisted of 516 records from patients between 5 and 15 years of age, systemically healthy, with panoramic and lateral skull radiographs taken on the same date. The chronological age of each patient was determined according to the clinical history. Dental age of each patient was calculated with the Demirjian approach, and the stage of maturation of cervical vertebrae was determined by means of the Lamparski method. The results showed a correlation of 72 % between chronological age and bone maturation, a correlation of 66 % between dental age and bone maturation, and a correlation of 86 % between chronological and dental age. It is concluded that both chronological and dental age exhibit a high correlation with the correspondent stage of vertebral maturity. Thus, dental and chronological age are appropriate indicators to estimate, with high precision the stage of skeletal maturation in pediatric patients.

Concordancia entre la Edad Cronológica y Edad Dental Según el Método de Demirjian en Pacientes Mexicanos / Concordance Between Chronological Age and Dental Age by the Demirjian Method in Mexican Patients

RESUMEN: En la práctica forense un dato de gran importancia es la edad cronológica de los pacientes, este puede obtenerse de múltiples formas, algunas son complejas, costosas y tardadas, el cálculo de la edad dental (ED) por vía radiográfica es sencillo y de bajo costo, ha mostrado ser concordante con la edad cronológica (EC), presentando variaciones por sexo y raza. El objetivo de este estudio es establecer la concordancia de la ED y la EC en población mexicana. Este es un estudio transversal, observacional en el que un residente estandarizado evaluó 88 Ortopantomografías (44 femeninos y 44 masculinos) de manera cegada respecto a la EC, del archivo de la clínica de Ortodoncia de la Facultad de Odontología de la Universidad Autónoma de Sinaloa, con edades desde los 3 a los 16 años. Existe una diferencia en meses de 3,36 entre los valores ED y EC en el total de la población (p=0,384) con una concordancia de 94 % entre los valores. Al analizarlos por sexo los masculinos muestran una diferencia de 5,16 (P=0,785) con una concordancia de 96 % y los femeninos de 7,32 (P=0,095) con una concordancia de 92 %. La ED según Demirjian es un método confiable para estimar la EC en esta población.

ABSTRACT: In forensic practice knowledge of chronological age (CA) is an important factor, and it can be estimated by several methods. Some are complex, expensive and time consuming. Dental Age (DA) estimation by radiographic methods is easy and inexpensive, it has shown to be consistent with chronological age (CA), with variations according to sex and race. The objective of this study was to estimate the concordance between DA and CA in Mexicans. This is a cross sectional, observational study, in which a standardized dental resident reviewed 88 Orthopantomographies (44 female, 44 male), blinded to CA, of the Orthodontics School Files of the Universidad Autónoma de Sinaloa, the population was 3 to 16 years of age. The main difference in months between DA and CA was 3.36 (p=0.384) and 94 % of concordance, the analysis by sex for males showed a main difference of 5.16 (P=0.785) and 96 % concordance; for females it showed 7.32 (P=0.095) and concordance of 92 %. In conclusion the DA according to Demirjian is a reliable method to estimate CA in these patients.

Estimación de la edad dental en radiografías panorámicas en niños y adolescentes de 7 a 17 años mediante el método de Demirjian, Cuenca ­ Ecuador / Estimation of dental age in panoramic radiographs in children and adoloescents from 7-17 years through Demirjian method, Cuenca ­ Ecuador

La edad es un indicador de maduración somática dental, de importancia clínica en Odontología para la planificación del tratamiento de pacientes en crecimiento. El método de Demirjian es el más ampliamente difundido para estimar la edad dental. Con este método se han realizado numerosos estudios en diferentes grupos étnicos, analizándose niños europeos, asiáticos y americanos, entre otros. Estos resultados sugieren posibles diferencias en los patrones de maduración dental entre las diferentes poblaciones. El objetivo del presente estudio fue correlacionar la edad dental, utilizando el método de Demirjian, con la edad cronológica de acuerdo al género en un grupo de niños que acudieron al Centro Radiológico "Innova" ubicado en Cuenca - Ecuador en el período 2012 ­ 2014, siendo este estudio de tipo descriptivo, retrospectivo y analítico, en donde se seleccionó una muestra estratificada por edad y genero incluyendo 362 radiografías, de las cuales 205 son de género femenino y 157 de género masculino. Se obtuvo un coeficiente de correlación inter- clase, como medida de correlación entre edad dental y cronológica, de 0,830 en el género femenino y 0,801 en el género masculino. En general el método de Demirjian tendió a subestimar la edad dental en niñas y en niños de manera similar. En conclusión, los resultados obtenidos en el presente trabajo no coinciden con numerosos lugares del mundo, es decir la edad dental en este grupo fue levemente menor tanto en las niñas como en los niños que la muestra original franco ­ canadiense. El rango obtenido, de la edad dental no es similar a la edad cronológica pero el grado de correlación entre ambas es el adecuado para aplicar en nuestra población, presentándose de igual manera de acuerdo al género por lo que se elaboró una tabla estándar para la población Cuencana. Consideramos que el método de Demirjian es aplicable a esta muestra de niños utilizando la base de datos planteada en la presente investigación

Age is an indicator of dental somatic maturation, of clinical importance in dentistry for planning the treatment of growing patients. The Demirjian method is the most widely disseminated to estimate dental age. With this method, numerous studies have been carried out in different ethnic groups, analyzing European, Asian and American children, among others. These results suggest possible differences in dental maturation patterns between different populations. The aim of the present study was to correlate the dental age, using the Demirjian method, with the chronological age according to gender in a group of children who attended the Radiological Center "Innova" located in Cuenca-Ecuador in the period 2012 - 2014, This study was descriptive, retrospective and analytical, in which a sample stratified by age and gender was selected, including 362 radiographs, of which 205 are female and 157 male. An inter-class correlation coefficient was obtained, as a measure of correlation between dental and chronological age, of 0.830 in the female gender and 0.801 in the male gender. In general, Demirjian's method tended to underestimate dental age in girls and boys in a similar way. In conclusion, the results obtained in the present work do not coincide with many places in the world, that is, the dental age in this group was slightly lower in both girls and boys than the original Franco - Canadian sample. The obtained range of dental age is not similar to the chronological age but the degree of correlation between both is adequate to apply in our population, presenting itself in the same way according to gender, so a standard table for the population was elaborated Cuencana. We consider that the Demirjian method is applicable to this sample of children using the database proposed in the present investigation.

Analysis of the rate of maturogenesis of a traumatized Cvek’s stage 3 anterior tooth treated with platelet‑rich fibrinas a regenerative tool using three‑dimensional cone‑beam computed tomography: An original case report.

Regenerative endodontic procedures are biologically based procedures which deal with the regeneration of pulp‑like tissue, more idealistically the pulp‑dentin complex. The regeneration of this pulp‑dentin complex in an infected necrotic tooth with an open apex is possible only when the canal is effectively disinfected. Though there are various procedures for treating open apex ranging from Ca(OH) 2 apexification, mineral trioxide aggregate apexification and surgical approach, regeneration of tissues has always taken superior hand over the repair of tissues. The mechanics behind the regenerative endodontic procedures is that despite the tooth being necrotic, some pulp tissue can survive apically which under favorable conditions proliferate to aid in the process of regeneration. In the past 2 decades, an increased understanding of the physiological roles of platelets in wound healing and after tissue injury has led to the idea of using platelets as therapeutic tools in the field regenerative endodontics. In the present case report with an open apex, high sterilization protocol is followed using triple antibiotic paste as intra‑canal medicament, followed which platelet rich fibrin is used as the regenerative material of choice. Over an 18‑month follow‑up period, clinically patient is asymptomatic and radiographically there is complete regression of the periapical lesion and initiation of the root end closure.

Long-term dental follow-up in hematological stem cells transplantation children / Acompanhametnto a longo prazo das alterações dentárias em pacientes pediátricos submetidos ao transplante de celulas tronco hematopoieticas

The aim of this paper is to update the current published content about the craniofacial long-term development disturbances of childhood hematopoietic stem-cell transplantation (HSCT) and the preparative regimens for the onco-hematological malignancies treatments. Methods: Two author sindependently reviewed the published articles about long-term effects of childhood HSCT that fitted into predetermined inclusion/exclusion criteria: clear definition of exposure or intervention, standard outcomes measurement and appropriate statistical analysis. Results: Twelve papers matched all the previous established eligibility criteria and were included in this review. The children’s age at HSCT were related to a higher risk of dental development disturbances, such as agenesis, dental hypoplasia, root stunting, crown-root proportion alterations, and microdontia. Craniofacial vertical growth was impaired in the irradiated patients without antero-posterior or latero-lateral impairment. Temporomandibular joint dysfunction was found to be more prevalent in the patients diagnosed withgraft-versus-host disease. Conclusion: The late effects of craniofacial development disturbances lead to several aesthetic and functional impairment, periodontal bone resorption with consequent impairment of chewing ability, and risk of early tooth loss often associated with life’s quality impairment. Further investigations should be performed to provide accurate information for patients, parent sand health care professionals...

Este artigo visa revisar o conteúdo publicado sobre as alterações tardias em crianças submetidas ao transplante de células-tronco hematopoiéticas(TCTH) e o regime pré-transplante para tratamento das doenças onco-hematológicas. Método: Dois autores independentes conduziram uma revisão simples dos artigos recentemente publicados sobre o tema, utilizando os critérios de exclusão/inclusão pré determinados: definição clara da intervenção clínica realizada, mensuração dos resultados padronizada e análise estatística adequada. Resultados: Doze artigos enquadraram-se em todos os critérios de avaliação pré-determinados para esta revisão. Houve correlação entre a idade da criança no momento do TCTH e maior risco de distúrbios de desenvolvimento dentário, como agenesia, hipoplasia dentária, encurtamento radicular,alterações da proporção coroa-raiz e microdontia.Houve alteração do crescimento craniofacial no sentido vertical sem, no entanto, alterar o crescimento anteroposterior e latero-lateral. Disfunção da articulação temporomandibular foi mais prevalente entre os pacientes com diagnostico de Doença do Enxerto contra o Hospedeiro. Conclusão: Os efeitos tardios do desenvolvimento craniofacial podem levara diversas alterações estéticas e funcionais, reabsorção óssea periodontal, diminuição da capacidade de mastigação e perda dentária precoce com possíveis impactos negativos sobre a qualidade de vida. Mais estudos são necessários para fornecer informações precisas aos pacientes, cuidadores e profissionais de saúde...

Radioprotective Effect of Sodium Selenite on Developing Teeth

Radioprotective agents like selenium are used to reduce the damage caused by radiation in healthy tissues. The aim of this study was to evaluate the effect of sodium selenite on the development of the molars of offspring of rats irradiated during odontogenesis. Twenty pregnant rats were randomly divided into 4 groups: control, irradiated, selenium and selenium/irradiated. The selenium and selenium/irradiated groups received 0.3 mg/kg of sodium selenite at 18 days of pregnancy. The rats of the irradiated and selenium/irradiated groups received a single dose of 4 Gy of X rays on the abdominal region at the 19th day of pregnancy. The offspring was sacrificed at 3 and 4 days after birth for evaluation of the birefringence of the enamel organic matrix, and at 30 days for evaluation of the intercuspal dimensions of the molars. The selenium/irradiated group was similar to the irradiated group with respect to the thickness and irregularity of the enamel organic matrix region in the evaluated birefringence, as the intercuspal dimensions of the molars. In conclusion, sodium selenite had no radioprotective action on the development of the molars of offspring of rats irradiated during odontogenesis and had a toxic effect in the initial time.

Agentes radioprotetores, como o selênio, são utilizados para reduzir os danos causados pela radiação nos tecidos sadios. O objetivo nesse estudo foi avaliar o efeito do selenito de sódio no desenvolvimento de molares de filhotes de ratas irradiadas. Vinte ratas grávidas foram aleatoriamente divididas em 4 grupos: controle, irradiado, selênio e selênio/irradiado. Os animais dos grupos selênio e selênio/irradiado receberam 0.3 mg/kg de selenito de sódio aos 18 dias de gestação. Os animais dos grupos irradiado e selênio/irradiado receberam dose única de 4 Gy de radiação X na região abdominal aos 19 dias de gestação. Os filhotes foram sacrificados aos 3 e 4 dias após o nascimento para avaliação da birrefringência da matriz orgânica do esmalte, e aos 30 dias para avaliação das dimensões dos molares. Os resultados do grupo selênio/irradiado foram similares aos do irradiado, tanto em relação à espessura e irregularidade região da matriz orgânica do esmalte quanto às dimensões dos molares. Dessa forma, foi possível concluir que o selenito de sódio não exerceu ação radioprotetora no desenvolvimento de molares de filhotes de ratas irradiadas durante a odontogênese e apresentou efeito tóxico nos tempos iniciais.

Comparação da eficiência oclusal do tratamento ortopédico com o regulador da função Frãnkel-2 e Bionator de Balters por meio do índice PAR / Comparison the occlusal efficiency of orthopedic treatments with Frãnkel-2 regulator and balters Bionator functional appliances using the PAR index

O objetivo deste estudo retrospectivo foi comparar a eficiência oclusal dotratamento ortopédico com os aparelhos funcionais Regulador de Função Fránkel-Z (RF-2) e Bionator de Balters em um estágio de desenvolvimento dental diferente e comparar com umgrupo controle. A amostra constituiu-se de 45 registros de documentações, pertencentes ao arquivo do programa de pós-graduação em Odontologia, área de concentração Ortodontia, da Universidade Metodista de São Paulo, com má-oclusão inicial de Classe II bilateral, divisão 1, sendo 15 pacientes provenientes do grupo tratado com Bionator (grupo 1) com idade média inicial de 8,56 anos e com 80% dos casos em um estágio de desenvolvimentodental-2 (OS 2), 15 pacientes tratados com RF-2 (grupo 2) com idade média inicial de 10,71 anos e com 80% dos casos em um estágio de desenvolvimento dental-3 (OS3), e 15 pacientescontrole (grupo 3) com idade média inicial de 10,03 anos e com estágio de desenvolvimento dental compatível com os grupos 1 e 2, ao início do tratamento. Os grupos foram divididos em duas fases, de acordo com o período de avaliação: Tl: início de tratamento e T2: final de tratamento, totalizando 90 pares de modelos. As avaliações oclusais foram realizadas em modelos de gesso, utilizando o índice PARcom auxílio da régua PAR.Para comparação entreos três grupos foi utilizado análise de variância a um critério e em seguida o teste de Tukey. A severidade da rná-oclusão (PARinicial) foi semelhante em ambos os grupos, porém, o PARfinal apresentou uma diferença estatisticamente significante onde o percentual de redução do índice PAR para o grupo 1 foi de 20,72%, para o grupo 2 foi de 60,06% e no grupo 3não houve alteração significante do valor do índice PAR. O presente estudo conclui que o tratamento da má-oclusão de Classe II, 1- divisão é mais eficiente quando iniciado no estágio de desenvolvimento dental 3 (OS 3) do que no estágio de desenvolvimento dental 2 (OS2). Além disso, ressalta-se a importância do uso...

The objective of this retrospective study was to compare the occlusal efficiencyof orthopedic treatments using the Frankel-2 regulator (RF-2) and Balters Bionator functional appliances, treated during different dental development stages, and compare them to acontrol group. The sample consisted of 45 documented records, belonging to the Dental School gradua te program with a concentration area in orthodontics at the Methodist University of São Paulo. Ali records featured an initial Class II division 1bilateral malocclusion. af these,15 patients were treated with the Bionator (group 1), with average initial age of 8.56 years and 80% of cases in dental development stage-2 (OS 2); 15 patients were treated with RF2(group 2), with average initial age of 10.71 years and 80% of cases in dental development stage -3 (OS 3); and a control group with 15 patients (group 3), with average initial age of 10.03 years and with dental development stage compatible both with groups 1 and 2. Thegroups were divided into two phases, according to the evaluation period: T1: beginning of treatment, and T2: final treatment, totaling 90 pairs of models. The occlusal evaluations were performed in plaster models, using the PAR index with the aid of the PAR ruler. Forintergroup comparison, Anova and Tukey test were used. The severity of the malocclusions (lnitial PAR) was similar in ali groups; however, the final PAR index showed a statistically significant difference, in which the percentile reduction for the PAR index was 20.72% for group 1, 60.06% for group 2, and no significant difference in the final PAR index for group 3. The present study concludes that the treatment for Class II division 1 malocclusion is more efficient when is begins during dental development stage-3 (OS 3) than in dental development stage-2 (OS 2). Moreover, importance is given to a more prolonged use of the dental appliance, as patients in group 2 showed better occlusal results.

Medidas lineares dos estágios de desenvolvimento da dentição permanente humana usando Tomografia Computadorizada de Feixe Cônico: um estudo preliminar / Linear measurements of human permanent dental development stages using Cone-Beam Computed Tomography: A preliminary study

OBJETIVO: determinar as medidas lineares dos estágios de desenvolvimento da dentição permanente humana, usando tomografia computadorizada de feixe cônico (TCFC). MÉTODOS: este estudo foi desenvolvido a partir de bancos de dados de clínicas radiológicas privadas, envolvendo 18 pacientes (13 do sexo masculino, 5 do sexo feminino, com idades variando entre 3 e 20 anos). As imagens das TCFC foram obtidas por meio do sistema i-CAT e medidas com uma função específica do programa desse mesmo sistema. Duzentos e trinta e oito dentes foram analisados, em diferentes estágios de desenvolvimento, nos planos coronal e sagital. O método foi baseado na delimitação e mensuração das distâncias entre pontos anatômicos correspondentes ao desenvolvimento das coroas e raízes dentárias. A partir dos valores obtidos, pôde-se desenvolver um modelo quantitativo para se avaliar os estágios inicial e final de desenvolvimento para todos os grupos dentários. RESULTADOS E CONCLUSÕES: as medidas obtidas dos diferentes grupos dentários estão de acordo com as estimativas das investigações publicadas previamente. As imagens por TCFC dos diferentes estágios de desenvolvimento podem contribuir no diagnóstico, planejamento e resultado dos tratamentos em diversas especialidades odontológicas. As dimensões das coroas e das raízes dentárias podem ter importantes aplicações clínicas e em pesquisas, constituindo uma técnica não invasiva que contribui com estudos in vivo. Entretanto, mais estudos são recomendados a fim de minimizar possíveis variáveis metodológicas.

OBJECTIVE: To determine the linear measurements of human permanent dentition development stages using Cone-Beam Computed Tomography. METHODS: This study was based on databases of private radiology clinics involving 18 patients (13 male and 5 female, with age ranging from 3 to 20 years). Cone-Beam Computed Tomography (CBCT) images were acquired with i-CAT system and measured with a specific function of the i-CAT software. Two hundred and thirty-eight teeth were analyzed in different development stages in the coronal and sagittal planes. The method was based on delimitation and measurement of the distance between anatomical landmarks corresponding to the development of the dental crowns and roots. These measurements allowed the development of a quantitative model to evaluate the initial and final development stages for all dental groups. RESULTS AND CONCLUSIONS: The measurements acquired from different dental groups are in agreement with estimates of investigations previously published. CBCT images of different development stages may contribute to diagnosis, planning and outcome of treatment in various dental specialties. The dimensions of dental crowns and roots may have important clinical and research applications, constituting a noninvasive technique which contributes to in vivo studies. However, further studies are recommended to minimize methodological variables.

Avaliação do apinhamento ântero-inferior por meio da análise de Bolton / Evaluation of lower incisal crowding by Bolton's analysis

Sabendo-se que a proporção entre o tamanho dos dentes superiores e inferiores é de fundamental importância para a finalização dos casos ortodônticos e que o apinhamento constitui uma das maiores causas de procura pelo tratamento ortodôntico, objetivou-se no presente estudo, avaliar com que frequência os pacientes com apinhamento na região ântero-inferior apresentam discrepância de tamanho dentário, bem como mensurar a quantidade do apinhamento que poderia estar relacionado com o excesso de estrutura dentária. A amostra foi constituída por 40 pares de modelos de gesso da documentação inicial de pacientes com apinhamento ântero-inferior, brasileiros, leucodermas, tanto do gênero masculino quanto do feminino. Foram utilizados os índices da Análise de Bolton para a avaliação da proporção entre os tamanhos dentários, e os resultados permitiram concluirque: l. Da amostra estudada, 57,5% tinham algum tipo de discrepância de tamanho dentário; 2. Em 52,5% da amostra, os pacientes apresentavam excesso de tamanho dentário na região anterior do arco inferior; 3. Os valores mínimo, máximo e a médiada discrepância de modelo, na amostra estudada, foram de 2 mm, 6 mm e 4,17 mm, respectivamente; e 4. Os valores mínimo, máximo e a média da discrepância de Bolton, para a amostra estudada, na região ântero-inferior foram de 1,22 mm, 3,74 mme 2, 13mm, respectivamente.

Knowing that the proportion between the size of maxillary and mandibular teeth is of fitndamental importance for finalizingorthodontic cases and that crowding is one ofthe major causes for seeking orthodontic treatment, the aim ofthis study was to assess the frequency with which patients with crowding in the antero-mandibular region present tooth size discrepancy, as well as to measurelheamount of crowding that may be related to excessive tooth structure. The sample comprised 40 pairs of plaster models from the original documentation of Brazilian, leucoderm patients of both genders, with antero-mandibular crowding. The Bolton analysisindexes were used to assess the proportion between the tooth sizes and the results allowed one to conclude that: 1. Ofthe studied sample, 57.5% had some type oftooth size discrepancy; 2. In 52.5% ofthe sample, the patients presented with excessive tooth sizein lhe anlerior region ofthe mandibular arch; 3. The minimum, maximum and mean model discrepancy values in the studied sample the were as follows: 2 mm, 6 mm and 4.17 mm, respectively; and 4. The minimum, maximum and mean Bolton discrepancy values forlhe studied sample, in the antero-mandibular region were as follows: 1.22 mm, 3.74 mm and 2.13 mm, respectively.

Supranumerários: etiologia e apresentação de casos clínicos / Supernumerary: etiology and report clinical cases

A presença de dentes supranumerários ocorre frequentemente em associação com fatores controlados geneticamente e concomitante com outras anomalias dentárias. A origem dessa anomalia ainda não foi completamente dirimida na literatura, embora existam evidências de que a genética seja o fator principal na sua etiologia, mesmo havendo dificuldades na identificação dosdiferentes fatores genéticos e ambientais. A presença de anomalias dentárias em síndromes pode indicar que os genes influenciam o número e o tamanho dos dentes, e a hereditariedade tem um papel importante, tendo uma participação efetiva na incidênciade dentes supranumerários em certos grupos familiares. O objetivo deste trabalho foi apresentar uma revisão da literatura pertinente e relatar casos não sindrômicos entre um irmão e uma irmã com dentes supranumerários, assim como descrever um caso sindrômico de disostose cleidocraniana.

The presence of supernumerary teeth often occurs in association with genetically controlled factors, along with other dental anomalies. The origin of this anomaly has not been fully clarified in the literature, although there is evidence that genetics is the mainfactor in its etiology, even though it is difficult to identify different genetic and environmental factors. The presence of dental anomalies in syndromes may indica te that genes influence the number and size ofthe teeth, and heredity plays an important role, with an effective participation in the incidence of supernumerary teeth in some family groups. This study aimed at presenting areJevantliterature reviel1, and report non-syndromic cases between a brother and a sister presented with supernumerary teeth, as well as describe a syndromic case of Cleidocranial Dysostosis.

Application of Demirjian's method for chronological age estimation in teenagers of Shanghai Han population / 法医学杂志

OBJECTIVE@#To study the applicability of Demirjian's method for age estimation in teenagers of Shanghai Han population in China.@*METHODS@#Paired t-test was performed between the chronological age and the age determined by Demirjian's method of 501 teenagers whose orthopantomograms were collected from the ninth hospital of Shanghai. There were 168 boys and 333 girls involved in this study with chronological age from 11 to 20 years. Uni-factor model was used to explore the relationships of the two kinds of age.@*RESULTS@#For the marked difference between the chronological age and determined age, Demirjian's method was not suitable to the Chinese Han adolescents. The results of paired t-test between chronological age and predicted age from quadratic equation showed that there was no significant difference in boys aged 12-16 years, in girls aged 12-14 years and 15-17 years repectively. The uni-factor model could make the error of determined age less than 1 year to 81.04% of the samples.@*CONCLUSION@#The age between 11 and 17 years can be well estimated by our method, except for the 17 years of age and above.

Repercusión del estado nutricional en el desarrollo dentario y esqueletal de escolares de Tucumán, Argentina: año 2004 / Impact of nutritional status on dental and skeletal development of school Tucumán, Argentina: 2004

El objetivo fue determinar el estado nutricional de niños y asociar la edad cronológica al estado madurativo esqueletal y dentario. Para determinar el estado nutricional de los escolares se usó la tabla de crecimiento normal de peso para talla de niños y niñas argentinos (Lejarraga y col, 1977). El estado madurativo esqueletal se relevó mediante radiografía carpal las que fueron comparadas con las del Atlas de Desarrollo Esqueletal de Greulich and Pyle. La edad dentaria se determinó mediante radiografías retroalveolares de canino inferior y comparadas con la Tabla de fases del desarrollo dental adaptado de Haavikko. No se encontraron diferencias significativas entre la edad cronológica, edad dentaria y ósea entre los grupos. ANOVA P= 0,76; P=0,17; P=0,50, respectivamente. Para este grupo de pacientes, la edad ósea de los niños desnutridos es significativamente inferior que la edad cronológica (Test de Kruskal-Wallis) P=0,021. En los niños eutróficos, la edad dentaria fue significativamente inferior que la cronológica (Kruskal- Wallis) P= 0,03

The objective was to determine children nutritional status and to associate chronological age to the skeletal and dental maduration status. In order to determine nutritional status of students, it was used a table for normal growing and development of weight and height for argentine children (Lejarraga, 1977). Skeletal madurative state was obtained using a wrist radiography which were compared with others included in the Atlas of Skeletal Development of the Hand and Wrist of Greulich and Pyle. Dental age was determined using dental radiograph of lower canine and compared with standards in the Table of dental Development Stages of Haaviko No significant difference was found between chronological, dental and skeletal age between groups. ANOVA P=0,76; P=0,17; P=0,50 respectively. For this population, skeletal age of malnourished children is significativelly lower than chronological age. For eutrophic children, dental age appeared significativelly lower than chronological age

Avaliação das alterações morfológicas faciais e dentárias em indivíduos adultos com incompetência labial / Evaluation of the face and dental morphologic alterations in adult individuals with labial incompetence

Objetivos: Avaliar determinadas características faciais e dentárias comparando indivíduos com incompetência labial e indivíduos com selamento labial passivo. Método: O estudo analisou cinquenta telerradiografias em norma lateral as quais 25 portadores de incompetência labial, com abertura mínima de 4 mm e 25 com selamento labial, sendo que nenhum havia passado por tratamento ortodôntico, todos entre 15 e trinta anos de idade, independentemente do gênero e maloclusão, com leve tendência de crescimento vertical. Utilizou - se as seguintes grandezas cefalométricas: Nfp - Nfa com o objetivo de determinar a largura da via aérea superior, Sn - St para medir o comprimento do lábio superior, Sn - IIs para o comprimento vertical da maxila e 1.NA para determinar a inclinação do incisivo superior. Resultados: As médias obtidas nos grupos com selamento labial passivo (G1) e incompetência labial (G2) foram respectivamente: 14,12 mm (G1) e 12,76 mm (G2) para largura da via aérea superior; 24,24 mm (G1) e 23,80 mm (G2) para comprimentos dos lábios superiores; 26,92 mm (G1) e 28,64 mm (G2) para o comprimento vertical da maxila e 26,76º (G1) e 30,76º (G2) para a inclinação dos incisivos superiores. Conclusão: Os resultados permitiram concluir que o indivíduo com incompetência labial apresentou a largura das vias aéreas superiores semelhante a do indivíduo com selamento labial passivo. Os indivíduos com incompetência labial apresentaram comprimento vertical maxilar aumentado e não o encurtamento do lábio superior. A presença dos incisivos superiores vestibularizados é condição inerente ao portador de incompetência labial que conseqüentemente apresentará hipotonicidade do lábio superior.

Objective: To evaluate certain facial and dental characteristics by comparing individuals with labial incompetence and individuals with passive labial sealing. Method: The study analyzed fifty lateral teleradiographs of which 25 were of subjects with labial incompetence, with minimum opening of 4 mm, and 25 of subjects with labial sealing, none of the subjects having undergone orthodontic treatment, all being between 15 and 30 years of age, irrespective of gender and malocclusion, with slight tendency towards vertical growth. The following cephalometric variables were used: Nfp - Nfa with the objective of determining the width of the upper airway, Sn -St to measure the length of the upper lip, Sn-IIs for the vertical length of the maxilla and 1.NA to determine the inclination of the maxillary incisor. Results: The measurements obtained in the group of passive lip sealing (G1) and labial incompetence (G2) respectively, were as follows:14.12 mm (G1) and 12.76 mm (G2) for width of the upper airway; 24.24 mm (G1) and 23.80 mm (G2) for the length of the upper lip;26.92 mm (G1) and 28.64 mm (G2) for the vertical length of the maxilla and 26.76º (G1) and 30.76º (G2) for the inclination of the maxillary incisor.Conclusion: The results allowed one to conclude that the individual with labial incompetence presented width of the upper airway similar to that of the individual with passive lip sealing. Individuals with labial incompetence presented increased vertical length of the maxilla and not shortening of the upper lip. The presence of vestibularized maxillary incisors is a condition inherent to the subject with labial incompetence, who will consequently present hypotonicity of the upper lip.