Accuracy of the use of radiographic visibility of root pulp in the mandibular third molar as a maturity marker at age thresholds of 18 and 21.

Evaluation of the radiographic visibility of root pulp in mandibular third molars has been suggested as an alternative method for estimation of legal age threshold in living individuals when the root apices are mature. Here, we assessed the accuracy of this method for age thresholds of 18 and 21 years. A sample of 463 panoramic radiographs of individuals aged between 16 and 34 years was examined. The root pulp visibility of the mandibular third molars was scored; the stages ranged from 0 to 3. A receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to select optimal cut-offs for 18- and 21-year-old thresholds. As prognostic predictors, the selected cut-offs were stages 1 and 2 for the 18- and 21-year-old thresholds of both sexes, respectively. For the 18-year-old threshold, the AUC, sensitivity and specificity were 0.829, 83.1% and 66.7% in females; and 0.930, 89.4% and 90.9% in males, respectively. For the 21-year-old threshold, the AUC, sensitivity and specificity were 0.874, 72.8% and 92.0% in females; and 0.906, 85.5% and 88.2% in males, respectively. The accuracy of the method for estimating the 18- and 21-year-old thresholds ranged from moderate to high. Therefore, the method must be used in conjunction with other age estimation methods, especially to predict whether a female has reached 18 years of age.

Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

PURPOSE: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. MATERIALS AND METHODS: A total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. RESULTS: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. CONCLUSION: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

[Terminology and classification of condylar hyperplasia: Two case reports and review]. / Kondiler hiperplazinin terminolojisi ve siniflandirilmasi: Iki olgu sunumu ve derleme.

Condylar hyperplasia is characterized by the growth of mandibular condyle. Its etiology and pathogenesis remain controversial. It often occurs unilaterally and leads to facial asymmetry and malocclusion. In the literature, it was also classified according to anomalies accompanied by the growth of other components of the mandible. Differential diagnosis of condylar hyperplasia usually includes tumors of temporomandibular joint. In this article, we discuss the term "condylar hyperplasia" and its classification considering two patients with condylar growth.

Applicability of Demirjian's four methods and Willems method for age estimation in a sample of Turkish children.

The aim of this study was to evaluate applicability of five dental methods including Demirjian's original, revised, four teeth, and alternate four teeth methods and Willems method for age estimation in a sample of Turkish children. Panoramic radiographs of 799 children (412 females, 387 males) aged between 2.20 and 15.99years were examined by two observers. A repeated measures ANOVA was performed to compare dental methods among gender and age groups. All of the five methods overestimated the chronological age on the average. Among these, Willems method was found to be the most accurate method, which showed 0.07 and 0.15years overestimation for males and females, respectively. It was followed by Demirjian's four teeth methods, revised and original methods. According to the results, Willems method can be recommended for dental age estimation of Turkish children in forensic applications.

Unilateral maxillary canine agenesis: a case report and literature review.

Congenital absence of maxillary permanent canines is an extremely rare condition, which may appear as part of a syndrome or as a nonsyndromic form. Nonsyndromic canine agenesis combined with other types of tooth agenesis has occasionally been described in the literature but isolated cases are rarely observed. This report presents an isolated case of maxillary permanent canine agenesis in a healthy 18-year-old female patient and a literature review on the prevalence, etiology, and differential diagnosis of the condition.

Sequential test selection by quantifying of the reduction in diagnostic uncertainty for the diagnosis of proximal caries.

BACKGROUND: In order to determine the presence or absence of a certain disease, multiple diagnostic tests may be necessary. Performance of these tests can be sequentially evaluated. AIMS: The aim of the study is to determine the contribution of the test in each step, in reducing diagnostic uncertainty when multiple tests are sequentially used for the diagnosis. STUDY DESIGN: Diagnostic accuracy study. METHODS: Radiographs of seventy-three patients of the Department of Dento-Maxillofacial Radiology of Hacettepe University Faculty of Dentistry were assessed. Panoramic (PAN), full mouth intraoral (FM), and bitewing (BW) radiographs were used for the diagnosis of proximal caries in the maxillary and mandibular molar regions. Diagnostic performance of radiography was sequentially evaluated by using the reduction in diagnostic uncertainty. RESULTS: FM provided maximum diagnostic information for ruling in potential in the maxillary and mandibular molar regions in the first step. FM provided more diagnostic information than BW radiographs for ruling in the mandibular region in the second step. In the mandibular region, BW radiographs provided more diagnostic information than FM for ruling out in the first step. CONCLUSION: The presented method in this study provides the clinicians with a solution for the decision of the sequential selection of diagnostic tests for the correct diagnosis of the presence or absence of a certain disease.

Treatment of a patient with oligodontia: a case report.

AIM: The aim of this report is to describe the management of a 16-year-old patient with oligodontia including six permanent teeth. BACKGROUND: Oligodontia is agenesis of six teeth or more, excluding third molars. The etiology of congenital absence of teeth is believed to be involved in heredity or developmental anomalies. It can be isolated or as part of a syndrome. There are a number of options available to restore space generated by missing teeth. Dental treatment can vary depending on the severity of the disease and generally requires a multidisciplinary approach. Treatment options include orthodontic therapy, implants, adhesive techniques, and removable prostheses. REPORT: A 16-year-old male patient with oligodontia affecting six permanent teeth received conservative care that met his and his parent's expectations. The existing primary teeth were restored to resemble permanent teeth in order to achieve a favorable esthetic result using direct composite resin. The restorative treatment was provided for the psychosocial comfort of the young patient. The loss of teeth in young patients can cause esthetic, functional, and psychological problems particularly if the teeth of the anterior region are involved. SUMMARY: Adhesive techniques and new restorative materials represent current options in the management of the dental rehabilitation of young patients with oligodontia.