Characterisation of anterior open bite in primary school-aged children: A preliminary study with artificial neural network analysis.

BACKGROUND: Non-nutritive sucking habits, bottle feeding, and facial hyperdivergency have been suggested as the influencing factors of anterior open bite (AOB). There was inconsistent reporting of prevalence and a gap of knowledge in the literature. AIM: The aim of this study was to investigate the prevalence of AOB in 7- to 12-year-olds, with a special interest to characterise the determinants of this malocclusion. DESIGN: A sample of 203 children aged 7 to 12 years were selected from a primary school in regional Australia. The legal guardian of each child completed a self-administered questionnaire. Data were assessed using methods of univariate statistics and neural analysis. RESULTS: The prevalence of AOB and thumb sucking was 24.1% and 23.2%, respectively. AOB was associated with the habit (correlation = 0.754) and duration (correlation = 0.574) of thumb sucking. Age, gender, birth order, feeding modality, sleep patterns, history of orthodontic treatment and tonsil, adenoid or grommet surgery, and parents' level of education were not related to AOB (correlation absolute value ≤ 0.474). CONCLUSIONS: Thumb sucking, specifically for prolonged duration, increases the risk of development of AOB. Cessation of thumb sucking habits should be encouraged at an early age to avoid the development of AOB.

Quantification of age-related changes in midsagittal facial profile using Fourier analysis: A longitudinal study on Japanese adult males.

OBJECTIVES: The aim of the present study was to use Fourier analysis to quantify and study age-related changes in midsagittal facial profile. MATERIALS AND METHODS: Midsagittal facial profiles were extracted as lists of x and y coordinates from 125 pairs of 3D facial scans captured at an average of 10.5 years apart for adult Japanese males aged 23-52 years. These were categorized into three 10-year-long age groups. Files of x and y coordinates underwent Fourier analysis at 30 harmonic levels. Paired t-tests were used to determine statistical significance of differences across corresponding harmonic coefficients. Mean harmonic coefficients were used to construct mean pre and post ageing profiles for each age group for qualitative comparisons. RESULTS: Full detail of facial profile was described by the first 20 harmonics. With increasing age, there was a trend of longitudinal changes involving more midsagittal shape features with increased magnitudes. However, all changes were lower than 1 mm. CONCLUSIONS: Fourier analysis is a useful morphometric approach to quantify age-related midsagittal facial changes. The small variations in the study groups prompt for testing Fourier analysis on the elderly and on other parasagittal and transverse facial features.

Clinical duration of eruption of deciduous teeth in Jordanian children: A cross-sectional study.

OBJECTIVE: The aim of this study was to investigate the clinical duration of eruption (CDE) for deciduous teeth in Jordanian children, from the moment of gingival emergence until functional occlusal contact. DESIGN: This cross-sectional study included 1988 children (885 females, 1103 males) aged 1-45 months examined for deciduous tooth emergence. Through probit regression analysis (SPSS Version 16.0), the median ages of emergence (MAE) and of functional eruption (MAF) were calculated per tooth; time difference between the two events represented CDE in months. Mann Whitney U tests and two-tailed Spearman's bivariate correlation test were used to investigate sexual dimorphisms in CDE, and find relationships between MAE and CDE, respectively. Significance was set at P ≤ 0.05. RESULTS: The average CDE was (4.45 ±â€¯1.96) months; it was less in males (4.33 ±â€¯1.99) than in females (4.57 ±â€¯1.93) with no significant gender differences (P = 0.38). Longest and shortest CDE were for maxillary first molars and mandibular lateral incisors, respectively. None of the teeth showed statistically significant differences in CDEs between genders. In addition, there were insignificant positive moderate correlations between MAE and CDE (r = 0.60, 0.52, P = 0.07, 0.12 for males and females, respectively). CONCLUSIONS: This study has established the first standards for CDE in deciduous teeth for Jordanian children with an average CDE (4.5 ±â€¯2, range 1.6-8 months). Some variations in CDE can be explained by variations in age of emergence however, variations in CDE were not related to gender. The deciduous dentition in Jordanians is in active state of eruption between approximately 8.2-32 months.

Association of weight and height with timing of deciduous tooth emergence.

OBJECTIVES: The aim of this study was to associate weight and height with the timing of deciduous tooth emergence. METHODS: 1756 children, aged from 1 to 33 months (755 females and 1001 males) had been previously examined for the timing of deciduous tooth emergence and their weights and heights measured. Children were categorized into weight and height groups (underweight, normal, overweight, short stature, normal and tall stature). Probit regression analysis was used to calculate the ages at emergence of each deciduous tooth. Tooth emergence ages were compared pairwise across the weight and height groups. RESULTS: The deciduous dentition emerged between 7.9-31.5, 7.8-29.6 and 6.3-26.5 months in the underweight, normal and overweight children, respectively. In the height groups, the ranges were 9.0-31.3, 7.4-27.0 and 6.7-24.3 in the short, normal and tall children, respectively. The extremes of weight and height were related to the times at deciduous tooth emergence where a substantial increase in weight or height was associated with earlier emergence, and vice versa. However, only canines, lateral incisors and upper central incisor showed statistically significant association with weight and none of the teeth exhibited statistically significant association with height. Moreover, no emergence sequence change was associated with weight and height. CONCLUSIONS: The present study provides the first weight and height- specific data on the timing of deciduous tooth emergence. Although both weight and height are generally associated with the timing of deciduous tooth emergence, weight shows a stronger association for canines, lateral incisors and upper central incisor. The findings will aid assessing normal emergence timing in children with variant weights and heights.

Age prediction in the adult based on the pulp-to-tooth ratio in lower third molars: a cone-beam CT study / Predicción de edad en el adulto basada en la proporción pulpa-a-diente en terceros molares inferiores: un estudio por TC de haz de cono

Estimation of age-at-death is an integral part of the identification process of individuals in many forensic odontology cases where their identity cannot be determined by visualization or other ways. Dental age estimation in the adult is more challenging as most of the dentition is completely developed by 18 years of age. This study employs a mesio-distal (MD) pulp-to-tooth ratio taken at the neck of lower third molars (LM3) to provide an estimation of age at the time of radiographic imaging based on the well-known fact that pulp volume tends to decrease with advancing age due to continued apposition of secondary dentine throughout adulthood. A total of 155 Cone-beam computed tomography (CBCT) radiographs of LM3s for a random sample of 155 Jordanian Arabs (80 females, 75 males; age range= 18-58 years, mean age= 28.2 years, SD =10.0 years) were used. Both pulp and tooth MD diameters were measured at the neck. MD pulp-to-tooth ratios for LM3s were linearly regressed against age. Statistically significant negative association was found between an individual's age at the time of imaging and the MD pulp-to-tooth ratio taken at the neck. Specifically, the strength of the association is r= -0.361, which means only 13.0 % of the variation in age can be explained by the MD pulp-to-tooth ratio taken at the neck. Therefore, it was concluded that MD pulp-to-tooth ratio taken at the neck of LM3s is not a reliable predictor of chronological age in adults, possibly due to the large variation in the timing of LM3 development.

La estimación de la edad es una parte integral del proceso de identificación de los individuos, en muchos casos en odontología forense donde la identidad no puede ser determinada por visualización u otras formas. La estimación de la edad dental en el adulto es aún más difícil ya que la mayor parte de la dentición se desarrolla completamente a los 18 años de edad. Este estudio emplea una relación mesio-distal (MD) de pulpa a diente tomada a nivel del cuello de los terceros molares inferiores (LM3) para proporcionar una estimación de la edad en el momento de la imagen radiográfica basada en que el volumen de pulpa tiende a disminuir con el avance de la edad debido a la continua posición de la dentina secundaria a lo largo de la edad adulta. Se examinaron un total de 155 radiografías de LM3 en una muestra aleatoria de 155 árabes jordanos (80 mujeres, 75 varones), rango de edad = 18-58 años, edad media = 28,2 años, DE = 10,0 años. Específicamente, la fuerza de la asociación es r=0,361, lo que significa que sólo el 13,0 % de la variación en la edad puede explicarse por la proporción pulpa-a-diente.

Mesiodistal and faciolingual diameters of the permanent teeth in a Jordanian population.

OBJECTIVES: This study aimed to provide, for a Jordanian population, the first norms of the faciolingual diameters of the permanent dentition and the mesiodistal diameters of the second molars and to provide and review previously published data on the mesiodistal diameters of the permanent teeth up to the first molars in order to investigate any secular trends. DESIGN: Mesiodistal and faciolingual diameters of the permanent teeth were manually measured on 204 archival pretreatment study casts of adolescents (80 males and 124 females) aged 11-18 years. SPSS (version 16) was used to generate descriptive statistics and investigate the statistically significant differences between right and left sides and between sexes. RESULTS: Males had larger teeth than females, significantly in the mesiodistal dimension and less significantly in the faciolingual dimension. Moreover, in the faciolingual dimension, there was a wider variation in anterior compared with posterior teeth and in males compared with females while the variations were more consistent mesiodistally between anterior and posterior teeth and between sexes. There were some secular trends in the mesiodistal permanent tooth diameters of Jordanians toward a slight reduction and wider variation in tooth size and a slight reduction in sexual dimorphism. CONCLUSIONS: the present study has established the first norms of the faciolingual permanent tooth diameters for a Jordanian population which were consistent with corresponding norms that have been published for few other populations. In addition, the present study has provided norms of the mesiodistal permanent tooth diameters of a Jordanian population that are newer and more complete than the previously published norms. It is anticipated that the new norms presented will be utilized in various clinical disciplines of dentistry, in basic dental research, in forensic odontology and in anthropological research.

Timing of clinical eruption of third molars in a Jordanian population.

OBJECTIVES: This study aimed at providing the first standards on the timing of third molar eruption in Jordanians. METHODS: A total of 571 healthy Jordanian adolescents and young adults aged 15-27 years (275 males and 296 females distributed into one-year age groups) were clinically examined for third molar eruption. Presence of four clinical eruption stages from crown emergence to full eruption were counted and expressed each as a frequency relative to the total of participants within a given age group. Using probit regression, median ages at each of the eruption stages were calculated for the whole sample and for both genders. RESULTS: In the whole sample, maxillary and mandibular third molars were found to emerge at 20 and 20.6 years and to reach full eruption at 22.7 and 23.5 years respectively. At all of the four clinical eruption stages, third molars of males and lower jaw slightly preceded those of females and upper jaw respectively. However, none of the differences were statistically significant. CONCLUSIONS: The first data on the timing of clinical eruption of third molars in a Jordanian population have been provided to be utilized in various clinical and research fields of orthodontics, dental pathology, oral surgery, paleodontology, forensic dentistry and police sciences. As the clinical duration of third molar eruption ranges from 20 to 24 years, the responsibility for providing care of third molar eruption problems is shifted from secondary schools to tertiary education, governmental and private work bodies.

The relationship between body mass index and periodontitis among postmenopausal women.

BACKGROUND: Periodontitis and overweight/obesity prevalence are both increasing worldwide. Overweight/obesity has been suggested as a risk factor for developing periodontitis. The aim of this study was to determine the association between obesity and periodontitis among postmenopausal Jordanian women. MATERIAL AND METHODS: Cross-sectional associations between obesity and periodontitis were examined in 400 postmenopausal women aged 50-79 years. All women completed a questionnaire, had a clinical periodontal examination and had their weight and height recorded. Multivariable analysis was carried out using logistic regression with adjustment for possible confounders. RESULTS: Based on body mass index (BMI), 23.5% of the women were considered overweight and 70% were obese. Obese participants with BMI≥25 had decreased odds (OR) for having periodontitis compared to participants with normal weight (OR: 0.54; 95% confidence interval [CI]: 0.27-0.87). The obese patients showed significantly higher loss of clinical attachment (CAL), calculus, as well as plaque and gingival index and as compared to normal and overweight (p<0.01). The extent of periodontal disease was also significantly higher in obese women as measured by average percent of sites with the deepest CAL≥5 mm (p=0.025). There was no significant difference in mean and percentage of sites with alveolar crestal bone loss (ACH) among different categories of obesity. In conclusion, BMI may be inversely associated with prevalence of periodontitis but positively related to the severity of periodontitis assessed by several periodontal parameters such as CAL, recession, plaque, and calculus. Additional prospective studies to further quantify, or understand the mechanisms, of this association are merited.

Timing and sequence of emergence of deciduous teeth in Jordanian children.

OBJECTIVE: The aim of this study was to provide the timing and sequence of deciduous tooth emergence in a sample of Jordanian children. DESIGN: A total of 1988 (885 female and 1103 male) children aged from 1 to 45 months recruited from nursery schools and child and maternity health centres in the northern, middle and southern regions of Jordan underwent a dental examination for the detection of deciduous tooth emergence. Children were categorized into 15 3-month-apart age groups. Using Probit regression (SPSS version 16), the median age of emergence per tooth was calculated for the total sample and for both genders. RESULTS: The period for acquiring deciduous dentition in the total sample ranged from 8.2 to 27.5 months. In either of the maxillary and mandibular arches, deciduous dentition emerged in the following order: central incisor, lateral incisor, first molar, canine and second molar. In addition, there were insignificant differences across side and there was a significant mandibular precedence of the central incisor although the maxillary precedence in the rest of the teeth was insignificant. Moreover, teeth emerged earlier in females although none of the inter-gender differences were significant. CONCLUSIONS: The first standards of the timing and sequence of deciduous tooth emergence specific to the Jordanian population were provided. These standards will be used along with the previously published standards of permanent tooth emergence to aid managing patients in paediatric dentistry and orthodontics and will find applications in forensic and police sciences and in anthropological research.

Studying the relationships between the outlines of the face, maxillary central incisor, and maxillary arch in Jordanian adults by using Fourier analysis.

STATEMENT OF THE PROBLEM: The outline shapes of the dental arch, face, and tooth are esthetic factors used to determine the proper form of artificial teeth when selected for artificial prostheses. PURPOSE: The purpose of this study was to investigate the quantitative relationships between the outlines of the face, the maxillary central incisor, and the maxillary arch by using Fourier analysis. MATERIAL AND METHODS: Frontal facial photographs and irreversible hydrocolloid impressions of the maxilla were obtained from 200 young, dentate individuals (100 men, 100 women) ages 22 to 28 years. On the resultant casts, standardized photographs were made for the dental arch and the maxillary central incisor. The outlines of the face, dental arch, and tooth were digitally traced and the digitized curved outlines were converted into X-Y coordinates with special software, which, in turn, were imported into Fourier Shape Descriptor software for harmonic analysis. The quantitative outputs of Fourier analyses were analyzed and tested with statistical software to investigate the differences across the shapes of the 3 outlines under study. RESULTS: Facial and tooth outlines were similar for each sex, although the similarity was stronger among the men. By contrast, no relationship was found between tooth and maxillary arch outlines or between face and maxillary arch outlines. CONCLUSIONS: Face and tooth forms were quantitatively related. Therefore, face form may reliably guide the selection of artificial anterior tooth form in complete denture prostheses or any complex anterior restorations.

Tooth shade measurements under standard and nonstandard illumination and their agreement with skin color.

PURPOSE: The purpose of this study was to examine the relationship between skin color (shade) and tooth shade under standard and nonstandard illumination sources. MATERIALS AND METHODS: Four hundred Jordanian participants (200 males, 200 females, 20 to 50 years of age) were studied. Skin colors were assessed and categorized using the L'Oreal and Revlon foundation shade guides (light, medium, dark). The Vita Pan Classical Shade Guide (VPCSG; Vident) and digital Vita EasyShade Intraoral Dental Spectrophotometer (VESIDS; Vident) were used to select shades in the middle thirds of maxillary central incisors; tooth shades were classified into four categories (highest, high, medium, low). RESULTS: Significant gender differences were observed for skin colors (P = .000) and tooth shade guide systems (P = .001 and .050 for VPCSG and VESIDS, respectively). The observed agreement was 100% and 93% for skin and tooth shade guides, respectively. The corresponding kappa statistic values were 1.00 and 0.79, respectively (substantial agreement, P < .001). The observed agreement between skin color and tooth shades (VPCSG and VESIDS) was approximately 50%. CONCLUSIONS: The digital tooth shade guide system can be a satisfactory substitute for classical tooth shade guides and clinical shade matching. There was only moderate agreement between skin color and tooth shade.

Polymorphisms in sequence of permanent tooth emergence: a cross-sectional study on Jordanian children and adolescents.

OBJECTIVE: This study aimed at providing the norms of polymorphic gender- variation in the sequence of permanent tooth emergence in Jordanian children and adolescents. MATERIALS AND METHODS: A total of 2650 Jordanian children and adolescents (1232 males and 1418 females) aged 4-16 years were examined for permanent tooth emergence. By counting the cases of present-absent and absent-present across all possible intra-arch tooth pairs, the frequencies of sequence polymorphisms were calculated and expressed as percentages in and arch-specific matrices. RESULTS: Sequence polymorphisms were more common in tooth pairs in phase II than in phase I of permanent tooth emergence and only rarely did teeth in phase I reverse sequence with teeth in phase II. In addition, maxillary and mandibular polymorphisms were most common in the sequences of canine-second premolar and first premolar-canine, respectively. Furthermore, central incisor-first molar and second molar-second premolar sequences were much more common in the mandible than in the maxilla. It was noticed that males and females had more similar frequencies of polymorphic sequences in the maxillary than in the mandibular tooth pairs. CONCLUSIONS: This study presented the norms of pairwise sequence polymorphisms in permanent tooth emergence in the Jordanians. Such norms are adequately useful for the evaluation and prediction of tooth emergence sequence in individual children and valuable in the assessment of emergence sequence problems in pediatric dentistry and in planning and following-up orthodontic treatment.

Level of education and gender-specific self-reported oral health behavior among dental students.

PURPOSE: To identify the oral health attitudes/behaviour among dental students in Jordan, and analyse the variations in oral health attitudes based on gender and level of education. MATERIALS AND METHODS: Out of the 653 registered dental students at the faculty of dentistry, 580 students (455 females and 125 males, mean age = 20.1 ± 1.6 years) participated in the study (response rate 89%). The Hiroshima University-Dental Behavioural Inventory (HU-DBI) was used to assess oral heath attitudes and behaviour of the participants. Data were analysed using the chi-square test, and statistical significance was set at P < 0.05. RESULTS: Females had better oral health attitudes and behaviour, especially towards visiting the dentist, toothbrushing habits and oral hygiene practice (P < 0.05). Also, students from the higher years had better oral health attitudes, behaviour and knowledge, especially towards gingival health, oral hygiene practice, toothbrushing and visiting the dentist (P < 0.05). CONCLUSION: Dental students in Jordan had poor oral health attitudes and behaviour. Females had better oral health knowledge, attitudes and behaviour than males. With increasing years of study, some aspects of dental students' oral health behaviour and attitudes improved. However, this improvement was limited and students should be encouraged to become an example of oral health for their society. Better comprehensive dental education with early exposure to dental health and prevention was suggested to improve dental students' oral health attitudes and behaviour.

Ciprofloxacin-induced antibacterial activity is reversed by vitamin E and vitamin C.

In the present study, we investigated the possible involvement of oxidative stress in ciprofloxacin-induced cytotoxicity against several reference bacteria including Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213, and clinical isolate of methicillin-resistant Staphylococcus aureus (MRSA). Oxidative stress was assessed by measurement of hydrogen peroxide generation using a FACScan flow cytometer. The antibacterial activity of ciprofloxacin was assessed using the disk diffusion method and by measuring the minimum inhibitory concentration (MIC). Ciprofloxacin induced a dose-dependent antibacterial activity against all bacteria where the highest tested concentration was 100 ug/ml. Results revealed that E. coli cells were highly sensitive to ciprofloxacin (MIC = 0.21 µg/mL ± 0.087), P. aeruginosa and S. aureus cells were intermediately sensitive (MIC = 5.40 µg/mL ± 0.14; MIC = 3.42 µg/mL ± 0.377, respectively), and MRSA cells were highly resistant (MIC = 16.76 µg/mL ± 2.1). Pretreatment of E. coli cells with either vitamin E or vitamin C has significantly protected cells against ciprofloxacin-induced cytotoxicity. These results indicate the possible antagonistic properties for vitamins C or E when they are used concurrently with ciprofloxacin.

Timing and sequence of emergence of permanent teeth in the Jordanian population.

OBJECTIVES: Population-specific standards of tooth emergence are essential resources for various fields of clinical and forensic dentistry. To date, such standards have not been provided for the Jordanian population. This study aimed at providing the timing and sequence of emergence of the permanent dentition in the Jordanian population. METHODS AND RESULTS: Using multistage clustered sampling, 1240 males and 1432 females aged 4-16 years from kindergartens and primary schools in the northern, middle and southern regions of Jordan were examined for emergence of permanent teeth. The subjects were classified into 1-year age groups. For a given tooth, "present" teeth were counted and expressed as a frequency relative to the total of subjects within a given age group. Using Probit regression (SPSS version 16), the median emergence age per tooth was calculated for the total sample and for both genders. No statistically significant differences were detected between sides. In addition, mandibular teeth were generally found to emerge earlier than the corresponding maxillary teeth. However, the difference in mandibular precedence was not statistically significant in all corresponding inter-maxillary tooth pairs. Furthermore, permanent teeth were found to emerge sooner in females than in males although the inter-gender differences were non-statistically significant for first molars and central incisors. CONCLUSIONS: The first standards of timing and sequence of permanent tooth emergence specific to the Jordanian population were provided and found to be consistent with those of Caucasian populations. These standards aid managing patients in paediatric dentistry, planning orthodontic therapy and forensic age estimation.

Variation in time of emergence of permanent teeth among urban and rural Jordanian school children.

OBJECTIVE: To investigate the variation in time of permanent tooth emergence between urban and rural Jordanian school children. METHODS: In this observational cross-sectional study, 1900 pupils at urban schools, and 772 at rural schools aged 5-16 years in both genders were examined for emergence of permanent teeth at different urban and rural primary schools and kindergartens in Jordan between March and June 2010. Probit analysis was used to estimate the median age of emergence per permanent tooth. RESULTS: The emergence ages for most of the permanent teeth were generally advanced in urban schoolboys in contrast to their fellows at rural schools. However, the differences were only statistically significant for the maxillary canine and maxillary premolars. Compared with boys, schoolgirls had smaller variation in permanent tooth emergence across school region, and none of the differences were statistically significant. CONCLUSION: Urban schoolboys have accelerated emergence of the maxillary canine and maxillary premolars compared to rural boys. The potential etiology behind this finding needs to be investigated further in the future.

Delineation of facial archetypes by 3d averaging.

The objective of this study was to investigate the feasibility of creating archetypal 3D faces through computerized 3D facial averaging. A 3D surface scanner Fiore and its software were used to acquire the 3D scans of the faces while 3D Rugle3 and locally-developed software generated the holistic facial averages. 3D facial averages were created from two ethnic groups; European and Japanese and from children with three previous genetic disorders; Williams syndrome, achondroplasia and Sotos syndrome as well as the normal control group. The method included averaging the corresponding depth (z) coordinates of the 3D facial scans. Compared with other face averaging techniques there was not any warping or filling in the spaces by interpolation; however, this facial average lacked colour information. The results showed that as few as 14 faces were sufficient to create an archetypal facial average. In turn this would make it practical to use face averaging as an identification tool in cases where it would be difficult to recruit a larger number of participants. In generating the average, correcting for size differences among faces was shown to adjust the average outlines of the facial features. It is assumed that 3D facial averaging would help in the identification of the ethnic status of persons whose identity may not be known with certainty. In clinical medicine, it would have a great potential for the diagnosis of syndromes with distinctive facial features. The system would also assist in the education of clinicians in the recognition and identification of such syndromes.