Radiographic evaluation of the mandible to predict age and sex in subadults.

OBJECTIVE: Forensic examinations involve the identification of age and sex from living or mortal remains. The mandible comprises several growth parameters and is often recovered intact, making it an important tool for radiological identification. Therefore, the present study was conducted to determine the accuracy of various mandibular measurements on digital panoramic images in indicating sex and age in a subadult population. Methods: Panoramic images from 1,100 individuals (550 males, 550 females) ranging in age between 3 and 13 years were divided into 11 groups according to age. Ten mandibular linear dimensions (ramus height, condylar ramus height, coronoid ramus height, maximum ramus breadth, minimum ramus breadth, bigonial breadth, bicondylar breadth, bimental breadth, lateral length of mental foramen, vertical length of mental foramen) and gonial angle were measured bilaterally. Univariate discriminant and regression analyses were performed to determine the most significant predictors of sex and age. RESULTS: All linear dimensions were higher for males than females for all age groups. Gonial angle did not vary significantly by gender. Discriminant analysis showed linear measurements and gonial angle exhibited poor accuracy in sex determination. Despite a positive correlation between linear measurements and a negative correlation between gonial angle and age, the discriminant analysis found that age estimations made using all the recorded variables had an accuracy of only 66.72%. CONCLUSION: In line with previous research on different populations, findings for the selected subadult population sample showed that the growing mandible does not present sufficient sexual dimorphism to be useful for sex and age estimations.

Regenerative Endodontic Treatment of Necrotic Primary Molars with Missing Premolars: A Case Series.

The endodontic treatment of necrotic primary teeth with missing successors presents a unique clinical challenge. The purpose of this report was to describe the clinical and radiological outcomes of regenerative endodontic treatment (revascularization) of necrotic primary molars. Four infected necrotic primary second molars with missing premolars were treated with a two-visit revascularization protocol. The crowns were restored with amalgam or acid-etch composite resin. The teeth were followed-up clinically and radiographically for 18 months. At six months, all teeth demonstrated radiographic evidence of complete periradicular healing and positive response to cold test, and remained symptomless thereafter.

Dental development in children with severe molar-incisor hypomineralization in Samsun, Turkey.

Anomalies in amelogenesis may be due to developmental defects or abnormalities in different components of developing teeth and can affect dental development. We compared dental development in a group of children with molar-incisor hypomineralization (MIH) with that in age- and sex-matched controls. Dental age was determined using panoramic radiographs of 105 children (59 girls, 46 boys) aged 7-11 years with severe MIH, and the findings were compared with those from 105 healthy age- and sex-matched controls. Although accelerated dental development was noted in the MIH group, the difference between the MIH and control groups was not statistically significant (P < 0.05). Furthermore, no relationship was found between number of affected teeth and the difference between dental and chronological age. In conclusion, children with severe MIH had slightly accelerated dental development as compared with controls.

Multidisciplinary treatment of a subgingivally fractured tooth with indirect composite restoration: a case report.

In pediatric patients, anterior teeth with fractures that extend subgingivally require a complex treatment plan that addresses biologic, esthetic, and functional factors, such as mastication and speech. The purpose of this clinical report was to describe a technique using indirect composite restoration to restore a subgingivally fractured permanent maxillary right central incisor in a 10-year-old boy. Due to the complex nature of the treatment, a multidisciplinary approach was used to restore the tooth. The crown fragment was removed, and endodontic treatment was performed. The tooth was then extruded orthodontically. A glass fiber post was placed to improve retention, and an indirect composite restoration was placed. A clinical and radiographic evaluation at a follow-up appointment 1 year later confirmed that the technique used in this case can be a good option for restoring anterior teeth with subgingival fractures.

Knowledge of medical hospital emergency physicians about the first-aid management of traumatic tooth avulsion.

OBJECTIVE: The aim of this study was to evaluate the knowledge of emergency medical physicians employed in hospital emergency rooms as to their potential role in the treatment for traumatic teeth avulsion injuries (TTAI). METHODS: A 15-item questionnaire was distributed to the emergency rooms of one university and 10 public hospitals. The questionnaire gathered data on the respondents' professional profiles and self-assessed perceived knowledge and actual knowledge of the emergency management of TTAIs. RESULTS: The study was implemented with 69 emergency physicians present at their workplaces during the time of data collection. Of these, 55 (79.7%) were employed at public hospitals and 14 (20.3%) at a university hospital. The professional profiles indicated that 47 (68.1%) of the participants were general practitioners and the remaining 22 (31.9%) were distributed among various other medical specialties. Overall, 28 respondents (40.6%) assessed their knowledge regarding medical treatment for TTAI as insufficient, and the majority (78.3%) stated that they would like further education. Importantly, a large majority of practitioners could not provide correct answers to questions related to the emergency management of TTAI. CONCLUSION: There is a need to improve the knowledge of emergency medical physicians regarding the emergency treatment for TTAI.

Reimplantation of an inverted maxillary premolar: case report of a multidisciplinary treatment approach.

Inversion of premolars is an extremely rare condition, which usually requires extraction. This case report describes the inversion of an impacted maxillary second premolar in an 11-year-old male, and the multidisciplinary treatment approach for bringing the tooth into a normal position within the arch. In order to provide sufficient space for surgical reimplantation of the tooth, the mesially-drifted neighbouring maxillary first molar was first endodontically treated, followed by orthodontic distalization of the tooth. The inverted tooth was removed surgically and reimplanted without the use of splints for stabilization. After a 12-month follow-up period, the tooth maintained its vitality without any root resorption. Reimplantation of impacted inverted premolars can be a viable treatment alternative to extraction.

Provisional use of a natural tooth crown following failure of replantation: a case report.

Despite a wide range of treatment options available, traumatized teeth may be inevitably lost on certain occasions. This case report presents an alternative treatment option for the premature loss of a traumatized maxillary central incisor because of extensive root resorption and mobility. A fixed appliance-type provisional prosthesis was fabricated by using the patient's natural clinical crown from the extracted tooth. This measure proved to be a very adequate, esthetic treatment solution before a permanent restorative plan could be developed in the future.