Accuracy of advanced deep learning with tensorflow and keras for classifying teeth developmental stages in digital panoramic imaging.

BACKGROUND: This study aims to propose the combinations of image processing and machine learning model to segment the maturity development of the mandibular premolars using a Keras-based deep learning convolutional neural networks (DCNN) model. METHODS: A dataset consisting of 240 images (20 images per stage per sex) of retrospect digital dental panoramic imaging of patients between 5 and 14 years of age was retrieved. In image preprocessing, abounding box with a dimension of 250 × 250 pixels was assigned to the left mandibular first (P1) and second (P2) permanent premolars. The implementation of dynamic programming of active contour (DP-AC) and convolutions neural network on images that require the procedure of image filtration using Python TensorFlow and Keras libraries were performed in image segmentation and classification, respectively. RESULTS: Image segmentation using the DP-AC algorithm enhanced the visibility of the image features in the region of interest while suppressing the image's background noise. The proposed model has an accuracy of 97.74%, 96.63% and 78.13% on the training, validation, and testing set, respectively. In addition, moderate agreement (Kappa value = 0.58) between human observer and computer were identified. Nonetheless, a robust DCNN model was achieved as there is no sign of the model's over-or under-fitting upon the learning process. CONCLUSIONS: The application of digital imaging and deep learning techniques used by the DP-AC and convolutions neural network algorithms to segment and identify premolars provides promising results for semi-automated forensic dental staging in the future.

The Correlation between Dental Stages and Skeletal Maturity Stages.

INTRODUCTION: The determination of skeletal maturity stages is very important in orthodontic treatment planning, especially skeletal discrepancies in growing individuals. A hand-wrist radiograph is considered the most accurate approach for skeletal maturity detection. Dental calcification stages have been suggested as an alternative diagnostic method to decrease radiation exposure. The recent study is aimed at detecting the efficacy of dental calcification stages in assessing skeletal maturity during the prepubertal and pubertal growth periods. METHODS: Patients' records were collected from the Aleppo Orthodontic Center. Dental maturity stages were assessed from a panoramic radiograph using the Demirjian method, while skeletal maturity stages were determined using the Björk method. Four permanent left mandibular teeth were included (canine, 1st premolar, 2nd premolar, and 2nd molar) for the study. RESULTS: From 517 records, 295 records (145 males and 150 females) were included. The Spearman rank-order correlation coefficients between skeletal maturation and dental maturation were strong and statistically significant (ranging from 0.789 to 0.835). The highest correlation was between skeletal stages and the second molar (r = 0.829 and 0.88 in males and females, respectively). Receiver operating characteristic (ROC ) curve suggested a high validity of the sum of dental stages for the four teeth in identifying MP3= stage (sensitivity was 70%, specificity was 92.77%, and ROC area was 0.81) but not for MP3cap (sensitivity was 50.85%, specificity was 81.36%, and ROC area was 0.66). CONCLUSIONS: The correlation between the skeletal maturity stages and the dental calcification stages was high. The orthodontist can use the dental stages as a definite diagnostic tool for prepubertal growth period.

Age and Sequence of Permanent Teeth Eruption in Lebanese Children.

BACKGROUND: The timing of eruption of permanent teeth can be a precious help to the pediatric practitioner in identifying an appropriate treatment plan. Usually, it presents a more precise sign of an early or late growth of the child. AIMS: It is to determine whether the timing of the permanent teeth eruption in Lebanese pediatric population can be considered as standard Lebanese values, since no other study was previously performed. MATERIALS AND METHODS: A cross-sectional study is conducted, and the clinical emergence data are collected for a sample of 2317 Lebanese children aged between 5.5 years and 13 years (1129 girls and 1188 boys) from different socioeconomic groups in rural and urban communities spread over different regions in Lebanon. The study investigates dental emergence patterns. RESULTS: Statistical analysis is performed with the SPSS Software. A confidence interval of 95% and significance level of 5% are adopted. The trend is for males to begin their permanent teeth eruption later than girls. Emergence of all permanent mandibular teeth is earlier than maxillary ones. Symmetry is found between the right and left teeth in the maxilla, as well as in the mandibula. CONCLUSION: In this study, the results indicate that premolars and second permanent molars erupt earlier in the Lebanese children compared to children of other countries reflected in several studies.

Age estimation of fragmented human dental remains by secondary dentin virtual analysis.

Unlike bones, teeth are remarkably resilient and can withstand severe trauma, making age assessment based on the dentition essential for forensic analysis. Modern techniques for age estimation focus on pulp-chamber volume measurements using radiographs and computerized tomography (CT); however, these are applicable only for complete teeth (i.e., with intact crown and root). In the current study, we developed a new approach using high-resolution micro-computerized tomography (µCT) to visualize the secondary dentin (SD), an inner layer surrounding the pulp which accumulates with age, thus facilitating age estimation of fragmented and broken teeth.The growth pattern of the SD with age was analyzed for 77 lower premolars from two anthropological collections. A comparison of SD virtual segmentation and histological measurement was highly correlative (ICC = 0.95). SD was measured per volume (mm3) of a 1 mm thick slice directly below the cemento-enamel junction. Regression analysis using SD measurements increased the success rates of age estimation (82%) compared with the "gold-standard" pulp/dentin method (54%) in the range of ± 10 years. The accuracy of age estimation based on SD analysis was improved to a range of 7-8 years.The SD method thus allows age estimation with greater prediction rates and better accuracy based on only a small fragment of a tooth in a non-invasive manner. This novel methodology is easy to use, accessible, and bears implications in various fields such as forensic sciences and anthropological research.

Human closed and open apex premolar teeth express different toll-like receptor.

BACKGROUND: The innate immune activation which promotes inflammation responses in the dental pulp tissue leads to the progression of dentin caries. Accordingly, toll-like receptors (TLRs) are key molecules of the innate immune system that identify pathogen-associated molecular patterns (PAMPs) on microorganisms and may have a critical role in a dental injury. Therefore, this study aimed to investigate the expression of TLR2, TLR3, and TLR4 in the human dental pulp of opened and closed apex teeth. METHODS: Human dental pulps were derived from the healthy opened and closed apex premolar, in which extraction was indicated for orthodontic reasons. The extraction of RNA was performed and the gene expression determined by real-time polymerase chain reaction (RT-PCR). The result from real-time PCR was confirmed using western blot analysis. RESULTS: Real-time PCR data analysis showed that the expression TLR2 and TLR4 were significantly increased in closed apex premolar teeth compared to open apex teeth, whereas TLR3 expression was not significantly different in these two groups (p < .05). CONCLUSION: The results of the present study suggested increased expression of TLR2 and TLR4 by the maturation of the apex, which may be due to the presence of microorganisms in the normal or destructed dental pulp tissue. Thus, identifying the expression of TLRs molecules in dental pulp tissue helps to develop a deeper knowledge of the immune responses in the oral cavity.

Endostructural morphology in hominoid mandibular third premolars: Discrete traits at the enamel-dentine junction.

The mandibular third premolar (P3) exhibits substantial differences in size and shape among hominoid taxa, and displays a number of discrete traits that have proven to be useful in studies of hominin taxonomy and phylogeny. Discrete traits at the enamel-dentine junction (EDJ) can be accurately assessed on moderately worn specimens, and often appear sharper than at the outer-enamel surface (OES). Here we use microtomography to image the P3 EDJ of a broad sample of extant apes, extinct hominins and modern humans (n = 100). We present typologies for three important premolar discrete traits at the EDJ (transverse crest, marginal ridge and buccal grooves), and score trait frequencies within our sample. We find that the transverse crest is variable in extant apes, while the majority of hominins display a transverse crest which runs directly between the two major premolar cusps. Some Neanderthals display a unique form in which the transverse crest fails to reach the protoconid. We find that mesial marginal ridge discontinuity is common in Australopithecus anamensis and Australopithecus afarensis while continuous marginal ridges largely characterize Australopithecus africanus and Paranthropus. Interrupted mesial and distal marginal ridges are again seen in Homo sapiens and Neanderthals. Premolar buccal grooves, previously identified at the OES as important for hominin systematics, are again found to show a number of taxon-specific patterns at the EDJ, including a clear difference between Australopithecus and Paranthropus specimens. However, their appearance may be dependent on the morphology of other parts of the crown such as the protoconid crest, and the presence of accessory dentine horns. Finally, we discuss rare variations in the form of dentine horns that underlie premolar cusps, and their potential homology to similar morphologies in other tooth positions.

Validation of Cameriere's medical-legal age estimation method using seconds premolars in a Portuguese population.

The goal of this project is to validate the Cameriere's method applied to the upper and lower second premolars in a Portuguese population, regarding the forensic estimate of age. The applied sample consisted in 100 panoramic radiographs, of 60 males and 40 females, patients of the Faculty of Dental Medicine of the University of Lisbon, whose ages vary between 15 and 35 years old. Thus, a total of 400 teeth were investigated (200 upper second premolars and 200 lower second premolars). Each radiograph was analysed using draw and measurement tools featured in Adobe Photoshop, applying the Cameriere's method, and then the pulp/tooth ratio was computed for the 15, 25, 35 and 45 teeth. All data were statistically analysed with the SPSS program, using a significant level of 5%. It was not observed any kind of relation, linear or not linear, between age and the pulp/tooth ratio. Linear regressions with considerably low values for the coefficient of determination were achieved, which indicates a low reliability for these models. Accordingly, we conclude that the knowledge of the pulp/tooth ratio does not allow the identification of an individual based on the Cameriere's method, in the scope of a forensic age estimate applied to panoramic radiograph. Further investigations with larger samples and broader age groups are required in order to provide suitable evidence to the legal and social aspects of age estimate in Forensic Dentistry.

Alveolar bone resorption after primary tooth loss has a negative impact on straightforward implant installation in patients with agenesis of the lower second premolar.

OBJECTIVES: To compare the alveolar bone dimensions in patients with lower second premolar (P2) agenesis prior to and after primary molar loss on CT scans, and assess the possibility for straightforward implant placement. METHODS: Alveolar bone dimensions were evaluated on 150 mandibular CT scans in three groups: (i) agenesis of P2, with the primary tooth in situ, and regularly erupted first premolar (P1) and molar (M1) (AW); (ii) agenesis of P2, without the primary tooth in situ for ≥3 m, but regularly erupted P1 and M1 (AWO); and (iii) P1, P2, and M1 regularly erupted (CTR). The possibility of straightforward placement of an implant 3.5 or 4.3 mm in Ø × 10 mm long was digitally simulated and compared to the actually performed treatment. RESULTS: Buccolingual width (7.3 ± 2.0 mm) at the coronal aspect of the ridge in the AWO group was statistically significantly smaller comparing with both the AW (9.2 ± 1.4 mm) and the CTR (9.5 ± 1.1 mm) group; width reduction appeared to be mainly due to "collapse" of the buccal aspect of the ridge. Simulated straightforward placement of implants with a diameter of 3.5 or 4.3 mm was possible in 62% and 56% of the cases in the AWO vs. 86% and 84% in the AW group (p = .006 and .002, respectively). Straightforward implant placement was actually possible in all patients (22) in the AW group, while 28% (11 of 39) of the patients in the AWO group needed additional hard tissue augmentation. CONCLUSIONS: Significant dimensional differences exist in the alveolar ridge, especially in the coronal part, at lower P2 agenesis sites missing the primary tooth for ≥3 m, when compared to P2 agenesis sites with the primary tooth in situ. It seems thus reasonable to advise that the primary second molar should be kept as long as possible, in order to facilitate straightforward implant installation and reduce the probability of additional bone augmentation procedures.

Morphological analysis of the lower second premolar for age estimation of Korean adults.

OBJECTIVES: This study aimed to examine the applicability of the pulp/tooth area ratio in the lower premolar teeth using panoramic radiography in age estimation of Korean adults. METHODS: 402 digital panoramic images of Korean adults between 20 and 78 years were analyzed. Following Cameriere et al.'s method, two observers measured the pulp and tooth areas of the lower second premolar on digital panoramic images, and the ratio of pulp to tooth area in the whole tooth (PTR) was calculated. In addition, the whole tooth was divided into coronal and root parts at the cementoenamel junction, and the ratios in the coronal part (PcCR) and root part (PrRR) were also calculated separately. Independent t-test, Analysis of covariance, linear regression, and the standard error of the estimate (SEE) were computed using statistical software. To justify the use of linear regression models for purposes of prediction, diagnostic tests of principal assumptions were also performed. RESULTS: Independent t-test revealed significant differences in genders. PrRR produced the best age correlation (male, SEE=10.8; female, SEE=9.8; total, SEE=10.4 years), followed closely by PTR (male, SEE=11.1; female, SEE=10.3; total, SEE=10.7 years) and a relatively lower accuracy for PcCR (male, SEE=14.7; female, SEE=14.4; total, SEE=14.6 years). Model assumptions and accuracy for purposes of prediction in PTR and PrRR were satisfied. CONCLUSIONS: The pulp/tooth area ratio using panoramic radiography has the potential as an effective tool for age estimation in the Korean adult population, and the pulp/tooth area ratio in the root part is more accurate than that of the whole tooth. Notably, female has shown higher accuracy compare to male subject.

Hypodontia: An Update on Its Etiology, Classification, and Clinical Management.

Hypodontia, or tooth agenesis, is the most prevalent craniofacial malformation in humans. It may occur as part of a recognised genetic syndrome or as a nonsyndromic isolated trait. Excluding third molars, the reported prevalence of hypodontia ranges from 1.6 to 6.9%, depending on the population studied. Most affected individuals lack only one or two teeth, with permanent second premolars and upper lateral incisors the most likely to be missing. Both environmental and genetic factors are involved in the aetiology of hypodontia, with the latter playing a more significant role. Hypodontia individuals often present a significant clinical challenge for orthodontists because, in a number of cases, the treatment time is prolonged and the treatment outcome may be compromised. Hence, the identification of genetic and environmental factors may be particularly useful in the early prediction of this condition and the development of prevention strategies and novel treatments in the future.

A Comparison of Mixed Dentition Dental Development in Cleft Patients Treated With and Without the Latham-type Appliance.

PURPOSE: The purpose of this study was to retrospectively evaluate the Latham-type appliance's effect on the development and eruption of posterior teeth during the mixed dentition stage before palatal expansion and secondary alveolar bone graft(s). METHODS: The charts of complete cleft lip and palate (CLP) patients treated with and without the Latham-type appliance were screened using the following inclusion criteria: nonsyndromic; CLP; and available panoramic radiographs and clinical photographs in the mixed dentition prior to palatal expansion and secondary alveolar bone grafts. Surgical repair for Latham-type appliance patients followed the Latham-Millard protocol. The differences in outcomes were analyzed using Fisher's exact tests. RESULTS: The sample consisted of 65 patients treated with the appliance (Latham group) and 36 subjects who were not (non-Latham group). Similar incidences were found between the non-Latham group and the Latham group for maxillary second premolar agenesis (11 percent versus 10 percent) and enamel defects in the maxillary arch (17 percent versus 14 percent). The incidence of ectopic permanent maxillary first molars was higher in the Latham group than in the non-Latham group (28 percent versus one percent, P=0.01). CONCLUSIONS: A higher incidence of ectopic permanent maxillary first molars was found in patients treated with the Latham-type appliance.

Predictive Value of Dental Maturity for a Positive Gonadotropin-Releasing Hormone Stimulation Test Result in Girls with Precocious Puberty.

Dental maturity is associated with skeletal maturity, which is advanced in girls with central precocious puberty (CPP). We investigated the performance of dental maturity as a screening method for CPP using mandibular second premolar and molar calcification stages, assessed the associated anthropometric and laboratory factors, and evaluated pubertal response predictors using the gonadotropin-releasing hormone stimulation test (GnRHST) in prepubertal and pubertal girls. A prospective case-control study was conducted in girls, aged 7.0-8.9 years, classified into pubertal (peak luteinizing hormone [LH] after GnRHST ≥ 5 IU/L), prepubertal (peak LH < 5 IU/L), and control groups. Auxological and biochemical tests, panoramic radiographs, and GnRHSTs in participants with breast development were conducted. Dental maturity was assessed using the Demirjian index (DI). We included 103 girls (pubertal, 40; prepubertal, 19; control, 44). Chronological age (CA) was not significantly different between groups. Bone age (BA) and BA advancement was higher in the pubertal and prepubertal groups. Increased DI values at the mandibular second premolar and molar were significantly associated with CA, BA, BA advancement, height standard deviation score (SDS), peak LH after GnRHST, and insulin-like growth factor-I (IGF-I) (all P < 0.05). Moreover, odds ratio (OR) of the mandibular second premolar and molar (a DI value of ≥ E) for predicting a positive response to GnRHST was 8.7 (95% confidence intervals [CI], 2.9-26.1) and 5.2 (95% CI, 2.2-12.7), respectively. Dental maturity was a strong predictor for diagnosing CPP. Determining dental maturity in girls with suspected precocious puberty might help determine the performance of GnRHSTs.

Eruption rates of lower second premolars at different development stages evaluated with cone-beam computed tomography.

OBJECTIVE: To evaluate and compare the eruption rates of lower second premolars (LPm2) at different developmental stages using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Retrospectively, 31 individuals (9.77 ± 1.25 years) had their LPm2 scored according to the Demirjian method, and afterwards they were split into three groups according to developmental stage, as follows: D = complete-formed crowns; E = root length less than crown height; and F = root length greater than or equal to crown height. Linear distances from the LPm2 crown tip to the anatomical reference line (ARL) and to the occlusal plane line (OPL) were measured in paired CBCT scans (T1, T2), taken with an average interval of 8.6 months between them. Eruption rates (mm/y) were calculated and then compared between groups. RESULTS: Eruption rates were greater for LPm2 at stage F than at stages D or E (P < .01) regardless of whether they were measured from the ARL (D = 2.84 mm/y; E = 2.55 mm/y; F = 5.38 mm/y) or from the OPL (D = 1.82 mm/y; E = 2.02 mm/y; F = 5.26 mm/y). Eruption rates evaluated from the ARL and the OPL had no statistically significant differences (P = .052), and a positive correlation (r = .79, P < .001) between them was observed. CONCLUSIONS: LPm2 at Demirjian stage F showed greater eruption rates than at stages D or E, regardless of whether rates were measured from the ARL or the OPL. Faster eruption is expected for LPm2 at stage F. Evaluation of the LPm2's developmental stage using CBCT can aid in clinical decision making regarding the correct timing for intervention.

Utility of panoramic radiography for identification of the pubertal growth period.

INTRODUCTION: Our aim in this study was to investigate the association between dental mineralization stages and the periods of the pubertal growth spurt (PGS). METHODS: The sample included panoramic and hand-wrist radiographs from 491 subjects (222 boys, 269 girls) aged 7 to 17 years. Dental development was rated, and skeletal maturation was evaluated. The relevant associations were investigated by analysis of ordinal multinomial logistic regression. RESULTS: The second molar (odds ratio [OR] = 4.34) and the first premolar (OR = 2.45) were the best growth predictors for girls. For boys, the second molar (OR = 6.80), second premolar (OR = 2.41), and canine (OR = 3.21) proved to be the best predictors. Stages D and E of the second molar for girls, and stages E and F for boys, corresponded to the onset of the accelerated growth spurt. Stage F of the second molar for girls and stage G for boys corresponded to the peak of the PGS. At the end of the PGS, most teeth had already attained apical closure. In girls, however, most second molars were found at stage G. CONCLUSIONS: An association exists between the dental mineralization stages and the periods of the PGS, especially for second molars. Panoramic radiographs can be used as the first diagnostic tool to estimate the pubertal growth period.

Infundibula of equine maxillary cheek teeth. Part 1: Development, blood supply and infundibular cementogenesis.

There is increasing interest in diseases of infundibula of equine maxillary cheek teeth. Imperfect infundibular cementogenesis has been recognized as an aetiopathological factor for the onset of infundibular necrosis. In this article, infundibular development was examined with particular attention to infundibular blood vessels and cementogenesis. Forty-one deciduous maxillary premolars prior to eruption were investigated using routine histological and immunohistological methods to visualize blood vessels and the enamel organ. Selected specimens were scanned by micro-computed tomography to analyze the three-dimensional configuration of the developing infundibulum. Before eruption, the infundibula are supplied by a central infundibular artery entering the infundibulum from an occlusal direction and by arteries entering the mesial infundibulum from the mesial aspect, and the distal infundibulum from the distal aspect. The central infundibular artery is destroyed shortly after tooth eruption but the lateral arteries remain vital for a time after eruption. As the arteries of the distal infundibulum are located in a more apical position, blood is received for a longer period compared with the mesial infundibulum. Cementogenesis starts first at distinct enamel in-foldings in the occlusal part of the infundibula, advancing in an apical direction. The results suggest a distinct asymmetry between the infundibula with the mesial infundibulum prone to incomplete cementogenesis due to early blood supply cessation.

Maturogenesis of an Early Erupted Immature Permanent Tooth: A Case Report With 7-Year Follow-Up.

The main objective of treatment of an undeveloped tooth (immature) is to provide vital pulp therapy to allow continued development of root dentin. A case report is presented that demonstrates the use of calcium hydroxide (CaOH2) as an indirect pulp-copping material for the purpose of continued maturogenesis of an early-erupted permanent tooth with severe mobility and almost-begun root formation. Seven-year radiographic and clinical follow-up demonstrated a vital pulp and physiologic root development without any endodontic failure clinically or radiographicaly.

New regression equations for predicting human teeth sizes.

INTRODUCTION: The aims of the study were; to evaluate the applicability of the Moyers and Tanaka-Johnston Methods to individuals with a Spanish ancestry, to propose new regression equations using the lower four permanent incisors as predictors for the sum of the widths of the lower permanent canine and premolars, and to compare the new data to those from other populations. METHODS: A total of 359 Spanish ancestry adolescents were selected. Their dental casts were measured using a 2D computerized system. Real teeth measurements were compared with those predicted using Moyers probability tables and Tanaka and Johnston equations, and standard regression equations were then developed. RESULTS: Results showed that Upper and Lower Canine and Premolar (UCPM, LCPM) predictions are quite different depending on the used method. Moyers tables can only be validly applied to a 75% percentile for the mandible in both, males and females, 85% in males and 90-92% in females. CONCLUSIONS: Moyers predictions tend to underestimate UCPM and LCPM whereas Tanaka-Johnston predictions tend to overestimate them. Equations for estimating the combined width of the unerupted canine and premolars were; Male: UCPM = 12.68 + 0.42 LI and LCPM = 11.71 + 0.44 LI. Female: UCPM = 12.06 + 0.43LI and LCPM = 10.71 + 0.46 LI.

Análise da influência das forças oclusais e fatores locais na morfologia das lesões cervicais não cariosas: estudo clínico transversal / Influence of occlusal forces and local factors in the morphology of noncarious cervical lesions: cross sectional trial

Objetivo: Analisar por meio de um estudo clinico transversal a influência das forças oclusais, assim como, de outros possíveis fatores locais na morfologia de lesões cervicais não cariosas (LCNC). Material e Método: Foram avaliados 32 indivíduos que possuíam LCNC nos primeiros pré-molares superiores, totalizando uma análise de 61 dentes, além disso, todos os sujeitos da pesquisa apresentavam todos os elementos dentais. Os mesmos eram pacientes regulares do serviço odontológico da Universidade Federal de Uberlândia, de ambos os gêneros, com idades entre 21 a 64. Para confirmação da morfologia e da severidade (profundidade) das LCNC, foi realizado exame cínico e replica das mesmas. As LCNC foram classificadas em anguladas ou arredondadas e em 3 níveis de severidade. A fim de determinar a presença de forças laterais, a presença de algum tipo de hábito parafuncional, como apertamento e bruxismo, foi analisado por meio de questionário e exame clinico. Também foram analisados, a presença de interferências oclusais (IO) em Relação Cêntrica (RC) e Movimentos excursivos, por meio de exame clinico de manipulação e análise dos modelos de gesso montados em articulador, assim como informações sobre a presença de facetas de desgaste. Além disso, informações sobre o periodonto, também foram coletadas, por meio de exame clinico, da mensuração das recessões gengivais no sentido cérvico-apical e mésio-distal. Assim como, da altura e espessura da cortical óssea vestibular, realizada por meio

de Tomografia Computadorizada do tipo Cone-Beam (TCCB). Resultados: Inicialmente, aplicou-se o teste de Shapiro wilk, para avaliar a normalidade dos dados. Para os dados normais, posteriormente, aplicou-se o teste de Kruskall-wallis. Enquanto, que para as variáveis que não apresentaram distribuição normal, foi aplicado o teste Mann- Whitney. Dados gerais da amostra, demonstraram que a idade apresentou associação tanto com a morfologia (p = ,016), quanto para a severidade das LCNC (p=,000). O que não foi encontrado para o gênero (morfologia, p =,139; severidade, p =,308), nem para a presença de algum distúrbio gástrico (morfologia, p =,260; severidade, p =,831). Além disso, nenhuma relação foi encontrada entre a preseça de hábitos parafuncionais ou alguma IO, com a morfologia e severidade das LCNC. Todos os sujeitos da pesquisa apresentaram facetas de desgaste, entretanto, a presença de uma ou duas facetas não influenciou a morfologia ou severidade das lesões. Já para a recessão gengival, associação significativa foi encontrada para a morfologia (p =,046). Em relação a altura e espessura da crista da cortical vestibular, a altura foi significante em relação a severidade (p= ,009), e a espessura da crista, apresentou associação com a morfologia (p=,001) e severidade (p=,044). Conclusão: Não houve associação direta entre a morfologia das LCNC e as forças oclusais, entretanto, a idade e o suporte ósseo (menor altura e cortical menos espessa), foram fatores determinantes para a prevalência de LCNC anguladas e mais severas

Objective: Analyze through a cross clinical study the influence of occlusal forces, as well as other possible local factors in the morphology of cervical lesions noncarious (LCNC). Material and Methods: We evaluated 32 individuals who had LCNC the first premolars, totaling an analysis of 61 teeth, moreover, all the subjects had complete dental arches. They were regular patients of the dental service at the Federal University of Uberlândia, of both genders, ages 21 to 64. To confirm the morphology and severity (depth) of LCNC was held cynical examination and replicates them. The LCNC were classified into angled or rounded and three severity levels. In order to determine the presence of lateral forces, the presence of some kind of habit parafuncional as bruxism and clenching was analyzed by questionnaire and clinical examination. Were also analyzed, the presence of occlusal interferences (OI) in Relation Centrica (CR) and movements excursive through clinical examination manipulation and analysis of plaster models mounted on articulator, as well as information about the presence of wear facets. In addition, information about periodontal were also collected through clinical examination, measurement of gingival recession in cervical-apical and mesiodistally. As well as the height and thickness of the buccal bone cortical held by Computed Tomography Cone-Beam type (TCCB). Results: Initially, we applied the Shapiro Wilk test to assess the normality of the data. For normal data, later applied the Kruskal-wallis test. While that for variables without normal distribution

the Mann-Whitney test was applied. General data of the sample, showed that age was associated with both the morphology (p =. 016), as to the severity of LCNC (p =.000). What was not found for the genre (morphology, p = .139; severity, p = 308), or to the presence of some gastric disorder (morphology, p = .260; severity, p = 831). Furthermore, no relationship was found between the preseça of parafunctional habits or some IO, with the morphology and severity of LCNC. All the subjects showed wear facets, however, the presence of one or two aspects not influence the morphology or severity of the lesions. As for the gingival recession, significant association was found for morphology (p =.046). Regarding the height and thickness of the crest cortical bone, the height was significant in relation to severity (p =.009), and the thickness of the crest, was associated with the morphology (p = .001) and severity (p = .044). Conclusion: There was no direct association between the morphology of NCCL and occlusal forces, however, the age and the bony support (lower thinner height and cortical), were determining factors for the prevalence of NCCL angled and more severe

Autogenous premolar transplantation into artificial socket in maxillary lateral incisor site.

INTRODUCTION: Autogenous transplantation of a natural tooth to another site has significant advantages over dental implants, particularly in cases of agenesis, accidental tooth loss, or poor prognosis for the maintenance of tooth function. METHODS: This report describes a case of autogenous premolar transplantation into an artificial socket in the site of a missing maxillary lateral incisor in a 13-year-old girl. Clinical examination and radiography revealed tooth agenesis (#4, #10, #13, and #20) and microdontia (#7). The occlusion and skeletal maxillomandibular relations were normal. RESULTS: Tooth #29 was chosen for transplantation into the site of tooth #10 because of its size, stage of root formation, and possible closure of the spaces created by agenesis. CONCLUSIONS: Autogenous transplantation is a feasible alternative to dental implants in cases of tooth agenesis or tooth loss because of trauma. Autotransplantation was indicated in this case because it ensures the natural (facial) growth of the alveolar process and preserves the function of periodontal tissues. A multidisciplinary approach (ie, combining techniques from different dental specialties) was important for treatment success. Clinical and radiographic follow-up confirmed that the transplanted premolar was esthetically comparable with the lateral incisor and that root development and pulp canal obliteration were complete.

Tooth mineralization stages as a diagnostic tool for assessment of skeletal maturity.

INTRODUCTION: The objective of this study was to determine whether dental calcification can be used as a first-level diagnostic tool for assessment of skeletal maturity. METHODS: A total of 150 healthy subjects (79 boys, 71 girls; mean age, 12.19 ± 2.03 years; range, 8-16 years) were enrolled in the study. Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine, the first and second premolars, and the second molar. Determination of skeletal maturity was according to the modified middle phalanx of third finger (MP3) stages method on digital radiographs. RESULTS: Diagnostic ability was evaluated according to the dental maturation stages for each tooth for identification of the MP3 stages and the growth phases (prepubertal, pubertal, postpubertal) using positive likelihood ratios. Dental maturation stage E of the first premolars and the combination of canine stage F, first premolar stage E, second premolar stage E, and second molar stage D (FEED) gave the highest values for identification of the prepubertal growth phase, and stage H of the second molar had the highest value for identification of the postpubertal growth phase. CONCLUSIONS: Dental maturation assessment is only useful for diagnosis of the prepubertal and postpubertal growth phases.