Dental age assessment: Which is the most applicable method?

To evaluate which method is the most applicable for estimating estimate dental age in Brazilian children, Nolla or Demirjian. For this purpose, both methods were reviewed and the differences between them brought to light. A total of 403 healthy children between the ages of 7 and 13 years with satisfactory panoramic radiographs, similar socio-economic background and ethnic origin were included. Panoramic radiographs were examined by the Nolla and Demirjian methods. Dental age was calculated for both methods, and the differences between the dental age and the chronological age were compared with analysis of variance with post hoc Dunnett. The Nolla method showed no significant difference in relation to chronological age in the majority of age groups for boys and girls, except for 12-year-old boys (over-estimation of 1.00) and between 11- and 12-year-old girls (over-estimation of 0.51 and 0.59, respectively). An over-estimation of the dental age was observed by using the Demirjian method (for boys 0.89-1.84 and for girls 0.69-1.97) for all age groups. The Nolla method is suitable for Brazilian children when it comes to age estimate with care to growth spurt beginning (around 11 and 12 years). However, the Dermijian method should not be used, because it over-estimated the age in both sexes.

Validation of cone-beam computed tomography as a predictor of osteoporosis using the Klemetti classification.

This study aimed at evaluating the validity of cone-beam computed tomography (CBCT) for assessing mandibular bone quality using the Klemetti classification. The morphology of the endosteal mandibular cortex of 30 (60 hemi-mandibles) postmenopausal women between the ages of 45 and 80 years was evaluated based on the Klemetti classification in panoramic radiographs used as reference images. Afterwards, panoramic reconstruction and cross-sectional slices of CBCT examinations of these patients were analyzed and categorized according to the same classification. All the images were assessed by two oral radiologists. The McNemar-Bowker test compared the agreement between the CBCT images and the reference images. No differences were found between the diagnostic results based on panoramic radiography and panoramic reconstruction. However, the mean scores for the cross-sectional evaluation were higher, and the results, statistically different from the others. Based on the disagreement found between the panoramic radiographs and the CBCT cross-sectional slices, the Klemetti classification is not an adequate means of assessing bone quality with CBCT. On the other hand, the higher values found for the cross-sectional slices could be associated with better visibility on the CBCT images.

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.

Validation of cone-beam computed tomography as a predictor of osteoporosis using the Klemetti classification

Abstract This study aimed at evaluating the validity of cone-beam computed tomography (CBCT) for assessing mandibular bone quality using the Klemetti classification. The morphology of the endosteal mandibular cortex of 30 (60 hemi-mandibles) postmenopausal women between the ages of 45 and 80 years was evaluated based on the Klemetti classification in panoramic radiographs used as reference images. Afterwards, panoramic reconstruction and cross-sectional slices of CBCT examinations of these patients were analyzed and categorized according to the same classification. All the images were assessed by two oral radiologists. The McNemar-Bowker test compared the agreement between the CBCT images and the reference images. No differences were found between the diagnostic results based on panoramic radiography and panoramic reconstruction. However, the mean scores for the cross-sectional evaluation were higher, and the results, statistically different from the others. Based on the disagreement found between the panoramic radiographs and the CBCT cross-sectional slices, the Klemetti classification is not an adequate means of assessing bone quality with CBCT. On the other hand, the higher values found for the cross-sectional slices could be associated with better visibility on the CBCT images.

Neoplasias de glândulas salivares menores: estudo retrospectivo de 83 casos / Minor salivary gland neoplasms: retrospective study of 83 cases

Objetivo: Analisar os achados clínicos e histopatológicos de neoplasias de glândulas salivares menores arquivadas no Serviço de Anatomia Patológica da Disciplina de Patologia Oral do Departamento de Odontologia da Universidade Federal do Rio Grande do Norte. Métodos: Dados referentes à idade e gênero dos pacientes e localização anatômica das neoplasias de glândulas salivares menores, diagnosticadas no período de janeiro de 1970 a dezembro de 2007, foram obtidos em fichas de requisição de biópsia. Para o estudo histopatológico, cortes histológicos corados em hematoxilina e eosina foram avaliados sob microscopia de luz. Resultados: Foram identificados 83 casos. Destes, 69,9% acometeram o gênero feminino. Pacientes com neoplasias malignas apresentaram maior média de idade (47,6 anos) que pacientes com neoplasias benignas (40,7 anos). Os sítios anatômicos mais acometidos foram: palato (43,4%), mucosa jugal (10,8%), lábio superior (10,8%) e rebordo alveolar (10,8%). Os três tipos histológicos mais frequentes foram: adenoma pleomórfico (38,6%), carcinoma mucoepidermóide (18,1%) e carcinoma adenóide cístico (13,3%). Conclusão: Neoplasias de glândulas salivares menores afetaram com maior frequência o gênero feminino. Pacientes com neoplasias malignas apresentaram maior média de idade ao diagnóstico da condição. O subtipo histológico mais comum foi o adenoma pleomórfico, seguido do carcinoma mucoepidermóide e do carcinoma adenóide cístico. Em conjunto, estas três neoplasias perfizeram 70,0% de todos os tumores diagnosticados.

Objective: The aim of this study was to evaluate the clinical and histopathological findings of minor salivary gland neoplasms recorded in the files of the Anatomic Pathology Service of the Discipline of Oral Pathology of the Department of Dentistry of the Federal University of Rio Grande do Norte. Methods: Data regarding age and gender of the patients and location of the minor salivary gland tumors diagnosed between January 1970 and December 2007 were taken from biopsy request forms. The histopathological study consisted of tissue sections stained with hematoxylin and eosin assessed under a light microscope. Results: Eighty-three cases were identified, of which 69.9% were females. The mean age of patients with malignant neoplasms (47.6 years) was higher than that of patients with benign neoplasms (40.7 years). The most common sites were: palate (43.4%), buccal mucosa (10.8%), upper lip (10.8%) and alveolar ridge (10.8%). The three most common histological types were: pleomorphic adenoma (38.6%), mucoepidermoid carcinoma (18.1%) and adenoid cystic carcinoma (13.3%). Conclusion: Minor salivary gland tumors are more common in females. Patients with malignant neoplasms presented higher mean age at diagnosis. The most common histological type was pleomorphic adenoma, followed by mucoepidermoid carcinoma and adenoid cystic carcinoma. Together, these three neoplasms accounted for 70% of all diagnosed tumors.