Assessment of midpalatal suture ossification using cone-beam computed tomography.

BACKGROUND AND OBJECTIVE: The degree of ossification of the midpalatal suture is an important factor in the selection of treatment procedure, especially in young individuals. Considering the discrepancies in the results of studies on the exact time of the closure of this suture, the present study was undertaken to evaluate ossification and morphology of the suture with the use of CBCT. METHODS: In the present cross-sectional study, the CBCT images of the maxilla in 144 Iranian subjects (72 males, 72 females) with an age range of 10 to 70 years, referring to a private radiology center in Sari, Iran, were evaluated. The CBCT images were evaluated in the axial cross-sectional slice at 1 mm intervals to determine morphology and the maturation stage of the suture and its degree of ossification. The six developmental stages that were observed were as follows: stage A, a direct line without disturbances; stage B, a scalloped appearance in the suture; stage C, two parallel lines with a scalloped appearance that were connected at some points; stage CD, the anterior portion was similar to stage C, and the posterior region was similar to stage D; stage D, ossification only in the palatine bone; stage E, complete ossification of the suture. The degree of ossification of the suture was calculated with the use of the ratio of the length of the ossified segment to the entire length of the suture. Data were analyzed with Spearman's correlation test, Chi-squared test, t-test, ANOVA, Mann-Whitney U, and Kruskal-Wallis test. Intra-observer agreement was calculated with the use of weighted kappa coefficient. Data were analyzed with SPSS 17. RESULTS: There was a strong correlation between the age groups and the developmental stages of the midpalatal suture in both genders (r=0.681, p<0.001). The ossification process occurred in the posterior to anterior direction in 98% of the cases. There was a significant relationship between aging and the degree of ossification (p<0.001); however, the difference was not significant between the two genders (p=0.193). CONCLUSION: Although the rate of suture closure increased with aging, age was not a reliable factor alone to determine the developmental stage of the suture. Use of CBCT is necessary in all the patients to determine the degree of ossification and morphology of the midpalatal suture.

Need for geriatric dentistry training programs in Iran.

A shifting pattern from communicable diseases to the chronic noncommunicable diseases and increased life expectancy are being sensed throughout the world. Aged populations with multiple chronic diseases come up with their unique needs and require specific attention to be challenged by the health systems. Neglected orodental facts among the elders and the dearth of specific designated undergraduate and postgraduate courses of geriatric dentistry in Iran inevitably adversely affect the delivery of appropriate dental care service to elders by untrained dentists. In this article, a proposal for academic geriatric dentistry courses in Iran is introduced and highlighted with regards to elders' special needs.

Comparison of tooth crown discoloration with Epiphany and AH26 sealer in terms of chroma and value: an in vitro study

Tooth crown discoloration may possess a heavy emotional burden and esthetic concern, especially when the anterior teeth are affected. Residue of sealers within the pulp chamber is a major contributor to the occurrence of tooth discoloration. Aim: The aim of this study was to evaluate the degree of crown discoloration when recently introduced sealer, Epiphany, is used. Methods: Forty human incisors were examined in vitro. Fifteen teeth were sealed with either AH26 or Epiphany sealer as experimental groups and root canals of the remaining 10 teeth with distilled water. Digital photographs of the buccal aspect of teeth were then examined in terms of brightness (value) and saturation (chroma) using Photoshop software at the beginning and consecutive 3, 6 and 9 months. Degree of brightness and saturation changes was defined as follows: less than 5% as slight, 10% to 15% as moderate and 15% to 20% as severe. Results: Fifteen, 14 and 10 teeth entered in Epiphany, AH26 and control groups, respectively. Significant brightness deterioration was noticed by time in both experimental groups [F (2, 8) =29.16, p<0.001], with no differences in Epiphany compared with AH26 (p=0.086). Saturation differed neither by time [F (2, 8) =0.129, p=0.881, nor by sealer type (p=0.136) during 9-month observation. At 9th month, crown segments (incisal, middle and cervical thirds) were not contrasted by the sealer type (p=0.982) or discoloration type (either brightness or saturation) (p=0.50). All changes in the experimental groups were significantly higher than the control group (p<0.001). Conclusions: Epiphany was equal to AH26 sealer in terms of relative long-term crown discoloration. One clinical correlation learned from the results of the present study is that Epiphany may safely be used interchangeably with the traditional AH26 sealer.