The role of orthodontics in children identification: a case report of two victims of mass disaster.

INTRODUCTION: Human Identification based on dental evidence cannot be accomplished if antemortem dental records are unavailable or of poor quality. The involvement of the orthodontist in mass disaster victim identification processes may be crucial in relation to the amount and quality of the records which can be obtained before, during, and following the treatment. AIM: The aim of the study is the description of the contribution of the findings drawn from orthodontic records to the identification of victims of mass disasters who had received an orthodontic treatment, through the presentation of two cases. The first case involves the identification of a child victim of a plane crash and the second case involves the identification of two identical twin girls who died in a fire. In both cases, the identification was based on the findings obtained from the ante-mortem records provided by the orthodontist. CONCLUSIONS: The orthodontists apply customized orthodontic appliances and keep a comprehensive file of images, casts, radiographs, and other records in their practice. As a result, they can make a substantial contribution to the identification of young people or even adult victims of mass disasters in any case in which the authorities make a request.

The CSI effect in Forensic Odontology. A systematic review.

The popularity of forensic science in recent decades is substantially related to the high rate of watching television programs dealing with the investigation of criminal cases, such as "CSI: Crime Scene Investigation" (CSI: Crime Scene Investigation, 2000) and the two sequels, "CSI: NY" (CSI: NY, 2004) and "CSI: Miami" (CSI: Miami, 2002). These medical-based TV series portrayed forensic science in a favorable way, encouraging viewers to experience differently this scientific field. Although it is considered a minor social phenomenon, the reality seems to diverge. The aim of this study is to systematically review the existing literature on the impact of the "CSI effect" on crime scene management, analysis, and interpretation of evidence on forensic odontology cases. Electronic research was attempted among four (4) different electronic databases from January 2005 to October 2021. After removing articles according to inclusion-exclusion criteria, the final selection resulted in 5 articles. The results indicated that forensic-based TV series provided a sense of plausibility not dependent on factual accuracy. In addition, an increasing pressure on law enforcement personnel and investigators to collect DNA at crime scenes, regardless of whether it was relevant to the case was also observed. The popularity of these TV shows has contributed to growing public interest in forensic science programs and hence the "CSI effect" had a greater impact on individuals who systematically watched such television series.

Dental age estimation in children that have undergone antineoplastic treatment.

OBJECTIVE: Even though many studies have been performed to estimate DA in general population, limited research has been performed concerning medical compromised populations such as childhood cancer survivors. The aims of this case-control study were (a) to estimate dental age in a population of children that have undergone antineoplastic treatment with three different methods and (b) to compare it with the estimates from healthy subjects (control group). MATERIALS AND METHODS: Seventy-three oncology patients and equal number of healthy control subjects from the Pediatric dentistry Department had their dental age estimated through recent orthopantograms using Dermijian's, Willems' and London Atlas methods. All OPGs randomly assessed by two calibrated observers. Mean age difference was calculated. Intraclass Correlation Coefficient was used to assess intra-observer reliability and the Concordance Correlation Coefficient used to assess inter-observer reliability. RESULTS: Concerning the CCS group 35 subjects (48%) were males and 38 (52%) were females, with an overall mean chronological age 10.95 years, ranging between 5.37 and 15.83 years. Intra- and inter-examiner reliability was exceptional for all methods. Mean DA differences in both groups and were not statistically sinificant regardless of the method used. The marginally lower values when males and females were investigated separately is basically due to the corresponding reduction of the sample size. CONCLUSION: An overestimation of DA observed in both groups by all methods was not significant. All three methods produced highly accurate comparable results when it comes to estimate the actual chronological age in both groups (CCS and control subjects) regardless of gender.

Developmental dental anomalies assessed by panoramic radiographs in a Greek orthodontic population sample.

PURPOSE: To assess developmental dental anomalies on panoramic radiographs in a Greek orthodontic population. MATERIALS AND METHODS: The sample consisted of 1200 panoramic radiographs that have been taken as part of routine orthodontic treatment planning in children and adolescents. The following exclusion criteria were applied: systemic disorders such as syndromes or clefts, previous jaw surgery and poor quality of the radiograph. Dental anomalies were classified as anomalies of tooth shape, size, eruption-, position- or number anomalies or root alterations. RESULTS: The age range of the subjects (536 males and 664 females) was 7-17 years with a mean age of 11.78 years. The prevalence of dental anomalies was assessed with a Chi-squared test. The intraobserver agreement was evaluated by calculating Cohen's [Formula: see text]. Among the 1200 digital panoramic radiographs examined, a total of 224 (18.67%) presented dental anomalies, 92 (7.67%) males and 132 (16.67%) females. Moreover, 203 patients (16.92%) had 1 dental anomaly, whereas 19 (1.58%) and 2 (0.17%) patients had 2 or more than 2 dental anomalies, respectively. Oligodontia was the most prevalent dental anomaly and was presented in 6.4% of the subjects, while supernumerary teeth were detected in 1% of the patients. CONCLUSIONS: A significant number of orthodontic patients had at least one DDA. The most common DDA in this sample was oligodontia followed by impaction and supernumerary teeth. Comparison to our data with other studies revealed variation in their prevalence suggesting genetic and environmental influences.

A systematic review of relative indications and contra-indications for prescribing panoramic radiographs in dental paediatric patients.

PURPOSE: To systematically review the evidence of the diagnostic efficacy of panoramic radiographs (PRs) in the following six clinical situations: caries, acute dental infections, dental trauma, dental anomalies, Developmental disorders and pathological conditions in children. The research question posed by the EAPD was: "In which clinical situations and age groups is it indicated/contra-indicated to prescribe PRs in relation to these six clinical situations, in children". METHODS: An electronic search of the following databases was conducted: MEDLINE via OVID, EMBASE via OVID, The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE) and the Cochrane Health Technology Assessment (HTA), to identify relevant studies published from 1990 to 2018. The systematic review was performed according to the PRISMA guidelines. Study screening, data extraction and risk of bias assessment of included studies was carried out independently and in duplicate using the QUADAS 2 tool. RESULTS: The search resulted in 3420 potentially relevant studies, and following screening 175 full texts were obtained, of which 16 were finally included in the review. Meta-analysis was not possible for any of the aforementioned clinical situations, therefore the included studies were tabulated in terms of qualitative descriptive hierarchy of evidence for diagnostic. CONCLUSION: Based on currently available evidence there is a need for high quality diagnostic accuracy efficacy studies to address important diagnostic tasks in these six clinical situations in children, as there is a lack of scientific evidence concerning PRs in children, as there would support the production of guidelines for prescribing PRs in children along with their relative indications and contra-indications.

Sex determination by tooth size in a sample of Greek population.

Sex assessment from tooth measurements can be of major importance for forensic and bioarchaeological investigations, especially when only teeth or jaws are available. The purpose of this study is to assess the reliability and applicability of establishing sex identity in a sample of Greek population using the discriminant function proposed by Rösing et al. (1995). The study comprised of 172 dental casts derived from two private orthodontic clinics in Athens. The individuals were randomly selected and all had clear medical history. The mesiodistal crown diameters of all the teeth were measured apart from those of the 3rd molars. The values quoted for the sample to which the discriminant function was first applied were similar to those obtained for the Greek sample. The results of the preliminary statistical analysis did not support the use of the specific discriminant function for a reliable determination of sex by means of the mesiodistal diameter of the teeth. However, there was considerable variation between different populations and this might explain the reason for lack of discriminating power of the specific function in the Greek population. In order to investigate whether a better discriminant function could be obtained using the Greek data, separate discriminant function analysis was performed on the same teeth and a different equation emerged without, however, any real improvement in the classification process, with an overall correct classification of 72%. The results showed that there were a considerably higher percentage of females correctly classified than males. The results lead to the conclusion that the use of the mesiodistal diameter of teeth is not as a reliable method as one would have expected for determining sex of human remains from a forensic context. Therefore, this method could be used only in combination with other identification approaches.

The relationship between osteoporosis and periodontitis in women aged 45-70 years.

OBJECTIVE: To explore the possible relationship between the osteoporotic condition and the severity of periodontitis in women aged 45-70 years. MATERIALS AND METHODS: Ninety women with generalized chronic periodontitis, aged 45-70 years, were studied. Areal bone mineral density (BMDa) was assessed using standardized dual energy X-ray absorptiometry (normal: T-score ≥ -1, osteopenic: -2.5 ≤ T-score <-1, osteoporotic: T-score < -2.5). Gingival index (GI), bleeding on probing, clinical attachment loss (CAL), probing pocket depth and gingival recession (GR) were recorded. Periodontitis severity was represented by CAL. Menopausal condition and smoking were documented. RESULTS: Mean GI, bleeding on probing, CAL and GR were significantly greater for osteoporotic women than women with normal BMDa (P = 0.002, P = 0.01, P = 0.04, respectively). Osteopenic women and women with normal BMDa significantly differed in mean GI (P = 0.02). The associations found between osteoporotic women and women with normal BMDa and the associations found between osteopenic women and women with normal BMDa existed even after adjusting for smoking and menopausal status. CONCLUSION: Subjects with osteoporosis (OPR) presented with greater CAL than the subjects with normal BMDa, which suggests a greater severity of periodontitis. Subjects with OPR had greater GR than the subjects with normal BMDa. Subjects with osteopenia and subjects with normal BMDa did not differ in CAL, which might suggest that the early diagnosis of reduced BMDa, prior to the establishment of a significant negative impact on the periodontal tissues, might be important. Smoking and menopausal status did not alter these associations.

Dental data of the Athens 2004 Olympic and Paralympic Games.

The Athens University, School of Dentistry, accepted the challenge to organize the Dental Health Services in the Athens 2004 Olympic and Paralympic Games in order to provide the best quality of oral health services to the athletes, coaches, escort members and Olympic Village personnel. Data from the whole activity protocol of the Athens 2004 Games Dental Health Services - the reception, admission and treatment protocols, the facilities and the infrastructure, the number of cases treated per specialty and the experience gained - were recorded. During the Olympic Games, there were more than 1400 dental cases in more than 650 patients, elite athletes, escort members, coaches and staff of the Olympic Village. Among them 313 fillings, 100 root canal therapies, 57 mouthguards and 9 dental trauma cases were treated. During the Paralympic Games, there were more than 240 dental cases in more than 220 patients. Among them 73 fillings, 12 root canal therapies, 21 extractions and 3 dental trauma cases were treated. In such events, highly trained dentists are needed and if possible, specialized in operative dentistry or endodontics. The role of team dentist seems to be of great importance.

Dental diagnostic radiology in the forensic sciences: two case presentations.

Dentomaxillofacial radiology is a useful tool in forensic science to reveal characteristics of the structures of the dentomaxillofacial region. Postmortem radiographs are valuable to the forensic odontologist for comparison with antemortem radiographs, which are the most consistent part of the antemortem records that can be transmitted during forensic examination procedures. By using dentomaxillofacial radiology we can, therefore, give answers to problems dealing with identification cases, mass disasters and dental age estimation. We present the contribution of dentomaxillofacial radiology to the forensic sciences through two cases of deceased persons, where identification was based on information provided by radiographs. The right performance, interpretation and reportage of dentomaxillofacial radiological examination and procedures can be extremely valuable in solving forensic problems.

Accuracy in osteoporosis diagnosis of a combination of mandibular cortical width measurement on dental panoramic radiographs and a clinical risk index (OSIRIS): the OSTEODENT project.

Clinical questionnaires and dental radiographic findings have both been suggested as methods of identifying women at risk of having osteoporosis and who might benefit from bone densitometry. The aim of this study was to measure the diagnostic accuracy of a combination of mandibular cortical width (MCW) measured from dental panoramic radiographs (DPRs) and the osteoporosis index of risk (OSIRIS) in the diagnosis of osteoporosis. 653 women (age range 45-70 years, mean age 54.95 years) in four European centres underwent standardised dual X-ray energy absorptiometry (DXA) to provide reference data on osteoporosis status. Each subject was interviewed to derive OSIRIS scores and underwent DPR examination. MCW was measured directly by five observers. Receiver Operating Characteristic (ROC) curve analysis was used to calculate sensitivities and specificities of the clinical and radiographic tests for the diagnosis of osteoporosis. 512 (78.4%) of the study population were classified as having normal BMD and 141 (21.6%) as having osteoporosis. Using ROC analysis, OSIRIS gave a ROC curve area (A(z)) of 0.838, with a sensitivity of 70.9% and a specificity of 79.5% at a diagnostic threshold of

Stevens-Johnson syndrome: case presentation.

Erythema Multiforme (EM) is a rare mucocutaneous disease with a variety of clinical manifestations. EM it was recognized in the early 1800's, and still the etiology is unknown. It has been recently suggested erythema multiforme (EM) major and Stevens-Johnson Syndrome (SJS) could be separated as two distinct clinical disorders with similar mucosal erosions, but different patterns of cutaneous lesions. In particular SJS should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that appear on erythematous or purpuric maculae, which are different from classic targets. In SJS mouth, eyes, skin, genitalia and occasionally the esophagus and respiratory track may be affected. Oral lesions may cause severe pain and usually lips may become encrusted. Concerning ocular involvement, if there is conjunctivitis or uveitis this may lead to scarring and blindness. Also, the course of disease and the prognosis are in most cases severe.

Oral health status in Greek children and teenagers, with disabilities.

Nowadays there is a sharp increase of population with disabilities. The aim of this investigation was a) to survey the dental health status, estimate the treatment requirements of children and adolescents with cerebral palsy, mental retardation and visual disorders and b) to compare the oral health status of these groups of individuals. The investigation entailed the clinical examination of 170 individuals, between 6 and 15 years old, who were attending four special schools in Athens, Greece. In conclusion, our investigation documented the following: The treatment needs regarding both dentitions are extremely high in all groups of individuals. The oral hygiene status is in general, moderate to low-grade, especially in the individuals with mental retardation. The highest rate of malocclusion is observed in the group of individuals with cerebral palsy.

Premolar development in Greek children with cleft lip and palate.

OBJECTIVE: The purpose of this investigation was to study the development of the premolars in a sample of Greek children with cleft lip and palate. METHOD AND MATERIALS: The study material consisted of panoramic radiographs of 34 individuals (22 boys and 12 girls) with cleft lip with or without cleft palate. The boys ranged from 9.0 to 14.0 years of age and the girls ranged from 8.0 to 14.5 years of age. The mean age was 11.3 years. Each panoramic radiograph was matched with a corresponding one of an unaffected individual of the same sex and chronologic age (+/- 3 months). The panoramic radiographs were used to categorize the stages of tooth development according to the 10 stages of mineralization described by Nolla. The assessment was repeated by a second observer. RESULTS: Individuals with clefts exhibited a statistically significant delay of formation and mineralization of the maxillary right and left second premolars and the mandibular right second premolar in comparison to individuals without clefts. In the cleft group, there was no statistically significant difference between boys and girls in premolar development. No asymmetric development of contralateral premolar teeth was observed in individuals with cleft lip and palate. CONCLUSION: Although the exact biologic explanation remains to be found, the formation of premolars is delayed in children with cleft lip and palate.