Iatrogenic trigeminal post-traumatic neuropathy: a retrospective two-year cohort study.

With the growing demand for dental work, trigeminal nerve injuries are increasingly common. This retrospective cohort study examined 53 cases of iatrogenic trigeminal nerve injury seen at the Department of Oral and Maxillofacial Surgery, University Hospitals of Leuven between 2013 and 2014 (0.6% among 8845 new patient visits). Patient records were screened for post-traumatic trigeminal nerve neuropathy caused by nerve injury incurred during implant surgery, endodontic treatment, local anaesthesia, tooth extraction, or specifically third molar removal. The patients ranged in age from 15 to 80years (mean age 42.1years) and 68% were female. The referral delay ranged from 1day to 6.5years (average 10months). The inferior alveolar nerve (IAN) was most frequently injured (28 cases), followed by the lingual nerve (LN) (21 cases). Most nerve injuries were caused during third molar removal (24 cases), followed by implant placement (nine cases) and local anaesthesia injuries (nine cases). Pain symptoms were experienced by 54% of patients suffering IAN injury, compared to 10% of patients with LN injury. Persistent neurosensory disturbances were identified in 60% of patients. While prevention remains the key issue, timely referral seems to be a critical factor for the successful treatment of post-traumatic neuropathy.

A comparative study of two different regression methods for radiographs in Polish youngsters estimating chronological age on third molars.

AIM: The aim of this study was to establish a third molar developmental database to model dental age of Polish youngsters, to investigate the rating level of the scores when dividing a year interval into a quarter of a year and to examine sex differences, left-right and upper-lower jaw asymmetry. MATERIAL AND METHODS: A cross-sectional sample of 1048 orthopantomograms of 644 females and 404 males aged between 12 and 26 years was investigated using the scoring system of Gleiser and Hunt modified by Köhler. Reference tables according to age were split in a whole year and in quarters of a year using descriptive statistics. The various developmental stages between males and females were analyzed with a paired t-test and the cusum method. Differences in mineralization between the quadrants were analyzed with a two-factor ANOVA and the Duncan post hoc test. The single quadratic and support vector regression were performed to describe the relationship between score and age. RESULTS: Dividing age classes in quarters of a year discriminated better between individuals provided that there is a sufficient sampling size for all age classes. The mineralization tempo occurred significantly at a faster rate in males. The maturational events in the upper arch developed significantly at earlier ages for both genders. Obtained chronological age had nearly the same standard error of estimate when calculated with both regression methods. DISCUSSION AND CONCLUSION: Comparing the results of the present study with those of other population groups suggests that there are differences in the ageing process of the wisdom tooth. This is the first database of Polish youngsters (15-24 years) with their respective regression equations to yield age estimations.

Human dental age estimation using third molar developmental stages: Accuracy of age predictions not using country specific information.

Unquestionable forensic age investigations are based on statistical models constructed on a sample containing subjects of identical origin as the examined individual. In cases where corresponding models are unavailable, the established report has to describe the possible effects of this unrelated information on the predicted age outcome. The aim of this study is to collect country specific databases of third molar development and to verify how the related dental age estimations are influenced if we were to use dental developmental information only from Belgium or from all collected countries together. Data containing third molar developmental stages scored following Gleiser and Hunt (modified by Köhler) were collected from 9 country specific populations (Belgium, China, Japan, Korea, Poland, Thailand, Turkey, Saudi-Arabia and South-India). Age predictions were obtained from a training dataset and validated on a test dataset. Bayes rule using the repeated third molar scores is applied to get age predictions and prediction intervals. Three age predictions were compared for males and females separately. For the first prediction, the training dataset contains only Belgian subjects. For the second prediction, the training dataset for each country consists only of subjects of the country itself. For the final prediction, subjects from all countries are pooled into one common training dataset. Besides the (absolute) difference between the chronological age and the predicted age, specific interest lies in the juvenile-adult distinction. In the age range from 16 to 22 years 6982 subjects (3189 male and 3793 female) were analyzed. Using information on third molar development from Belgium compared to information from the country specific databases hardly increased the mean absolute differences (MAD) and mean squared errors (MSE): the MAD and MSE increased on average with 0.5 and 2.5 months with maximal increases of, respectively 1.6 and 7.3 months. Using information from all countries pooled compared to country specific information provided even on average negligible increases (0.05 and 0.2 months for MAD and MSE, respectively). For the juvenile-adult discrimination, using information from all countries instead of country specific information yielded comparable performances. Using Belgium instead of country specific information increased the percentage of correctly identified juveniles, but decreased the percentage of correctly identified adults. The adult-juvenile discrimination based on information used from Belgium provides judicially the best applied reference.

[Team work in the treatment of patients with congenital craniofacial malformations]. / "Team-work" bij de behandeling van patiënten met congenitale craniofaciale afwijkingen.

The longlasting multidisciplinary approach of patients born with craniofacial deformities is reviewed. A schedule of treatment depending on the severity of the cleft is proposed.

The width of the attached gingiva during orthodontic treatment: a clinical study in human patients.

Studies of the influence of orthodontic movement on the width of the attached gingiva gave conflicting results. Therefore, it was decided to evaluate this parameter in human patients during a full orthodontic movement with fixed appliances. Retrusion of six maxillary anterior teeth was performed in thirteen patients scheduled in a prophylactic program that included a 2-week recall during the entire experiment. Before and after treatment the plaque index, the sulcus bleeding index, the width of the keratinized and the attached gingiva, and the marginal gingiva mobility index were measured. The results indicated that retrusion of the maxillary anterior teeth had no influence on any of the measured parameters.