Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH).

OBJECTIVES: This in vitro pilot study aimed to evaluate whether different pre-treatments (demineralization, deproteinization, (chemo-)mechanical reduction of the surface layer) influence the penetration depth of a resin infiltrant into MIH-affected enamel compared to initial carious lesions. METHODS: Thirty extracted human permanent molars with non-cavitated initial carious lesions (n = 5) or MIH (n = 25) were chosen and randomly assigned to six experimental groups: IC: initial caries; M: MIH; MN: MIH, 5.25% sodium hypochlorite; MM: MIH, microabrasion; MA: MIH, air abrasion; MAN: MIH, air abrasion and 5.25% sodium hypochlorite. A modified indirect dual fluorescence staining method was adopted to assess the penetration depth (PD) of the resin infiltrant and the lesion depth (LD) by confocal laser scanning microscopy (CLSM). Exemplarily, scanning electron microscopic (SEM) images were captured. The relationship between group assignment and penetration/lesion depth was estimated using a linear mixed model incorporating the tooth as random effect (two observations/tooth). The significance level was set at p < 0.05. RESULTS: For MIH-affected molars, the mean PD (in µm; median, [minimum-maximum]) were M (178.2 [32.5-748.9]), MN (275.6 [105.3-1131.0]), MM (48.7 [0.0-334.4]), MA (287.7 [239.4-491.7]), and MAN (245.4 [76.1-313.5]). Despite the observed differences in PD between the groups, these could not be statistically verified (Bonferroni, p = 0.322). The percentage penetration was significantly higher for IC than for MIH groups (Bonferroni, p < 0.05). SIGNIFICANCE: Compared to IC, resin infiltration into MIH-affected enamel ist more variable. Different pre-treatments influence the resin penetration into developmentally hypomineralized enamel to a fluctuating level.

Gingival proteomics reveals the role of TGF beta and YAP/TAZ signaling in Raine syndrome fibrosis.

Raine syndrome (RNS) is a rare autosomal recessive osteosclerotic dysplasia. RNS is caused by loss-of-function disease-causative variants of the FAM20C gene that encodes a kinase that phosphorylates most of the secreted proteins found in the body fluids and extracellular matrix. The most common RNS clinical features are generalized osteosclerosis, facial dysmorphism, intracerebral calcifications and respiratory defects. In non-lethal RNS forms, oral traits include a well-studied hypoplastic amelogenesis imperfecta (AI) and a much less characterized gingival phenotype. We used immunomorphological, biochemical, and siRNA approaches to analyze gingival tissues and primary cultures of gingival fibroblasts of two unrelated, previously reported RNS patients. We showed that fibrosis, pathological gingival calcifications and increased expression of various profibrotic and pro-osteogenic proteins such as POSTN, SPARC and VIM were common findings. Proteomic analysis of differentially expressed proteins demonstrated that proteins involved in extracellular matrix (ECM) regulation and related to the TGFß/SMAD signaling pathway were increased. Functional analyses confirmed the upregulation of TGFß/SMAD signaling and subsequently uncovered the involvement of two closely related transcription cofactors important in fibrogenesis, Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ). Knocking down of FAM20C confirmed the TGFß-YAP/TAZ interplay indicating that a profibrotic loop enabled gingival fibrosis in RNS patients. In summary, our in vivo and in vitro data provide a detailed description of the RNS gingival phenotype. They show that gingival fibrosis and calcifications are associated with, and most likely caused by excessed ECM production and disorganization. They furthermore uncover the contribution of increased TGFß-YAP/TAZ signaling in the pathogenesis of the gingival fibrosis.

Optical coherence tomography and gray scale digital analysis as noninvasive techniques for evaluating molar-incisor hypomineralization severity: A comparative study with microcomputed tomography.

Molar-incisor hypomineralization (MIH) is a qualitative defect of dental enamel characterized by demarcated opacities present in permanent first molars and other teeth. It is considered a major clinical challenge in dentistry because it makes affected teeth more susceptible to fractures and dental caries. Its diagnosis is mainly clinical and there are few technological resources that allow for a more accurate diagnosis, especially with respect to the depth of the defect in the dental enamel. In this context, optical coherence tomography (OCT), which is routinely used in ophthalmology, can produce images of the depth of the dental enamel, making it a promising method. In this study, 33 teeth with different MIH severities were evaluated using OCT and microcomputed tomography (microCT). Semi-quantitative methods of grayscale pattern analysis were used to compare images obtained from different severities of MIH with the mineral density obtained through microCT. MicroCT evaluation revealed that hypomineralized enamel had a significantly lower mineral density than intact enamel. However, this difference was not observed between the mild and severe MIH lesions. In the OCT evaluation, significant differences were observed between the intact and hypomineralized enamel, and the gray value comparison provided a method for quantitative differentiation between the two. This study suggests that OCT could be a useful adjunct to traditional diagnostic methods for MIH, offering a noninvasive approach to evaluate enamel defects. RESEARCH HIGHLIGHTS: Combining optical coherence tomography with grayscale digital analysis shows potential as a promising method for diagnosing molar-incisor hypomineralization and assessing its level of severity.

Linear enamel hypoplasia in Homo naledi reappraised in light of new Retzius periodicities.

OBJECTIVES: Among low-latitude apes, developmental defects of enamel often recur twice yearly, linkable to environmental cycles. Surprisingly, teeth of Homo naledi from Rising Star in South Africa (241-335 kya), a higher latitude site with today a single rainy season, also exhibit bimodally distributed hypoplastic enamel defects, but with uncertain timing and etiology. Newly determined Retzius periodicities for enamel formation in this taxon enable a reconstruction of the temporal patterning of childhood stress. METHODS: Using high resolution casts of 31 isolated anterior teeth from H. naledi, 82 enamel defects (linear enamel hypoplasia [LEH]) were identified. Seventeen teeth are assigned to three individuals. Perikymata in the occlusal wall of enamel furrows and between the onsets of successive LEH were visualized with scanning electron microscopy and counted. Defects were measured with an optical scanner. Conversion of perikymata counts to estimates of LEH duration and inter-LEH interval draws upon Retzius periodicities of 9 and 11 days. RESULTS: Anterior teeth record more than a year of developmental distress, expressed as two asymmetric intervals centered on 4.5 and 7.5 months bounded by three LEH. Durations, also, show bimodal distributions, lasting 3 or 12 weeks. Short duration LEH are more severe than long duration. Relative incisor/canine rates of formation are indistinguishable from modern humans. DISCUSSION: We invoke a disease and dearth model, with short episodes of distress reflecting onset of disease in young infants, lasting about 3 weeks, followed by a season of undernutrition, possibly intensified by secondary plant compounds, spanning about 12 weeks, inferably coincident with austral winter.

Development of undergraduate students' diagnostic accuracy for the classification of molar incisor hypomineralization.

INTRODUCTION: One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. METHODS: In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). RESULTS: The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). CONCLUSION: Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.

Dental and temporomandibular joint pathology of the red fox (Vulpes vulpes).

Skulls from 305 red foxes (Vulpes vulpes) were examined using predefined criteria to assess for the presence and severity of dental and temporomandibular joint (TMJ) pathology. Of the 305 specimens examined, 131 were male (42.9%), 103 were female (33.4%), 71 were of unknown sex (23.3%), 238 were adults (78.03%) and 67 were young adults (21.97%), with juveniles excluded from the study. Of a maximum of 12,810 possible teeth, 12,355 (96.5%) were present for examination, 72 (0.6%) were absent congenitally, 97 (0.8%) were acquired tooth loss and 280 (2.2%) were absent artefactually. Eight teeth (0.06%) in five specimens (1.6%) had abnormal tooth form and four (0.03%) supernumerary teeth were present across four (1.3%) specimens. Ten persistent deciduous teeth were present in seven (2.3%) specimens and six (0.05%) unerupted teeth were found in four (1.1%) specimens. Root number variation was present in 51 (0.4%) teeth, predominantly premolar teeth. Twenty-one (6.9%) specimens had lesions consistent with enamel hypoplasia and 42 (13.8%) showed root fenestrations in the maxillary alveolar bone. Periodontitis and attrition/abrasion were present in most specimens (56.7% and 96.1%, respectively). Three-hundred and eighty (3.1%) teeth were fractured, with the most common fracture type being root fractures. Eleven periapical lesions were found in nine (0.03%) specimens. Six-hundred and eight TMJs were evaluated and many specimens (11.5%) had evidence of low-grade TMJ osteoarthritis. Overall, these red foxes share similar dental pathology to other foxes, but had a higher prevalence of congenital tooth absence, persistent deciduous teeth, TMJ pathology and enamel hypoplasia.

Knowledge of Dentists about Hypomineralization Enamel Defects: A Cross-Sectional Study

ABSTRACT Objective: To evaluate a group of Brazilian dentists on their knowledge of Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molars (HSPM) related to clinical aspects, consequences, and diagnostic criteria. Material and Methods: In this cross-sectional, the participants were invited by e-mail and Whatsapp® to answer a questionnaire about their knowledge of hypomineralization enamel defects (MIH/HSPM) on the Google Forms® platform. The questionnaire comprised eight questions about personal data and multiple-choice questions about their knowledge concerning clinical aspects, diagnostic criteria of MIH/HSPM and differential diagnosis through clinical images. Chi-square test was applied with the significance level set at 5%. Results: Most participants (n = 492; 91.1%) reported having knowledge about MIH/HSPM. The general dentists gave more incorrect answers (n = 40; 65.6 %;) about dental tissues affected by MIH/HSPM. Overall, 83.3% of the dentists gave the correct answer to which dentitions are associated with this condition. In addition, most dentists presented knowledge about the consequences related to possible fractures (n= 487; 90.2%) and about an increased risk of caries (n= 479; 88.9%) in the affected teeth. Regarding the differential diagnosis performed through clinical images, most participants gave incorrect answers (p≤0.001). Conclusion: The participants presented knowledge about the dentition associated with this condition and possible consequences related to the teeth affected by MIH/HSPM; however, they showed difficulties concerning clinical diagnostic criteria.

Artificial intelligence system for training diagnosis and differentiation with molar incisor hypomineralization (MIH) and similar pathologies.

OBJECTIVES: Molar incisor hypomineralization (MIH) is a difficult-to-diagnose developmental disorder of the teeth, mainly in children and adolescents. Due to the young age of the patients, problems typically occur with the diagnosis of MIH. The aim of the present technical note was to investigate whether a successful application of a neural network for diagnosis of MIH and other different pathologies in dentistry is still feasible. MATERIALS AND METHODS: For this study, clinical pictures of four different pathologies were collected (n = 462). These pictures were categorized in caries (n = 118), MIH (n = 115), amelogenesis imperfecta (n = 112) and dental fluorosis (n = 117). The pictures were anonymized and a specialized dentist taking into account all clinical data did the diagnosis. Then, well-investigated picture classifier neural networks were selected. All of these were convolutional neural networks (ResNet34, ResNet50, AlexNet, VGG16 and DenseNet121). The neural networks were pre-trained and transfer learning was performed on the given datasets. RESULTS: For the vgg16 network, the precision is the lowest with 83.98% as for the dense121 it shows the highest values with 92.86%. Comparing the different pathologies between the investigated neural networks, there is no trend detectable. CONCLUSION: In the long term, an implementation of artificial intelligence for the detection of specific dental pathologies is conceivable and sensible. CLINICAL RELEVANCE: Finally, this application can be integrated in the area of training and teaching in order to teach dental students as well as general practitioners for MIH and similar dental pathologies.

Enamel Developmental Defect Masking on Central Incisor with Infiltrant Resin.

The aim of this paper is to present a case of masking of a hypoplastic lesion using the infiltrating resin technique, without use of drilling or any loss of tooth structure. A 22-year-old female patient complained of a noncarious white spot on the buccal surface of the upper right central incisor which affected the esthetics of her smile. Despite the tooth discoloration, the tooth structure was intact, with no depressions, cracks, or grooves. During the anamnesis, she reported that the white spot had been present since childhood. On the basis of the information provided by the patient and collected during intraoral clinical examination, it was determined that the stain was suggestive of enamel hypoplasia. The treatment proposed to the patient was the application of infiltrating resin to mask the hypoplasia on the surface of the tooth enamel without any loss of tooth structure. In this case, Icon infiltrating resin proved to be efficient in masking the hypoplastic lesion. The final appearance of the treated tooth was satisfactory, with homogeneity and gloss on the surface, which minimized the characteristics of an unpleasant smile.

Association between hypomineralization of deciduous and molar incisor hypomineralization and dental caries.

This study aimed to evaluate the association between the severity of hypomineralized second primary molars (HSPM), molar-incisor hypomineralization (MIH) and dental caries in children. 450 children between the ages of 6 and 7 years were included in this cross-sectional study. A calibrated examiner classified the enamel hypomineralizations and dental caries lesions using the MIH and HSPM and the Nyvad criteria, respectively. The primary outcome was the severity of MIH according to the severity of HSPM. Statistical analysis was performed using the generalized linear model and ordinal logistic regression. The prevalence of concomitant MIH and HSPM was 26% sex and age adjusted. Mild enamel defects were more frequent than severe enamel defects. An association was found between the severity of MIH and HSPM, both for mild defects (OR=87.54; 95%CI: 55.87, 137.17) and severe defects (OR=82.15; 95%CI: 45.72, 147.61). The severity of hypomineralization in permanent molars was associated with the activity of dental caries lesions (OR=29.85; 95%CI: 12.95, 68.83). To conclude, there is a strong association between the severity of HSPM and MIH, which is more significant in the presence of active dental caries lesions.

Morphological, histological, and chemical analysis of first permanent molars with molar incisor malformation.

PURPOSE: Molar incisor malformation (MIM) is a dental anomaly rendering first permanent molar pulps inflamed/necrotic at a young age. It often affects permanent incisors, primary second molars and less frequently other teeth. The purpose of this study was to investigate the anatomy and histology of MIM in seeking insight into its pathogenesis. METHODS: Five MIM first permanent molars were examined with micro-computed tomography (micro-CT) for 3D morphology, with scanning electron microscopy for microanatomy, with energy-dispersive X-ray spectrometer (EDS) for chemical composition and for histology with optical microscopy. Composition differences were statistically determined using one-way ANOVA. RESULTS: Micro-CT confirmed dentin abnormalities in the middle and cervical third of the crown in the form of the radiodense 'cervical mineralized diaphragm' (CMD). This was peripherally intertwined with enamel fjords and projections severely disrupting the integrity of pulp chamber and its continuity with root canals. EDS showed increased Ca in CMD compared to dentin. The histological examination revealed anomalous osteodentin-like hard tissue with denticles in the CMD. CONCLUSION: An interconnection of anomalous cervical enamel with crown CMD dentin preceded to the severe pulp chamber and root dysplasias in MIM molar teeth.

Singleton-Merten syndrome: A rare cause of femoral head necrosis.

Singleton-Merten syndrome (SMS) is a type I interferonopathy. In this report, we disclose the first-to the best of our knowledge-direct association of SMS with femoral head necrosis (FHN). The following case report presents the condition of a 38-year-old male suffering from SMS with FHN, characterized by acute symptoms and rapid disease progression. As per the recommendations of the Association Research Circulation Osseous (ARCO) and the S3-guidelines, we successfully treated the FHN with core decompression. Our histological results correlate with the changes described in medical literature in patients with SMS and MDA5-knockout in vivo experiments such as osteopenia, widened medullary cavity, and thin cortical bone. Moreover, the conducted immunohistochemistry shows strong CD56 positivity of the osteoblasts and osteocytes, as well as significant CD68 and CD163 positivity of the middle-sized osteoclasts. Collectively, these findings suggest an underlying syndrome in the FHN. A six-month post-operative follow-up revealed complete recovery with the absence of the initial symptoms and ability to resume normal daily activities. Taken together, our findings suggest that SMS is an additional cause of FHN in young adults. Early detection and adequate treatment using well-established joint-preserving techniques demonstrate a favorable improvement of the patient's clinical condition.

An integrative approach to studying plasticity in growth disruption and outcomes: A bioarchaeological case study of Napoleonic soldiers.

OBJECTIVES: The aim of this study was to investigate how much variation in adult stature and body mass can be explained by growth disruption among soldiers who served in Napoleon's Grand Army during the Russian Campaign of 1812. METHODS: Linear enamel hypoplasia (LEH) were recorded as representations of early life growth disruption, while the impact on future growth was assessed using maximum femur length (n = 73) as a proxy for stature and maximum femoral head diameter (n = 25) as a proxy for body mass. LEH frequency, severity, age at first formation, and age at last formation served as explanatory variables in a multiple regression analysis to test the effect of these variables on maximum femur length and maximum femoral head diameter. RESULTS: The multiple regression model produced statistically significant results for maximum femur length (F-statistic = 3.05, df = 5 and 67, P = .02), with some variation in stature (adjusted r2 = 0.13) attributable to variation in growth disruption. The multiple regression model for maximum femoral head diameter was not statistically significant (F-statistic = 1.87, df = 5 and 19, P = .15). CONCLUSIONS: We hypothesized stress events during early life growth and development would have significant, negative, and cumulative effects on growth outcomes in adulthood. The results did not support our hypothesis. Instead, some variables and interactions had negative effects on stature, whereas others had positive effects. This is likely due to catch-up growth, the relationship between acute and chronic stress and growth, resilience, and plasticity in human growth over the life course.

Dentists' Knowledge and Clinical Experience towards Molar-Incisor-Hypomineralization in Iran

ABSTRACT Objective: To determine the knowledge and clinical experience of dentists regarding MIH in Kerman/Iran. Material and Methods: In this cross-sectional study, a census sampling method was used, and all dentists registered in Kerman medical council were asked to participate in the study. A validated and reliable researcher administered questionnaire was used to determine participants' demographic characteristics, knowledge, and clinical experience. The association between knowledge score and demographic variables was determined using an independent t-test and ANOVA. The level of significance was set as 0.05. Results: Overall, 400 specialized and general dentists in Kerman completed the questionnaire. The mean knowledge score of dentists was 6.6±1.9 of 11. Female dentists' knowledge was higher than male dentists (p<0.05). General dentists had a higher level of knowledge regarding MIH compared to specialists (p<0.05). Overall, 79.5 % had been faced with MIH during their practice years. After confronting MIH teeth, 48.8% of dentists referred patients to specialists for treatment. Providing aesthetics was considered the most difficult part of treatment (43.2%). Resin composite was the most favorable dental material for treating MIH (60.9%). Conclusion: Although most dentists in Kerman had encountered MIH defects during their clinical practice, they did not have enough knowledge of the defect and required education on all aspects of MIH diagnosis and management. Younger dental practitioners, general dentists and females presented higher knowledge of MIH.

ORAL HYGIENE IN CHILDREN WITH DISTURBANCES IN TOOTH FORMATION WHO WERE AFFECTED AS A CONSEQUENCE OF THE ChNPP ACCIDENT. / STAN GIGIIeNY POROZhNYNY ROTA U DITEI Z PORUShENNIaMY FORMUVANNIa ZUBIV, POSTRAZhDALYKh VNASLIDOK AVARIÏ NA ChAES.

OBJECTIVE: evaluation of oral hygiene to enhance the prophylaxis of complications specifically of dental caries inchildren with disturbances in tooth formation (DTF) who live on radiologically contaminated territories after theChornobyl NPP (ChNPP) accident. MATERIALS AND METHODS: Children aged 6-14 years (n = 1470) with DTF were the study subjects examined in 2012-2016. Among them there were (n = 528) residents of the zones III and IV of radiological contamination after theChNPP accident with 137Cs soil contamination density 1-15 Ci/km2. The effective radiation dose in them was notexceeding 1 mSv/year. The Green-Vermillion and Silness-Loe oral hygiene indices were assesses within clinicalexamination methods. RESULTS: The worth oral hygiene was revealed in children having got the DTF, compensated chronic diseases oforgans and systems, and in those with burdened radiation history. The Green-Vermilion and Silness-Loe indices were1.7 ± 0.51 and 1.65 ± 0.46 respectively. CONCLUSIONS: A significant deterioration in oral hygiene confirmed by the highest values of the Green-Vermillion index (1.7 ± 0.51; p < 0.001 - «unsatisfactory oral hygiene¼ criterion) and Silness-Loe index (1.65 ± 0.46; p < 0.001 -«poor oral hygiene¼ criterion) was found in children with DTF aged 6-14 years being residents of contaminated areasas a result of the Chernobyl accident. The revealed deterioration may be due to a set of negative factors, includingthe impact of ionizing radiation in low doses and peculiarities of social status. Results of the questioning of surveyed pediatric contingents both having got an DTF and with no defects of the hard tissues of teeth indicate aninsufficient level of knowledge and skills in hygienic care of oral cavity regardless of the area of residence.Development of a set of measures to prevent the DTF complications in children should be carried out taking intoaccount the state of oral hygiene, level of knowledge and skills in oral care, and include the use of hygiene products, namely toothpastes and anti-caries mouthwashes.

Evaluating the changes in molar incisor hypomineralization prevalence: A comparison of two cross-sectional studies in two elementary schools in Mexico City between 2008 and 2017.

BACKGROUND: Little information is available on the trends over time of the prevalence of molar incisor hypomineralization (MIH). This condition may be preventing dental caries decline. AIM: (a) To compare the prevalence of MIH, in Mexico City schoolchildren, evaluated in 2008 with a group evaluated in 2017, (b) to identify the association of MIH with dental caries, and (c) to assess the mother's perception of her child's oral health status. DESIGN: Two cross-sectional studies performed in 2008 and in 2017 were compared. The oral examiner and the selected schools were the same in both surveys. RESULTS: A total of 549 schoolchildren were evaluated. The prevalence of MIH in the first survey was 20.3%, and 31.9 % in the second survey, (p = .002). Children with MIH were more likely to have dental caries. The odds ratio was 2.24 (p = .036) and 4.18 (p ˂ .001) in the first and second surveys, respectively. Mothers of children with MIH perceived worse oral health status of their children than the mothers whose children did not have MIH (odds ratio = 4.47, p ˂ .001). CONCLUSION: The findings portray a clear increase in prevalence of MIH and highlight the need for increased awareness about this condition among dentists and the general population.

Prevalence of Molar Incisor Hypomineralisation Among School Children aged 7-12 years in Tunis, Tunisia

Abstract Objective: To evaluate the prevalence and the characteristics of Molar Incisor Hypomineralisation (MIH) in 7-12-year-old children in Tunis, Tunisia. Material and Methods: This study was designed as a cross-sectional study, in which school children aged 7 to 12 years were included. A total of 510 children (257 girls and 253 boys) who had their first permanent molar and incisors were evaluated using the 2003 European Academy of Paediatric Dentistry (EAPD) recommendation criteria were examined. Descriptive data analysis and Pearson's chi-squared test were performed (p<0.05). Results: A total of 510 children were included in the study. MIH was present in 35.4 % of our study population. Boys exhibited slightly higher MIH (19,4%) and Post Eruptive Breakdown (PEB) (7,3%) prevalence compared to girls, but the difference was not statistically significant (p=0.07). Moreover, demarcated opacities were more prevalent than PEB. More precisely, the main prevalence without PEB was MIH with white/creamy demarcated opacities, which was more frequent than yellow/brown demarcated opacities (p<0.05). Conclusion: The prevalence of MIH in Tunis was 35.4%, with no difference between girls and boys. The main MIH type prevalence was white/creamy demarcated opacities without PEB.

Temporal changes in childhood health during the medieval Little Ice Age in Denmark.

OBJECTIVE: This study examines the evidence of three skeletal markers of childhood health that leave permanent observable changes in the adult skeleton during two climate events, the Medieval Warm Period (MWP) and the Little Ice Age (LIA) that occurred in the medieval period (1050-1536 CE). MATERIAL: A total of 241 adult skeletons from the Danish medieval period were included. METHODS: Linear enamel hypoplasia (LEH) was examined macroscopically. Harris lines (HL) and infectious middle ear disease (IMED) were examined from CT imaging. The skeletons were segregated by the mortuary pattern of arm position that coincidentally changes between the MWP to the LIA. RESULTS: LEH and IMED increase in frequency from the MWP to the LIA while there is a reverse trend for HL. SIGNIFICANCE: This is the first study that examines childhood health as reflected on skeletal remains of adults using a combination of CT imaging and macroscopic examination for temporal changes in the medieval period. LIMITATIONS: The study did not include any sub-adults due to limitation of methods, i.e. the method of IMED is not yet developed to assess sub-adults. Neither was time-of-occurrence for the skeletal marker included as there is conflicting information from different methods for HL and neither has it been developed yet for IMED. SUGGESTIONS FOR FURTHER RESEARCH: A sample of sub-adults from both time periods could be compared by sub-adult mortality, as well as for differences in the timing of skeletal age markers.

Faster growth corresponds with shallower linear hypoplastic defects in great ape canines.

Deeper or more 'severe' linear enamel hypoplasia (LEH) defects are hypothesized to reflect more severe stress during development, but it is not yet clear how depth is influenced by intrinsic enamel growth patterns. Recent work documented inter- and intraspecific differences in LEH defect depth in extant great apes, with mountain gorillas having shallower defects than other taxa, and females having deeper defects than males. Here, we assess the correspondence of inter- and intraspecific defect depth and intrinsic aspects of enamel growth: enamel extension rates, outer enamel striae of Retzius angles, and linear enamel thickness. Thin sections of great ape canines (n = 40) from Gorilla beringei beringei, Gorilla gorilla gorilla, Pan troglodytes, and Pongo spp. were analyzed. Enamel extension rates were calculated within deciles of enamel-dentine junction length. Linear enamel thickness and the angle of intersection between striae of Retzius and the outer enamel surface were measured in the imbricational enamel. Mountain gorillas have faster enamel extension rates and shallower striae angles than the other taxa examined. Mountain gorillas have thinner imbricational enamel than western lowland gorillas and orangutans, but not chimpanzees. In the combined-taxon sample, females exhibit larger striae angles and thicker imbricational enamel than males. Enamel extension rates are highly negatively correlated with striae angles and LEH defect depth. Enamel growth variation corresponds with documented inter- and intraspecific differences in LEH defect depth in great ape canines. Mountain gorillas have shallower striae angles and faster extension rates than other taxa, which might explain their shallow LEH defect morphology and the underestimation of their LEH prevalence in previous studies. These results suggest that stressors of similar magnitude and timing might produce defects of different depths in one species or sex vs. another, which has implications for interpretations of stress histories in hominins with variable enamel growth patterns.