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Vila-Blanco N, Varas-Quintana P, Tomás I, Carreira MJ. A systematic overview of dental methods for age assessment in living individuals: from traditional to artificial intelligence-based approaches. Int J Legal Med 2023; 137:1117-1146. [PMID: 37055627 PMCID: PMC10247592 DOI: 10.1007/s00414-023-02960-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 04/15/2023]
Abstract
Dental radiographies have been used for many decades for estimating the chronological age, with a view to forensic identification, migration flow control, or assessment of dental development, among others. This study aims to analyse the current application of chronological age estimation methods from dental X-ray images in the last 6 years, involving a search for works in the Scopus and PubMed databases. Exclusion criteria were applied to discard off-topic studies and experiments which are not compliant with a minimum quality standard. The studies were grouped according to the applied methodology, the estimation target, and the age cohort used to evaluate the estimation performance. A set of performance metrics was used to ensure good comparability between the different proposed methodologies. A total of 613 unique studies were retrieved, of which 286 were selected according to the inclusion criteria. Notable tendencies to overestimation and underestimation were observed in some manual approaches for numeric age estimation, being especially notable in the case of Demirjian (overestimation) and Cameriere (underestimation). On the other hand, the automatic approaches based on deep learning techniques are scarcer, with only 17 studies published in this regard, but they showed a more balanced behaviour, with no tendency to overestimation or underestimation. From the analysis of the results, it can be concluded that traditional methods have been evaluated in a wide variety of population samples, ensuring good applicability in different ethnicities. On the other hand, fully automated methods were a turning point in terms of performance, cost, and adaptability to new populations.
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Affiliation(s)
- Nicolás Vila-Blanco
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Departamento de Electrónica e Computación, Escola Técnica Superior de Enxeñaría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Paulina Varas-Quintana
- Oral Sciences Research Group, Special Needs Unit, Department of Surgery and Medical Surgical Specialities, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Inmaculada Tomás
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
- Oral Sciences Research Group, Special Needs Unit, Department of Surgery and Medical Surgical Specialities, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
| | - María J Carreira
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Departamento de Electrónica e Computación, Escola Técnica Superior de Enxeñaría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Evaluation of the Relationship between the BMI and the Sequence and Chronology of Eruption in Permanent Dentition in Spanish Population. Healthcare (Basel) 2022; 10:healthcare10061046. [PMID: 35742098 PMCID: PMC9222528 DOI: 10.3390/healthcare10061046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
The aim was to analyze the relationship between BMI (body mass index) and the sequence and chronology of the eruption of permanent teeth in a sample of Spanish children. Methods: The study design was descriptive, cross-sectional, observational, and epidemiological. Patients of pediatric age were included. Emerged teeth, and patient’s age, race, and sex were recorded. The nutritional status of the child was assessed by calculating the BMI, according to the WHO parameters. Statistical analysis was carried out with a confidence interval of 95%. A prediction model with logistic regression models was obtained. Results: A total of 725 pediatric patients between 4 and 14 years old were analyzed. BMI acts as a predictor variable for eruption symmetry, as it was most frequent in overweight children (p < 0.001). The probability of symmetry in dental eruption increases for South American children, for an extra month of age, and each meter of height. BMI had an influence in the first tooth to appear only in the fourth quadrant. BMI did not seem to influence present teeth, and the sequence of permanent dental eruption was not influenced by the BMI category. Conclusions: Age, weight, height, and BMI act as significant predictors for eruption symmetry. BMI does not produce alterations in the eruption sequence of the permanent dentition.
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Awadh W, Pegelow M, Heliövaara A, Rice DP. Dental age, agenesis, and morphological anomalies in individuals with Van der Woude syndrome and isolated cleft palate. Eur J Orthod 2021; 43:387-393. [PMID: 34079993 DOI: 10.1093/ejo/cjaa082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To analyse the differences between dental age and chronological age and dental anomalies in individuals with Van der Woude syndrome (VWS) and compare with non-syndromic cleft palate (NSCP) and non-cleft controls. MATERIALS AND METHODS In total, 204 oral panoramic radiographs (118 girls and 86 boys) consisting of 51 VWS patients (age x̅ = 8.17 ± 1.34 years), 51 NSCP patients (age x̅ = 8.09 ± 1.41 years), and 102 normative non-cleft children (age x̅ = 8.62 ± 1.24 years) were collected. Dental stages were assessed by the Demirjian method, with the local dental maturity index as reference. Dental anomalies including agenesis were investigated. Statistical differences were determined by One-way ANOVA and regression. Repeatability was calculated by an intra-class correlation test and 95% confidence interval. RESULTS The difference between dental age and chronological age of the VWS group (0.12 years) and the NSCP group (0.09 years) was significantly lower than the non-cleft group (0.40 years) (P = 0.002). There was no significant difference between the VWS and NSCP groups (P = 0.885). Hypodontia was more prevalent in both the VWS group (37.25%, P = 0.0001) and the NSCP group (19.60%, P = 0.035) compared with the non-cleft group (5.88%). The odds for hypodontia in the VWS group were approximately double compared with the NSCP group. In VWS patients, the most commonly missing teeth were the permanent second premolars and the maxillary permanent laterals incisors. Peg-shaped teeth had a prevalence of 13.70% in VWS patients. CONCLUSIONS In VWS and NSCP patients compared with non-cleft children, the difference in dental age compared with chronological age decreased. Hypodontia occurs at a high prevalence in VWS and NSCP patients compared with non-cleft children.
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Affiliation(s)
- Wael Awadh
- Department of Oral and Maxillofacial Diseases, Division of Orthodontics, University of Helsinki and Helsinki University Hospital, Finland.,Department of Dental Medicine, Division of Orthodontics, Karolinska Institutet, Stockholm, Sweden.,Department of Preventive Dental Sciences, Division of Orthodontics, College of Dentistry, Jazan University, Saudi Arabia
| | - Marie Pegelow
- Department of Dental Medicine, Division of Orthodontics, Karolinska Institutet, Stockholm, Sweden
| | - Arja Heliövaara
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Hospital, Finland
| | - David P Rice
- Department of Oral and Maxillofacial Diseases, Division of Orthodontics, University of Helsinki and Helsinki University Hospital, Finland
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Markovic E, Marinkovic N, Zelic K, Milovanovic P, Djuric M, Nedeljkovic N. Dental Age Estimation According to European Formula and Willems Method: Comparison Between Children With and Without Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 58:612-618. [PMID: 33535820 DOI: 10.1177/1055665621990513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess dental age and deviations of dental from chronological age according to the Willems and Cameriere methods (European formula) in patients with cleft lip and/or cleft palate (CL/P) and compare it with control group. DESIGN Retrospective cross-sectional study. SETTING Clinic of Orthodontics. PARTICIPANTS Sixty-nine patients with CL/P between 6 and 15 years of age (55 with unilateral and 14 with bilateral CL/P) with 148 panoramic radiographs. The same number of radiographs was examined in the age-matched control group. MAIN OUTCOME MEASURES Estimation and comparison of dental age and differences of dental from chronological age in relation to the type of cleft, sex, and age in the group of patients with and without CL/P according to Willems and Cameriere method. RESULTS No significant intersex and intergroup differences were found in deviations of dental from chronological age according to Cameriere method (P > .05). Significant difference in deviation of dental from chronological age was found between the patients with and without CL/P according to Willems method (P < .001). CONCLUSION Cameriere European formula for dental age estimation, which is not influenced by sex and tooth morphology, showed similar dental development of children with and without CL/P. However, Willems method detected that deviation of dental from chronological age significantly differed between children with and without clefts.
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Affiliation(s)
- Evgenija Markovic
- Clinic for Orthodontics, School of Dental Medicine, 119082University of Belgrade, Belgrade, Serbia
| | - Nemanja Marinkovic
- Clinic for Orthodontics, School of Dental Medicine, 119082University of Belgrade, Belgrade, Serbia
| | - Ksenija Zelic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, 119082University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, 119082University of Belgrade, Belgrade, Serbia
| | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, 119082University of Belgrade, Belgrade, Serbia
| | - Nenad Nedeljkovic
- Clinic for Orthodontics, School of Dental Medicine, 119082University of Belgrade, Belgrade, Serbia
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Deep orofacial phenotyping of population-based infants with isolated cleft lip and isolated cleft palate. Sci Rep 2020; 10:21666. [PMID: 33303814 PMCID: PMC7730196 DOI: 10.1038/s41598-020-78602-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/24/2020] [Indexed: 11/24/2022] Open
Abstract
Isolated orofacial clefts (OFC) are common with poorly understood aetiology. Heterogeneous phenotypes and subphenotypes confound aetiological variant findings. To improve OFC phenome understanding, population-based, consecutive, pre-treatment infants with isolated unilateral cleft lip (UCL, n = 183) and isolated cleft palate (CP, n = 83) of similar ancestry were grouped for deep phenotyping. Subphenotypes stratified by gender and cleft severity were evaluated for primary dental malformations and maturation using radiographs. We found that cleft severity and tooth agenesis were inadequate to distinguish heterogeneity in infants with UCL and CP. Both groups featured slow dental maturity, significantly slower in males and the UCL phenotype. In 32.8% of infants with UCL, supernumerary maxillary lateral incisors were present on the cleft lip side, but not in infants with CP, suggesting a cleft dental epithelium and forme fruste cleft dentoalveolus of the UCL subphenotype. The findings underscored the importance of deep phenotyping to disclose occult OFC subphenotypes.
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Van Dyck J, Begnoni G, Willems G, Laenen A, Thevissen P, Verdonck A, Cadenas de Llano-Pérula M. Dental development in patients with and without unilateral cleft lip and palate (UCLP): a case control study. Clin Oral Investig 2020; 25:2619-2631. [PMID: 32914272 DOI: 10.1007/s00784-020-03573-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/03/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate if the presence of unilateral cleft lip and palate (UCLP) causes delay in dental age and tooth development. MATERIALS AND METHODS Panoramic radiographs of 189 non-syndromic UCLP patients, aged from 6 to 20 years, were collected. Two measures of tooth development were examined: dental maturity scale for the seven left mandibular teeth (dental age-DA) and the degree of each tooth development (developmental score-DS). All the teeth except third molars were staged according to the Demirjian's method. The data of the cleft group were compared with a control group matched for age and gender, based on the findings observed in other 189 panoramic radiographs. RESULTS At all ages, DA was lower in the UCLP group, but not always significantly; the highest difference was - 1.411 for females at 13 years old and - 0.776 for males at 12 years old. DS of all teeth was significantly lower in the UCLP group, at all ages under 17 in females, and at all ages under 18 in males. In UCLP group, tooth development was more delayed in the maxilla compared with the mandible. No evidence of a slower development at the cleft side compared with the non-cleft side was highlighted. CONCLUSIONS Significant lower dental development was observed in UCLP patients compared with control ones by using DS and DA indexes. CLINICAL RELEVANCE These findings can help the clinicians in establishing a proper orthodontic and surgical diagnosis and treatment planning in UCLP patients and for forensic age estimation's purposes.
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Affiliation(s)
- Julie Van Dyck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Annouschka Laenen
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven and University Hasselt, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Patrick Thevissen
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
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Ribeiro EC, Lacerda RHW, da Silva LGM, Santiago BM, da Costa CHM, Almeida MSC. An analysis of third molar mineralization in Brazilian patients with cleft lip and palate. Acta Odontol Scand 2020; 78:384-389. [PMID: 32096419 DOI: 10.1080/00016357.2020.1731594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: This study investigated the third molar mineralization in patients with cleft lip and palate.Materials and methods: From a total of 253 digital panoramic radiographs from patients with cleft lip and palate within the age range of 7-21 years, 97 radiographs were selected (cleft group). A control group was formed from same sex individuals, without malformation and chronological age matched within 30 days. The analysis of third molar mineralization was carried out by three calibrated examiners using Demirjian's and Nolla's methods. McNemar and Wilcoxon test for paired samples were used for pairwise comparisons between the groups. The Likelihood Ratio test was used to check for an association between the type of cleft and tooth calcification.Results: In both methods, the mineralization means were smaller in the case group than in the control, with significant differences for all third molars (p < .05). The type of cleft affected dental mineralization. There was no significant difference when comparing the left or right sides, but maxillary molars showed earlier mineralization.Conclusions: A significant delay in third molar mineralization was observed in patients with cleft lip and palate according to Demirjian's and Nolla's methods.
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Affiliation(s)
- Esther Carneiro Ribeiro
- Academic Center for Biological Sciences, School of Dentistry, Federal University of Campina Grande, Patos, Brazil
| | | | | | - Bianca Marques Santiago
- Department of Clinics and Social Dentistry, Federal University of Paraíba, João Pessoa, Brazil
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Almeida MSC, Lacerda RHW, Leal KB, Figueiredo CHMDC, Santiago BM, Vieira AR. Analysis of permanent second molar development in children born with cleft lip and palate. J Appl Oral Sci 2020; 28:e20190628. [PMID: 32520078 PMCID: PMC7299560 DOI: 10.1590/1678-7757-2019-0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/21/2020] [Accepted: 04/04/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The study of dental development in individuals born with cleft lip and palate (CLP) serves to determine when orthodontic intervention should start. To evaluate the permanent second molar development in children born with cleft lip and palate according to Demirjian's and Nolla's methods. METHODOLOGY Out of a total of 513 digital panoramic radiographs, 113 pairs of children aged 3 to 16 years were selected. The exams were from children born with or without cleft lip and palate, of the same sex, with an age difference of up to 30 days. The images were analyzed by three examiners and reliability was checked through intra-examiner agreement by the Kappa test. The data were analyzed by Wilcoxon's and Mann-Whitney tests according to each dataset. RESULTS The findings indicated delayed development of the permanent second molars in children with CLP (P<0.001). The development of the right permanent second molar was delayed compared to the left molar in children with CLP. Moreover, mandibular teeth showed significantly earlier development than maxillary teeth in both the case and control groups. There was no significant difference in the development of permanent second molars between sexes. CONCLUSION Children with CLP presented delay in the development of permanent second molars.
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Affiliation(s)
| | | | | | | | | | - Alexandre Rezende Vieira
- Universidade Federal da Paraíba , João Pessoa , Paraíba , Brasil
- University of Pittsburgh , Pittsburgh , Pennsylvania , United States of America
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Zelic K, Marinkovic N, Milovanovic P, Cameriere R, Djuric M, Nedeljkovic N. Age estimation in children based on open apices measurement in the Serbian population: Belgrade Age Formula (BAF). Ann Hum Biol 2020; 47:229-236. [PMID: 32460570 DOI: 10.1080/03014460.2020.1764621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Cameriere's method has been tested in many populations and is widely accepted for dental age estimation.Aim: To establish a new formula for age estimation by measurement of open apices of mandibular teeth based on Cameriere's European formula.Subjects and methods: Panoramic radiographs of 333 healthy Serbian children aged 5-14 years were analysed by two independent researchers. The new formula - Belgrade Age Formula (BAF) - was created and tested on the same Serbian sample. Furthermore, BAF was tested on the Serbian validation sample of 126 children and 2115 Italian children aged 5-14 years.Results: In the Serbian sample, the residuals of the BAF and European formula demonstrated that BAF is significantly better in age estimation than the European formula. No significant difference was found in females from the Serbian validation sample between dental and chronological age when BAF was applied. For males, the BAF and European formula had similar accuracy. In the Italian sample, the mean differences between estimated and real age for the European formula were -0.214 ± 0.934 and 0.109 ± 0.773 for females and males, respectively, while for BAF these differences were 0.182 ± 0.951 and -0.195 ± 0.923 for females and males, respectively.Conclusion: BAF was found to be accurate in the Serbian and Italian populations.
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Affiliation(s)
- Ksenija Zelic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nemanja Marinkovic
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Milovanovic
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Marija Djuric
- Laboratory for Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nenad Nedeljkovic
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Cesur E, Arslan C, Münevveroğlu AP, Altuğ AT. Evaluation of Dental Age in Individuals of Different Ages with Unilateral Cleft Lip and Palate. Turk J Orthod 2020; 33:103-109. [PMID: 32637191 DOI: 10.5152/turkjorthod.2020.19094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/13/2020] [Indexed: 11/22/2022]
Abstract
Objective This study aimed to evaluate the dental age of unilateral cleft lip and palate (UCLP) patients aged 7-12 and 12-16 years using Demirjian's method and to compare these results with a control group. Methods We evaluated the panoramic radiographs of 54 individuals with UCLP and 54 age- and gender-matched individuals without UCLP (control). The UCLP and control groups were divided into two groups: 7-12 and 12-16 years of age. Their dental ages were determined using Demirjian's method. Dental ages of the cleft side and noncleft side were assessed separately and were also compared with those of the control group to assess potential asymmetric dental developments in the UCLP group. Results The chronological age was lower than the dental ages on both right and left sides in the control group (p<0.01). When age groups were evaluated separately, it was found that the chronological age was lower than the dental age in 7-12 year old individuals in the UCLP group (p<0.05), whereas it was less than the left and right dental ages in 7-12 (p<0.01) and 12-16 year old individuals (p<0.05) in the control group. Conclusion We detected no differences in dental age between UCLP patients and healthy controls, and lack of asymmetrical dental development in the mandibular teeth of either group. However, based on assessments performed using Demirjian's method, subjects' dental and chronological ages were incompatible.
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Affiliation(s)
- Emre Cesur
- Department of Orthodontics, Medipol University School of Dentistry, İstanbul, Turkey
| | - Can Arslan
- Department of Orthodontics, Medipol University School of Dentistry, İstanbul, Turkey
| | - Aslı Patır Münevveroğlu
- Department of Paediatric Dentistry, Medipol University School of Dentistry, İstanbul, Turkey
| | - Ayşe Tuba Altuğ
- Department of Orthodontics, Ankara University School of Dentistry, Ankara, Turkey
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Dental Age Estimation in Southern Turkish Children: Comparison of Demirjian and Willems Methods. IRANIAN JOURNAL OF PEDIATRICS 2017. [DOI: 10.5812/ijp.11726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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