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Paddenberg E, Dees A, Proff P, Kirschneck C. Individual dental and skeletal age assessment according to Demirjian and Baccetti: Updated norm values for Central-European patients. J Orofac Orthop 2024; 85:199-212. [PMID: 36239773 PMCID: PMC11035409 DOI: 10.1007/s00056-022-00431-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/16/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Chronological age often differs from dental and skeletal age. With orthopantomograms and lateral cephalograms, dental and skeletal development can be determined according to the methods published by Demirjian et al. and Baccetti et al. However, gender and skeletal class as possible confounders were frequently not considered and available norm values are not up-to-date. This retrospective cross-sectional study thus aimed to evaluate effects of skeletal class and gender on dental and skeletal age of growing patients and to generate updated norm values for contemporary Central-European patients. METHODS A total of 551 patients were included in the dental and 733 in the skeletal age assessment, respectively. Dental analysis was based on tooth mineralisation stages in orthopantomograms (Demirjian) and skeletal age was defined by cervical vertebrae maturation stages (CVMS) in lateral cephalograms (Baccetti). Skeletal class was determined by the individualised ANB angle of Panagiotidis/Witt. With nonlinear regression analysis a formula for determining dental age was established. Effects of gender and skeletal class were evaluated and updated norm values generated. RESULTS Inter- and intrarater reliability tests revealed at least substantial measurement concordance for tooth mineralisation and CVMS. Demirjian stages and CVMS significantly depended on gender with girls developing earlier. Skeletal class significantly affected skeletal age only, but without clinical relevance. Updated norm values for dental age differed significantly from the original values of Demirjian and the values for skeletal age differed from those published by Baccetti. CONCLUSION Optimised norms, separated by gender, increase precision in determining individual dental and skeletal age during orthodontic treatment planning. Further studies analysing the effect of skeletal class on dental and skeletal development are needed.
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Affiliation(s)
- Eva Paddenberg
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Adrian Dees
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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Fonseca-Souza G, Renostro-Souza A, Alves-Souza L, Junior GT, de Menezes-Oliveira MAH, Antunes LAA, Beisel-Memmert S, Kirschneck C, Feltrin-Souza J, Küchler EC. Association between dental age and malocclusions: a systematic review. BMC Oral Health 2024; 24:383. [PMID: 38528527 DOI: 10.1186/s12903-024-04143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions. METHODS The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023. RESULTS One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian's method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated. CONCLUSION DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail. TRIAL REGISTRATION This study was registered in the PROSPERO database (CRD42023454207).
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Affiliation(s)
- Gabriela Fonseca-Souza
- Department of Stomatology, Federal University of Paraná, Av. Prefeito Lothário Meissner 632, Jardim Botânico, Curitiba, Paraná, 80210-170, Brazil
| | - Amanda Renostro-Souza
- Department of Biomaterials, University of Uberaba, Av. Nenê Sabino 1801, Bairro Universitário, Uberaba, Minas Gerais, 38055-500, Brazil
| | - Lhorrany Alves-Souza
- Department of Biomaterials, University of Uberaba, Av. Nenê Sabino 1801, Bairro Universitário, Uberaba, Minas Gerais, 38055-500, Brazil
| | - Geraldo Thedei Junior
- Department of Biomaterials, University of Uberaba, Av. Nenê Sabino 1801, Bairro Universitário, Uberaba, Minas Gerais, 38055-500, Brazil
| | | | - Lívia Azeredo Alves Antunes
- Department of Specific Formation, Fluminense Federal University, Rua Dr. Silvio Henrique Braune 22, Centro, Nova Friburgo, Rio de Janeiro, 28625‑650, Brazil
| | - Svenja Beisel-Memmert
- Department of Orthodontics, Medical Faculty, University Hospital Bonn, Welschnonnenstr. 17, Bonn, 53111, Germany
| | - Christian Kirschneck
- Department of Orthodontics, Medical Faculty, University Hospital Bonn, Welschnonnenstr. 17, Bonn, 53111, Germany
| | - Juliana Feltrin-Souza
- Department of Biomaterials, University of Uberaba, Av. Nenê Sabino 1801, Bairro Universitário, Uberaba, Minas Gerais, 38055-500, Brazil
| | - Erika Calvano Küchler
- Department of Orthodontics, Medical Faculty, University Hospital Bonn, Welschnonnenstr. 17, Bonn, 53111, Germany.
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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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The bridging and normal dimensions of sella turcica in Yemeni individuals. Oral Radiol 2021; 38:162-170. [PMID: 34143355 PMCID: PMC8211719 DOI: 10.1007/s11282-021-00541-7] [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: 01/24/2021] [Accepted: 06/03/2021] [Indexed: 11/21/2022]
Abstract
Objective This study aimed to evaluate and compare sizes, shapes and bridging of the sella turcica (ST) in Yemeni individuals with different skeletal patterns, genders, and ages, and to assess the association between the linear dimension of ST and gender, age, or skeletal patterns. The standard anatomical structure of ST among Yemeni subjects is still unknown and this study can be considered as the first reference regarding ST of Yemeni individuals.
Materials and methods Cephalogram images for 234 subjects (167 females and 67 males) were traced and classified for groups by gender, age, and dentofacial skeletal patterns. Size, shape, and bridging of ST were assessed. Multivariate ANOVA (MANOVA) analysis was used to detect the interaction between gender, age, and skeletal patterns on ST dimensions.
Results The mean values for length, anteroposterior diameter, and depth of ST were 8.02 ± 1.67, 11.37 ± 1.60, and 8.56 ± 1.26 mm, respectively. A significant difference in length of ST between gender and age stages (p < 0.05) was detected while older subjects revealed a greater anteroposterior diameter than younger subjects (p < 0.05). The morphological variations of ST were observed in 55.6% of samples. No significant association between the shape of ST and skeletal patterns (p > 0.05) was found.
Conclusions ST bridging was highly prevalent in Yemeni subjects (35.9%). Samples showed a higher rate of complete ST bridging in the three skeletal patterns, Class I (17.1%), Class II (18.9%), and Class III (20%). ST dimensions and shape findings in this study can be used as reference standards for further investigation, including the ST area in the Yemeni population.
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Hostiuc S, Diaconescu I, Rusu MC, Negoi I. Age Estimation Using the Cameriere Methods of Open Apices: A Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9020237. [PMID: 33672206 PMCID: PMC7926662 DOI: 10.3390/healthcare9020237] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: To evaluate the actual variability of the mean difference between chronological and dental age using the Cameriere method of open apices and to test its accuracy in variable age groups. Method: We selected studies that contained data about the mean, standard deviation, and number of cases for chronological age, dental age and gender. We used a random-effects model. Statistical significance was estimated, at a p < 0.05, using prediction intervals. For the analysis of publication bias we used the funnel plot and Egger’s regression test for plot asymmetry. I2 was used to test the presence of heterogeneity between studies. The Z test was used to test for statistical differences between subgroups, with p < 0.05 being considered statistically significant. We also used 95% for confidence intervals and prediction intervals. Results: In boys, the average difference between chronological and dental age was 0.44 (0.26–0.63) years, while in girls the average difference between chronological and dental age was 0.34 (0.19–0.49) years. In the 6–7 years age group and in the 14–15 years age group, there was a statistically significant difference between dental and chronological age. Our study shows that the Cameriere method is useful for estimating the chronological age, with errors of less than one year. Conclusions: The Cameriere method of evaluating dental age using open apices is sufficiently accurate for forensic practice, at least in the 7–14 age-interval.
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Affiliation(s)
- Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 042122 Bucharest, Romania
- Correspondence: or ; Tel.: +40-723791072
| | - Ioana Diaconescu
- National Institute of Legal Medicine, 042122 Bucharest, Romania;
| | - Mugurel Constantin Rusu
- Department of Anatomy, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Ionut Negoi
- Department of Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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Różyło-Kalinowska I, Kalinowski P, Krasicka E, Galić I, Mehdi F, Cameriere R. The Cameriere method using cone-beam computed tomography (CBCT) scans for dental age estimation in children. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1789221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ingrid Różyło-Kalinowska
- Independent Unit of Epidemiology, Medical University of Lublin, Lublin, Poland
- Independent Unit of Propaedeutics of Dentomaxillofacial Radiology, Medical University of Lublin, Lublin, Poland
| | - Paweł Kalinowski
- Independent Unit of Epidemiology, Medical University of Lublin, Lublin, Poland
| | | | - Ivan Galić
- Department of Oral Surgery, University of Split School of Medicine and University Hospital Centre, Split, Croatia
- AgEstimation Project, University of Macerata, Macerata, Italy
| | - Fuad Mehdi
- Department of Oral Surgery, University of Split School of Medicine and University Hospital Centre, Split, Croatia
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Gulsahi A, Çehreli SB, Galić I, Ferrante L, Cameriere R. Age estimation in Turkish children and young adolescents using fourth cervical vertebra. Int J Legal Med 2020; 134:1823-1829. [DOI: 10.1007/s00414-020-02246-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 01/02/2020] [Indexed: 12/17/2022]
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Khdairi N, Halilah T, Khandakji MN, Jost-Brinkmann PG, Bartzela T. The adaptation of Demirjian’s dental age estimation method on North German children. Forensic Sci Int 2019; 303:109927. [DOI: 10.1016/j.forsciint.2019.109927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
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Ozveren N, Serindere G, Meric P, Cameriere R. A comparison of the accuracy of Willems’ and Cameriere’s methods based on panoramic radiography. Forensic Sci Int 2019; 302:109912. [DOI: 10.1016/j.forsciint.2019.109912] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/03/2019] [Accepted: 07/30/2019] [Indexed: 11/25/2022]
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Paz Cortés MM, Rojo R, Mourelle Martínez MR, Dieguez Pérez M, Prados-Frutos JC. Evaluation of the accuracy of the Nolla method for the estimation of dental age of children between 4–14 years old in Spain: A radiographic study. Forensic Sci Int 2019; 301:318-325. [DOI: 10.1016/j.forsciint.2019.05.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/11/2019] [Accepted: 05/29/2019] [Indexed: 01/24/2023]
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da Luz LCP, Anzulović D, Benedicto EN, Galić I, Brkić H, Biazevic MGH. Accuracy of four dental age estimation methodologies in Brazilian and Croatian children. Sci Justice 2019; 59:442-447. [DOI: 10.1016/j.scijus.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 02/04/2019] [Accepted: 02/17/2019] [Indexed: 10/27/2022]
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Abstract
Determining a patient's dental age is essential from the dental standpoint but can also have connotations of a forensic, anthropological and medicolegal nature. In this study, we assessed the correspondence between dental age and chronological age in a group of 50 children with autism spectrum disorders, with a chronological age range of 3-17 years. The dental age was calculated using panoramic radiography images, applying linear regression models derived from the classical indices by Nolla and Demirjian. In 2 of every 3 boys, the dental age was ahead of the chronological age, and in almost 1 of every 3 cases, the difference was ≥ 12 months. In the girls, conversely, we found no significant differences between dental age and chronological age.
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Shrestha GK, Pokharel PR, Gyawali R, Bhattarai B, Giri J. The morphology and bridging of the sella turcica in adult orthodontic patients. BMC Oral Health 2018; 18:45. [PMID: 29548316 PMCID: PMC5857073 DOI: 10.1186/s12903-018-0499-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/02/2018] [Indexed: 11/24/2022] Open
Abstract
Background The purpose of this study was to determine and compare the shapes, sizes, and bridging of the sella turcica in patients with different skeletal patterns and genders. Methods It was a cross-sectional comparative study. The samples were divided into three groups according to the skeletal pattern viz. Class I, Class II and Class III, and each group consisted of 40 samples (20 males and 20 females). The lateral cephalograms were traced and the sella turcica was assessed for its size, shape, and bridging. Results The mean length, anteroposterior diameter and depth of sella turcica were 8.13 ± 2.03 mm, 9.60 ± 1.43 mm and 6.40 ± 1.21 mm respectively. The mean length of sella turcica was 7.91 ± 1.52 mm in Class I, 7.32 ± 1.62 mm in Class II and 9.16 ± .2.42 in Class III skeletal pattern; anteroposterior diameter was 9.30 ± 1.02 mm in Class I, 9.15 ± 1.28 mm in Class II and 10.35 ± 1.64 mm in Class III skeletal pattern; and the depth was 6.40 ± 0.92 mm in Class I, 6.07 ± 1.01 mm in Class II and 6.74 ± .1.54 mm in Class III skeletal pattern. There were significant differences in length and anteroposterior diameter and sella turcica between Class I, Class II and Class III skeletal patterns (p = 0.01), (p = 0.01) respectively. There was no significant difference in size of sella turcica between different genders and age groups. Sixty percent of the patients studied had normal Sella morphology. Partial Sella turcica bridging and Sella turcica bridging was seen in this study in 23.33% and 11.67% of patients respectively. Conclusion Sixty percent of the patients had normal sella turcica. There were significant differences in lengths and anteroposterior diameters among Class I, Class II and Class III patients. The larger size was present in skeletal Class III patients.
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Affiliation(s)
- Gunjan Kumar Shrestha
- Department of Orthodontics, M.B. Kedia Dental College, Rajat Jayanti chowk, Birgunj, 44300, Nepal.
| | - Prabhat Ranjan Pokharel
- Department of Orthodontics, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, 56700, Nepal
| | - Rajesh Gyawali
- Department of Orthodontics, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, 56700, Nepal
| | - Bhushan Bhattarai
- Department of Orthodontics, Nobel Medical College, Biratnagar, 56600, Nepal
| | - Jamal Giri
- Department of Orthodontics, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, 56700, Nepal
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Comparison between Two Radiological Methods for Assessment of Tooth Root Resorption: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5152172. [PMID: 29687001 PMCID: PMC5857342 DOI: 10.1155/2018/5152172] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 01/24/2018] [Accepted: 02/05/2018] [Indexed: 02/06/2023]
Abstract
Purpose This study aims to verify the validity of the radiographic image and the most effective radiological techniques for the diagnosis of root resorption to prevent, cure, and reduce it and to verify if radiological images can be helpful in medical and legal situations. Methods 19 dental elements without root resorption extracted from several patients were examined: endooral and panoramic radiographs were performed, with traditional and digital methods. Then the root of each tooth was dipped into 3-4 mm of 10% nitric acid for 24 hours to simulate the resorption of the root and later submitted again to radiological examinations and measurements using the same criteria and methods. Results For teeth with root resorption the real measurements and the values obtained with endooral techniques and digital sensors are almost the same, while image values obtained by panoramic radiographs are more distorted than the real ones. Conclusions Panoramic radiographs are not useful for the diagnosis of root resorption. The endooral examination is, in medical and legal fields, the most valid and objective instrument to detect root resorption. Although the literature suggests that CBCT is a reliable tool in detecting root resorption defects, the increased radiation dosage and expense and the limited availability of CBCT in most clinical settings accentuate the outcome of this study.
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