Demirjian's system for estimating dental age among Northwestern Turkish children aged 4-16 years

AIM

The aim of this study was to investigate the timing of individual tooth formation stages in a group of northwestern Turkish children and to evaluate the suitability of Demirjian's method.

STUDY DESIGN

dental ages (DAs) were assessed from 1,678 digital panoramic radiographs of healthy children (aged 4-16 years; 743 females and 935 males). Seven mandibular teeth were evaluated according to the Demirjian's eight-grade dental maturity scale by one examiner. Dental age was compared to chronologic age (CA) using a paired t-test. Intra- and inter-observer agreements were assessed with 250 OPGs.

RESULTS

The mean difference between DA and CA was statistically significant among genders (p = 0.004), and it was 0.50 +/-1.90 years in girls and 0.77+/-1.86 years in boys. The mean DA was significantly higher (p<0.0001) than the mean CA in the entire studied group; therefore, dental development was considerably accelerated. The Intra- and Interclass Correlation Coefficient (ICC) for the assessment of DA were 0.964 and 0.961, respectively, which is considered "substantial agreement".

CONCLUSION

Results show that the mean DAs of the studied group of Turkish children are significantly higher than the CAs. Overestimation is notable at the beginning of puberty.

Osteomyelitis due to arsenic trioxide use for tooth devitalization

AIM

To present a case of osteomyelitis that was caused by the use of arsenic trioxide during root canal treatment in a mandibular left first molar.

SUMMARY

Arsenic was once in common use to devitalize inflammed pulp tissue before root canal treatment. Its prolonged application or leakage leads to toxic effects beyond the pulp tissue, and necrosis of periodontal tissues and supporting alveolar bone has been described. This report presents a case of osteomyelitis resulting from leakage of arsenic trioxide used in pulp devitalization. Sequestrectomy and excision of non-vital alveolar bone was performed to treat the severe tissue necrosis.

KEY LEARNING POINTS

Agents containing arsenic are still employed by some clinicians and may be encountered when patients present with tissue destruction resulting from their use. Dental practitioners should be aware that arsenic paste may diffuse into periodontal tissues through apical, lateral or accessory canals, through perforations and around leaking restorations. Osteomyelitis caused by arsenic trioxide can be treated by a combination of pharmacotherapeutic and invasive surgical methods. Arsenic pastes have no place in endodontic practice.

Almost complete absence of the scalp and body hair in association with oligodontia and zygodactylous palmar triradii

We describe an 18-year-old girl with a distinctive facial appearence, almost complete absence of the scalp and body hair, absence of the eyebrows and eyelashes, oligodontia, conically shaped maxillary central incisors and zygodactylous palmar triradii suggesting for syndactyly type I.

Neurinoma in the buccal mucosa

A 14-year-old girl was referred to our clinic with a problem of a painless slow growing lesion for approximately three years. MR imaging findings of lesion was "retention cyst of the salivary gland". Controversially, the histological examination of the total excised specimen was "neurinoma" and that was inconsistent with MR findings. Neural tissue tumors of the oral cavity are rare, however, this diagnosis was confirmed by surgical excision and histopathological examination. There was a rare location of the lesion as well.

Cleidocranial dysostosis: report of a case

This case of cleidocranial dysostosis showed nearly 40 accessory teeth and the unerupted teeth on radiological examinations. Other diagnostic procedures found hypoplasia in maxillary and zygomatic bones, deep palate, open fontanel and open sutures, the collapse of sagittal suture, and aplasia of the clavicle. There were some abnormalities of the fingers. Under general anesthesia eleven supernumerary teeth in the mandible and eight in the maxilla were surgically extracted. Upper and lower removable acrylic appliances were fabricated.