Are Dentists Hypocrites? Oral Self-care Habits and Self-reported Oral Health Status among Dentists and Non-dentists in Croatia.

Objectives: Dentists provide dental care to their patients and educate them on their oral hygiene and how to maintain oral health. This paper aimed to determine whether dentists are hypocritical when advising their patients on oral hygiene procedures and dental treatments because they do not apply to themselves what they recommend to others. Material and methods: This is a self-reported study conducted through an online survey questionnaire completed by 1001 participants, of whom 551 were non-dentists and 450 dentists. This is the first study on oral hygiene habits and oral status among dentists in Croatia. This research included almost 10% of the total number of working dentists in Croatia. Results: In terms of dental hygiene habits, dentists brushed, flossed and used interdental brushes more frequently, and they also changed toothbrushes more frequently, whereas they attended check-ups less frequently. Dentists also reported a smaller number of teeth with cavities, a greater number of teeth with fillings, a greater number of extracted teeth, and a greater number of dental crowns, but a smaller number of healthy teeth compared to general population. However, dentists had a much higher proportion of participants over 30 years of age, and when sub-analysis of participants over 30 years of age was performed, dentists had a greater number of healthy teeth compared to the general population. Conclusions: The results showed that dentists are aware of the importance of their oral health and that they do not pay attention only to their oral hygiene habits, but also apply advice they give their patients. Therefore, they cannot be considered hypocritical.

Insight into structural and chemical profile / composition of powdered enamel and dentine in different types of permanent human teeth.

Research on the structure and chemical composition of dental tissues allows for the optimisation of materials used in the treatment and care of teeth. Understanding pathological processes occurring in dental tissues and their reactions to various substances, including dental materials, are crucial for the development of new dental technologies. The aim of the study was to check the similarities in the chemical and morphological structure of enamel and dentine powders in various groups of permanent teeth, as well as differential chemical analysis for both grinded tissues tested. The extracted non-carious and non-pathological human permanent teeth were divided into four groups: incisors, canines, premolars and molars. Each tooth was sectioned to thick slices. Enamel and dentine were mechanically separated and ground in an agate mortar and pestle. FT-Raman and FTIR spectroscopy methods were used for the analysis of biological tissues. SEM method was applied to visualise hard dental tissues structures present on the surface and within the particles. The morphological structures were the same within the analysed tissues and did not depend on the analysed group of teeth. A comparison of the mineral-to-organic ratios of enamel and dentine in each tooth group showed that the bands related to PO43- were clearly higher in content for enamel than for dentine. Higher absorbance measured at the region of 2800-3700 cm-1 and at 1500-1800 cm-1 for dentine as compared to enamel samples were indicative of a higher content of organic structures. The highest contribution of phosphates was in canine enamel samples.The studies showed that the carbonate-to-phosphate ratio was higher for dentine (0.20 - 0.48) compared to the values obtained for enamel (0.13 - 0.22), however, minor differences were found in each group of enamel or dentine samples. The lack of significant differences between the enamel and dentine powders of incisors, canines, premolars and molars may prove that each extracted tooth, regardless of the tooth group, is an excellent substrate for their substitution.

Prolonged Face Mask Wearing Worsens Self-Reported Dry Eye Symptoms during the COVID-19 Pandemic in Dental Healthcare Practitioners.

Objectives: The aim of the study was to evaluate self-reported MADE during the COVID-19 pandemic in dental healthcare practitioners and identify their possible risk factors. Material and Methods: An anonymous questionnaire was sent to doctors of dental medicine in the time period from February 2022 to August 2022. The online questionnaire included demographic characteristics and clinical characteristics: presence and deterioration of DED symptoms while wearing the face mask, personal protective face equipment, use of contact lenses, history of eye surgery, current use of medications, number of hours wearing face mask, and evaluation of subjective DED symptoms using modified Ocular Surface Disease Index (OSDI). Results: A total of 405 participants were included in the study and an overall prevalence of MADE was 29.1% (95% CI: 24.7 - 33.6). The participants who used masks more than 6 hours per day during the whole day reported a higher OSDI score (12.5 (IQR = 2.6 - 29.2)) compared to the participants who used masks less than 6 hours/day (6.25 (IQR = 0 - 22.92); Mann-Whitney U Test p = 0.066). Multivariable logistic regression revealed the following possible risk factors for self-reported MADE: age (older than 61 years) OR: 3.522 (95% CI 1.448 - 8.563); p=0.05, and wearing the face mask more than 6 h at work OR: 1.779 (95% CI 1.017 - 3.113); p=0.044. Conclusion: The prevalence of self-reported MADE among dental healthcare practitioners appears to be significant. The use of a face mask for a prolonged duration increases OSDI scores. MeSH Terms: face masks, dry eye, MADE, ocular discomfort, COVID-19, protective face equipment.

Artificial Intelligence in Medicine and Dentistry.

Introduction: Artificial intelligence has been applied in various fields throughout history, but its integration into daily life is more recent. The first applications of AI were primarily in academia and government research institutions, but as technology has advanced, AI has also been applied in industry, commerce, medicine and dentistry. Objective: Considering that the possibilities of applying artificial intelligence are developing rapidly and that this field is one of the areas with the greatest increase in the number of newly published articles, the aim of this paper was to provide an overview of the literature and to give an insight into the possibilities of applying artificial intelligence in medicine and dentistry. In addition, the aim was to discuss its advantages and disadvantages. Conclusion: The possibilities of applying artificial intelligence to medicine and dentistry are just being discovered. Artificial intelligence will greatly contribute to developments in medicine and dentistry, as it is a tool that enables development and progress, especially in terms of personalized healthcare that will lead to much better treatment outcomes.

Elemental mapping of human teeth enamel, dentine and cementum in view of their microstructure.

This paper presents a detailed analysis to directly compare the morphology and chemistry of human tooth layers using advanced scanning electron microscopy (SEM) techniques together with supporting data from energy dispersive spectroscopy (EDS) measurements. The aim of this study was to visualise and evaluate the structural and microanalytical differences of the mineralised hard tissues of human teeth. The extracted sound teeth without any pathologies were divided into the following groups: incisors, canines, premolars, and molars. Tooth samples were broken vertically to preserve the primary structures and to visualise individual tooth tissues. Specimens were also used to find variations in the elemental composition of tissues for different tooth groups. The average thickness of the enamel in the tooth groups studied was 1.1 mm and the average width of the enamel prisms was 4.2 µm, with the highest values observed for molars. The analysis of the chemical composition of the enamel showed that Ca and P were among the predominant elements. The average dentine thickness was 1.87 mm, with the highest values determined for molars, and the lowest for canines. The width of the dentinal tubules was less than 2 µm, for molars being significantly smaller. The analysis of the chemical composition of the dentine showed the highest O content of the all tooth tissues analyzed, while a lower P and Ca content was observed compared to the enamel. The cementum thickness averaged 0.14 mm, with the highest values observed for molars and the lowest for incisors. The analysis of the chemical composition of the cementum showed the lowest average O and P content, and the highest average C and N content, compared to the enamel and the dentine. Increasingly accurate imaging and analysis of dental hard tissue structures provides the opportunity for multifactorial evaluation in terms of their clinical application.

Teeth macroabrasion for determination of dental age and diet in the Illyrian population from the Kopila necropolis on the Island of Korcula, Croatia.

This paper presents the changes caused by macroabrasion of teeth on skeletal remains found in tomb No 4 in the west necropolis of the archeological site Kopila near Blato on the island of Korcula. The site archeologically dates back to the Late Iron Age, when the island was inhabited by the Illyrians. The aim of this study was to assess the dental age of the buried individuals at death and determine the type of their diet, which could give us a preliminary insight into the socio-economic standard of the inhabitants of the settlement. The analyzed sample is part of the collection of excavated skeletal remains kept in the Vela Luka Cultural Center on the island of Korcula. 284 permanent teeth, 19 fragments of the maxilla and 20 fragments of the mandible were found in the tomb, which were classified into 32 individuals and by sex. Teeth were analyzed by metric and non-metric methods of determining dental status in order to assess the dental age at the time of death and the diet of the inhabitants. The dental age of individuals was determined by the Lovejoy method and the degree of tooth wear by the Smith-Knight method. The analysis of the stable isotope 14C determined the exact time of death of the analyzed individuals. The tooth wear changes were very pronounced and present on 92.9% of teeth, equally on incisors and molars (p = 0.236). There is no significant gender difference (p > 0.05 for all teeth and jaw parts). There was no difference in the degree of tooth wear of the teeth of the mandible and maxilla (t = -0.266, p = 0.791), nor in the degree of tooth wear of the teeth of the maxilla right and left (t = -0.392, p = 0.702) or in the degree of tooth wear of the teeth of the mandible right and left (t = -0.889, p = 0.390). The average age of the analyzed population sample was 35.6 (±3.1) years. They were buried between 360-40 BC. Tooth wear changes observed on the analyzed teeth indicate a diet rich in hard, weakly cariogenic food with particles that were probably of inorganic origin, which caused an increased wear of tooth structures. The population was sedentary, agricultural type and the life expectancy was normal for the Late Iron Age. Besides, their socio-economic status was good. The age at the time of their death was between 30 and 40 years. Further studies should include more accurate and standardized methods for assessing the condition.

The Cameriere, Haavikko, Demirjian, and Willems methods for the assessment of dental age in Croatian children.

AIM: This study aimed to evaluate the accuracy and precision of the Cameriere European formula, Demirjian, Haavikko, and Willems methods for estimating dental age in a sample of children with permanent dentition in Croatia. MATERIAL AND METHODS: The study consisted of a sample of 1576 panoramic radiographs; a sub-sample of 84 OPGs, in which all first seven mandibular teeth were maturated, was excluded from the study. A final sample of 1492 (704 males and 788 females) aged 6.0 to 13.9 years was evaluated. Seven mandibular teeth from the left side of the mandible were analyzed, and dental age (DA) was determined by the Cameriere European formula, Demirjian method from 1976, Haavikko, and Willems methods and compared to chronological age (CA). In addition, the mean age difference (DA-CA), the mean absolute error (MAE) between dental and chronological age, the percentage of the individuals of dental age within ± 0.25 to ± 2 years of chronological age, and intra-observer and inter-observer statistics were calculated. RESULTS: The Cameriere European formula estimated the best dental age compared to the chronological age; the mean underestimation was - 0.4 years for both sexes, Haavikko underestimated by - 0.17 years, while Demirjian and Willems overestimated by 1.02 years and 0.48 years, respectively. The most significant difference showed the Demirjian method in 11-year-old and 12-year-old females. The MAE were 0.50 years, 1.01 years, 0.61 years, and 0.78 years in males and 0.51 years, 1.18 years, 0.61 years, and 0.70 years in females for the Cameriere European formula, Haavikko, Willems, and Demirjian methods, respectively. Furthermore, the Cameriere European formula showed the highest proportions of individuals with DA within ± 0.5 year difference of the CA, 61.5% in males and 59.6% in females. In addition, the Cameriere method showed the best intra-observer and inter-observer agreements. CONCLUSIONS: Although the Demirjian method was used previously in Croatian children for legal, medical, and clinical purposes, the Cameriere European formula, Haavikko, and Willems were more accurate in the tested sample. According to our findings, the Cameriere European formula showed the best accuracy and precision in dental age assessment in Croatian children following Haavikko, and we recommend it as the method of the first choice in forensic and clinical analyses.

Possibility of Human Gender Recognition Using Raman Spectra of Teeth.

Gender determination of the human remains can be very challenging, especially in the case of incomplete ones. Herein, we report a proof-of-concept experiment where the possibility of gender recognition using Raman spectroscopy of teeth is investigated. Raman spectra were recorded from male and female molars and premolars on two distinct sites, tooth apex and anatomical neck. Recorded spectra were sorted into suitable datasets and initially analyzed with principal component analysis, which showed a distinction between spectra of male and female teeth. Then, reduced datasets with scores of the first 20 principal components were formed and two classification algorithms, support vector machine and artificial neural networks, were applied to form classification models for gender recognition. The obtained results showed that gender recognition with Raman spectra of teeth is possible but strongly depends both on the tooth type and spectrum recording site. The difference in classification accuracy between different tooth types and recording sites are discussed in terms of the molecular structure difference caused by the influence of masticatory loading or gender-dependent life events.

Occupational Injuries among Dentists in Croatia.

OBJECTIVES: Dental profession is characterized by a high risk of injuries at work due to exposure to specific working conditions. The operating area in a patient's mouth is small, and it is handled by a large number of sharp instruments and drills that rotate at high speed, which creates an aerosol contaminated with particles of saliva and blood. This poses a risk of transmitting infections from patients to the dentist through stabbing incidents and cuts, which are some of the most common occupational injuries that are reported in the scientific literature. OBJECTIVE: The aim of this study was to examine the frequency of occupational injuries among dentists in Croatia, to establish most common injuries, and to determine the main risk factors. The aim of this research was also to determine the dentists' opinion on causes that are responsible for the occupational diseases and injuries. MATERIALS AND METHODS: The survey was conducted based on a sample of 406 dentists from Croatia as respondents to an electronic survey. RESULTS: 63.05% of the respondents suffered injuries caused by dental practitioners. The most common injuries were needle puncture incidents (57.75%) and cuts (20.86%), followed by eye injuries (13.37%), patient bite (4.81%) and punches (1.60%). The largest number of respondents stated the improper posture as the most important cause of occupational diseases and injuries, followed by stress, infection and noise. CONCLUSION: Knowledge of risk factors is the first step of injury prevention. Our respondents were largely aware of the dangers surrounding them. Nevertheless, the frequency of injuries was high and there is still a need for preventive measures to minimize the frequency of injuries in dentistry.

Principal Component Regression for Forensic Age Determination Using the Raman Spectra of Teeth.

Raman spectra of mineralized tooth tissues were used to build a principal component regression (PCR) age determination model for forensic application. A sample of 71 teeth was obtained from donors aging from 11 to 76 years. No particular selection criteria were applied; teeth affected with various pathological processes were deliberately included to simulate a realistic forensic scenario. In order to comply with the nondestructive specimen handling, Raman spectra were collected from tooth surfaces without any previous preparation. Different tooth tissues were evaluated by collecting the spectra from three distinct sites: tooth crown, tooth neck, and root apex. Whole recorded spectra (3500-200 cm-1) were used for principal component analysis and building of the age determination model using PCR. The predictive capabilities of the obtained age determination models varied according to the spectra collection site. Optimal age determination was attained by using Raman spectra collected from cementum at root apex (R2 values of 0.84 and 0.71 for male and female donors, respectively). For optimal performance of that model, male and female donors had to be analyzed separately, as merging both genders into a single model considerably diminished its predictive capability (R2 = 0.29).

An Analysis of Skin Prick Tests to Latex and Patch Tests to Rubber Additives and other Causative Factors among Dental Professionals and Students with Contact Dermatoses.

BACKGROUND: Dental workers often experience unwanted allergic and nonallergic skin reactions resulting in different contact dermatoses (e.g., contact urticaria, irritant and allergic contact dermatitis) that are often attributed to rubber gloves. OBJECTIVE: To examine allergic and nonallergic contact dermatoses by different methods amongst dental professionals and dental students, more specifically, reactions to natural rubber latex (NRL), rubber additives, and other causative factors. METHODS: In this cross-sectional study we surveyed a total of 444 subjects (dentists, assistants, technicians, and students); 200 agreed to be tested to latex by the standard skin prick test (SPT) and prick-by-prick test, of whom 107 were patch tested to rubber additives (mercapto mix, thiuram mix, carba mix, and N-isopropyl-N-phenyl-4-phenylenediamine [IPPD]). RESULTS: Skin lesions appeared significantly more frequently with longer work experience (p = 0.002; V = 0.181), frequent glove changes (p < 0.001; V = 0.310), and hand washing (p < 0.001; V = 0.263), and in subjects with a history of allergies (atopic dermatitis, allergic rhinitis, allergic conjunctivitis, and others) (p < 0.001; V = 0.183). Positive SPTs to latex occurred in 14/200 subjects (7%), of whom 5/14 subjects (35.7%) were also positive in prick-by-prick tests. Patch tests were positive in 5/104 subjects (4.8%) (mercapto mix 1%, thiuram mix 1.9%, and carba mix 1.9%). CONCLUSION: Only a small number of our subjects were allergic to latex (7%) or rubber additives (4.8%). Thus, self-reported contact dermatoses (during NRL product use) in dental professionals and students are not commonly caused by allergies to latex and rubber additives, as is often assumed, but by other factors.

Dental age estimation using four Demirjian's, Chaillet's and Willems' methods in Kosovar children.

BACKGROUND: Tooth formation was recognized as useful body system to assess maturity and predict age. Tooth mineralization is much less affected by the endocrine and different nutritional status than bone mineralization, and teeth formation provides a more reliable indication of chronological age. Demirjian et al. in 1973 presented a scoring system and method for dental age estimation on a sample of French-Canadian children. Chaillet et al. and Willems et al. modified original Demirjian method. This study aimed to evaluate the accuracy of four Demirjian's, Chaillet and Willems methods for age estimation in the children of Kosovo. MATERIALS AND METHODS: The cross-sectional study was based on the evaluation of the sample of 1022 orthopantomograms (OPTs) of healthy Kosovar children, aged between 5 and 14 years. OPTs were taken from the Radiology unit of University Dentistry Clinical Center of Kosova, as part of random clinical treatment. We tested the accuracy of four methods based on seven mandibular teeth, Demirjian from 1973 (Dem73) and 1976 (Dem76), Chaillet from 2005 (Chaillet) and Willems from 2001 (Willems) and two Demirjian's methods based on different sets of four teeth (Dem76PM1 and Dem76IN2). RESULTS: For most tested methods, we found statistically significant differences between the chronological age (CA) and dental age (DA) (p < 0.05). In males, the most accurate method were those using four teeth, Dem76IN2 (0.03 years) following by Dem76PM1 (-0.05 years), following those using seven teeth, Willems (-0.14 years), Chaillet (-0.24 years) and Dem73 (0.43 years). In females, dental age was the most accurate for the Willems method (-0.24 years) following Chaillet (-0.35 years), Dem76 (0.43 years) and Dem73 (0.55 years), while Dem76PM1 and Dem76IN2 overestimated by 0.45 years and 0.46 years, respectively. The mean absolute difference between DA and CA were between 0.61 years for the Willems, to 0.78 years for the Dem73 in males, and 0.64 years for the Willems to 0.75 years for the Dem76IN2 in females. CONCLUSION: The Willems method was the most accurate for estimating a dental age if all seven mandibular teeth are available for analysis, and we found the similar accuracy of Dem76PM1 and Dem76IN2 methods. Therefore, we may encourage their use for age estimation on the Kosovar children.

The third molar maturity index in indicating the legal adult age in Kosovar population.

The third molar tooth, known as the "wisdom tooth," is the only tooth that can be used to determine legal adult age. This study aimed to test the accuracy of Cameriere's third molar maturity index (I3M) in assessing the legal adult age of 18 years in the Kosovar population. Orthopantomographs (OPTs) of 1221 healthy living Kosovar individuals, aged between 12 and 23 years and with no congenital or developmental anomalies, were analyzed. Intra-class correlation coefficients were 0.858 (95% CI, 0.786 to 0.906) and 0.852 (95% CI, 0.779 to 0.903) for intra-rater and for inter-rater agreement, respectively. The sample was divided into training dataset (800 OPTs) and test dataset (421 OPTs). The training dataset was used to generate the logistic regression model, while the test dataset was used to study the performance of the model. I3M and gender as independent variables and adult age (≥ 18 years) or minor age (< 18 years) as the dependent variable were used for logistic regression analysis. The receiver operating curve (ROC) analysis was used to determine the specific cut-off value of I3M for predicting adult age. The results showed that only I3M statistically significantly contributed to discriminating adults and minors. ROC analysis showed that the cut-off value of I3M < 0.08 was the best in discriminating adults and minors. An analysis of the test dataset (421 OPTs) showed that as I3M decreased the age gradually increased. The performance of the cut-off value of I3M < 0.08, to discriminate between adults and minors, was analyzed by contingency tables for both sexes. In males, the accurate classification (Acc) was 0.968 (95% CI, 0.926 to 0.985), the sensitivity (Se) was 0.962 (95% CI, 0.925 to 0.978), and the specificity (Sp) was 0.976 (95% CI, 0.929 to 0.995). The Bayes post-test probability (Bayes PTP) was 0.975 (95% CI, 0.905 to 1.00). In females, Acc was 0.909 (95% CI, 0.870 to 0.917), Se and Sp were 0.826 (95% CI, 0.787 to 0.834) and 0.991 (95% CI, 0.953 to 1.00) respectively, while Bayes PTP was 0.989 (95% CI, 0.926 to 1.00). Our data support the usefulness of I3M < 0.08 to indicate legal adult age in a Kosovar population.

Motivation and Career Perceptions of Dental Students at the School of Dental Medicine University of Zagreb, Croatia.

PURPOSE: Health care studies are usually considered to be complex, demanding and time consuming. The right motivation toward choosing a career in the health field is of utmost importance for the successful completion of studies. The aim of this study was to gain insight into the factors motivating students at the School of Dental Medicine University of Zagreb, Croatia and, also, to examine their career perceptions. MATERIAL AND METHODS: Based on specific questions from available literature, a questionnaire was designed and a total of 270 questionnaires were distributed to the first year students during 2013, 2014 and 2015. RESULTS: A total of 206 students responded, for a response rate of 76.3%. 26.9% of students enrolled in dental studies because it was their first career choice; 16.4% of them believed that it is easy to find a regular job in dentistry. 9.9% of students thought that salaries are high in the field of dental medicine. 45.4% of the first year students were interested in a career in private practice after graduation. These results provide interesting clues to motivation and give additional insights into the expectations of students regarding their studies and profession. CONCLUSSION: The obtained data can be used for the further improvements in the quality of dental study curricula and teaching process.

Education on occupational health and health related habits among dental students in Croatia.

INTRODUCTION: Occupational diseases are diseases caused by occupational exposures at the workplace, while diseases related to work are diseases caused by many factors, wherein the harmful work conditions are one of the possible causes. Dental medicine is a profession with a high risk of developing occupational diseases. The aim of this paper was to present the results of a survey about occupational health risks and health related habits among dental students at the School of Dental Medicine University of Zagreb and to show how this survey led to an improvement in education by introducing a new course into the dental curriculum. PARTICIPANTS AND METHODS: Students of all years at the School of Dental Medicine University of Zagreb (total of 663) were offered to participate in a survey about occupational health risks and health related habits. RESULTS: A questionnaire was completed by 351 students. 28.0% of male students and 22.5% of female students were smokers. During the first two years of study, up to 84.6% of students consumed alcoholic beverages at least once a week. Prior to enrollment in the university, 85.3% male and 77.6% female students were engaged in sports. The significant drop in the number of students who participated in sports was noticed in the first study year in both sexes. Student awareness of the health risks related to dental profession increases with the year of study. Most students believe that occupational diseases can be prevented. CONCLUSION: The results have shown that students enter the School of Dental Medicine with a relatively low level of awareness of the health hazards of dental profession. Although the level of awareness increases with years of study, harmful habits such as smoking, alcohol consumption, and the lack of physical activity also remain present in the later years of study.

Morphologic Patterns of Lip Prints in a Sample of Croatian Population.

PURPOSE: Cheiloscopy deals with the study of elevations and depressions which form a characteristic pattern on the external surface of the lips. Lip grooves are considered to be unique and analogous to the fingerprint. The aim of the research was to determine the type of grooves on healthy lips of men and women using lip prints in a sample of Croatian population, to determine whether there is a statistically significant difference between men and women in the types of grooves and to determine whether there are any differences between male and female lip prints. MATERIAL AND METHODS: A randomly selected sample of Croatian population consisted of 40 male and 50 female subjects. The samples of lip grooves were classified according to Tsuchihashi classification. RESULTS: The research has shown that most women in Croatia belong to Type 2 (40.0%), followed by Type 1 (34.0%), Type 3 (12.0%), Type 4 (8.0%), and Type 5 (6.0%) which is of less importance. Most Croatian men belong to Type 3 (35.0%) and Type 2 (25.0%). A small number of men belong to Type 4 (15.0%), Type 5 (12.5%) and Type1 (12.5%). CONCLUSION: There was a statistically significant difference between men and women regarding the types of lip grooves.

Dental health in antique population of Vinkovci - Cibalae in Croatia (3rd-5th century).

Roman city Cibalae (Vinkovci) - the birthplace of Roman emperors Valentinian I and Valens was a very well developed urban ares in the late antique what was evidenced by numerous archaeological findings. The aim of this paper is to get insight in dental health of antique population of Cibalae. One hundred individuals with 2041 teeth dated to 3rd - 5th century AD have been analyzed for caries, antemortem tooth loss, periapical diseases and tooth wear. Prevalence of antemortem tooth loss was 4.3% in males, 5.2% in females. Prevalence of caries per tooth was 8.4% in males, 7.0% in females. Compared to other Croatian antique sites, ancient inhabitants of Roman Cibalae had rather good dental health with low caries prevalence and no gender differences. Statistically significant difference was found between males in females in the prevalence of periapical lesions and degree of tooth wear. Periapical lesions were found only in males.

Third molar maturity index (I3M) for assessing age of majority in a black African population in Botswana.

Assessment of legal age, also known as age of majority, is a controversial issue as there are few body biomarkers or evidence during late adolescence differentiating a subject from being a minor or adult. The third molar was recognized as a suitable site for age examination in late adolescence. We analyzed the development of the left mandibular third molar by the third molar maturity index (I3M) and a specific cut-off value of I3M = 0.08, established by Cameriere et al. in 2008 and used it for discriminating between minors and adult black Africans from Gaborone, Botswana. A final sample of panoramic radiographs (OPTs) of 1294 people (582 males and 712 females) aged between 13 and 23 years was evaluated. The real age decreased as I3M gradually increased. There was no statistically significant difference in the third molar development evaluated using I3M between males and females (p > 0.05) across different I3M classes. Results of 2 × 2 contingency tables for different cut-off values indicated that I3M = 0.08 was useful in discriminating between adults and minors. Precisely, for I3M = 0.08, the values of accuracy or overall fraction of correctly classified were 0.91 in males with a 95 % confidence interval (95 % CI) of 0.88 to 0.93 and 0.92 (95 % CI, 0.90 to 0.93) in females. Values of sensitivity of the test or the proportion of participants being 18 years and older were 0.88 (95 % CI, 0.87 to 0.90) in males and 0.88 (95 % CI, 0.90 to 0.93) in females, while values of specificity or proportion of individuals younger than 18 who have I3M <0.08 were 0.94 (95 % CI, 0.91 to 0.96) in males and 0.96 (95 % CI, 0.94 to 0.98) in females. Positive predictive values of the test, where the participants whose I3M <0.08 were adults, were 0.94 (95 % CI 0.91 to 0.96) in males and 0.97 (95 % CI, 0.94 to 0.98) in females, while negative predictive values of the test, where the participants whose I3M was ≥0.08 were minors, were 0.88 (95 % CI 0.85 to 0.90) in males and 0.97 (95 % CI, 0.94 to 0.98) in females. The likelihood ratios of the positive test (LR+) were 13.67 (95 % CI, 9.21 to 21.02) in males and 23.73 (95 % CI, 14.20 to 42.28) in females, while likelihood ratios of the negative test (LR-) were 0.12 (95 % CI 0.10 to 0.16) in males and 0.12 (95 % CI, 0.11 to 0.15) in females. Bayes post-test probabilities, p, were 0.94 (95 % CI 0.90 to 0.98) in males and 0.97 (95 %CI, 0.93 to 1.00) in females. These results indicate with high accuracy that I3M may be a useful alternative method in legal and forensic practice to discriminate individuals of black African origin who are around the legal adult age of 18 years in Botswana. Further studies should address the usefulness of this method and specific cut-off for different adolescent populations.