Regeneration of Horizontal Bone Defect in Edentulous Maxilla Using the Allogenic Bone-Plate Shell Technique and a Composite Bone Graft-A Case Report.

An insufficient volume of the alveolar bone may prevent implants from being placed in the prosthetically optimal position. Complex restoration of bony structures is required to achieve long-term peri-implant bone stability and represents an adequate prosthetic solution. Background and Objectives: The shell technique has become a widespread and important method for guided bone regeneration in dentistry. Allogeneic bone materials appear to be the most similar substitution for autogenous bone transplants. However, there are few studies using cortical bone allografts in combination with a mix of autogenous and xenograft materials for the augmentation of horizontal ridge defects. This combination offers the advantage of reduced patient morbidity while adding adequate volume and contour to the alveolar ridge. Case report: The present case study aimed to clinically and radiographically evaluate the efficacy of allogenic cortical bone lamina combined with a composite bone graft in the augmentation of a horizontal bone defect in the edentulous maxilla during a 6-year follow-up period. Three CB CT scans taken before treatment, 6 months after the augmentation period/before implant placement, and after a 6-year follow-up period, were analyzed using stable referent points. After the 6 -year follow-up period, the average resorption rate was 21.65% on the augmented buccal side, with no implant exposure being observed. Conclusions: The bone shell technique used in conjunction with allogenic bone plates combined with autogenous bone, xenografts, and collagen membranes is an effective technique to manage horizontal ridge defects.

Oral Health Knowledge, Attitude, and Behavior of Nursing and Technical Students in Croatia.

OBJECTIVE: The aim of this study was to test knowledge, attitudes, and behavior of the students from the Bjelovar University of Applied Sciences in relation to oral health, and to determine the respectable differences between students of nursing and technical study programs. MATERIALS AND METHODS: Students were randomly selected to represent a convenient sample. A total of 140 students from nursing and technical studies were interviewed by using the World health organization Oral Health Questionnaire, adapted to fit the study purposes. STATISTICAL ANALYSIS: Descriptive statistics were used to determine frequency distribution and percentages for all variables. Pearson's Chi-square test was used to compare the proportions. A p-value less than 0.05 was considered to be statistically significant. RESULTS: The distribution of participants regarding gender was significantly different between the study programs (p = 0.000). Significant difference was also observed in their perceived socioeconomic status (p = 0.001). A significant difference was found between the study programs regarding the knowledge whether bad teeth could impair general health (p = 0.001), could tooth decay and periodontal disease may be prevented (p = 0.002), as well as the importance of regular dental check-ups for prevention of tooth decay (p = 0.028). There were significant differences regarding dietary habits and alcohol consumption in the past 30 days between the observed study programs (p = 0.000) while no significant differences were found regarding tobacco and tobacco product use (p = 0.170). CONCLUSION: Results obtained and presented in this paper show better knowledge and more favorable habits and behaviors among the students from nursing study program compared with the technical ones. Still all students' habits should be changed to improve oral health. To change attitudes and influence habits, effective oral health promotion programs are needed; not only in colleges, but also in primary and secondary schools.

ODONTOMAS: PEDIATRIC CASE REPORT AND REVIEW OF THE LITERATURE.

Odontomas are benign odontogenic tumors formed from epithelial and mesenchymal cells. They are mostly associated with disorders of tooth eruption, causing impaction and/or delayed tooth eruption, and are an accidental finding on routine radiological examination. The aim of this paper is to present current findings in the etiology and treatment of odontomas, as well as the clinical and radiographic features, describing a case that is rarely found in the literature. A case of multiple complex odontoma in the mandible of an 11-year-old boy is presented, causing impaction of the first permanent right molar, 46. The treatment consisted of surgical enucleation of the multiple complex odontoma with preservation of the impacted tooth, monitoring clinically and radiologically its spontaneous eruption followed by final orthodontic alignment. Odontomas are not an everyday part of clinical practice and given that they are most commonly associated with permanent tooth impaction, it is extremely important to have knowledge of their clinical and radiological features. Early diagnostics and appropriate treatment result in better diagnosis, thus increasing the possibility of preserving the impacted teeth.

Metallothioneins and Megalin Expression Profiling in Premalignant and Malignant Oral Squamous Epithelial Lesions.

This study aimed to assess the relationship and possible interactions between metallothioneins (MTs) and megalin (LRP-2) in different grades of oral squamous cell carcinoma (OSCC) and premalignant lesions of the oral mucosa (oral leukoplakia and oral lichen planus). The study included archived samples of 114 patients and control subjects. Protein expression was examined by immunohistochemistry and immunofluorescence, and staining quantification was performed by ImageJ software. Protein interaction in cancer tissue was tested and visualized by proximity ligation assay. Mann-Whitney and Kruskal-Wallis tests were used to determine the significance of differences between each group, whereas Pearson correlation coefficient was performed to test correlation. Expression of both proteins differed significantly between each group showing the same pattern of gradual increasing from oral lichen planus to poorly differentiated OSCC. Moreover, MTs and megalin were found to co-express and interact in cancer tissue, and their expression positively correlated within the overall study group. Findings of prominent nuclear and chromosomal megalin expression suggest that it undergoes regulated intramembrane proteolysis upon MTs binding, indicating its ability to directly affect gene expression and cellular division in cancer tissue. The data obtained point to the onco-driving potential of MTs-megalin interaction.

Oral Candidal Colonization in Patients with Different Prosthetic Appliances.

Oral infections caused by Candida species are becoming more common, which may be related to an increase in the number of immunologically compromised patients as well as favorable conditions in the oral cavity that often include removable prosthetic appliances. The purpose of this study was to determine the presence of a particular Candida species in patients with PMMA and Cr-Co prosthetic appliances, as well as the salivary flow rate, and oral signs and symptoms. This investigation included a total of 120 subjects with different kinds of removable dentures. A sample of concentrated oral rinse was collected from all subjects in order to detect Candida colonization and identify the Candida species, a quantum of salivation was measured, and subjects were examined clinically. Candida spp. was predominant among the subjects who were denture wearers (p < 0.0001). In all subjects, the most frequently detected species was C.albicans. A statistically significant difference was found between the prevalence of C.albicans (p < 0.001) and C.krusei (p < 0.001) in denture wearers. Subjects with PMMA-based removable prosthetic appliances mostly demonstrated a significant decrease in salivation (p < 0.001), an increase in burning sensations (p < 0.001), and dry mouth (p < 0.001) compared to the subjects who wore partial dentures with Co-Cr metallic frameworks. Red oral lesions were more frequently found among the subjects with partial dentures with Co-Cr metallic frameworks (p < 0.001). Regardless of the material used for the denture, patients must be regularly checked by their dentists in order to prevent the development of oral lesions.

An Enhanced Histopathology Analysis: An AI-Based System for Multiclass Grading of Oral Squamous Cell Carcinoma and Segmenting of Epithelial and Stromal Tissue.

Oral squamous cell carcinoma is most frequent histological neoplasm of head and neck cancers, and although it is localized in a region that is accessible to see and can be detected very early, this usually does not occur. The standard procedure for the diagnosis of oral cancer is based on histopathological examination, however, the main problem in this kind of procedure is tumor heterogeneity where a subjective component of the examination could directly impact patient-specific treatment intervention. For this reason, artificial intelligence (AI) algorithms are widely used as computational aid in the diagnosis for classification and segmentation of tumors, in order to reduce inter- and intra-observer variability. In this research, a two-stage AI-based system for automatic multiclass grading (the first stage) and segmentation of the epithelial and stromal tissue (the second stage) from oral histopathological images is proposed in order to assist the clinician in oral squamous cell carcinoma diagnosis. The integration of Xception and SWT resulted in the highest classification value of 0.963 (σ = 0.042) AUCmacro and 0.966 (σ = 0.027) AUCmicro while using DeepLabv3+ along with Xception_65 as backbone and data preprocessing, semantic segmentation prediction resulted in 0.878 (σ = 0.027) mIOU and 0.955 (σ = 0.014) F1 score. Obtained results reveal that the proposed AI-based system has great potential in the diagnosis of OSCC.

Application of Artificial Intelligence-Based Regression Methods in the Problem of COVID-19 Spread Prediction: A Systematic Review.

COVID-19 is one of the greatest challenges humanity has faced recently, forcing a change in the daily lives of billions of people worldwide. Therefore, many efforts have been made by researchers across the globe in the attempt of determining the models of COVID-19 spread. The objectives of this review are to analyze some of the open-access datasets mostly used in research in the field of COVID-19 regression modeling as well as present current literature based on Artificial Intelligence (AI) methods for regression tasks, like disease spread. Moreover, we discuss the applicability of Machine Learning (ML) and Evolutionary Computing (EC) methods that have focused on regressing epidemiology curves of COVID-19, and provide an overview of the usefulness of existing models in specific areas. An electronic literature search of the various databases was conducted to develop a comprehensive review of the latest AI-based approaches for modeling the spread of COVID-19. Finally, a conclusion is drawn from the observation of reviewed papers that AI-based algorithms have a clear application in COVID-19 epidemiological spread modeling and may be a crucial tool in the combat against coming pandemics.

On Urinary Bladder Cancer Diagnosis: Utilization of Deep Convolutional Generative Adversarial Networks for Data Augmentation.

Urinary bladder cancer is one of the most common urinary tract cancers. Standard diagnosis procedure can be invasive and time-consuming. For these reasons, procedure called optical biopsy is introduced. This procedure allows in-vivo evaluation of bladder mucosa without the need for biopsy. Although less invasive and faster, accuracy is often lower. For this reason, machine learning (ML) algorithms are used to increase its accuracy. The issue with ML algorithms is their sensitivity to the amount of input data. In medicine, collection can be time-consuming due to a potentially low number of patients. For these reasons, data augmentation is performed, usually through a series of geometric variations of original images. While such images improve classification performance, the number of new data points and the insight they provide is limited. These issues are a motivation for the application of novel augmentation methods. Authors demonstrate the use of Deep Convolutional Generative Adversarial Networks (DCGAN) for the generation of images. Augmented datasets used for training of commonly used Convolutional Neural Network-based (CNN) architectures (AlexNet and VGG-16) show a significcan performance increase for AlexNet, where AUCmicro reaches values up to 0.99. Average and median results of networks used in grid-search increases. These results point towards the conclusion that GAN-based augmentation has decreased the networks sensitivity to hyperparemeter change.

Estimation of COVID-19 Epidemiology Curve of the United States Using Genetic Programming Algorithm.

Estimation of the epidemiology curve for the COVID-19 pandemic can be a very computationally challenging task. Thus far, there have been some implementations of artificial intelligence (AI) methods applied to develop epidemiology curve for a specific country. However, most applied AI methods generated models that are almost impossible to translate into a mathematical equation. In this paper, the AI method called genetic programming (GP) algorithm is utilized to develop a symbolic expression (mathematical equation) which can be used for the estimation of the epidemiology curve for the entire U.S. with high accuracy. The GP algorithm is utilized on the publicly available dataset that contains the number of confirmed, deceased and recovered patients for each U.S. state to obtain the symbolic expression for the estimation of the number of the aforementioned patient groups. The dataset consists of the latitude and longitude of the central location for each state and the number of patients in each of the goal groups for each day in the period of 22nd January 2020-3rd December 2020. The obtained symbolic expressions for each state are summed up to obtain symbolic expressions for estimation of each of the patient groups (confirmed, deceased and recovered). These symbolic expressions are combined to obtain the symbolic expression for the estimation of the epidemiology curve for the entire U.S. The obtained symbolic expressions for the estimation of the number of confirmed, deceased and recovered patients for each state achieved R2 score in the ranges 0.9406-0.9992, 0.9404-0.9998 and 0.9797-0.99955, respectively. These equations are summed up to formulate symbolic expressions for the estimation of the number of confirmed, deceased and recovered patients for the entire U.S. with achieved R2 score of 0.9992, 0.9997 and 0.9996, respectively. Using these symbolic expressions, the equation for the estimation of the epidemiology curve for the entire U.S. is formulated which achieved R2 score of 0.9933. Investigation showed that GP algorithm can produce symbolic expressions for the estimation of the number of confirmed, recovered and deceased patients as well as the epidemiology curve not only for the states but for the entire U.S. with very high accuracy.

Automatic Evaluation of the Lung Condition of COVID-19 Patients Using X-ray Images and Convolutional Neural Networks.

COVID-19 represents one of the greatest challenges in modern history. Its impact is most noticeable in the health care system, mostly due to the accelerated and increased influx of patients with a more severe clinical picture. These facts are increasing the pressure on health systems. For this reason, the aim is to automate the process of diagnosis and treatment. The research presented in this article conducted an examination of the possibility of classifying the clinical picture of a patient using X-ray images and convolutional neural networks. The research was conducted on the dataset of 185 images that consists of four classes. Due to a lower amount of images, a data augmentation procedure was performed. In order to define the CNN architecture with highest classification performances, multiple CNNs were designed. Results show that the best classification performances can be achieved if ResNet152 is used. This CNN has achieved AUCmacro¯ and AUCmicro¯ up to 0.94, suggesting the possibility of applying CNN to the classification of the clinical picture of COVID-19 patients using an X-ray image of the lungs. When higher layers are frozen during the training procedure, higher AUCmacro¯ and AUCmicro¯ values are achieved. If ResNet152 is utilized, AUCmacro¯ and AUCmicro¯ values up to 0.96 are achieved if all layers except the last 12 are frozen during the training procedure.

Comparison of different surgical procedures on the stability of dental implants in posterior maxilla: A randomized clinical study.

BACKGROUND: Stability of a dental implant is very important when planning immediate loading and design of a final restoration. The aim of this study was to compare the primary and the secondary stability of dental implants inserted by three different surgical techniques: conventional (standard) technique using a sequence of drills for implant bed preparation, osteotome technique using tapered hand instruments for creating implant sites by condensing the bone and guided flapless implant surgery with surgical templates. MATERIAL AND METHODS: The study included 150 patients (80 males and 70 females), 46-71 years old, who required implant supported fixed partial dentures in the posterior maxilla of D3 or D4 bone density. Patients were randomly assigned into one of the three surgical insertion technique groups. All patients received tapered implants of the same manufacturer of the same length and two different widths (3.3 × 11.5 mm or 4.2 × 11.5 mm). Primary and secondary implant stability were measured by means of resonance frequency analysis (RFA) at the time of implant placement and 5 months after surgery using the Ostell ISQ device (Osstell AB, Sampgatan, Goteborg, Sweden). Statistical analysis included one-sample Kolmogorov Smirnov test, descriptive statistics, multivariate analysis (Bonferoni post-hoc tests) and paired t-tests. RESULTS: Patients in the osteotome group exhibited higher primary stability (P < 0.01) than in the conventional and surgically guided flapless groups. There were no significant differences in the secondary stability (p > 0.05). Wider implants presented higher ISQ values (P<0.01). CONCLUSION: The osteotome technique led to the highest implant primary stability, therefore it can be recommended when immediate loading is planned or for one-piece implant insertion.

Trigeminal neuralgia--case and treatment analysis at the Department of Oral Surgery of the University Hospital Dubrava.

The aim of the study was to explore certain risk factors for trigeminal neuralgia (TN), assess the prevalence of misdiagnoses of TN made by primary care dentists, compare the treatment practice for TN at the Department of Oral Surgery with the guidelines, and the importance of interdisciplinary approach in TN treatment. The study included 237 patient records (70 men and 167 women, aged 5-91 years) referred to the Department under the diagnosis of TN. From their medical records, demographic data, referral diagnose, clinical diagnose, additional diagnostic procedures and treatment were analysed. Neuralgia of the trigeminal nerve affects predominantly elderly female population, while the impact of the season on the incidence of the disease has not been determined. The most common therapy used at the Department were blockades, carbamazepine or their combination. 63.3% patients were referred for further diagnostic tests following the first examination. The number of misdiagnosed cases referred by primary care dentists (33.6%) points that better training in diagnosing TN is needed for the dental practitioners. The treatment methods at the Department need to be harmonized with the latest guidelines on neuralgia treatment. Due to the complexity of etiological factors, an interdisciplinary approach is necessary.

Secular trend in the development of permanent teeth in a population of Istria and the littoral region of Croatia.

The study evaluated secular trends in dental development during a period of 30 years, correlation between dental and chronological age in Istria and the littoral region of Croatia. The sample consisted of 1000 panoramic radiographs of children, aged 6-16 years (mean 10.0±1.8), taken in the period 1977-1979 (N=500; 243 females) and 2007-2009 (N=500; 299 females). Dental age was assessed according to Demirjian's method. Correlation between chronological and dental age was linear, positive, high, and statistically significant in both periods and genders, ranging from 0.73 to 0.86. Dental age was underestimated when compared to chronological age by 1 year on average, more 30 years ago (-1.35±1.17) than today (-0.63±1.09), less for girls (-0.80±1.22) than boys (-1.21±1.10). A statistically significant positive secular trend in acceleration of dental development was present of 0.72 years during the 30-year period and was more significant in girls than boys (0.83- and 0.51-year acceleration).

Multivariate analysis of different factors affecting the patient general satisfaction with complete dentures.

The aim of the study was to investigate different factors that affect the level of patient's general satisfaction with maxillary and mandibular complete dentures (CDs) using a multivariate analysis. A total of 100 CD wearers participated in this study. There were 46 men (37-77 years old; mean age 62.6 +/- 9.2) and 54 women (34-77 years old; mean age 60.9 +/- 9.3). In the questionnaire the patients answered the questions regarding gender, age, number of previous CDs worn, the present dentures' age and denture-wearing habits. Participants rated the level of their satisfaction with the esthetics, retention, speech, mastication, sense of taste, comfort and general satisfaction with their CDs. More than 70% of the examined patients claimed all the examined variables to be the best-score category. Of the 9 factors examined, satisfaction with the mastication and esthetics, denture-wearing habits and satisfaction with retention in the maxilla explained the variability of the patients's general satisfaction with their CDs by 72%. Satisfaction with the mastication, denture-wearing habits and satisfaction with speech and comfort in mandible explained the variability of the patients's general satisfaction with their CDs by 79%. These findings suggest that the general patient satisfaction with maxillary CDs is related more to the mastication and retention abilities, as well as with esthetics and denture-wearing habits, while in the mandible CDs is related to mastication and speaking abilities, denture-wearing habits and comfort of wearing.

Displacement of a mandibular incisor--an infrequent complication of mandibular fracture.

A case of a mandibular fracture with an unusual complication is reported. A 13-year-old boy was admitted four years after conservative treatment of a symphyseal fracture. He complained of recurrent swelling. A radiographic evaluation showed a horizontally laid permanent mandibular left lateral incisor (PMLLI) that had probably slid into the fracture line and provoked repetitive infection episodes. After a surgery, a clinical and radiological analysis showed satisfactory healing.

Health condition of first permanent molars in year 1977 and 2007 in children in Istria (Croatia).

The aim of this study was to examine differences between health condition of the first permanent molar (M1) in children in 1977 and 2007. The materials for the study consisted of data on the health condition of M1 determined in a study in 1977 (Group I) for children from the district of Buje in Istria. The health condition of M1 was examined again in the same area in 2007 (Group II). The first permanent molar is most frequently affected by caries and represent a good indicator for general caries incidence of children. Study included 709 subjects in Group I (363 boys, 346 girls) and 460 subjects in Group II (242 boys, 218 girls), aged from 6 years and 0 months to 12 years and 5 months. The difference in the frequency of intact, decayed, filled and missingd M1 was examined in both groups. Chi2 test was used to determine the differences between the number of I (intact), D (decayed), F (filled) and M (missing) teeth for each age group in Group I and Group II. In Group I there were 29.3% intact, 48.9% decayed, 17.4% filled and 4.3% missing M1, and in Group II there were 53.0% intact, 22.6% decayed, 22.1% filled and 2.1% missing M1. During the period of 30 years, a significant increase of number of dental surgeries, and thus better preventive and health education, resulted in the significant increase in the number of intact (24.0%) and filled (4.7%) M1, and decrease in the number of decayed (26.3%) and missing (2.2%) M1. From 1977 to 2007, the number of intact M1 in group II increased considerably according to group I, while the number of decayed M1 in group II significant decreased according to group I. These changes were the result of a considerably increased number of dental surgeries.

The impact of oral health and 0.2% chlorhexidine oral gel on the prevalence of nosocomial infections in surgical intensive-care patients: a randomized placebo-controlled study.

OBJECTIVES: To evaluate the impact of oral health on the evolution of nosocomial infections and to document the effects of oral antiseptic decontamination on oral health and on the rate of nosocomial infections in patients in a surgical intensive-care unit (ICU). DESIGN: A prospective, randomized, double-blind, placebo-controlled clinical trial. SETTING: Surgical ICU in University Hospital Dubrava. PATIENTS: The study included 60 nonedentulous patients consecutively admitted to the surgical ICU and requiring a minimum stay of three days. MAIN OUTCOME MEASURES: After randomization, the treatment group underwent antiseptic decontamination of dental plaque and the oral mucosa with chlorhexidine gel. The control group was treated with placebo gel. Dental status was assessed using a caries-absent-occluded (CAO) score, and the amount of plaque was assessed using a semi-quantitative score. Samples of dental plaque, oral mucosa and nasal and tracheal aspirates were collected for bacterial culture, and nosocomial infections were assessed. RESULTS: The plaque score significantly increased in the control group and decreased in the treated patients. Patients who developed a nosocomial infection had higher plaque scores on admission and during their ICU stay. The control group showed increased colonization by aerobic pathogens throughout their ICU stay and developed nosocomial infections (26.7%) significantly more often than the treated patients (6.7%); the control group also stayed longer in the ICU (5.1 +/- 1.6 vs. 6.8 +/- 3.5 days, P = 0.019). Furthermore, a trend in reduction of mortality was noted in the treated group (3.3% vs. 10%). CONCLUSIONS: Among surgical ICU patients, poor oral health had a significant positive correlation with bacterial colonization and the evolution of nosocomial infections. Oral decontamination with chlorhexidine significantly decreased oropharyngeal colonization, the incidence of nosocomial infections, length of ICU stay, and mortality in these patients.

Follicular jaw cysts.

The aim of this study was to examine the occurrence, localization, size, ways of diagnosing and treatment of a foIlicular jaw cyst. Assessment of the patients' motives and their earlier health status was recorded, as well as their postoperative clinical course. Most of the patients were admitted because of pain, swelling, trismus, or other difficulties associated with cyst formation. Follicular cysts with persisting primary predecessor had an asymptomatic development, and were discovered after orthodontic examination or by chance. In most cases pathohistological finding and description of the formation have coincided with each other (p < 0.05). Cysts of different sizes were treated by different surgical approaches, most commonly alveolotomy and cystectomy in small cysts, while alveolotomy and cystectomy with suction or iodine tampon in large cysts. Cooperation of a dentist, an oral surgeon, a pathologist, and other specialists can lead to early diagnose and prevention of further growth of a follicular jaw cyst, thus preventing substantial bone damage.

The reliability of chronological age determination by means of mandibular third molar development in subjects in Croatia.

The aim of this study was to determine the development of the mandibular third molar and its relation to chronological age. The evaluated material consisted of 979 orthopantomograms of patients of Croatian Caucasian origin aged between 5.7 and 14.6 years. Third molar developmental stages were evaluated according to the stages proposed by Nolla. The frequencies of different stages of mineralization and the mean value of the mineralization of the mandibular third molars with regard to age, gender, and size of the mandible were determined and the coefficient of correlation determined between the age of the subject and the stage of development of the mandibular molars. Statistically significant correlation was determined between mineralization of the mandibular third molar and chronological age of the subjects (boys, mandibular left third molar r = 0.779, right third molar r = 0.793; girls, mandibular left third molar r = 0.746, right third molar r = 0.725). It can be concluded that the accuracy of age estimation based on Nolla's method is applicable for Croatian children.

Correlation between the pattern of facial growth and the position of the mandibular third molar.

PURPOSE: The purpose of this study was to examine the correlation between variables that determine the position of the third molar (M3) and correlation between the pattern of facial growth and examined variables. MATERIALS AND METHODS: Material for the study consisted of 130 panoramic radiographs and lateral radiographs of subjects' heads in whom orthodontic therapy had been started. Analysis of the position of the mandibular M3 and its relation to the bone and other teeth were determined by 4 variables: evaluation of the space for both M3, spatial relation between the second molar and M3, vertical position of the M3 in relation to the alveolar ridge, and inclination of the germ of the M3. RESULTS: In boys, significant correlation was determined on the right side of the jaw, between the retromolar area and the vertical position of M3. Significant correlation was determined in girls, between the retromolar area and the vertical position of M3 on both sides, retromolar area and M3 inclination on the left side, and retromolar area and spatial relation of M3 on the right side. Analysis of correlation between facial growth pattern and 4 variables that determinate the position of M3 showed positive correlation only for the lower right M3 inclination in subjects with anterior facial rotation. CONCLUSION: The present study showed that the amount of retromolar space for the position of the M3 is not a sign of its normal development. No significant differences were determined between the position of M3 and type of facial growth.