Computed tomography assessment of hypodontia and crown size in hemifacial microsomia.

OBJECTIVE: Our aims were to assess the prevalence of hypodontia in unilateral hemifacial microsomia (HFM), and to compare tooth (crown) size between affected and unaffected sides. DESIGN: In a retrospective cross-sectional study of South Australians, computed tomography (CT) scans were used to assess hypodontia and crown size (mesiodistal length, buccolingual width and crown height). The inclusion criteria were the absence of other congenital anomalies and the availability of CT scans. The exclusion criteria were the lack of extraction history or reproducible landmarks for morphometric assessment. The final sample comprised 41 participants in both dentitions, including 32 children and 9 adults (median age 13.9 years, range 0.4 - 47.6 years; 19 males and 22 females). Hypodontia was assessed in all participants, and the permanent crown size in 30 (73.2%) participants. Linear mixed-effects models were performed to determine if crown size was significantly different between the two sides, controlling for sex, HFM severity, and tooth and jaw type. RESULTS: Hypodontia occurred in none of the participants in the primary dentition, but in 6/30 (20%) participants in the permanent dentition (3/30 each on the affected and unaffected sides). There was no significant difference in the mean crown dimensions between the two sides, but the crown size was larger in males (p < 0.05), except for mesiodistal length, and became progressively smaller with increased HFM severity (p < 0.05). CONCLUSIONS: Hypodontia spared the primary dentition but featured prominently in the permanent dentition. The permanent crown dimensions were unaltered between the two sides.

Craniofacial Phenomics: Three-Dimensional Assessment of the Size and Shape of Cranial and Dentofacial Structures.

Craniofacial phenomics has opened up numerous opportunities to correlate genetic and epigenetic factors to craniofacial phenotypes in order to improve our understanding of growth and development in health and disease. Three-dimensional (3D) imaging has played a key role in advancing craniofacial phenomics by facilitating highly sensitive and specific characterizations of craniofacial and dental morphology. Here we describe the use of micro-computed tomography (micro-CT) to image the murine craniofacial complex, followed by surface reconstruction for traditional morphometric analyses. We also describe the application of geometric morphometrics, based on Generalized Procrustes Analysis, for use in human premolars. These principles are interchangeable between various vertebrate species, and between various surface imaging techniques (including micro-CT and 3D surface scanners), offering a high level of versatility and precision for extensive phenotyping of the entire craniofacial complex.

Three-dimensional profilometric assessment of early enamel erosion simulating gastric regurgitation.

OBJECTIVES: A priority research area in minimal intervention dentistry is the characterization of the early stages of dental erosion. The aim of this in vitro study was to assess the effect of short, repetitive erosive challenges to human enamel over 2 min at pH 1.5 and 3.0 under conditions simulating gastric regurgitation. METHODS: Enamel surfaces were subjected to erosive challenges at pH 1.5 (Group 1, n=10) and pH 3.0 (Group 2, n=9) for periods of 30s (stage 1), 60s (stage 2) and 120 s (stage 3). Quantitative changes were assessed longitudinally by measuring the 3D average surface roughness (Sa) values using 3D confocal microscopy. Qualitative micrographic assessment of surface changes was also conducted by using environmental scanning electron microscopy. RESULTS: Linear mixed model analysis showed significant effects of the pH values (p<0.001) and the stages (p<0.001) on the observed Sa values. Post hoc tests showed significant increases in the Sa values between baseline and other stages in both groups (p<0.01). The mean Sa values also increased significantly from stage 1 to stage 2 in Group 1 (p<0.05). Micrographic analysis displayed severely etched enamel rods in Group 1, but only subtle changes in Group 2. CONCLUSIONS: The complexity of the enamel surface is influenced by both acid concentration (pH value) and duration of acid exposure during early stages of erosion. Erosion occurring under conditions simulating GORD can be detected in its initial stages, opening up the possibilities of early diagnosis and management of this condition. CLINICAL SIGNIFICANCE: Erosive tooth wear occurs progressively and insidiously, often creating complex treatment challenges. This emphasizes the need for early diagnosis and management in accordance with minimal intervention philosophy. Our findings provide a foundation for further research that could lead to the development of highly-sensitive clinical diagnostic tools and preventive strategies.

An in vitro assessment of the effect of load and pH on wear between opposing enamel and dentine surfaces.

OBJECTIVE: Previous in vitro studies have described the wear characteristics of specimens in which enamel has been opposed to enamel and dentine opposed to dentine. The aim of this study was to assess the characteristics of wear between specimens in which enamel was opposed to dentine at loads simulating attrition and at pH values simulating different erosive environments. It was hypothesized that enamel would wear more slowly than dentine under all conditions. DESIGN: Opposing enamel and dentine specimens from 57 human third molar teeth were worn in electromechanical machines with various loads (32, 62 and 100 N) and lubricants (pH 1.2, 3.0 and 6.1). Tooth wear was quantified by measuring reduction in dentine volume over time using a 3D profilometer. Qualitative assessment was also carried out using scanning electron microscopy. RESULTS: Dentine wear increased with increasing load, and dentine wear was faster at pH 1.2 than at pH 3.0 or 6.1 for all loads tested. Interestingly, enamel wore more rapidly than dentine at pH 1.2 under all loads. At pH values of 3.0 and 6.1, enamel wear rates were not measurably different from zero and they were less than wear rates for opposing dentine specimens at all loads. Micrographic assessment showed extensive surface destruction of dentine wear facets due to erosion at pH 1.2. Dentine wear facets were smoother at pH 3.0 that at pH 6.1. CONCLUSIONS: When enamel wears against dentine in an acidic environment enamel will wear more rapidly at very low pH, while under less acid conditions dentine will wear faster than enamel.

New growth references for assessment of stature and skeletal maturation in Australians.

BACKGROUND: We have provided evidence of secular increases in stature and acceleration of skeletal maturation in Australian male children and young adults in recent decades, and relatively less prominent secular increases in stature in females. AIMS: Our aims were to construct new references for stature and skeletal age in Australians. METHODS: We conducted a cross-sectional study of 2,497 South Australians, comprising 1,255 males and 1,242 females aged between 9 and 18 years. Clinical records obtained from 1995 to 2005 comprised stature, chronological and skeletal ages of these individuals. Means and standard deviations for stature and skeletal age were visually smoothed for each sex to construct growth charts depicting the 97th, 90th, 75th, 50th, 25th, 10th and 3rd centiles. RESULTS: Comparisons of the new stature references with the NHMRC (1975) charts indicated an upward shift of stature centiles across all age groups in both sexes by around 4-5 cm. Generally, skeletally advanced individuals tended to be taller, and skeletally delayed individuals tended to be shorter compared with the total sample in younger age groups, but this was less apparent in older age groups. Males aged 9 years in our study were skeletally advanced, on average, by 0.4 years, whereas males aged 17 years were skeletally delayed, on average, by 0.3 years compared with the Greulich and Pyle (1959) standards. In contrast, skeletal and chronological ages were concordant in females. CONCLUSION: Our new references for stature and skeletal age provide up-to-date information for orthodontists, paedodontists and paediatricians requiring growth data for young Australians.