Comparison of statural height growth velocity at different cervical vertebral maturation stages.

INTRODUCTION: Knowledge of a patient's stage of growth and development plays a vital role in diagnosis, treatment planning, results, and stability of the outcome. Cervical vertebral maturation (CVM) predicts the stage of growth and development, but its validity has only been investigated restrospectively, using historic samples. Our objective was to assess prospectively whether a correlation exists between CVM stage and statural height growth velocity. METHODS: Participants were aged between 8 and 18 years and of both sexes. Standing height was measured every 6 weeks with participants barefoot and in natural head position. CVM stage was assessed from lateral cephalograms taken at the start of treatment. Intraobserver and interobserver reliability of CVM staging and statural height measurements were assessed using the Cohen weighted kappa, percentage of agreement, intraclass correlation coefficient, and Bland-Altman plots, respectively. Analysis of variance was used to test for statistically significant differences between growth velocities at the CVM stages. RESULTS: We analyzed 108 participants. The peak in statural height growth velocity occurred at CVM stage 3 (P = 0.001). There was a statistically significant difference in the mean annualized growth velocity between all CVM stages except stages 2 and 4. Girls had their peak pubertal growth spurt an average of 1.2 years earlier than did boys. CONCLUSIONS: This study suggests that there is a significant relationship between CVM stage and statural height velocity.

Evidence of secular trend in mandibular pubertal growth.

BACKGROUND: During puberty, mandibular growth follows a growth curve comparable to somatic growth. This study aimed to review the relationship between mandibular pubertal peak height velocity (PHV) and skeletal age, and to investigate the possibility of a secular trend. METHODS: Retrospective analysis was performed of two historical craniofacial growth studies (Denver Growth Study; observational time: 1943-1965, and Zurich Growth Study; observational time: 1982-1984) of healthy untreated subjects. Two mandibular growth measures (Articulare-Pogonion [Ar-Pg], Condylion-Pogonion [Co-Pg]) were retrieved from cephalograms (n: 990) and corresponding skeletal age based on hand-wrist radiographs. Mandibular growth velocity was related to skeletal age, PHV was established by use of cubic smoothing splines and variability was calculated by bootstrap resampling for every growth study and gender separately. RESULTS: Sexual dimorphism in mandibular growth was apparent in both cohorts. In subjects of the Denver Growth Study, mandibular PHV occurred at a more advanced skeletal age than in subjects of the Zurich Growth Study. This trend was more pronounced in males, for whom PHV of Co-Pg shifted from 14.4 to 13.8 years and of Ar-Pg from 14.6 to 13.7 years. This tendency was more subtle in females: PHV of Co-Pg shifted from 12.7 to 12.4 years and of Ar-Pg from 12.6 to 11.8 years. CONCLUSIONS: Mandibular growth appears to be subject to a secular trend. When related to skeletal age, this secular trend seems to be more accentuated than the established secular trend for somatic pubertal growth.

New perspectives on the relationship between mandibular and statural growth.

BACKGROUND: Condylar and somatic growth have similar growth curves. The aim of this study was to compare both growth curves in untreated subjects at different ages and investigate if a correlation factor (CF) could be established. MATERIAL AND METHODS: Semi-longitudinal records (cephalograms and body height) of 418 untreated, healthy children (193 girls and 225 boys) from a craniofacial growth study were analyzed. Incremental changes of three mandibular measurements from articulare and three from condylion were compared to statural growth changes separately. Based on the assumption that mandibular and somatic growth both follow a parallel line, a CF was postulated and checked for validity and reliability. RESULTS: Mandibular growth spurt could be observed in all six different mandibular measurements, but distances from condylion were more informative. Gonial measurements were not as indicative as symphyseal distances. Mandibular growth did not coincide with somatic growth precisely, and condylar peak velocity preceded statural peak velocity in boys and was slightly delayed in girls. CF was close to the value of 0.4, and its validity could be ascertained when using the condylion-gnathion distance for all ages in girls and up to the age of 12 in boys. Reliability, however, proved to be poor owing to heterogeneity of the sample. CONCLUSIONS: Although the relationship between mandibular and statural growth increments can be expressed as a CF with some degree of adequacy, the variance rendered CF unreliable. When evaluating growth-related changes, condylion should be preferred as condylar reference, and symphyseal landmarks should be favoured over gonion.

The use of non-adult vertebral dimensions as indicators of growth disruption and non-specific health stress in skeletal populations.

OBJECTIVE: Traditional methods of detecting growth disruption have focused on deficiencies in the diaphyseal length of the long bones. This study proposes the implementation of vertebral measurements (body height and transverse diameter of the neural canal) from non-adults (0-17 years) as a new methodology for the identification of growth disruption. METHODS: Measurements of vertebral body height and transverse diameter were taken from 96 non-adult skeletons and 40 adult skeletons from two post-medieval sites in England (Bow Baptist, London and Coronation Street, South Shields). Non-adult measurements were plotted against dental age to construct vertebral growth profiles through which inter-population comparisons could be made. RESULTS: Results demonstrated that both sites experienced some growth retardation in infancy, evident as deficiencies in transverse diameter. However, analysis of vertebral body height revealed different chronologies of growth disruption between the sites, with a later age of attainment of skeletal maturity recorded in the Bow Baptist sample. DISCUSSION: These vertebral dimensions undergo cessation of growth at different ages, with transverse diameter being "locked-in" by ∼1-2 years of age, while vertebral body height may continue to grow into early adulthood. These measurements can therefore provide complementary information regarding the timing of growth disruption within archaeological populations. Non-adult vertebral measurements can increase our osteobiographical understanding of the timings of episodes of health stress, and allow for the analysis of growth when other skeletal elements are fragmentary.

Weight loss in orthognathic surgery: a clinical study.

OBJECTIVE: To analyse weight change, body composition change and Body Mass Index change in patients undergoing orthognathic surgery. DESIGN: A service evaluation was undertaken in orthognathic patients pre-operatively and at 4 weeks post-surgery. SETTING: Queen Elizabeth Hospital Birmingham outpatient department. SUBJECTS: Thirty-one patients scheduled for single- or two-jaw orthognathic surgery and rigid internal fixation. METHODS: Immediately pre-operatively and at 4 weeks post-surgery the following information was gathered: (1) patient height; (2) patient weight (kg); (3) Patient Body Mass Index; and (4) patient body fat percentage. RESULTS: In the 4-week post-operative period, the average weight loss was -4·96 kg (range: -9·6 to +3·0 kg), with a body fat reduction of -3·07% (range: -5·80% to +2·30%) and an average reduction in Body Mass Index of -1·63 (range: -3·4 to +0·8). There was no statistically significant difference in weight loss (P = 0·1562) or body fat composition change (P = 0·2391) between single- or two-jaw surgery. There was no statistically significant difference in weight loss (P = 0·4858) or body fat composition change (P = 0·5321) between male and female patients. CONCLUSIONS: Weight loss observed was similar to that reported in studies using inter-maxillary fixation. Closer psychological and dietetic support is needed for patients who have a low normal or underweight Body Mass Index. Better and more bespoke tailored Oral Nutritional Supplementation must be provided for all orthognathic surgery patients to potentially reduce this significant weight loss.

Aspects of health in prehistoric mainland Southeast Asia: Indicators of stress in response to the intensification of rice agriculture.

Numerous bioarcheological investigations have suggested that as agriculture intensifies, levels of physiological stress and poor health increase. However, previous research in Southeast Asia suggests that a decline in health was not universal. This study aimed to provide the first investigation of human health during the intensification of rice agriculture in the large skeletal sample from the prehistoric site of Ban Non Wat, Northeast Thailand (1750-420 b.c.). Health was analysed using two indicators of childhood stress, the prevalence of linear enamel hypoplasia (LEH), a measure of early childhood stress, and stature, as a measure of late childhood stress, were collated for 190 adults. Sex-specific diachronic relationships between the prevalence of LEH and stature were explored. For both sexes, initially the prevalence of LEH was found to decrease and then increase over time. Stature remained constant over time for males, although for females stature increased initially, then decreased. Early childhood stress was not significantly correlated with stature in females (P = 0.185), but high levels of LEH were unexpectedly correlated with taller male stature (P = 0.017). Our findings suggest an initial improvement in health during agricultural intensification at this site, likely related to a reduction in physiological perturbations and maintenance of a nutritious diet during this time. The subsequent deterioration in health may reflect geomorphologically and archaeologically indicated variation in environmental conditions and consequential sociocultural changes. We suggest that the sex-differences in the relationship between stature and LEH may relate to the timing of stress and/or catch-up growth.

Interpreting skeletal growth in the past from a functional and physiological perspective.

The study of juvenile skeletal remains can yield important insights into the health, behavior, and biological relationships of past populations. However, most studies of past skeletal growth have been limited to relatively simple metrics. Considering additional skeletal parameters and taking a broader physiological perspective can provide a more complete assessment of growth patterns and environmental and genetic effects on those patterns. We review here some alternative approaches to ontogenetic studies of archaeological and paleontological skeletal material, including analyses of body size (stature and body mass) and cortical bone structure of long bone diaphyses and the mandibular corpus. Together such analyses can shed new light on both systemic and localized influences on bone growth, and the metabolic and mechanical factors underlying variation in growth.

The pattern of facial skeletal growth and its relationship to various common indexes of maturation.

INTRODUCTION: Sequential stages in the development of the hand, wrist, and cervical vertebrae commonly are used to assess maturation and predict the timing of the adolescent growth spurt. This approach is predicated on the idea that forecasts based on skeletal age must, of necessity, be superior to those based on chronologic age. This study was undertaken to test this reasonable, albeit largely unproved, assumption in a large, longitudinal sample. METHODS: Serial records of 100 children (50 girls, 50 boys) were chosen from the files of the Bolton-Brush Growth Study Center in Cleveland, Ohio. The 100 series were 6 to 11 years in length, a span that was designed to encompass the onset and the peak of the adolescent facial growth spurt in each subject. Five linear cephalometric measurements (S-Na, Na-Me, PNS-A, S-Go, Go-Pog) were summed to characterize general facial size; a sixth (Co-Gn) was used to assess mandibular length. In all, 864 cephalograms were traced and analyzed. For most years, chronologic age, height, and hand-wrist films were available, thereby permitting various alternative methods of maturational assessment and prediction to be tested. The hand-wrist and the cervical vertebrae films for each time point were staged. Yearly increments of growth for stature, face, and mandible were calculated and plotted against chronologic age. For each subject, the actual age at onset and peak for stature and facial and mandibular size served as the gold standards against which key ages inferred from other methods could be compared. RESULTS: On average, the onset of the pubertal growth spurts in height, facial size, and mandibular length occurred in girls at 9.3, 9.8, and 9.5 years, respectively. The difference in timing between height and facial size growth spurts was statistically significant. In boys, the onset for height, facial size, and mandibular length occurred more or less simultaneously at 11.9, 12.0, and 11.9 years, respectively. In girls, the peak of the growth spurt in height, facial size, and mandibular length occurred at 10.9, 11.5, and 11.5 years. Height peaked significantly earlier than both facial size and mandibular length. In boys, the peak in height occurred slightly (but statistically significantly) earlier than did the peaks in the face and mandible: 14.0, 14.4, and 14.3 years. Based on rankings, the hand-wrist stages provided the best indication (lowest root mean squared error) that maturation had advanced to the peak velocity stage. Chronologic age, however, was nearly as good, whereas the vertebral stages were consistently the worst. Errors from the use of statural onset to predict the peak of the pubertal growth spurt in height, facial size, and mandibular length were uniformly lower than for predictions based on the cervical vertebrae. Chronologic age, especially in boys, was a close second. CONCLUSIONS: The common assumption that onset and peak occur at ages 12 and 14 years in boys and 10 and 12 years in girls seems correct for boys, but it is 6 months to 1 year late for girls. As an index of maturation, hand-wrist skeletal ages appear to offer the best indication that peak growth velocity has been reached. Of the methods tested here for the prediction of the timing of peak velocity, statural onset had the lowest errors. Although mean chronologic ages were nearly as good, stature can be measured repeatedly and thus might lead to improved prediction of the timing of the adolescent growth spurt.

A comparative clinical evaluation of diet intake and effect of various nutritions on aggressive periodontitis patients.

AIM: The aim of this study is to investigate the effect various dietary nutrients in aggressive periodontitis patients. MATERIALS AND METHODS: A total of 85 patients were selected and divided into two groups, 45 patients are with aggressive periodontitis and 40 patients are healthy. Periodontal parameters such as oral hygiene index, Russels periodontal index and radiograph were taken. The food consumption survey was conducted in all the households of subjects both in control and experimental group. The individual of food intake of the subjects was assessed by the oral questionnaire (24 hours recall) method. The quantity of raw foods used for various preparations and volumes of cooked quantities of such preparations in terms of standardized cups were noted. Body measurements were taken on all the subjects, standing height using a height measuring rod and weight in standard weighing machine. RESULTS: Aggressive periodontitis is seen in young individual and mostly in females; majority of the patients of both groups belongs to low socioeconomic group. Body mass index which is a refection of nutritional status of an individual indicated that chronically energy defcient subjects in experimental group appeared to be higher. The average food and nutrient intake in control group was slightly better than that of experimental group. CONCLUSION: The diet survey indicated marginal and negligible defciencies in aggressive periodontitis patients compared to controls, and this coupled with chronically energy defciency as indicated by body mass index, calls for a detailed study of this aspect of aggressive periodontitis. The present study indicates that nutritional infuences point to a needle of suspicion toward the etiology of aggressive periodontitis.

Relationship between severe early childhood caries and body mass index.

AIM: This study was undertaken to evaluate the relationship between Severe Early Childhood Caries (S-ECC) and Body Mass Index (BMI) in the absence of any underlying medical condition for the school going (3 to 6 years old) children of Mathura city, India. METHOD: One hundred caries free children (50 boys and 50 girls) and one hundred children (50 boys and 50 girls) affected with S-ECC in the age range of 3-6 years without any contributing medical history were included in the study. Measurements of the weight (kg) and height (m) were done using a standard balanced beam scale and stadiometer. The BMI (kg/m2) was determined and the body weight status was evaluated using CDC based classification for each child. Independent t-test was used to evaluate whether the weight, height and BMI of S-ECC children is significantly different from caries free children. RESULT: Although the weight of the S-ECC children is more when compared to the normal children, the difference is not statistically significant. However, the mean BMI of S-ECC children is more when compared to the caries free children which was found to be statistically significant at p < 0.05. The body weight status of the Normal and S-ECC affected children based on the CDC classification revealed that 48% have been classified in underweight category and 43% in normal weight category and very few children are found to be at risk of overweight and overweight. CONCLUSIONS: A positive correlation between the BMI and S-ECC was observed in this study. 51% of caries free children and 45% of S-ECC children were classified in underweight category based on CDC classification.

The effects of extraction of pulpally involved primary teeth on weight, height and BMI in underweight Filipino children. A cluster randomized clinical trial.

BACKGROUND: Severe dental caries and the treatment thereof are reported to affect growth and well-being of young children. The objective of this study was to assess the effects of extraction of severely decayed pulpally involved primary teeth on weight and height in underweight preschool Filipino children. METHODS: Underweight preschool Filipino children with severe dental decay had their pulpally involved primary teeth extracted during a stepped wedge cluster randomized clinical trial. Day care centers were randomly divided into two groups; children from Group A day care centers received treatment as soon as practical, whereas children from Group B day care centers were treated four months after Group A. Clinical oral examinations using WHO criteria and the pufa-index were carried out. Anthropometric measurements were done on both groups immediately before treatment of Group A and at follow-up four months later. Height and weight z-scores were calculated using 2006 and 2007 WHO Growth Standards. Multilevel analysis was used to assess the effect of dental extractions on changes in anthropometric measurements after dental treatment. RESULTS: Data on 164 children (85 in Group A and 79 in Group B), mean age 59.9 months, were analyzed. Both groups gained weight and height during the trial period. Children in Group A significantly increased their BMI (p < 0.001), and their weight-for-age (p < 0.01) and BMI-for-age z-scores (p < 0.001) after dental treatment, whereas untreated children in Group B did not. Children in Group A had significantly more weight gain (p < 0.01) compared to untreated children in Group B. However, children in Group A had an inverse change in height gain (p < 0.001). Adjustment for the time interval between the two visits had little effect on the results. CONCLUSIONS: The extraction of severely decayed primary teeth resulted in significant weight gain in underweight Filipino children. Untreated dental decay should be considered an important co-factor affecting child growth and should be considered when planning for interventions to improve child growth. TRIAL REGISTRATION: ISRCTN90779069 http://www.controlled-trials.com/isrctn/isrctn_loa.

Somatic problems and self-injurious behaviour 18 years after teenage-onset anorexia nervosa.

The aim of this study was to study long-term outcome of physical health and self-injurious behaviour (SIB) in anorexia nervosa (AN). Fifty-one adolescent-onset AN cases, originally recruited after community screening, and 51 matched controls (COMP) were interviewed regarding somatic problems and SIB and physically examined 18 years after AN onset, at mean age 32 years. Six individuals had an eating disorder (ED). No one had died. The AN group weighed less than the COMP group. The frequency of somatic problems did not differ between groups. Dental enamel lesions and shorter than expected stature occurred only in the AN group. Dysdiadochokinesis was overrepresented in the AN group and age of AN onset was lower among those with the neurological deficit. Severe SIB occurred only in the AN group, predominantly during adolescence. To conclude, somatic problems were common in both groups. Most individuals in the AN group had recovered from their ED, but weight revealed a persistent restricted eating behaviour.

Do Class III patients have a different growth spurt than the general population?

INTRODUCTION: Understanding the timing and length of the growth spurt of Class III prognathic patients is fundamental to the strategy of interceptive orthopedic orthodontics as well as to the timing of orthognathic surgery. Consequently, this study was undertaken to determine whether there are any significant differences in the stature growth pattern of Class III subjects compared with non-Class III subjects and the general population. METHODS: Twelve-year longitudinal stature growth data were collected for 402 randomly selected adolescents in the general population, 55 Class III mandibular prognathic patients, and 37 non-Class III patients. The growth data were analyzed by using the traditional linear interpolation method and nonlinear growth functions. The 6 stature growth parameters were measured: age at takeoff, stature at takeoff, velocity at takeoff, age at peak height velocity, stature at peak height velocity, and velocity at peak height velocity. Comparisons in the stature growth parameters and 15 cephalometric variables among the general population, Class III subjects, and non-Class III subjects were made with multivariate analysis. RESULTS: Patients with Class III prognathism did not have different growth parameters compared with Class II subjects or the general population. CONCLUSIONS: This study does not allow meaningful conclusions with regard to the relationship of mandibular size and stature growth pattern. The application of nonlinear growth curves vs the traditional linear interpolation method was also discussed.

Long-acting PEGylated growth hormone in children with idiopathic short stature.

Objective: To evaluate the safety and efficacy of weekly PEGylated-recombinant human growth hormone (PEG-rhGH) in children with idiopathic short stature (ISS) in China. Design and methods: This was a multicenter, phase II study in which all subjects were randomized 1:1:1 to weekly s.c. injections of PEG-rhGH 0.1 (low-dose (LD) group) or 0.2 mg/kg/week (high-dose (HD) group) or control for 52 weeks. The primary end point was change (Δ) in height s.d. score (HT-SDS) from baseline to week 52. Secondary end points were height velocity (HV), bone maturity, insulin-like growth factor-1 (IGF-1) SDS, and IGF-1/insulin-like growth factor-binding protein-3 (IGFBP-3) molar ratio. Results: A total of 360 children with ISS were recruited in the study (n = 120 in each group). At week 52, ΔHT-SDS was 0.56 ± 0.26, 0.98 ± 0.35, and 0.20 ± 0.26 in the LD, HD, and control groups, respectively (within-group P < 0.0001; intergroup P < 0.0001). Statistically significant values of ΔHV, IGF-1, IGF-1/IGFBP-3 ratio, and IGF-1 SDS at week 52 from baseline were observed in both treatment groups (P < 0.0001). There were clear dose-dependent responses for all auxological variables. PEG-rhGH was well tolerated throughout the treatment period with treatment-emergent adverse events (TEAEs) reported in 86.5%, 84.6%, and 91.3% of children in the HD, LD, and control groups, respectively. The incidence of TEAEs was similar in all treatment groups despite the difference in doses. A total of 27 (8.7%) children experienced drug-related TEAEs. Conclusion: Fifty-two-week treatment with PEG-rhGH 0.1 or 0.2 mg/kg/week achieved significant improvement in HT-SDS and other growth-related variables, including HV, IGF-1 SDS, and IGF-1/IGFBP-3 ratio, in a dose-dependent manner. Both doses were well tolerated with similar safety profiles.

A novel vertebroplasty technique using a larger-diameter needle for thoracolumbar osteoporotic vertebral compression fracture.

ABSTRACT: Percutaneous vertebroplasty (VP) and kyphoplasty (KP) are well-established minimally invasive surgical procedures for the treatment of osteoporotic vertebral compression fractures (OVCF). However, some drawbacks have been reported regarding these procedures, including height loss, cement leakage, and loss of the restored height after balloon deflation. We performed a novel VP technique to minimize these limitations of conventional procedures. This study aimed to compare radiological and clinical outcomes of our method using a larger-diameter needle versus conventional VP (using a smaller needle) for thoracolumbar OVCF.From April 2016 to May 2017, 107 consecutive patients diagnosed with thoracolumbar OVCF were enrolled. Patients were divided into two groups: group 1 underwent conventional VP, i.e., using a smaller diameter needle, and group 2 underwent VP through a modified method with a larger-diameter needle. For radiological evaluation, parameters related to anterior vertebral height (AVH) and segmental angle were assessed using plain standing radiographs, and patient-reported outcomes were evaluated using the visual analog scale. Cement injection amount and leakage pattern were also analyzed. Group 2 showed a larger anterior vertebral height change than group 1 immediately postoperatively and one year postoperatively. The 1-year postoperatively-AVH maintained better in group 2 than in group 1. Group 2 showed more significant improvement of segmental angle immediately postoperatively than group 1 (3.15° in group 1 vs 9.36° in group 2). IYPo-visual analog scale significantly improved in both groups, with greater improvement in group 2 (3.69 in group 1 vs 5.63 in group 2). A substantially larger amount of cement was injected, with a lower leakage rate in group 2 than in group 1.A novel VP technique using a larger-diameter needle showed superior radiological and clinical outcomes than conventional VP. Therefore, it can be considered a useful treatment option for OVCF.

Phenotype presentation of hypophosphatemic rickets in adults.

Hypophosphatemic rickets (HR) is a group of rare disorders caused by excessive renal phosphate wasting. The purpose of this cross-sectional study of 38 HR patients was to characterize the phenotype of adult HR patients. Moreover, skeletal and endodontic severity scores were defined to assess possible gender differences in disease severity in patients with genetically verified X-linked HR. Compared to normal reference data, i.e., z = 0, HR patients had significantly lower final height, with a mean difference in z-score of -1.9 (95% CI -2.4 to -1.4, P < 0.001). Compared to paired z-scores of final height, z-scores of leg length were significantly lower and those of sitting height were significantly higher (P < 0.001), resulting in disproportion as indicated by the significantly elevated sitting height ratio, mean difference in z-score of 2.6 (95% CI 2.1-3.1, P < 0.001). Z-scores of head circumference (median 1.4, range -0.4 to 5.5, P < 0.001) and z-scores of bone mineral density (BMD) of the lumbar spine (median 1.9, range -1.5 to 8.6, P < 0.001) were significantly elevated compared to normal reference data. The relative risk (RR) of fracture was reduced (RR = 0.34, 95% CI 0.20-0.57, P < 0.001). The skeletal severity score tended to be higher in males compared to females (P = 0.07), and no gender difference in endodontic severity was found. In conclusion, adult HR patients were characterized by short stature and were disproportioned. They had elevated BMD of the lumbar spine and a reduced risk of fractures. We found a tendency for males to be more severely affected than females.

Overweight and obesity weakly predict the development of periodontal infection.

AIM: The aim of this study was to investigate the association between body weight and periodontal infection in a longitudinal setting. MATERIAL AND METHODS: This study was based on a subpopulation of the Health 2000 Survey that included dentate, non-diabetic subjects aged 30-59 years, who had never smoked and who had participated in the Follow-Up Study on Finnish Adults' Oral Health approximately 4 years later (n=396). The number of new teeth with deepened (4 mm deep or deeper) periodontal pockets in the follow-up examination was used as the outcome variable. Body weight was measured using body mass index, categorized into three categories: <25.0 (normal weight), 25.0-29.9 (overweight) and 30.0 or more (obesity). Incidence rate ratios were estimated using Poisson's regression models. RESULTS: Body weight was weakly, but not statistically significantly, associated with the number of new teeth with deepened periodontal pockets among subjects who were periodontally healthy in the baseline examinations, whereas only a minuscule association was found among subjects who had periodontal infection at baseline. CONCLUSIONS: The results of this follow-up study do not provide evidence that overweight and obesity can be considered significant risk factors in the pathogenesis of periodontal infection.

Analysis of body mass index, the mandible, and dental alveolar arch factors in prediction of mandibular third molar impaction: a pilot study.

AIM: The aim of this study was to determine how some physical characteristics can be used to predict the occurrence of impacted mandibular third molars. BACKGROUND: While the concept of prophylactic removal of the asymptomatic erupting or impacted mandibular third molar has generated much controversy over the years, new theories of therapeutic surgical removal of the erupting tooth and therapeutic agenesis of the tooth bud are emerging. However, there are a few studies that address the anthropometric factors that could predict an impacted mandibular third molar. METHODS AND MATERIALS: The study included Nigerian patients of both genders who were at least 16 years of age. A total of 83 subjects participated in the study; there were 44 (53 percent) females and 39 (47 percent) males. RESULTS: Eighty-one (97.6 percent) of the participants were between 16 and 23 years old, while 2 (2.4 percent) were between 30 and 39 years old, of which 44 (53 percent) were women and 39 (47 percent) were men. There were 38 (45.8 percent) cases of impaction and 45 (54.2 percent) cases of unimpacted third molar. The mean and standard deviation values of BMI for the two groups in males and females were 21.10±1.90, 22.40±2.70 and 22.00±2.40, 22.30±1.99 respectively, with no significant difference, p>0.05, CI 95%. The two determinant factors of impaction were mandibular length and the difference between alveolar arch length (p=0.04) and total teeth size. Both of these variables had significant inverse correlations with impaction values of p=0.04 and p=0.003, respectively. The prediction values were 59 percent for mandibular length and 81.9 percent for differences between mandibular length and teeth sizes, respectively. The synthesized prediction value by the two determinant factors is 75.6 percent.The subjects were divided into two categories: presence of impaction (Group 1) and absence of impaction (Group 2). Impaction of the mandibular third molar was assessed by clinical and radiographic evaluation. Body mass index (BMI) of each subject was determined by measuring the body weight (BW) and body height (BH), then dividing the weight of the body by the square of the height. The mandibular index (MI) was assessed by measuring the length and width of the mandible (MW). It was calculated by dividing the width of the mandible by the length of the mandible. The mandibular length (ML) consisted of the total teeth sizes of the three anterior teeth, the two premolars, and the first and second molars. These dimensions were measured with a divider/ruler and recorded. The anterior-posterior distance of the arch from the midline to the retromolar pad (alveolar arch length) also was measured. CONCLUSION: The prediction of mandibular third molar impaction was mainly dependent on two factors: the length of the mandible and the difference between arch length and total teeth size. CLINICAL SIGNIFICANCE: Small mandible, small dental arch, and large teeth are risk factors that are strongly associated with the occurrence of impacted third molars.

[Timing of permanent tooth emergence and its association with physical growth among children aged from four to seven years in nine cities of China].

Objective: To investigate the timing of permanent tooth emergence and its association with physical growth among children aged 4-7 years in 9 cities of China, and to analyze the trend of permanent teeth development. Methods: According to a stratified cluster sampling design, a cross-sectional survey on the timing of permanent tooth emergence children aged 4-7 years was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. A total of 37 973 children (19 035 boys and 18 938 girls) were recruited and were divided into different age groups (4.0-<4.5, 4.5-5.0, 5.0-5.5 and 6.0-<7.0 years of age). The situation of the exfoliation of primary teeth and the eruption of permanent teeth were investigated. Height and weight were measured using the standardized methods. Z-scores of physical growth indicators were calculated using the growth standards for Chinese children in 2009. Probit regression analysis was used to determine the median and percentile age of transition from deciduous to permanent teeth. Chi-square test was used for comparison of categorical data and t test was used for comparison of measurement data between boys and girls, urban and suburban as well as among different ages and regions. Meanwhile, the data from the national survey on physical growth and development of children under 7 years of age in 9 cities of China in 1995 were used to analyze the trends of the permanent teeth development. Results: The rate of transition from deciduous to permanent teeth in 37 973 children aged 4-7 years was higher with age, which was 0.6% (42/7 568) in 4.0-<4.5 years of age group, 30.3% (2 295/7 583) in 5.5-<6.0 years of age group, and 74.5% (5 680/7 627) in 6.0-<7.0 years of age group. The rates of transition from deciduous to permanent teeth in boys were all lower than those of girls except for children aged 4.0-<4.5 years (all P<0.01). The rate of transition from deciduous to permanent teeth in urban children was higher than that in suburban children for older than 5.5-6.0 years of age group in boys and older than 4.5-5.0 years of age group in girls, which was 74.2% (1 427/1 924) in urban boys aged 6.0-<7.0 years and 69.2% (1 305/1 885) in suburban boys aged 6.0-<7.0 years (χ(2)=11.446, P<0.01). The age of transition from deciduous to permanent teeth was 6.00 (95%CI: 5.98-6.01) years and the range of the 3-97 percentile was 4.88-7.11 years of age. The median permanent tooth emergence age of girls was lower than that of boys (5.94 vs. 6.06 years) and the median age of urban children was lower than that of suburban children (5.94 vs. 6.05 years). The median permanent tooth emergence age of southern Chinese children (6.05 years) was higher than that of northern (5.97 years) and central Chinese children (5.97 years). The weight for age Z-scores (WAZ), height for age Z-scores (HAZ) and body mass index for age Z-scores (BMIZ) of children with transition from deciduous to permanent teeth (0.35±1.17, 0.32±1.00, 0.23±1.16) were significantly higher than those of children without transition from deciduous to permanent teeth (0.03±1.13, 0.03±1.02, 0.04±1.13, t=20.81,21.67,12.09, all P<0.05). In comparison with the data in 1995, data in 2015 showed that the rate of transition from deciduous to permanent teeth was higher, for example, the rate of urban boys aged 6.0-<7.0 years group was 63.8% (1 146/1 796) in 1995, and increased to 74.2% (1 427/1 924) in 2015 (χ(2)=46.748, P<0.01). The median permanent tooth emergence age decreased by 0.24 years in 2015 as compared with that in 1995. Conclusions: The development of permanent teeth is earlier in girls than in boys, earlier in urban children than in suburban children and slightly delay in southern children than in central and northern Chinese children. In addition, the development of permanent teeth, which is related to the physical growth, slightly accelerate in China during the past 20 years.

Biological history of an Italian prehistoric community and the population of the central Italy during the 1st millennium BCE.

Understanding the population of Central Italy during the 1st millennium BCE is a crucial topic in the biological history of the Mediterranean basin. This period saw the emergence of the Etruscan and Roman cultures which had a significant impact on the bio-cultural history of the region. In this study, we analyse a prehistoric population from Caracupa (Iron Age, Latium, Central Italy). The results suggest an overall good level of health for the population. Despite this, some musculoskeletal changes related to biomechanical stressors were observed, probably as the result of strenuous physical activity. The results of a Simple Matching analysis of intragroup distance distributions suggest potential model of kinship structures and lineages. This may be due to the relative geographic isolation of the Caracupa population. Furthermore, in order to investigate the wider population of Central Italy during the 1st millennium BCE, we have constructed a population pattern using genetic and phenotypic skeletal and dental traits. The comparison between Central Italy and more isolated populations indicated a divergence between the Western and Eastern sides of Central Italy. However, we do not exclude a probable common genetic substratum for all Central Italian populations during the 1st millennium BCE.