Third molar maturity index and legal age in different ethnic populations: Accuracy of Cameriere's method.

Molar development is widely accepted as a reliable indicator of chronological age in a forensic context. A quantitative method for age estimation has been proposed by Cameriere et al. based on the relationship between chronological age and the third molar maturity index (I3M), which is the ratio between the two apical pulp widths and the total tooth length. Cameriere's cut off value of 0.08 was found to be a reliable tool in assessing the threshold of 18 years of age. The aim of this study was to evaluate the accuracy of the I3M in different ethnic populations focusing on its specificity (subjects correctly classified as <18 years based on I3M >0.08) and sensitivity (subjects correctly classified as ≥18 years based on I3M <0.08). A review of 22 scientific articles was performed, representing data from panoramic radiographs of 12,286 individuals (5723 males and 6563 females) from all over the world, including some ethnical subgroups. The I3M showed an overall sensitivity for both sexes ranging from 51.8% to 93.4% and a specificity ranging from 86.2% to 100%. The proportion of correctly classified individuals ranged from 74% to 95%. These results can be useful to refer the age estimation with the margin of error of subjects correctly classified as minors (specificity) or adults (sensitivity), according to sex, ethnicity and geographical distribution. The I3M can be considered a suitable method for estimating adulthood in forensic settings, regardless of sex. However, ethnic group can affect the accuracy.

Assessment of Age at the Stages of the Eruption of Third Molar Teeth among the People of North-Eastern India.

METHODS: A cross-sectional descriptive and analytical study was undertaken with 1060 Assamese individuals (642 males and 418 females) aged 14-26 years and was subjected to a clinical, dental, and general physical examination from January 2014 to December 2018. The data were statistically analyzed using Microsoft Excel and the Statistical Package for the Social Sciences (SPSS) version 22. The significant differences among variables were tested using the chi-square test and Student's t-test, considering a p value < 0.05 as significant. RESULTS: The carried-out research showed no eruption (NE) status of M3 with an overall mean (±SD) age at 17.39 (±2.273) years, although a significantly lower age among males with a mean age of 16.92 (±2.138) years (p value < 0.001) was observed. The mean age (overall) for the complete eruption (CE) was observed at 20.33 (±2.566) years, which was seen earlier in males. The mandibular M3 appears earlier compared to the maxillary M3. The third molar eruption (TME) on both left and right quadrants of the jaw was observed substantially earlier in the lower jaw, compared to the upper jaw (p value < 0.025). The earliest CE of M3 was marked at 15 years. The differences in the frequencies of TME in different chronological age groups were found significant (p value < 0.001). A significant association between gender and TME (p value < 0.045) in the current study is worth noting. CONCLUSION: Thus, determined by TME as a valid method, age can be used for various purposes to establish a person's identity. Dental age estimated using third molar eruption status has a weighty association with chronological age. Thus, it should be utilized to determine the likely age of an individual.

Forensic Validity of the Third Molar Maturity Index (I 3M) for Age Estimation in a Russian Population.

The aim of this cross-sectional study was to test the accuracy of the third molar maturity index (I 3M) cut-off value (0.08) to distinguish between individuals above and below the adult age of legal responsibility (18 years) in a Russian population. A sample of 571 digital panoramic radiographs of healthy Russian minors and young adults (363 females and 208 males), aged between 14 and 24 years, was evaluated. The lower left third molars were analyzed by applying the cut-off value of 0.08 determined by Cameriere et al. (2008). Lin's concordance correlation coefficient (ρ c) and Cohen's kappa coefficient (κ) showed that repeatability and reproducibility are high for both intra- and interobserver errors. The I 3M value decreased with age in both sexes. Age distribution gradually decreases as I 3M increases in both girls and boys. In the male group, molar maturity stages 0-0.04, 0.04-0.08, 0.08-0.3, 0.3-0.5, and 0.9-1.4 were reached slightly earlier than in the female group. The results demonstrated that sensitivity is 0.96 in boys and 0.93 in girls; associated specificity values were both 0.98. The cut-off value of I 3M is statistically robust and thus valid for forensic application in a Russian population to determine whether or not a subject has reached 18 years of age. Finally, we compared our results with those of other studies in which the same I 3M cut-off value was tested on different populations. The method is novel as it is reliable and easily reproducible, thus ensuring a universal way of comparing the results obtained (based on a cut-off value) among many populations, in order to develop an ever-increasing database.

Clarifying relationships between cranial form and function in tapirs, with implications for the dietary ecology of early hominins.

Paleontologists and paleoanthropologists have long debated relationships between cranial morphology and diet in a broad diversity of organisms. While the presence of larger temporalis muscle attachment area (via the presence of sagittal crests) in carnivorans is correlated with durophagy (i.e. hard-object feeding), many primates with similar morphologies consume an array of tough and hard foods-complicating dietary inferences of early hominins. We posit that tapirs, large herbivorous mammals showing variable sagittal crest development across species, are ideal models for examining correlations between textural properties of food and sagittal crest morphology. Here, we integrate dietary data, dental microwear texture analysis, and finite element analysis to clarify the functional significance of the sagittal crest in tapirs. Most notably, pronounced sagittal crests are negatively correlated with hard-object feeding in extant, and several extinct, tapirs and can actually increase stress and strain energy. Collectively, these data suggest that musculature associated with pronounced sagittal crests-and accompanied increases in muscle volume-assists with the processing of tough food items in tapirs and may yield similar benefits in other mammals including early hominins.

The Risk Factors that Can Increase Possibility of Mandibular Canal Wall Damage in Adult: A Cone-Beam Computed Tomography (CBCT) Study in a Chinese Population.

BACKGROUND The objective of this study was to analyze the factors that can increase the possibility of mandibular canal (MC) defect in Chinese people, to evaluate the risk of nerve impairment, and to choose the proper operative method to reduce the risk of mandibular alveolar nerve injury during the extraction of mandibular third molar (MTM). MATERIAL AND METHODS A total of 954 patients (1,304 MTMs) who underwent orthopantomography (OPG) and cone-beam computed tomography (CBCT) between July 2014 and December 2014 were included in this study. The age and gender of patients, impacted type (high impaction, moderate impaction, and low impaction), Winter classification of MTM, position of MTM relative to MC, vertical classification of MTM and MC, and the feature images of OPG were collected and compared to the imperfection of the MC wall in CBCT images. RESULTS The wall situation of MC was significantly correlated with the age of the patient, the depth of the molar, the position of the roots, and six imaging appearances on OPG. There was no significant difference based on gender. CONCLUSIONS Most incomplete walls of MCs could be inferred by OPG. However, images based on CBCT could clarify the defect of the MC and also could clearly display the spatial relationship between the root and inferior alveolar canal.

Demirjian's stages and Cameriere's third molar maturity index to estimate legal adult age in Peruvian population.

OBJECTIVE: To compare the accuracy of Demirjian's stages (DS) and Cameriere's third molar maturity index cut-off value (I3M<0.08) to estimate the age of majority on panoramic radiographs (OPTs) from the dental clinic of the Scientific University of the South (UCSUR), Lima, Peru. METHODS: An observational cross-sectional study was conducted on the sample of 208 digital panoramic radiographs of patients aged 14-22years examined during 2015 in UCSUR. The left lower third molars were analyzed using Adobe Photoshop® CS6. An effectiveness of specific DS and I3M<0.08 was evaluated by using accurate classification, sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratios and Bayes post-test probability (p). RESULTS: Only G and H stages were practical for classify adults and minors in the tested sample, while I3M<0.08 showed the best performance in both sexes. For I3M<0.08, the accurate classification, sensitivity and specificity were 0.96, 0.96, 0.96 and 0.90, 0.84 and 0.95 in males and females, respectively. Values of LR+, LR- and p were 24.96, 0.04, 0.97 and 15.68, 0.17, 0.95 in males and females, respectively. CONCLUSION: The specific cut-off value of third molar maturity index (I3M<0.08) showed to be more accurate in discriminating adults and minors in Peruvian sample when a test with high sensitivity and specificity is required.

Does Orthodontic Extraction Treatment Improve the Angular Position of Third Molars? A Systematic Review.

PURPOSE: To systematically assess the available evidence on the effect of orthodontic extractions on third molar (M3) angulation. MATERIALS AND METHODS: Three databases were searched up to April 25, 2016 to identify orthodontic studies comparing M3 angular changes in patients with and without extraction. Information on methodology, treatment procedures, and outcome was retrieved from each study. Assessment of overall and individual quality of the included studies was performed using validated criteria. RESULTS: Fourteen retrospective studies were considered eligible for this systematic review. Two studies achieved a moderate evidence score, whereas the lowest grade was assigned to 12 studies. The overall evidence level was classified as limited. Meta-analysis was not feasible because of the high heterogeneity across studies. Based on the best available evidence, premolar extraction followed by fixed orthodontic appliances can substantially improve the angular position of M3s by 10° to 18°. CONCLUSIONS: There is limited evidence that orthodontic extractions can substantially enhance the uprighting of M3s. Clinicians should be aware of the potentially beneficial effect of orthodontic extraction treatment on M3 development, although well-designed prospective studies are necessary to strengthen this statement.

Age assessment based on third molar mineralisation : An epidemiological-radiological study on a Central-European population.

PURPOSE: The method published in 1973 by Demirjian et al. to assess age based on the mineralisation stage of permanent teeth is standard practice in forensic and orthodontic diagnostics. From age 14 onwards, however, this method is only applicable to third molars. No current epidemiological data on third molar mineralisation are available for Caucasian Central-Europeans. Thus, a method for assessing age in this population based on third molar mineralisation is presented, taking into account possible topographic and gender-specific differences. METHODS: The study included 486 Caucasian Central-European orthodontic patients (9-24 years) with unaffected dental development. In an anonymized, randomized, and blinded manner, one orthopantomogram of each patient at either start, mid or end of treatment was visually analysed regarding the mineralisation stage of the third molars according to the method by Demirjian et al. Corresponding topographic and gender-specific point scores were determined and added to form a dental maturity score. Prediction equations for age assessment were derived by linear regression analysis with chronological age and checked for reliability within the study population. RESULTS: Mineralisation of the lower third molars was slower than mineralisation of the upper third molars, whereas no jaw-side-specific differences were detected. Gender-specific differences were relatively small, but girls reached mineralisation stage C earlier than boys, whereas boys showed an accelerated mineralisation between the ages of 15 and 16. CONCLUSIONS: The global equation generated by regression analysis (age = -1.103 + 0.268 × dental maturity score 18 + 28 + 38 + 48) is sufficiently accurate and reliable for clinical use. Age assessment only based on either maxilla or mandible also shows good prognostic reliability.

Topographic relationship between root apex of mesially and horizontally impacted mandibular third molar and lingual plate: cross-sectional analysis using CBCT.

The present study was aimed to determine the topographic relationship between root apex of the mesially and horizontally impacted mandibular third molar and lingual plate of mandible. The original cone beam computed tomography (CBCT) data of 364 teeth from 223 patients were retrospectively collected and analyzed. The topographic relationship between root apex and lingual plate on cross-sectional CBCT images was classified as non-contact (99), contact (145) and perforation (120). The cross-sectional morphology of lingual plate at the level of root apex was defined as parallel (28), undercut (38), slanted (29) and round (4). The distribution of topographic relationship between root apex and lingual plate significantly associated with gender, impaction depth, root number and lingual plate morphology. Moreover, the average bone thickness of lingual cortex and distance between root apex and the outer surface of lingual plate were 1.02 and 1.39 mm, respectively. Furthermore, multivariate regression analyses identified impaction depth and lingual plate morphology as the risk factors for the contact and perforation subtypes between root apex and lingual plate. Collectively, our findings reveal the topographic proximity of root apex of impacted mandibular third molar to the lingual plate, which might be associated with intraoperative and postoperative complications during tooth extraction.

Third-molar mineralization as a function of available retromolar space.

OBJECTIVE: To test in the maxilla and mandible for an association between stage of third-molar (M3) mineralization and space in the jaws for M3 eruption. Mineralization is hypothesized to be delayed not only for impacted M3s but also for M3s with eruption space less than their mesiodistal crown diameter. MATERIAL AND METHODS: Retrospective cone beam computed tomography (CBCT) scans of 37 females and 32 males aged 17-24 years, for a total sample of 197 upper and lower M3s, were used to assess the status of M3 eruption and measure the M3 crown diameter (CD) relative to the length of the retromolar space (RS). Stage of M3 mineralization was then compared between impacted and erupting M3s as well as between two conditions of relative eruption space (RS/CD ≥ 1 versus RS/CD < 1) using Mann-Whitney U tests. RESULTS: Impacted M3s were at significantly earlier (delayed) stages of mineralization compared to erupting M3s. Mineralization was also delayed for M3s with eruption space less than their mesiodistal crown diameter (e.g. RS/CD < 1). A moderate positive correlation between stage of M3 mineralization and space was seen in both jaws, and was stronger in the mandible. CONCLUSION: Our study shows for the first time that stage of M3 mineralization is associated not only with impaction but also with amount of retromolar space, and that these associations are consistent in upper and lower jaws. Present findings underscore that M3 mineralization stage may be a clinically useful predictor of M3 impaction that thus merits further investigation.

Evaluation of skeletal maturity using maxillary canine, mandibular second and third molar calcification stages.

OBJECTIVE: The objective of this study was to evaluate whether the calcification stages of maxillary canine, mandibular second molar, and mandibular third molar can be used for assessment of growth phase. MATERIALS AND METHODS: The study group consisted of 274 subjects. Pre-treatment digital panoramic and lateral cephalometric radiographs of the patients were analysed. The patients' age was ranging from 7 to 19 years. Right maxillary canine, mandibular second molar and third molar were used as a sample. The teeth mineralization was assessed using modification of Gleiser and Hunt method. The skeletal maturation was assessed by the cervical vertebrae maturation (CVM) method. RESULTS: A significant association was found between CVM stage 2 and maxillary canine (UC) stage 4, mandibular second molar (LM2) stage 4, and mandibular third molar (LM3) stage 1. CVM stage 3 corresponded with UC stage 5, LM2 stage 5, LM3 stage 2. CVM stage 4 matched with UC stage 5, LM2 stage 6 and LM3 stage 3. The highest correlations between CVM and calcification stages were in the group of the maxillary canine (r = 0.812, P < 0.01) and mandibular second molar (r = 0.824, P < 0.01). LIMITATIONS: Limitation of our study was that the study sample was not very big and the distribution value in the groups was very high, so it was impossible to check more statistical parameters. CONCLUSIONS: The calcification stages of UC, LM2, and LM3 as indicators of skeletal maturity could be clinically used with caution, until this method is verified with a larger sample group.

Effect of in vitro chewing and bruxism events on remineralization, at the resin-dentin interface.

The purpose of this study was to evaluate if different in vitro functional and parafunctional habits promote mineralization at the resin-dentin interface after bonding with three different adhesive approaches. Dentin surfaces were subjected to distinct treatments: demineralization by (1) 37% phosphoric acid (PA) followed by application of an etch-and-rinse dentin adhesive, Single Bond (SB) (PA+SB); (2) 0.5 M ethylenediaminetetraacetic acid (EDTA) followed by SB (EDTA+SB); (3) application of a self-etch dentin adhesive, Clearfil SE Bond (SEB). Different loading waveforms were applied: No cycling (I), cycled in sine (II) or square (III) waves, sustained loading hold for 24 h (IV) or sustained loading hold for 72 h (V). Remineralization at the bonded interfaces was assessed by AFM imaging/nano-indentation, Raman spectroscopy and Masson's trichrome staining. In general, in vitro chewing and parafunctional habits, promoted an increase of nano-mechanical properties at the resin-dentin interface. Raman spectroscopy through cluster analysis demonstrated an augmentation of the mineral-matrix ratio in loaded specimens. Trichrome staining reflected a narrow demineralized dentin matrix after loading in all groups except in PA+SB and EDTA+SB samples after sustained loading hold for 72 h, which exhibited a strong degree of mineralization. In vitro mechanical loading, produced during chewing and bruxism (square or hold 24 and 72 h waveforms), induced remineralization at the resin-dentin bonded interface.

Radiographic assessment of lower third molar eruption in different anteroposterior skeletal patterns and age-related groups.

OBJECTIVE: To analyze radiographic predictors for lower third molar eruption among subjects with different anteroposterior skeletal relations and of different age groups. MATERIALS AND METHODS: In total, 300 lower third molars were recorded on diagnostic digital orthopantomograms (DPTs) and lateral cephalograms (LCs). The radiographs were grouped according to sagittal intermaxillary angle (ANB), subject age, and level of lower third molar eruption. The DPT was used to analyze retromolar space, mesiodistal crown width, space/width ratio, third and second molar angulation (α, γ), third molar inclination (ß), and gonion angle. The LC was used to determine ANB, angles of maxillar and mandibular prognathism (SNA, SNB), mandibular plane angle (SN/MP), and mandibular lengths. A logistic regression model was created using the statistically significant predictors. RESULTS: The logistic regression analysis revealed a statistically significant impact of ß angle and distance between gonion and gnathion (Go-Gn) on the level of lower third molar eruption (P < .001 and P < .015, respectively). The retromolar space was significantly increased in the adult subgroup for all skeletal classes. The lower third molar impaction rate was significantly higher in the adult subgroup with the Class II (62.3%) compared with Class III subjects (31.7%; P < .013). CONCLUSION: The most favorable values of linear and angular predictors of mandibular third molar eruption were measured in Class III subjects. For valid estimation of mandibular third molar eruption, certain linear and angular measures (ß angle, Go-Gn), as well as the size of the retromolar space, need to be considered.

Eficácia analgésica da associação de 30mg do fosfato de codeína com 500mg do paracetamol após exodontias de terceiros molares inferiores impactados / Analgesic efficacy of codeine phosphate 30mg association with paracetamol 500mg after extraction of impacted lower third molars

Avaliar a eficácia analgésica da associação de 30mg do fosfato de codeína com 500mg do paracetamol após exodontias de terceiros molares inferiores impactados. Foi realizado um estudo clínico bilateral com uma amostra de 47 pacientes. Em um dos lados, todos os pacientes receberam a dosagem de 30mg do fosfato de codeína em associação com 500mg do paracetamol após exodontia (grupo teste). Para a exodontia contralateral, foi disponibilizado outro frasco contendo cápsulas idênticas, porém com a dosagem de 500mg de paracetamol (grupo controle). 100% dos pacientes do grupo teste não necessitaram utilizar a medicação resgate e não consumiram doses adicionais da medicação após as cirurgias. No grupo controle, 44,7% dos participantes relataram o uso do medicamento resgate. O consumo total de comprimidos no grupo teste foi, em média, inferior quando comparados ao lado contralateral. 80,8% dos pacientes relataram maior conforto, quanto ao critério da dor, no lado em que foi utilizado a dosagem de 30mg de fosfato de codeína associado a 500mg de paracetamol. Os efeitos colaterais estiveram mais presentes no grupo teste, sendo mais comum o relato de sonolência (34%) e tontura (31,9%), não havendo relato de abandono desta medicação por nenhum dos pacientes. Concluímos que a dosagem de 30mg do fosfato de codeína associada a 500mg de paracetamol apresentou resultados favoráveis no controle da dor e uma baixa incidência de efeitos colaterais...

To assess the analgesic efficacy of regular dosage of codeine phosphate 30mg association with paracetamol 500mg after extraction of impacted lower third molars. We performed a bilateral clinical study analyzing a sample of 47 patients. All patients received a 30mg codeine phosphate dosage in combination with paracetamol 500mg after extraction (test group). For the contralateral tooth extraction, we had another bottle available containing identical capsules, with a 500mg paracetamol dosage (control group). 100% of the test group patients did not need to use rescue medication and did not consume additional doses of medication after surgeries. In the control group, 44.7% reported the use of rescue medication. Total consumption of pills in the test group was on average lower than the contralateral side. 80.8% of patients reported greater comfort, as the criterion of pain in the side that was used 30mg codeine phosphate dosage associated with paracetamol 500mg. The adverse effects were more present in the test group, with sleepiness being more common (34%) and dizziness (31.9%), without any patient medication abandonment. We conclude that the 30mg codeine phosphate dosage associated with paracetamol 500mg showed favorable results in controlling pain associated with a low incidence of side effects...

Effect of premolar extraction and presence of the lower third molar on lower second molar angulation in orthodontic treatment.

OBJECTIVE: To evaluate the change in mandibular second-molar (M2) angulation in orthodontic treatment with premolar extraction and lower third molar (M3). STUDY DESIGN: Panoramic radiographs were evaluated in 3 groups of 129 participants: (1) control, no orthodontic treatment (n = 65); (2) extraction, orthodontic treatment with premolar extraction (n = 30); and (3) nonextraction, orthodontic treatment without premolar extraction (n = 34). The angular difference and ratio of M2 to the first molar (M1), the change in the angulation of M2 between pre- and postorthodontic treatment, and the distal bone level of M2 were assessed. RESULTS: The angular difference and ratio of M2 to M1, the angulation change of M2 between pre- and postorthodontic treatment, and the distal bone level of M2 were higher in the nonextraction group than in the control and extraction groups. CONCLUSIONS: The successful orthodontic alignment of the M2 may not be achieved in nonextraction cases when the M3s are present.

Size dependent elastic modulus and mechanical resilience of dental enamel.

Human tooth enamel exhibits a unique microstructure able to sustain repeated mechanical loading during dental function. Although notable advances have been made towards understanding the mechanical characteristics of enamel, challenges remain in the testing and interpretation of its mechanical properties. For example, enamel was often tested under dry conditions, significantly different from its native environment. In addition, constant load, rather than indentation depth, has been used when mapping the mechanical properties of enamel. In this work, tooth specimens are prepared under hydrated conditions and their stiffnesses are measured by depth control across the thickness of enamel. Crystal arrangement is postulated, among other factors, to be responsible for the size dependent indentation modulus of enamel. Supported by a simple structure model, effective crystal orientation angle is calculated and found to facilitate shear sliding in enamel under mechanical contact. In doing so, the stress build-up is eased and structural integrity is maintained.

Third molars emergence status among 15 to 16 year-old Tanzanian youths.

BACKGROUND: Adequate knowledge of timing and pattern of the third molars is essential. The molars are often used to supplement human maturity indicators for school attendance, social benefits, employment, and marriage, differentiating the juvenile from the adult's status in criminal law cases, unidentified cadavers and human remains when birth records are not adequate or not available. BROAD OBJECTIVE: The study was carried out to investigate the emergence status of the third molar tooth among 15 to 16 year-old Tanzanian adolescents. METHODOLOGY: A cross-sectional community based study was carried out among secondary school children in Ilala District, Dar es Salaam, Tanzania. This study included 203 adolescents aged 15-16 years old of whom 54% were boys and 46% girls. It was a subsample of randomly selected Tanzanian youths who were part of a larger sample of 869 children from randomly selected 16 schools from different parts of the district covering the whole range of socio-economic background. RESULTS: More third molars were already in occlusion in girls (11-13%) than in boys (3-4%) while girls had more third molars emerged into the oral cavity than boys did. The girls had about 15% to 20% of the four third molar teeth emerged in the oral cavity compared to about 3% to 18% in boys. Except for the mandibular right third molar, all the differences in emergence of the third molars between girls and boys were statistically significant. More mandibular third molars had emerged than the corresponding maxillary ones. DISCUSSION AND CONCLUSIONS: Third molars were in occlusion in 3-13% of the Tanzanian youths aged 15-16 years indicating earlier emergence than in Caucasian populations. Hence, the need for specific third molars emergence standard tables molars is evident. More studies both cross sectional and longitudinal type involving a larger sample to provide the median and mean ages, rate and pattern of emergence of the third molars in the Tanzanian youth populations are recommended.

O uso do terceiro molar na estimativa de idade em brasileiros / The use of third molar in the age estimation in Brazilians

A estimativa de idade em indivíduos vivos ou mortos desempenha um importante papel das ciências forenses, pois pode ser requisitada para propósitos civis ou por razões criminais: desastres em massa, adoção, asilo, direitos civis ou imputabilidade penal, dentre outros. Os dentes desempenham um protagonismo neste contexto, pois são mais resistentes que os ossos em condições ambientais extremas e seu desenvolvimento dificilmente é afetado por fatores exógenos ou endógenos. Pelo fato dos terceiros molares (3ºM) serem os únicos ainda em desenvolvimento a partir dos 14 anos de idade, tornam-se úteis para determinar se um indivíduo atingiu a maioridade legal aos 18 anos de idade. As técnicas desenvolvidas na atualidade para estimativa de idade em pessoas vivas em sua maioria dependem de imagens radiográficas dos dentes, pois é um método não-invasivo e com potencial de conseguir amostras de banco de dados de clínicas radiológicas para estudos populacionais. Este estudo almejou verificar o método de Cameriere et al. (2008c) (MC) em brasileiros, no intuito de estabelecer parâmetros para discriminar se um indivíduo é maior ou menor de 18 anos de idade a partir do índice de maturidade do 3ºM (I3m); também teve como objetivo comparar a sensibilidade (SE) e a especificidade (ES) deste método com os estágios G e H do método desenvolvido por Demirjian et al. (1973) e adaptado por Mincer et al. (1993) (MD). A análise de 444 radiografias panorâmicas de indivíduos entre as idades de 14 a 22 anos resultou em, para o valor de corte do I3m<=0,08 (MC), uma SE de 77,4%, uma ES de 86,2% e uma probabilidade estimada (PE) corretamente de 87,8%

Para o MD foram encontrados, respectivamente para os estágios G e H, SE: 80,54% / 52,94%, ES: 85,27% / 95,54% e PE: 86,8% / 94,2%. Diferenças significativas de dimorfismo sexual, com mineralização mais precoce para o sexo masculino, foram encontradas apenas paras médias de idade pertencentes às faixas de I3M>=0,08 (MC) - à exceção da faixa [0,7, 0.9) - e aos estágios E e F (MD). O método é adequado para estimar a idade adulta para propósitos forenses em brasileiros, entretanto deve ser aplicado cuidadosa e criteriosamente. Recomenda-se uma combinação de diversos métodos disponíveis para aumentar sua acurácia, bem como o estabelecimento de diferentes parâmetros de probabilidade para determinar se uma pessoa é maior ou menor de 18 anos de idade, a depender dos diferentes requisitos legais, se civil ou criminal. Para brasileiros, o método atinge sua melhor performance com I3m<=0,13 (MC) ou estágio G (MD), parâmetros recomendados para considerar a maioridade legal para fins civis, administrativos e trabalhistas. Para fins criminais, recomenda-se o I3m<=0,05 (MC) ou estágio H (MD)

The age estimation of living or dead individuals is an important part of forensic sciences because it can be used in various situations, including mass disasters, or for civil or criminal reasons, such as adoption, asylum, civil rights or criminal responsibility. Teeth play a major role in this context because they are more resistant than bones in extreme environmental conditions and their development is hardly affected by exogenous or endogenous factors. Because the third molars (3rdM) are still in development from the age of 14, they are useful for determining whether an individual has reached the legal age of 18 years. The techniques developed at present to estimate the age of living people mostly rely on radiographic images of teeth, because it is a non-invasive method and has potential to get samples database of clinical radiological for population studies. This study aims to verify the method of Cameriere et al. (2008) (CM) in Brazil to discriminate whether an individual is under or over 18 years from the maturity index of the 3rdM (I3m), as well as comparing the sensitivity (SE) and the specificity (SP) of this method with the G and H stages of the Demirjian et al. (1973) method (DM) modified by Mincer et al. (1993). The analysis of 444 panoramic radiographs resulted in a SE of 78.3%, a SP of 85.1% and a correct classification (CC) of 87%, for a cutoff value of I3m <= 0.08 as in original study

Significant differences in sexual dimorphism in the early mineralization of males were found only for the average age belonging to the bands I3m >= 0.08, except for the range [0.7, 0.9). For the MD were found, respectively, for the G and H stages - SE: 80.54% / 52.94%, SP: 85.27% / 95.54% and CC: 86.8% / 94.2%. The method is suitable for estimating adulthood for forensic purposes in Brazil, although it must be applied carefully and judiciously. We recommend a combination of several methods that are available to increase accuracy as well as the establishment of different parameters that are likely to determine whether a person is more or less than 18 years of age, depending on the different legal requirements, whether civil or criminal. For Brazilians, MC an MD achieve its best performance with I3m <= 0.13 or G stage, respectively, recommended parameters to consider the legal age for civil purposes. For criminal purposes, it is recommended I3m <= 0.05 (CM) or H stage (DM)

Terceiros molares: avaliação da presença de cárie, doença periodontal e qualidade de vida, e suas variações conforme posição dental / Third molar: evaluation of caries, periodontal desease and quality of life and its variation concerning to dental position

A cárie e a doença periodontal são doenças crônicas da cavidade oral. A cárie dentária ainda continua sendo o principal problema de saúde bucal dos brasileiros. A maioria dos estudos de levantamento de cáries excluem os terceiros molares. A presença destes dentes pode levar à doença periodontal na região, e muitas vezes, pode levar à injúrias e prejuízo à saúde bucal do indivíduo, tendo um significativo impacto na qualidade de vida. A incidência de cárie e doença periodontal pode variar em função da posição do terceiro molar. Material e método: tratou-se de um estudo clinico, transversal, observacional, onde foram avaliados 116 pacientes que procuraram a triagem do curso de especialização de Cirurgia e Traumatologia Bucomaxilofacial da FUNDECTO-FFO-USP, para avaliação da necessidade de exodontia dos terceiros molares. As variáveis avaliadas foram: cárie, doença periodontal e qualidade de vida. A avaliação da cárie foi feita através de exame clínico com sonda exploradora e espelho clínico; a doença periodontal através de sondas milimetradas em dois pontos, considerando sua presença da doença quando bolsa maior que 4 mm, bem como, a presença radiográfica de ambos. A avaliação da qualidade de vida relacionada à saúde bucal, por meio do questionário Ohip-14, aplicado sobre forma de entrevista.

A avaliação da posição dos terceiros molares realizou-se por meio da avaliação clínica e de radiografias panorâmicas, segundo a classificação de Pell e Gregory e Winter. O objetivo foi avaliar se a posição do terceiro molar interfere na incidência de cárie e doença periodontal, mensurar a qualidade de vida, e contribuir na tomada de decisão terapêutica de exodontia. Os dados foram analisados no pacote estatístico STATA 13.0, com estatística descritiva e inferencial. O nível de significância utilizada foi de 95%. Resultados: angulação e semierupção aumentam a incidencia de cárie e doença periodontal em terceiros molares. Sintomas e idade são fatores associados a cárie e Dp. Cáries nos superiores alteram domínios 3 e 6 e Dp nos inferiores alteram domínios 3 e 4. Alterações patológicas na região alteram o domínio 7. Conclusão: a posição dos dentes influenciam na incidência de cárie e doença periodontal em terceiros molares. Cárie e doença periodontal tem impacto na qualidade de vida. A Pesquisa teve aprovação do comitê de ética em pesquisa da FOUSP sob numero 280084.

Caries and periodontal disease are chronic diseases of the oral cavity. Dental caries still remains the main problem of oral health of Brazilians. Most clinical studies of caries do not consider third molar teeth. The presence of these teeth can lead to periodontal disease in the region, and often can lead to injuries and damage to the oral health, having a significant impact on the quality of life. The incidence of caries and periodontal disease can vary depending on the position of the third molar. Methods: We performed a clinical, observational cross-sectional study within 116 patients. That were screened attending to evaluate the need for extraction of third molars at the specialization course of Oral and Maxillofacial Surgery of FUNDECTO-FFO-USP. Caries, periodontal disease and quality of life are the outcomes that were evaluated by the main researcher. Caries lesions were assessed by visual tactile examination and periodontal disease through two probing sites around third molar, considering the presence of periodontal pathology when at least one periodontal probing depth was greater than 4 mm, and both were evaluated by radiograph diagnostic methods. The assessment of oral health related quality of life by Oral Health impact Profile questionary (OHIP-14), applied as an interview.

The evaluation of the position of the third molars was made by clinical and panoramic radiographs according to the classification of Pell and Gregory and Winter. The aim of these study was to evaluate whether third molar position interferes with the incidence of caries and periodontal disease, in addition to measure the quality of life, and contribute in making treatment decisions for extraction. Data was treated and analyzed according to STATA 13.0, software with descriptive and inferential statistics. The level of significance used was 95%. Results: partially erupted and angulation of third molar increase the incidence of caries and periodontal disease in these teeth. Symptoms and age are factors associated with caries and periodontal disease. Patients with caries have higher scores in domains 3 and 6 and those with periodontal disease have higher scores in domains 3 and 4. Pathologies on third molar region had impact on domain 7. Conclusion: tooth position influence on the incidence of caries and periodontal disease in third molars. Caries and periodontal disease have impacts on the quality of life. The study had the approval of ethics committee from University of Sao Paulo Dental School (numero 280084).

Terceiros molares: avaliação da presença de cárie, doença periodontal e qualidade de vida, e suas variações conforme posição dental / Third molar: evaluation of caries, periodontal disease and quality of life and its variation concerning to dental position

A cárie e a doença periodontal são doenças crônicas da cavidade oral. A cárie dentária ainda continua sendo o principal problema de saúde bucal dos brasileiros. A maioria dos estudos de levantamento de cáries excluem os terceiros molares. A presença destes dentes pode levar à doença periodontal na região, e muitas vezes, pode levar à injúrias e prejuízo à saúde bucal do indivíduo, tendo um significativo impacto na qualidade de vida. A incidência de cárie e doença periodontal pode variar em função da posição do terceiro molar. Material e método: tratou-se de um estudo clinico, transversal, observacional, onde foram avaliados 116 pacientes que procuraram a triagem do curso de especialização de Cirurgia e Traumatologia Bucomaxilofacial da FUNDECTO-FFO-USP, para avaliação da necessidade de exodontia dos terceiros molares. As variáveis avaliadas foram: cárie, doença periodontal e qualidade de vida. A avaliação da cárie foi feita através de exame clínico com sonda exploradora e espelho clínico; a doença periodontal através de sondas milimetradas em dois pontos, considerando sua presença da doença quando bolsa maior que 4 mm, bem como, a presença radiográfica de ambos. A avaliação da qualidade de vida relacionada à saúde bucal, por meio do questionário Ohip-14, aplicado sobre forma de entrevista...

Caries and periodontal disease are chronic diseases of the oral cavity. Dental caries still remains the main problem of oral health of Brazilians. Most clinical studies of caries do not consider third molar teeth. The presence of these teeth can lead to periodontal disease in the region, and often can lead to injuries and damage to the oral health, having a significant impact on the quality of life. The incidence of caries and periodontal disease can vary depending on the position of the third molar. Methods: We performed a clinical, observational cross-sectional study within 116 patients. That were screened attending to evaluate the need for extraction of third molars at the specialization course of Oral and Maxillofacial Surgery of FUNDECTO-FFO-USP. Caries, periodontal disease and quality of life are the outcomes that were evaluated by the main researcher. Caries lesions were assessed by visual tactile examination and periodontal disease through two probing sites around third molar, considering the presence of periodontal pathology when at least one periodontal probing depth was greater than 4 mm, and both were evaluated by radiograph diagnostic methods. The assessment of oral health related quality of life by Oral Health impact Profile questionary (OHIP-14), applied as an interview...