Perceptibility and acceptability of lightness difference of a single maxillary central incisor.

OBJECTIVES: The aim of this study was to assess the lightness difference perceptibility and acceptability thresholds, for a single maxillary central incisor, and to investigate possible differences in these thresholds regarding the direction (+ΔL* vs. -ΔL*), the observer group (dentists vs. laypersons), and the gender and age of the observers. MATERIALS AND METHODS: A series of images with varying lightness (L*), were created by altering the right maxillary central incisor of a male Caucasian, on a frontal view full-portrait image. Digital modification of one central incisor by 1 ΔL* unit resulted in 15 different images: one control, seven with increased and seven with decreased lightness. The images were presented in random order, on a digitally calibrated monitor, to 158 observers, grouped into 79 dentists, and 79 laypersons, who were asked to evaluate every image and answer whether they perceive a difference and if yes, whether they accept this difference. A multifactorial analysis of covariance was performed to analyze the perception and acceptance of any difference in the central incisors and to estimate the thresholds. The statistical significance level was α = 0.05. RESULTS: Overall, the magnitude of ΔL*, direction of ΔL*, observer group and age were each significant (p < 0.001), as was gender (p = 0.03). The effect of the magnitude of ΔL* interacted with its direction and the observer group (p = 0.045), and the effect of age interacted with the direction of ΔL*, and the gender and the group of the observers. Estimated 50%:50% perceptibility thresholds ranged from 0.1 to 2.7, and 50%:50% acceptability thresholds ranged from 2.3 to 4.5. Overall, dentists perceived lightness differences at lower magnitudes than laypersons; difference in lightness was perceived and accepted at lower magnitudes when the tooth become lighter instead of darker; and female observers perceived and accepted lightness differences at lower magnitudes compared to males. As age increased overall, differences of lightness were perceived and accepted at higher magnitudes. CONCLUSIONS: Perceptibility and acceptability of lightness differences of a single maxillary central incisor are affected by the magnitude and the direction of lightness change, as well as the gender, the age, and the type of the observers. CLINICAL SIGNIFICANCE: Even small changes in lightness are perceivable; however, thresholds of perception and acceptance are dependent on the magnitude and the direction of change and are also dependent on the observer, with women, dentists and younger people perceiving and accepting changes at lower magnitudes of ΔL*.

Accuracy of Indirect Veneer Mock-Up in Comparison to Diagnostic Wax-Up.

PURPOSE: To evaluate the dimensional discrepancy between the diagnostic wax-up and the resulting mock-up. MATERIAL AND METHODS: A maxillary model with misaligned teeth was scanned, and an initial cast was 3D printed. A total of 60 identical casts were 3D printed from the initial one after scanning. Based on a digital additive veneer wax-up on the six anterior teeth, 10 more casts were 3D printed. The specimens were allocated to seven groups (n = 10) as follows-group 1: transparent silicone matrix with a flowable light-cured composite resin; group 2: same as group 1 but with the addition of a prefabricated transparent tray; group 3: silicone impression putty (65 Shore A) and light-body silicone impression material with a dual-cured bisacryl resin; group 4: same as group 3 but without the light-body silicone; group 5: silicone laboratory putty (92 Shore A) with a dual-cured bisacryl resin; group 6: silicone laboratory putty (92 Shore A) with PMMA; group 7: wax-up casts (control). Scans from the mock-ups were coregistered, segmented, and superimposed with the scans from the wax-up. The difference between the mock-up and the wax-up was quantified by morphologic operations. Results were analyzed by Kruskal-Wallis test and Dunn post hoc test (P < .05). RESULTS: All mock-ups were larger than the wax-up. Significant differences were found for every labial surface third. The incisal third was the least accurate third while the middle third the most accurate. The most accurate were groups 2 and 5, and the largest discrepancy was observed in group 6. CONCLUSIONS: The analog mock-up differs dimensionally from the wax-up, regardless of the technique/materials used.

In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia.

To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.

Coverage error of three resin composite systems to vital unrestored maxillary anterior teeth.

OBJECTIVE: Define the color of anterior teeth of a selected population and correlate it (by using coverage error [CE] and the frequency of best match) with the final color of all possible enamel-dentine combinations of three different resin composite systems. MATERIALS AND METHODS: Color of 636 vital unrestored anterior teeth (central incisors, lateral incisors and canines; n = 212) and disk specimens (12 mm diameter, varying thickness) corresponding to enamel-dentin combinations of all available enamel (0.5 mm and 1.0 mm thickness) and dentin shades (3.0 mm thickness) of Essentia, Enamel Plus HRi and IPS Empress Direct composite systems was measured using a clinical dental spectrophotometer (Spectroshade Micro). CE and frequency of best match for all composite systems were calculated for the measured in-vivo teeth color space. RESULTS: Natural in-vivo teeth exhibit higher lightness when compared to enamel-dentin composite combinations, independently of the enamel thickness used. The best (lowest) CE was found for IPS Empress, while the highest values were found for Enamel Plus Hri independently of tooth type and enamel thickness (p < 0.001). The use of 0.5 mm instead of 1.0 mm enamel thickness within enamel-dentin composite combinations resulted in a lower CE for in-vivo tooth color (p < 0.001). CONCLUSIONS: The color space defined by all possible enamel-dentin combinations of the studied resin composite systems does not fully match the color range of anterior teeth. All composite systems examined lack combinations with lightness values as high as the population's. IPS Empress Direct composite system represented better the in-vivo teeth color. CLINICAL SIGNIFICANCE: The use of 0.5 mm enamel shade thickness is suggested when building layered restorations, as it provided better color coverage than using 1.0 mm thickness.

Color comparison of three layered resin composite systems with three shade guides.

OBJECTIVE: To investigate the color difference using both ΔE*ab and CIEDE2000 formulas of all combinations of all enamel and dentin shades of three different composite systems with three different shade guides, to compare the coverage error (CE) of the shade guides for each composite and to investigate whether coverage error is affected by enamel shade layer thickness (0.5 vs 1 mm). MATERIALS AND METHODS: Disk specimens from all enamel and dentin shades of Essentia, Enamel Plus HRi, and IPS Empress Direct composites were fabricated. Color measurements were performed for all enamel-dentin combinations and for two thicknesses per enamel shade: 0.5 and 1 mm. Color was measured for three shade guides: Vitapan Classical, 3DMaster, and Ivoclar. Minimum color difference between layered composites and shade tabs, closest shade tab match and CE of all shade guides were calculated for all composite shade combinations. RESULTS: In most cases, the closest match was a mismatch. CE of 3DMaster was significantly lower for IPS Empress Direct and Enamel Plus HRi at 0.5 mm enamel thickness. Shade guides exhibited higher lightness values compared to composites and composites lower chroma values compared to shade guides. CONCLUSIONS: Shade guides do not match well to the layered composites. 3DMaster performed better than the other two shade guides, in most cases.

Influence of lightness difference of single anterior tooth to smile attractiveness.

OBJECTIVES: To evaluate the influence of lightness difference of a single anterior maxillary tooth on difference smile attractiveness. METHODS: A frontal view full-portrait image of a smiling male Caucasian, was digitally modified altering a single tooth, creating a series of images with varying lightness (ΔL) for the maxillary central, lateral and canine. A total of 160 participants (80 dentists, 80 laypersons) were asked to fill out a Visual Analog Scale questionnaire for every image recording smile attractiveness. RESULTS: For central incisors ΔL≥1 negatively affected attractiveness. There was a higher tolerance for lightness mismatch when one lateral incisor is lighter and the same applies when the canine was darker. Difference in lightness affected smile attractiveness both for dentists and laypersons. No difference between males and females was observed for the dentists. For laypersons, females perceived smiles with lightness difference as significantly less attractive compared to males. Dentist's age did not affect smile attractiveness perception. Younger laypersons perceived darker color, as less attractive. CONCLUSIONS: Changes in lightness of a single anterior tooth significantly affected smile attractiveness in a different way for the central vs lateral vs canine. For the dentists, age and gender did not significantly affect smile perception, in contrast to laypeople. CLINICAL SIGNIFICANCE: Lightness differences of a single anterior tooth affects smile attractiveness.

Emotion Control Predicts Internalizing and Externalizing Behavior Problems in Boys With and Without an Autism Spectrum Disorder.

Children and adolescents with Autism Spectrum Disorder (ASD) often show comorbid emotional and behavior problems. The aim of this longitudinal study is to examine the relation between emotion control (i.e., negative emotionality, emotion awareness, and worry/rumination) and the development of internalizing and externalizing problems. Boys with and without ASD (N = 157; age 9-15) were followed over a period of 1.5 years (3 waves). We found that baseline levels of worry/rumination was a specific predictor of later externalizing problems for boys with ASD. Furthermore, the developmental trajectory of worry/rumination predicted the development of internalizing and externalizing problems in both groups. Our findings suggest that worry/rumination may constitute a transdiagnostic factor underlying both internalizing and externalizing problems in boys with and without ASD.

Evaluation of reliability and validity of three dental color-matching devices.

PURPOSE: To assess the repeatability and accuracy of three dental color-matching devices under standardized and freehand measurement conditions. MATERIALS AND METHODS: Two shade guides (Vita Classical A1-D4, Vita; and Vita Toothguide 3D-Master, Vita), and three color-matching devices (Easyshade, Vita; SpectroShade, MHT Optic Research; and ShadeVision, X-Rite) were used. Five shade tabs were selected from the Vita Classical A1-D4 (A2, A3.5, B1, C4, D3), and five from the Vita Toothguide 3D-Master (1M1, 2R1.5, 3M2, 4L2.5, 5M3) shade guides. Each shade tab was recorded 15 continuous, repeated times with each device under two different measurement conditions (standardized, and freehand). Both qualitative (color shade) and quantitative (L, a, and b) color characteristics were recorded. The color difference (ΔE) of each recorded value with the known values of the shade tab was calculated. The repeatability of each device was evaluated by the coefficient of variance. The accuracy of each device was determined by comparing the recorded values with the known values of the reference shade tab (one sample t test; α = 0.05). The agreement between the recorded shade and the reference shade tab was calculated. The influence of the parameters (devices and conditions) on the parameter ΔE was investigated (two-way ANOVA). Comparison of the devices was performed with Bonferroni pairwise post-hoc analysis. RESULTS: Under standardized conditions, repeatability of all three devices was very good, except for ShadeVision with Vita Classical A1-D4. Accuracy ranged from good to fair, depending on the device and the shade guide. Under freehand conditions, repeatability and accuracy for Easyshade and ShadeVision were negatively influenced, but not for SpectroShade, regardless of the shade guide. CONCLUSION: Based on the total of the color parameters assessed per device, SpectroShade was the most reliable of the three color-matching devices studied.

The Modified Semidirect Onlay Technique With Articulated Elastic Model.

The modified semidirect onlay technique with articulated elastic model involves the fabrication of a stone model that is quickly mounted on an articulator and it includes an elastic part that enables the fabrication of a restoration with proper occlusal anatomy. The technique overcomes the disadvantages of the direct technique such as polymerization shrinkage stress and difficulty in achieving proper contours and, compared to the indirect technique, treatment is completed in a single appointment, without laboratory cost. The novelty of the technique is that, since the restoration is fabricated on an articulated model it eliminates time for occlusal adjustments.

Influence of enamel composite thickness on value, chroma and translucency of a high and a nonhigh refractive index resin composite.

OBJECTIVES: To evaluate the influence of thickness on the optical properties of two enamel shade composites, one with a high refractive index and one traditional. METHODS: A medium value enamel shade was selected from the resin composites Enamel Plus HRi (UE2) and Enamel Plus HFO (GE2). Enamel Plus HRi is a high refractive index composite. Samples were fabricated in five different thicknesses: 0.3, 0.5, 1, 1.5 and 2 mm. Three specimens per material and thickness were fabricated. Three measurements per sample, over white, black and dentin composite background were generated with a spectrophotometer (Spectroshade Micro, MHT). Value, chroma, translucency and color differences (ΔE) of the specimens were calculated. RESULTS were analyzed by the Pearson correlation test, ANOVA and a post-hoc Tukey test. RESULTS: Increasing the thickness of the enamel layers decreased the translucency and the chroma of the substrate for both materials tested. For HRi the increase of the thickness resulted in an increase of the value, whereas for HFO it resulted in a reduction of the value. The two composites showed a significant difference in value for each thickness, but not in translucency and chroma. Color difference between them was perceptible in layers equal or higher than 0.5 mm. CONCLUSIONS: The high refractive index enamel (HRi) composite exhibits different optical behavior compared to the traditional one (HFO). HRi enamel composite behaves more like natural enamel as by increasing the thickness of the enamel layer, the value also increases.

Disentangling the effects of working memory, language, parental education, and non-verbal intelligence on children's mathematical abilities.

It is assumed that children's performance in mathematical abilities is influenced by several factors such as working memory (WM), verbal ability, intelligence, and socioeconomic status. The present study explored the contribution of those factors to mathematical performance taking a componential view of both WM and mathematics. We explored the existing relationship between different WM components (verbal and spatial) with tasks that make differential recruitment of the central executive, and simple and complex mathematical skills in a sample of 102 children in grades 4-6. The main findings point to a relationship between the verbal WM component and complex word arithmetic problems, whereas language and non-verbal intelligence were associated with knowledge of quantitative concepts and arithmetic ability. The spatial WM component was associated with the subtest Series, whereas the verbal component was with the subtest Concepts. The results also suggest a positive relationship between parental educational level and children's performance on Quantitative Concepts. These findings suggest that specific cognitive skills might be trained in order to improve different aspects of mathematical ability.

Change of optical properties of contemporary polychromatic resin composites after light curing and finishing.

OBJECTIVES: To compare color and translucency changes after light curing and finishing in various shades of five contemporary resin composites. METHODS: Light and dark (A1 & A4 or equivalents), enamel (e) and dentin (d), shades were selected from the resin composites Enamel Plus HRi (Micerium), Miris 2 (Coltene), IPS Empress Direct (Ivoclar), Filtek Supreme (3M ESPE) and TPH Spectum (Densply). Ten disc-shaped samples (depth = 10 mm, thickness = 1 mm) per material and shade were fabricated. Three colorimetric readings, over white and black background, according to the CIELab system were taken before and after light polymerization and after finishing with wet carbide papers. Color (ΔE) and translucency (ΔTP) differences were calculated. Results were analyzed by ANOVA, post-hoc Scheffe's test and linear regression analysis. RESULTS: Polymerization provided a wide range of color change, ranging from 1.36 (Hri/UD1) to 8.07 (Miris/WB). Translucency increased in all groups, except Miris/NT. Translucency change varied from -0.4 (Miris/NT) to 8.88 (Hri/UE3). After finishing, ΔE ranged from 0.58 (Hri/ UD4) to 3.41 (Miris/NT). ΔE was significantly positively correlated with ΔL, Δb after curing and with ΔL, Δa, ΔTP after finishing. CONCLUSIONS: Polymerization caused remarkable color and translucency changes, which were product and shade dependent. Thirteen out of 18 of the tested resin composites exhibited clinically perceptible (ΔE>2.6) color change after light curing and 2 out of 18 after finishing. CLINICAL SIGNIFICANCE: Shade matching with non-polymerized resin composite may be erroneous.

Change of optical properties of contemporary resin composites after one week and one month water ageing.

OBJECTIVES: To compare color and translucency changes after water ageing for one-week and one-month in light and dark shades of contemporary polychromatic resin composites. METHODS: Enamel (e) and dentine (d), light and dark (A1 and A4 or equivalents) shades were selected from the composites Enamel-Plus HRi/Micerium, Miris-2/Coltene, IPS Empress-Direct/Ivoclar and Filtek-Supreme/3M ESPE and light and dark shades from the TPH-Spectum/Densply monochromatic composite. Five disks (d = 10mm, h = 1mm) per material, enamel/dentine and light/dark shade were prepared. A colorimetric evaluation, over white and black background, according to the CIELab system was performed just after preparation and after one-week and one-month dark water-storage at 37°C. Color (ΔEab) and translucency (ΔTP) differences were calculated. Results were analysed by ANOVA and Scheffe's test, paired t-test and linear regression analysis (a = 0.05). RESULTS: One-week water ageing provided a wide range of ΔEab values (0.79 Filtek(e)/D2 to 5.19 Filtek(d)/A1) and ΔTP values (-2.74 Hri/UD1 to 1.03 TPH/A1). After one-month water ageing ΔEab ranged from 1.09 Filtek(e)/D2 to 7.94 Filtek(d)/A1 and ΔTP values from -2.71Hri/UD1 to 1.07 Filtek(d)/A4. Significant changes in ΔEab between one-week and one-month water ageing were noted for Filtek and Miris dentine and Miris light enamel shades. As for ΔTP, significant difference was recorded only for IPS(e)/A4. ΔEab was significantly correlated with ΔL, Δα, Δb and ΔTP after one-week and with ΔL and Δα after one-month ageing. CONCLUSIONS: Water ageing caused remarkable color changes, which were material and shade depended. Thirteen out of eighteen of the tested composites exhibited clinically perceptible (ΔEab>2.6) color changes even after short water ageing period.

The course of childhood anxiety symptoms: developmental trajectories and child-related factors in normal children.

This three-wave longitudinal study explored developmental trajectories for various types of childhood anxiety symptoms (i.e., specific fears, social anxiety, generalized anxiety, and separation anxiety) and examined how these trajectories were associated with several factors thought to be involved in the pathogenesis of anxiety. Parents of a community sample of 224 children aged 4 to 11 years repeatedly completed a standardized questionnaire of anxiety symptoms during a 2-year period. At Time 1, parents also filled out scales for measuring children's level of behavioral inhibition (BI), internalizing and externalizing symptoms, and prosocial behaviors, while an interview was conducted with children to assess Theory-of-Mind (TOM) ability. Growth Mixture Modeling identified multiple developmental trajectories in childhood anxiety symptoms of which the 'stable-low' or 'stable-medium' reflected the normative trajectories. Further, multinomial regression analyses indicated that the higher developmental trajectories of anxiety were associated with higher levels of BI and internalizing symptoms at Time 1. In sum, results show heterogeneity in the development of anxiety symptoms and underline the importance of early prevention programs for children at high risk for developing an anxiety disorder.

Effects of symptoms of ADHD, ODD, and cognitive functioning on social acceptance and the positive illusory bias in children.

OBJECTIVE: To examine the effects of symptoms of ADHD and ODD and cognitive functioning on social acceptance and positive bias in children. METHOD: The sample consisted of 86 children (49 girls) between 7 and 13 years old, recruited to reflect a wide range of ADHD symptoms. Parents and teachers reported on ADHD and ODD symptoms and social acceptance. Children reported on social acceptance and were given tasks measuring working memory, inhibition and reaction-time variability. A discrepancy score between child and adult reports of social acceptance was used as a measure of positive bias. RESULTS: Inattention independently explained variance in social acceptance. The cognitive factors were related to social acceptance and the positive bias, but not beyond the ADHD and ODD symptoms. CONCLUSION: It is primarily disruptive behavior that contributes to external reports of children's social acceptance.

Gender differences in the development and adult outcome of co-occurring depression and delinquency in adolescence.

Using a dual trajectory modeling approach, we examined co-occurring trajectories of depression and delinquency from age 11 to age 18 and their relation to adult outcome six years later in a community sample of 1423 (674 boys) adolescents. We also examined the effects of childhood externalizing, internalizing, and social problems on trajectory membership for depression and delinquency. The results showed that although more girls than boys were likely to follow high-level, co-occurring trajectories on depression and delinquency, the adult outcome of adolescents following high-level trajectories on both domains was poorer for boys than for girls. However, the combination of decreasing depression symptoms and increasing delinquency symptoms across adolescence was related with poorer adult outcomes for girls compared to boys. Finally, whereas boys' high-level co-occurring trajectory of depression and delinquency was predicted by childhood aggression, girls' equivalent trajectory was predicted by childhood depression and delinquency. The findings support the "gender paradox" effect (Loeber & Keenan, 1994) stating that in disorders with an unequal gender ratio, members of the gender with the lower prevalence rate tend to be more seriously affected in terms of comorbidity and poor outcome.

The parallel development of ODD and CD symptoms from early childhood to adolescence.

This study examined the developmental relations between symptoms of oppositional defiant disorder (ODD) and conduct disorder (CD) from early childhood to adolescence. Specifically we tested, according to parent-reported problems, whether symptoms of ODD precede the development of CD symptoms, whether ODD and CD symptoms are reciprocally associated across time, or whether ODD and CD symptoms develop parallel to each other across time. Participants were a community-based sample (at time 1: N = 485, 48% boys) assessed biannually five times from age 4 to 6 until age 12-14. The findings suggested that, with control for stability effects, baseline SES, and symptoms of attention deficit hyperactivity disorder, ODD and CD symptoms develop parallel to each other. No gender differences were obtained. We conclude that without the initial presence of CD symptoms, ODD symptoms are not developmental precursors to CD symptoms.

Visual working memory capacity and stimulus categories: a behavioral and electrophysiological investigation.

It has recently been suggested that visual working memory capacity may vary depending on the type of material that has to be memorized. Here, we use a delayed match-to-sample paradigm and event-related potentials (ERP) to investigate the neural correlates that are linked to these changes in capacity. A variable number of stimuli (1-4) were presented in each visual hemifield. Participants were required to selectively memorize the stimuli presented in one hemifield. Following memorization, a test stimulus was presented that had to be matched against the memorized item(s). Two types of stimuli were used: one set consisting of discretely different objects (discrete stimuli) and one set consisting of more continuous variations along a single dimension (continuous stimuli). Behavioral results indicate that memory capacity was much larger for the discrete stimuli, when compared with the continuous stimuli. This behavioral effect correlated with an increase in a contralateral negative slow wave ERP component that is known to be involved in memorization. We therefore conclude that the larger working memory capacity for discrete stimuli can be directly related to an increase in activity in visual areas and propose that this increase in visual activity is due to interactions with other, non-visual representations.

Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: results of a 24-year longitudinal study.

OBJECTIVE: Childhood externalizing behavior is found to be relatively persistent. Developmental pathways within types of externalizing behavior have been recognized from childhood to adolescence. We aimed to describe the prediction of adult DSM-IV disorders from developmental trajectories of externalizing behavior over a period of 24 years on a longitudinal multiple birth cohort study of 2,076 children. This has not been examined yet. METHODS: Trajectories of the four externalizing behavior types aggression, opposition, property violations, and status violations were determined separately through latent class growth analysis (LCGA) using data of five waves, covering ages 4-18 years. Psychiatric disorders of 1,399 adults were assessed with the CIDI. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric disorders. RESULTS: All externalizing behavior types showed significant associations with disruptive disorder in adulthood. In all antisocial behavior types high-level trajectories showed the highest probability for predicting adult disorders. Particularly the status violations cluster predicted many disorders in adulthood. The trajectories most often predicted disruptive disorders in adulthood, but predicted also anxiety, mood, and substance use disorders. CONCLUSIONS: We can conclude that an elevated level of externalizing behavior in childhood has impact on the long-term outcome, regardless of the developmental course of externalizing behavior. Furthermore, different types of externalizing behavior (i.e., aggression, opposition, property violations, and status violations) were related to different adult outcomes, and children and adolescents with externalizing behavior of the status violations subtype were most likely to be affected in adulthood.

Predicting adult emotional and behavioral problems from externalizing problem trajectories in a 24-year longitudinal study.

The aim of this study was to examine the prediction of adult behavioral and emotional problems from developmental trajectories of externalizing behavior in a 24-years longitudinal population-based study of 2,076 children. The adult psychiatric outcome of these trajectories has not yet been examined. Trajectories of the four externalizing behavior types: aggression, opposition, property violations and status violations were determined separately through latent class growth analysis using data of five waves, covering ages 4-18 years. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric problems based on the Adult Self-Report. The developmental trajectories of the four types of externalizing behavior mostly predicted intrusive, aggressive and rule-breaking behavior in adulthood. Non-destructive behaviors in childhood such as opposition and status violations predict adult problems to a larger extent than destructive behaviors such as aggression and property violations. In general, children who develop through high-level trajectories are likely to suffer from both internalizing and externalizing problem behavior in adulthood, regardless the direction of change (i.e. increasing/decreasing/persisting) of the high-level trajectory. We can conclude that the level rather than the developmental change of externalizing behavior problems has a larger impact on adult outcome.