Comparison of the third molar maturity index (I3M) between left and right lower third molars to assess the age of majority: a multi-ethnic study sample.

The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10,181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.

Assessment of intraoral image artifacts related to photostimulable phosphor plates in a dentomaxillofacial radiology department.

OBJECTIVE: The aim of the present study was to evaluate the presence, frequency, and causes of artifacts in intraoral images obtained using photostimulable phosphor (PSP) plates. MATERIALS AND METHODS: A total of 11,443 intraoral images, including 4291 periapical and 7152 bitewing images, acquired over a 6-month period as well as over a month 1-year after the initial imaging were evaluated by a single observer and image artifacts only related to the PSP system were recorded. Before the study, an experienced dentomaxillofacial radiologist and a research assistant assessed a set of image artifacts and agreed on the causes of these artifacts. All unidentified artifacts were reassessed by both researchers before the final decision. The data were analyzed using the statistical software SPSS 11.5. RESULTS: The total number of images with one or more artifacts was 2344 (20.4%). Of these, 2008 were of adult patients and 336 were of pediatric patients. While movement of the phosphor plate in the disposable pocket was the most common cause of the observed image artifacts in the children, non-uniform image brightness was the most frequently observed artifact in the case of the adults. CONCLUSION: The percentage of images with artifacts in the 6th month was lower than that during the 1st month. More significantly, the lowest percentage was obtained 1-year after the initial imaging, owing to the increase in familiarity with the system. Understanding the reasons for the image artifacts and studying ways of preventing are of high clinical importance.

The reliability of Cameriere's method in Turkish children: a preliminary report.

Dental age estimation in children is an important issue both legally and medically. Currently, however, there is a lack of contemporary dental age estimation standards for a Turkish population. This study assessed the accuracy of Cameriere's method by examining the panoramic radiographs of 573 healthy Turkish children between the ages of 8 and 15 years. Radiographs of the left permanent developing mandibular teeth, except wisdom teeth, were evaluated. All subjects were divided into 7 groups according to their chronological age. The Intra-class Correlation Coefficient was used to determine the intra- and inter-observer agreement error. A comparison of the distributions of estimation errors among age groups was performed using the Nemenyi test. There were no significant differences between inter-observer (p=0.352), and intra-observer readings after 2 weeks (p=0.275 and p=0.273, respectively). The dental age was underestimated when using Cameriere's method with a mean difference of -0.35 years (-0.24 years for girls and -0.47 years for boys). The median values of the differences between dental and chronological age were -0.44 years in boys (range: -3.70, 4.06) and -0.21 years in girls (range: -2.74, 3.29). In addition, the differences between dental and chronological ages in the different age groups decreased with increasing chronological age. Results from the Nemenyi test implied that Cameriere's method is more accurate for girls than for boys in this cohort of a Turkish population.

Alveolar ridge preservation with a free gingival graft in the anterior maxilla: volumetric evaluation in a randomized clinical trial.

The aim of this study was to evaluate and compare the dimensional changes in maxillary extraction sockets that have healed spontaneously and those treated with free gingival grafts. Ten subjects with at least two maxillary anterior teeth scheduled for extraction were selected for this study. Two maxillary teeth were allocated randomly to either the test group or the control group. In the test group, the extraction socket was covered with a free gingival graft harvested from the palate, while in the control group the sockets healed spontaneously. Cone beam computed tomography (CBCT) scans were taken on the day of extraction and at 3 months postoperative. Soft tissue healing of the extraction sockets was assessed visually by clinical inspection. Hard tissue measurements were obtained from the CBCT scans. After 3 months of healing, the control sockets had lost height in the buccal and lingual crestal bones (-1.03 and -0.56mm, respectively); however, the height in the buccal and lingual crestal bones was preserved at the test sites (+0.06 and +0.25mm, respectively). This difference between the two groups was statistically significant (P<0.05). In contrast, both the control and test groups lost width in the buccal and lingual crestal bones; the difference between the control and test groups was not statistically significant (P>0.05). The authors propose that covering the orifice of the extraction socket with a free gingival graft can result in preservation of the alveolar bone height.

Assessment of bone mineral density in the jaws and its relationship to radiomorphometric indices.

OBJECTIVES: The aim of this study was to evaluate maxillary, mandibular and femoral neck bone mineral density using dual energy X-ray absorptiometry (DXA) and to determine any correlation between the bone mineral density of the jaws and panoramic radiomorphometric indices. METHODS: 49 edentulous patients (18 males and 31 females) aged between 41 and 78 years (mean age 60.2 +/- 11.04) were examined by panoramic radiography. Bone mineral density (BMD) of the jaws and femoral neck was measured with a DXA; bone mineral density was calculated at the anterior, premolar and molar regions of the maxilla and mandible. RESULTS: The mean maxillary molar BMD (0.45 g cm(-2)) was significantly greater than the maxillary anterior and premolar BMD (0.31 g cm(-2), P < 0.05). Furthermore, the mean mandibular anterior and premolar BMD (1.39 g cm(-2) and 1.28 g cm(-2), respectively) was significantly greater than the mean mandibular molar BMD (1.09 g cm(-2), P < 0.01). Although BMD in the maxillary anterior and premolar regions were correlated, BMD in all the mandibular regions were highly correlated. Maxillary and mandibular BMD were not correlated with femoral BMD. In addition, mandibular cortical index (MCI) classification, mental index (MI) or panoramic mandibular index (PMI) values were not significantly correlated with the maxillary and mandibular BMDs (P > 0.05). CONCLUSIONS: The BMD in this study was highest in the mandibular anterior region and lowest in the maxillary anterior and premolar regions. The BMD of the jaws was not correlated with either femoral BMD or panoramic radiomorphometric indices.

A radiographic assessment of the prevalence of pulp stones in a group of Turkish dental patients.

AIM: To determine the prevalence of pulp stones in a group of patients using radiographs, and to assess any associations with age, gender, systemic diseases, tooth type, jaw, caries, restorations, impacted third molars and dental anomalies including dens invaginatus, taurodontism, dens evaginatus and microdontia. METHODOLOGY: A total of 519 patients were selected randomly amongst patients referred to Oral Diagnosis and Radiology Department, Faculty of Dentistry, Ankara University. After clinical inspection, full-mouth periapical radiographs were obtained. An oral radiologist examined the radiographs to identify pulp stones. Frequency distribution of teeth with pulp stones was calculated and statistical analysis was performed with chi-square test. RESULTS: Of the patients, 313 (60%) were female and 206 (40%) were male. Sixty (12%) had one or more teeth that contained pulp stones. Amongst the 13,474 teeth examined radiographically, 627 (5%) had pulp stones. There was no significant association between pulp stone occurrence and gender or systemic diseases. As age increased, the prevalence of pulp stones increased (P < 0.01). Molars had statistically more pulp stones than premolars and incisors (P < 0.001). Frequencies in both maxillary and mandibular jaw were similar. There was no association between pulp stones and impacted third molars, caries, restorations or dental anomalies. CONCLUSIONS: The prevalence of pulp stones increased with age and was significantly higher in molar teeth than premolars and incisors. There was no significant association between pulp stones and gender, systemic diseases, impacted third molars, condition of the crown and dental anomalies.

Assessment of panoramic radiomorphometric indices in Turkish patients of different age groups, gender and dental status.

OBJECTIVES: The aim of the study was to determine the distribution of the appearance of the inferior mandibular cortex (Mandibular Cortical Index (MCI)) in a large Turkish population group and to assess a range of values for cortical width at the mental foramen region (Mental Index (MI)) and the ratio of the thickness of the mandibular cortex to the distance between the inferior margin of the mental foramen and the inferior mandibular cortex (Panoramic Mandibular Index (PMI)) according to the MCI. In addition, we assess how age, sex and dental status affected the MCI. METHODS: Panoramic radiographs of 1,863 patients, 698 (37.5%) men and 1,165 (62.5%) women over 20 years old, were assessed during 2005-2006 from the files of Baskent University. Gender, age and dental status were recorded for each patient. MCI classifications, MI and PMI values in the MCI groups were evaluated and comparisons were made using logistic regression analysis. RESULTS: Compared with patients aged 20-49 years, the likelihood of MCI C3 category in patients over 70 years of age and in patients aged 50-69 years of age was 79.14 and 9.17 times higher. The likelihood of the C3 category in edentulous and partially dentate patients was 27.30 and 2.68 times higher than in fully dentate patients, respectively. The likelihood of C3 category in patients with MI <3 mm was 14.86 times higher than in patients with MI >or=3 mm; also, in patients with a PMI of <0.30 this likelihood was 9.78 times higher than in patients with a PMI of >or=0.30. CONCLUSION: Without respect to gender, edentulous patients with C3 category, MI <3 mm and PMI <0.30 may be seen as high-risk patients for osteoporosis and therefore should be referred for further osteoporosis investigation.

Frequency of root-filled teeth and prevalence of apical periodontitis in an adult Turkish population.

AIM: To report the frequency and distribution of root-filled teeth as well as the prevalence of apical periodontitis in an adult population in Turkey. SUMMARY: Digital panoramic radiographs of 1000 patients who were examined at the Baskent University Faculty of Dentistry between December 2004 and May 2005 were evaluated. Patients ageing <15 years and those with less than nine remaining teeth were excluded. The coronal and periapical status of all the teeth with the exception of third molars was examined according to the criteria proposed by De Moor et al. (2000). Statistical analysis was performed with the Rao and Scott adjusted chi-square test for the comparison of clustered binary data. In all, 24 433 teeth were examined. A total of 346 teeth (1.4%) had radiographic signs of apical periodontitis, and 812 were root filled (3.3%). Of the 812 root-filled teeth, 148 (18.2%) had apical periodontitis. Of the 23,621 nonroot-filled teeth, 198 (0.8%) had apical periodontitis. The number of root-filled teeth in male subjects was significantly less than that in female subjects (P < 0.001), but the presence of apical periodontitis in male subjects was significantly higher than that in female subjects (P < 0.05). KEY LEARNING POINTS: * The prevalence of apical periodontitis and the frequency of root-filled teeth with apical periodontitis were lower than in comparable populations in other countries. * The number of root-filled teeth was comparable to that found in other epidemiologic studies.