Validation of radiographic visibility of root pulp in mandibular first, second and third molars in the prediction of 21 years in a sample of south Indian population: A digital panoramic radiographic study.

This study examines the radiographic visibility of root pulp (RPV) in lower first, second and third molars to validate the completion of 21 years. RPV in all lower three molars of both sides was assessed using a sample of 930 orthopantomograms of individuals aged between 15 and 30. The scoring of RPV was done using the Olze et al. four-stage classification (Int J Legal Med 124(3):183-186, 2010). Cut-off values were determined for each molar using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). The selected cut-off values were stage 3 for the first molar, stage 2 for the second molar and stage 1 for the third molar. For lower first molar, the AUC was 0.702, and the sensitivity, specificity and posttest probability (PTP) were 60.1%, 98.8% and 98.1% in males, and 64.5%, 99.1% and 98.6% in females. For lower second molar, the AUC was 0.828, and the sensitivity, specificity and PTP were 75.5%, 97% and 96.2% in males, and 74.4%, 96.3% and 95.3% in females. For the lower third molar, the AUC was 0.906; the sensitivity was 74.1% and 64.4% in males and females, while specificity and PTP were 100% in both sexes. The accuracy of predictions for the completion of 21 years was high. However, the greater percentage of false negatives and inapplicability of this method in one-third of lower-third molars have been recommended for using this method in conjunction with other dental or skeletal methods.

Testing the maturation and the radiographic visibility of the root pulp of mandibular third molars for predicting 21 years. A digital panoramic radiographic study in emerging adults of south Indian origin.

Prediction of the attainment of legal age thresholds, especially in children and young adults, is a common task in medico-legal practice. In many countries, 21 years has medico-legal importance. In the present study, we assessed and compared the accuracy of the third molar maturity index (I3M) and the stages of radiographic visibility of the root pulp (RPV) in predicting the age threshold of 21 years. A sample of 910 digital panoramic radiographs (455 males and 455 females) of adolescents and young adults aged between 16 and 30 of south Indian origin were evaluated. The authors examined the performance of different I3M cut-off values and RPV stages. I3M cut-off value of 0.02 has resulted in better discrimination with an accuracy of 76.92% and 80.44%, specificity of 48.28% and 56.16% in males and females, a sensitivity of 100%, and post-test probability of 65.9% in both sexes. The accuracy and sensitivity of RPV stage 2 were 84.76% and 84.55%, 78.17%, and 78.97% in males and females, while the specificity and post-test probability were 100% in both sexes. In conclusion, the I3M method resulted in a more significant percentage of false positives and cannot be used to state the attainment of 21 years. However, the presence of RPV stage 2 could say that the subject had already attained the age of 21 years. Further studies are warranted to address the usefulness of these methods.

Parenting practices and children's dental caries experience: A structural equation modelling approach.

AIM: To evaluate the direct and mediated associations between parenting practices and dental caries experience in Indian school children. METHODS: The target population consisted of school children and their parents (N=1539) of Medak district in the state of Telangana, India. Parents completed a questionnaire that consisted of questions related to socioeconomic status (SES), family structure, the number of children, their own oral hygiene behaviour and parenting practices. Parenting practices were assessed using a translated version of the short form of Parent-Child Relationship Questionnaire (PCRQ) which was found to have two factors, power assertion (ie over control and coercion) and positive parenting (warmth and positive parent-child interaction). Children completed a questionnaire on tooth brushing frequency, dental visiting and sugar consumption practices to evaluate their oral hygiene behaviour, and underwent a clinical examination for dental caries by a single examiner. Path analysis was used to explore the influence of parent-child relationship, SES and other family-level variables on dental caries experience of children. RESULTS: Parents' oral hygiene behaviour was positively (ß=0.18, P=0.009), and power assertion negatively (ß=-0.06, P=0.041) associated with children's oral hygiene behaviours. Families reporting higher SES had children with less dental caries experience (ß=-0.10, P=0.028) and better oral hygiene behaviour (ß=0.13, P=0.009). Power assertion parenting had an indirect association with dental caries experience (ß=0.003, P=0.038). CONCLUSIONS: Children had higher dental caries experience when they lived in families with lower SES and used more power assertion parenting practices.

Effect of Toothbrushing Frequency on Incidence and Increment of Dental Caries: A Systematic Review and Meta-Analysis.

Toothbrushing is considered fundamental self-care behavior for maintenance of oral health, and brushing twice a day has become a social norm, but the evidence base for this frequency is weak. This systematic review and meta-analysis aims to assess the effect of toothbrushing frequency on the incidence and increment of carious lesions. Medline, Embase, Cinahl, and Cochrane databases were searched. Screening and quality assessment were performed by 2 independent reviewers. Three different meta-analyses were conducted: 2 based on the caries outcome reported in the studies (incidence and increment) with subgroup analyses of categories of toothbrushing frequency; another included all studies irrespective of the caries outcome reported with the type of dentition as subgroups. Meta-regression was conducted to assess the influence of sample size, follow-up period, diagnosis level for carious lesions, and methodological quality of the articles on the effect estimate. Searches retrieved 5,494 titles: after removing duplicates, 4,305 remained. Of these, 74 were reviewed in full, but only 33 were eligible for inclusion. Self-reported infrequent brushers demonstrated higher incidence (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.34 to 1.69) and increment (standardized mean difference [SMD], 0.28; 95% CI: 0.13 to 0.44) of carious lesions than frequent brushers. The odds of having carious lesions differed little when subgroup analysis was conducted to compare the incidence between ≥2 times/d vs <2 times/d (OR: 1.45; 95% CI: 1.21 to 1.74) and ≥1 time/d vs <1 time/d brushers (OR: 1.56; 95% CI: 1.37 to 1.78). When meta-analysis was conducted with the type of dentition as subgroups, the effect of infrequent brushing on incidence and increment of carious lesions was higher in deciduous (OR: 1.75; 95% CI: 1.49 to 2.06) than permanent dentition (OR: 1.39; 95% CI: 1.29 to 1.49). Findings from meta-regression indicated that none of the included variables influenced the effect estimate.

Effectiveness of a mouthrinse containing active ingredients in addition to chlorhexidine and triclosan compared with chlorhexidine and triclosan rinses on plaque, gingivitis, supragingival calculus and extrinsic staining.

OBJECTIVES: To assess the effectiveness of three different mouthrinses--chlorhexidine, triclosan + sodium fluoride and chlorhexidine + triclosan + sodium fluoride + zinc chloride--on plaque, calculus, gingivitis and stains and to evaluate the occurrence of adverse effects with these three treatments. METHODS: Forty-eight healthy subjects participated in a double-blind, randomized, parallel experiment and were randomly allocated to any one of the three experimental mouthrinses: group A (0.2% chlorhexidine (CHX) gluconate), group B (0.03% triclosan + 0.025% sodium fluoride (NaF) + 12% ethyl alcohol) or group C (0.2% CHX + 0.3% triclosan + 0.3% NaF + 0.09% Zn chloride (ZnCl(2)). All the subjects were assessed for gingivitis, plaque, supragingival calculus and extrinsic stains at baseline and at the end of the 21-day experimental period. RESULTS: There was a significant difference (P = 0.046) in the effectiveness for the prevention of gingivitis and plaque, with subjects of group A and group C presenting least and highest gingival and plaque scores, respectively. Significant differences (P = 0.03) were observed for the accumulation of supragingival calculus where the deposition of calculus in group A was nearly double that of the group B, and group B was most effective in the prevention of supragingival calculus. Highest deposition of extrinsic stains was in the group A followed by group C and group B. There was no significant difference between the three treatments for adverse events' occurrence. CONCLUSIONS: CHX mouthrinse was most effective in controlling plaque and gingivitis but caused greatest deposition of extrinsic stains. Supragingival calculus deposition was least in triclosan + NaF group followed by CHX + triclosan + NaF + ZnCl(2) and CHX. More than half of the subjects reported adverse events during the experimental phase.

Oral health related quality of life among children with parents and those with no parents.

OBJECTIVES: To compare the oral health related quality of life (OHRQoL) and caries status between school children living with their parents and orphan children, and to assess the factors that influence the oral health related quality of life. METHODS: Study sample consisted of 279 school children living with their parents and 257 orphan children thus making a total sample of 536 school children. Sampling frame comprised of 12-15 year old children attending two upper primary public schools and two special schools for orphan children at Udaipur city, India. Clinical examination for caries status and personal interviews for oral health related quality of life were conducted by a single investigator. RESULTS: Children without parents presented poor scores for OHRQoL compared to those having parents. Caries status was significantly related to OHRQoL and its domains. Subjects with no caries reported good OHRQoL which deteriorated as the caries score increased. Children who never visited dentist reported poorer OHRQoL than regular visitors and males experienced better oral health quality of life than females. All the four variables (gender, group, dental visits and DMFT) entered the step wise linear regression analysis when the effect of each independent variable was adjusted for all others and were responsible for a variance of 21.6% for OHRQoL; however DMFT constituted the first best predictor which solely explained a variance 15.8%. CONCLUSIONS: Oral health related quality of life along with its domains differed significantly between children with and without parents. Furthermore, gender, dental visiting habits and caries status significantly influenced the OHRQoL.