Comparative Analysis of the Comfort of Children and Adolescents in Digital and Conventional Full-Arch Impression Methods: A Crossover Randomized Trial.

The aim of this study was to evaluate the comfort of children and adolescents with conventional full-arch dental impression methods compared to two intraoral scanners (iTeroTM and PrimescanTM). METHODS: A monocentric, analytical, controlled crossover study was designed to compare conventional impression and digital impression with two intraoral scanners (iTeroTM and PrimescanTM) in children and teenagers. Patient comfort was evaluated using a 100 mm VAS scale adapted to Spanish and for children. A descriptive and analytical statistical method was conducted with a confidence level of 95% (p ≤ 0.05) and asymptotic or bilateral significance. RESULTS: A total of 51 subjects were enrolled in the study (mean age = 12.35 years). Although the group of 10-14-year-olds was the most numerous, gender was equally distributed among the age groups. None of the variables on the VAS scale showed differences between the gender categories (p > 0.05). There were differences (p < 0.05) with respect to the age categories, as the middle adolescent group showed the worst general perception and total comfort during the conventional impression. Statistically significant differences were found between all VAS scale items and the three impression methods (p < 0.05). CONCLUSIONS: The digital impression technique is superior in terms of total comfort to the conventional alginate impression in children and adolescents.

Limas rotatorias de uso en Odontopediatría: revisión de la literatura / Rotary files for use in pediatric dentistry: Literature review

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)

Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)

Técnicas de manejo de conducta en odontopediatría: aspectos éticos y legales / Behavioral management techniques in pediatric dentistry: ethical and legal aspects

Introducción: la profesión odontológica es una actividad orientada al cuidado de personas, entre ellos los niños, que necesitan un cuidado más específico estando en pleno desarrollo físico y emocional. Al trabajar con los niños se tiene que lidiar con la ansiedad con la que el pequeño entra por primera vez a la consulta. Para solucionar este problema, se han descrito diferentes técnicas cuya elección depende de la edad, de las necesidades del paciente y de la habilidad profesional. Estas técnicas se pueden agrupar en tres grupos: técnicas farmacológicas, técnicas comunicativas y técnicas no comunicativas. Objetivo: revisar la evidencia científica sobre los aspectos éticos y legales de las técnicas de manejo de conducta en odontopediatría. Material y método: se realizó una búsqueda en las bases de datos de PubMed/ Medline, Google Scholar y Scopus de acuerdo a unos criterios de inclusión y exclusión. Resultados: los resultados determinan que el empleo de las técnicas de manejo de conducta disminuye los niveles de ansiedad durante el tratamiento dental. El bajo nivel socioeconómico y educativo, y la utilización frecuente de videojuegos aumentan la ansiedad dental mientras la realización de deporte y una vida saludable la disminuyen. Conclusiones: entre las técnicas de manejo de conducta del paciente pediátrico, las de gestión comunicativa son las más aceptadas por los padres. Aunque no hay ninguna prohibición legal en el uso de técnicas farmacológicas o no comunicativas, estas la mayoría de las veces son rechazadas por los padres. (AU)

Introduction: The dental profession is an activity oriented to the people care, including children, who need more specific care being in full physical and emotional development. When working with children you have to deal with the anxiety with which the child first enters the consultation. To solve this problem, different techniques have been described whose choice depends on the age, patient needs and professional skills. These techniques can be grouped into three groups: pharmacological techniques, communicative techniques and noncommunicative techniques. Objective: To review scientific evidence on the ethical and legal aspects of behavioral management techniques in pediatric dentistry. Material and method: A search was performed in the databases of PubMed/ Medline, Google Scholar y Scopus, according to inclusion and exclusion criteria. Results: The results determine that the use of behavioral management techniques decreases anxiety levels during dental treatment. The low socioeconomic and educational level and the frequent use of video games increase dental anxiety while the performance of sports and a healthy life decrease it. Conclusions: Among the pediatric patient behavior management techniques, those with communicative management were the most accepted by parents. Although there is no legal prohibition on the use of pharmacological or non-communicative techniques, these are most often rejected by parents. (AU)

Metagenómica salival aplicada en Odontología: revisión bibliográfica / Salivary metagenomics applied in dentistry: Literature review

Introducción: la metagenómica es un campo nuevo en el que se persigue obtener secuencias del genoma de los diferentes microorganismos que componen una comunidad, extrayendo y analizando su ADN de forma global. La posibilidad de secuenciar directamente los genomas de microorganismos sin necesidad de cultivarlos abre nuevas opciones que suponen un cambio de rumbo en la microbiología, sobre todo, teniendo en cuenta que en la cavidad oral sólo el 35% han sido identificadas. La microbiota oral humana es la comunidad de microorganismos comensales, simbióticos y patógenos que se encuentran en la cavidad oral. La saliva juega un papel importante en la determinación de su composición y actividad, siendo bien reconocida como un conjunto de marcadores biológicos, que se puede recolectar fácilmente, de forma no invasiva, indolora y no traumática, por lo que podría ser un sustituto de la sangre en el pronóstico y diagnóstico de enfermedades. Material y método: se realizó una búsqueda bibliográfica en Pubmed de acuerdo con unos criterios de inclusión y exclusión previamente establecidos. Resultados: fueron seleccionadas un total de 37 referencias bibliográficas entre 2010-2023. Conclusión: el análisis microbiológico de la saliva es una alternativa fácil y no invasiva. La microbiota salival refleja las alteraciones bacterianas locales que se producen en la microbiota subgingival y supragingival. Por ello resulta interesante poder ampliar el conocimiento en el mundo microbiano oral, y poder ayudar a definir con más exactitud la etiología de la caries y periodontitis y así poder avanzar hacia tratamientos preventivos y curativos mucho más eficaces. (AU)

Introduction: Metagenomics is a new field in which the aim is to obtain genome sequences of the different microorganisms that make up a community, extracting and analyzing their DNA globally. The possibility of directly sequencing the genomes of micoorganism, without the need to cultive them, opens up new options that represent a change of direction in microbiology, especially considering that only 35% have been identified in the oral cavity. The human oral microbiota is the community of commensal, symbiotic and pathogenic microorganisms found in the oral cavity. Saliva plays an important role in determining its composition and activity, being well recognized as a set of biological markers, wich can be easily collected and non-invasive, painless and non-traumatic way, so it could be a substitute for blood in the prognosis and diagnosis of diseases. Method: A literature search was carried out in Pubmed according to previously established inclusion and exclusion criteria. Results: A total of 37 bibliographic references were selected between 20102023. Conclusion: Microbiological analysis of saliva is an easy and non-invasive alternative. The salivary microbiota reflects the local bacterial alterations that occur in the subgingival and supragingival microbiota. It is therefore interesting to be able to expand knowledge in the oral microbial world, and to be able to help define more accurately the etiology of caries and periodontitis and thus be able to move towards much more effective preventive and curative treatments. (AU)

Limas rotatorias de uso en Odontopediatría: revisión de la literatura / Rotary files for use in pediatric dentistry: Literature review

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)

Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)

Técnicas de manejo de conducta en odontopediatría: aspectos éticos y legales / Behavioral management techniques in pediatric dentistry: ethical and legal aspects

Introducción: la profesión odontológica es una actividad orientada al cuidado de personas, entre ellos los niños, que necesitan un cuidado más específico estando en pleno desarrollo físico y emocional. Al trabajar con los niños se tiene que lidiar con la ansiedad con la que el pequeño entra por primera vez a la consulta. Para solucionar este problema, se han descrito diferentes técnicas cuya elección depende de la edad, de las necesidades del paciente y de la habilidad profesional. Estas técnicas se pueden agrupar en tres grupos: técnicas farmacológicas, técnicas comunicativas y técnicas no comunicativas. Objetivo: revisar la evidencia científica sobre los aspectos éticos y legales de las técnicas de manejo de conducta en odontopediatría. Material y método: se realizó una búsqueda en las bases de datos de PubMed/ Medline, Google Scholar y Scopus de acuerdo a unos criterios de inclusión y exclusión. Resultados: los resultados determinan que el empleo de las técnicas de manejo de conducta disminuye los niveles de ansiedad durante el tratamiento dental. El bajo nivel socioeconómico y educativo, y la utilización frecuente de videojuegos aumentan la ansiedad dental mientras la realización de deporte y una vida saludable la disminuyen. Conclusiones: entre las técnicas de manejo de conducta del paciente pediátrico, las de gestión comunicativa son las más aceptadas por los padres. Aunque no hay ninguna prohibición legal en el uso de técnicas farmacológicas o no comunicativas, estas la mayoría de las veces son rechazadas por los padres. (AU)

Introduction: The dental profession is an activity oriented to the people care, including children, who need more specific care being in full physical and emotional development. When working with children you have to deal with the anxiety with which the child first enters the consultation. To solve this problem, different techniques have been described whose choice depends on the age, patient needs and professional skills. These techniques can be grouped into three groups: pharmacological techniques, communicative techniques and noncommunicative techniques. Objective: To review scientific evidence on the ethical and legal aspects of behavioral management techniques in pediatric dentistry. Material and method: A search was performed in the databases of PubMed/ Medline, Google Scholar y Scopus, according to inclusion and exclusion criteria. Results: The results determine that the use of behavioral management techniques decreases anxiety levels during dental treatment. The low socioeconomic and educational level and the frequent use of video games increase dental anxiety while the performance of sports and a healthy life decrease it. Conclusions: Among the pediatric patient behavior management techniques, those with communicative management were the most accepted by parents. Although there is no legal prohibition on the use of pharmacological or non-communicative techniques, these are most often rejected by parents. (AU)

Metagenómica salival aplicada en Odontología: revisión bibliográfica / Salivary metagenomics applied in dentistry: Literature review

Introducción: la metagenómica es un campo nuevo en el que se persigue obtener secuencias del genoma de los diferentes microorganismos que componen una comunidad, extrayendo y analizando su ADN de forma global. La posibilidad de secuenciar directamente los genomas de microorganismos sin necesidad de cultivarlos abre nuevas opciones que suponen un cambio de rumbo en la microbiología, sobre todo, teniendo en cuenta que en la cavidad oral sólo el 35% han sido identificadas. La microbiota oral humana es la comunidad de microorganismos comensales, simbióticos y patógenos que se encuentran en la cavidad oral. La saliva juega un papel importante en la determinación de su composición y actividad, siendo bien reconocida como un conjunto de marcadores biológicos, que se puede recolectar fácilmente, de forma no invasiva, indolora y no traumática, por lo que podría ser un sustituto de la sangre en el pronóstico y diagnóstico de enfermedades. Material y método: se realizó una búsqueda bibliográfica en Pubmed de acuerdo con unos criterios de inclusión y exclusión previamente establecidos. Resultados: fueron seleccionadas un total de 37 referencias bibliográficas entre 2010-2023. Conclusión: el análisis microbiológico de la saliva es una alternativa fácil y no invasiva. La microbiota salival refleja las alteraciones bacterianas locales que se producen en la microbiota subgingival y supragingival. Por ello resulta interesante poder ampliar el conocimiento en el mundo microbiano oral, y poder ayudar a definir con más exactitud la etiología de la caries y periodontitis y así poder avanzar hacia tratamientos preventivos y curativos mucho más eficaces. (AU)

Introduction: Metagenomics is a new field in which the aim is to obtain genome sequences of the different microorganisms that make up a community, extracting and analyzing their DNA globally. The possibility of directly sequencing the genomes of micoorganism, without the need to cultive them, opens up new options that represent a change of direction in microbiology, especially considering that only 35% have been identified in the oral cavity. The human oral microbiota is the community of commensal, symbiotic and pathogenic microorganisms found in the oral cavity. Saliva plays an important role in determining its composition and activity, being well recognized as a set of biological markers, wich can be easily collected and non-invasive, painless and non-traumatic way, so it could be a substitute for blood in the prognosis and diagnosis of diseases. Method: A literature search was carried out in Pubmed according to previously established inclusion and exclusion criteria. Results: A total of 37 bibliographic references were selected between 20102023. Conclusion: Microbiological analysis of saliva is an easy and non-invasive alternative. The salivary microbiota reflects the local bacterial alterations that occur in the subgingival and supragingival microbiota. It is therefore interesting to be able to expand knowledge in the oral microbial world, and to be able to help define more accurately the etiology of caries and periodontitis and thus be able to move towards much more effective preventive and curative treatments. (AU)

In vitro analysis of the influence of the thermocycling and the applied force on orthodontic clear aligners.

The mechanical properties of polyurethane dental aligners have been studied in an oral environment at 37°C and subjected to thermal cycling between 5°C and 55°C for long periods of time at different mechanical stresses. The aim is to determine the efficacy of the orthodontic aligner at different stress levels, the effect of thermal cycling with therapy time on tooth position correction. Sixty aligners with the same design were studied applying tensions of 0, 3 and 30 N and determining the deformation at different times from 1 to 760 h. Half of these aligners were subjected to stresses submerged in artificial saliva at 37°C and the other half were subjected to thermal cycles between 2°C and 55°C in salivary medium. Deformation was determined using a high-resolution stereo magnifier and ImageJ image analysis software. Water adsorption by the polyurethane was determined at the different test times. The results showed that in the unloaded aligners there is no appreciable deformation, but with thermal cycling there is a light shrinkage of the aligner due to the semi-crystallization process (ordering of polymeric chains) of the polyurethane. When applying loads of 3 and 30 N, creep curves with constant deformation transition zones can be seen. The transition zones decrease as the applied mechanical load increases. In addition, the significant effect of thermal cycling on the reduction of the transition zone of the aligners has been demonstrated. The transition zones are optimal for dental correction as constant stresses are exerted for tooth movement. The effect of thermal cycling shortens the constant deformation zone and reduces tooth alignment time. It was observed that the absorption of water in the aligner is constant after 1 h of immersion and does not exceed 0.4% by weight of absorbed water.

Association between dental agenesis and delay in dental development: a preliminary study in a Spanish paediatric population in relation with Dental Anomaly Pattern (DAP).

BACKGROUND: The association between dental anomalies has been studied, giving rise to the concept of Dental Anomaly Pattern (DAP). Tooth agenesis has been associated with alterations such as molar infracclusion, taurodontism and delayed dental development. The aim of this study was to evaluate the dental development pattern in patients with non-syndromic dental agenesis, in comparison with a control group. METHODS: Dental and chronological age was analysed in a sample size of 204 orthopantomographs divided into a study group (n = 104) and a control group (n = 100) with the Demirjian Method. Intra and intergroup differences in chronological and dental age, and the correlation between them were calculated by statistical analysis with a 95% confidence level (p < 0.05). RESULTS: Dental age exceeded chronological age both in the control group and in the study group. Statistically significant differences (p = 0.004) were found when comparing the difference between chronological and dental age in the study (-0.16 ± 1.12) and control group (-0.58 ± 0.90). Regarding sex and age intergroup differences, the results were only statistically significant in the girls' group (p = 0.017), and the age over 8 years old (p < 0.05). There were no significant differences in tooth development depending on the number of missing teeth or the affected tooth group, but there was a delay in the development of the homologous tooth contralateral to the absent one in 14.9% of patients. CONCLUSIONS: The difference between chronological and dental age in permanent dentition is significantly lower in Spanish children with non-syndromic agenesis compared to a control group, presenting a lower dental age than chronological age than children without non-syndromic agenesis.

Evaluation of the Relationship between the BMI and the Sequence and Chronology of Eruption in Permanent Dentition in Spanish Population.

The aim was to analyze the relationship between BMI (body mass index) and the sequence and chronology of the eruption of permanent teeth in a sample of Spanish children. Methods: The study design was descriptive, cross-sectional, observational, and epidemiological. Patients of pediatric age were included. Emerged teeth, and patient's age, race, and sex were recorded. The nutritional status of the child was assessed by calculating the BMI, according to the WHO parameters. Statistical analysis was carried out with a confidence interval of 95%. A prediction model with logistic regression models was obtained. Results: A total of 725 pediatric patients between 4 and 14 years old were analyzed. BMI acts as a predictor variable for eruption symmetry, as it was most frequent in overweight children (p < 0.001). The probability of symmetry in dental eruption increases for South American children, for an extra month of age, and each meter of height. BMI had an influence in the first tooth to appear only in the fourth quadrant. BMI did not seem to influence present teeth, and the sequence of permanent dental eruption was not influenced by the BMI category. Conclusions: Age, weight, height, and BMI act as significant predictors for eruption symmetry. BMI does not produce alterations in the eruption sequence of the permanent dentition.

Cronología y secuencia de erupción de la dentición permanente. Actualización en la población infantil española / Chronology and sequence of the permanent dentition. A review in spanish children population

Estudiar la emergencia y secuencia deerupción es indispensable para establecer protocolos de prevención y tratamientos a nivel odontopediátrico, ortodóncicoy forense. En 1933 se estableció el iniciode la erupción definitiva a los 6 años y sutérmino a los 13 a excepción de los cordales. Sin embargo, posteriormente se hanobservado variaciones determinadas porfactores raciales, hormonales, mejoras enla alimentación y parámetros corporales.Con el objetivo de conocer posibles cambios en la cronología y secuencia de erupción en dentición permanente y poblaciónespañola se ha llevado a cabo una búsqueda bibliográfica en los buscadoresPubmed, Scielo, Dentistry y Oral Science.Empleando una estrategia avanzada conoperadores boleanos “AND” y “OR”. Losresultados obtenidos advierten de unaemergencia de la dentición permanentemás precoz en el sexo femenino. Los autores coinciden en que el primer diente enerupcionar es el incisivo central inferior yel último el segundo molar superior. Sinembargo, en cuanto a la edad media dela emergencia del primer diente no hayconsenso.Los dientes permanentes mandibulareserupcionaban antes que los maxilares.La secuencia de erupción más prevalente en la Arcada superior es: primer molar, incisivo central, incisivo lateral, primerpremolar, segundo premolar, canino ysegundo molar. Y en la inferior: incisivocentral, primer molar, incisivo lateral, canino, primer premolar, segundo premolary molar. Se concluyó que existía una correlación directa entre el tiempo de erupción de los dientes temporales y la de los permanentes canine, first premolar, second premolar and second molar.To conclude, we noticed an extremely direct relation between the eruption time of the temporal teeth and thepermanent teeth (AU)

In order, to develop prevention andtreatment protocols in pediatric,orthodontic and forensic dentistry, it isvitally needed to study the sequence andchronology of eruption of the permanentteeth. Logan and Kronfield establishedthat the eruption of permanent teethstarted at the age of six and finished atthe age of 13, except the third permanentmolars. Nevertheless, in later studies thisrange of age has been modified due toan early puberty, an improvement in thenutrition and due to other factors, suchas, race, weight, and heigh. Our objectiveis to get to know the current situationabout the chronology and sequence ofpermanent dentition.We did a bibliographic review in differentweb browsers, such as, PubMed, Scieloand Dentistry and Oral Science. Weapplied an advanced strategy searchingwith “AND” and “OR”. The results warn usthat the permanent teeth erupted earlieralways in the female sex. All the authorsagree that the first tooth to erupt is thelower central incisor and the last one isthe upper second molar. Despite this fact,regarding the media age of eruption therewas not agreement between the authors.Therefore, we can conclude thatpermanent teeth erupt before in themandible than in the maxilar. The mostprevalent sequence in the maxilar was:first molar, central incisor, lateral incisor,first premolar, second premolar, canineand second molar. In the mandible was:central incisor, first molar, lateral incisor(AU)

Efectos del tratamiento de ortodoncia sobre el tejido periodontal: revisión bibliográfi ca / Effects of the orthodontic treatment in the periodontal tissue: bibliographic review

Introducción: La ortodoncia mejora la estética, la oclusión, la posición dentoalveolar, favoreciendo la higiene y la salud periodontal. Sin embargo, también puede generar alteraciones como gingivitis, periodontitis, recesión o pérdida ósea. Lascomplicaciones están infl uenciadas por el tipo de técnica o aparatología y por factores asociados al paciente. El objetivo de esta revisión fue estudiar los efectos del tratamiento de ortodoncia sobre el periodonto.Material y métodos: Se realizó una búsqueda bibliográfi ca en Pubmed, Web of Science y Scielo de acuerdo con criterios de inclusión y exclusión previamente establecidos.Resultados: Tras aplicar los criterios de inclusión y excusión fueron seleccionadas un total de 37 referencias bibliográfi - cas entre 2011 y 2020.Conclusión: El adecuado tratamiento ortodóncico puede mejorar positivamente la salud periodontal al reducir el trauma oclusal y favorecer la higiene oral. El tratamiento ortodóncico puede tener efectosiatrogénicos periodontales (p.ej. gingivitis, recesiones, etc.). La combinación de ortodoncia y periodoncia es básica para el éxito y estabilidad del tratamiento (AU)

Accuracy assessment of dental age estimation with the Willems, Demirjian and Nolla methods in Spanish children: Comparative cross-sectional study.

BACKGROUND: The objective of this study was to evaluate and compare the validity and accuracy of the Willems, Demirjian and Nolla methods in predicting chronological age in a Spanish ethnicity population. METHODS: A sample of 604 orthopantomographs of Spanish children aged 4 to 13 years was evaluated by two independent evaluators. Descriptive statistics were applied to calculate the chronological age and dental age, presenting the mean and standard deviation. The difference between dental age and chronological age was calculated for each method. A positive result indicated an overestimation and a negative figure indicated an underestimation. The Wilcoxon test for paired data and Spearman's correlation coefficient were applied by age groups and sex to compare the chronological age and dental age of each method (that of Willems, Demirjian and Nolla). Statistical tests were performed at a 95% confidence level. RESULTS: The interexaminer agreement was 0.98 (p = 0.00), and the intraexaminer agreement was 0.99 (p = 0.00). The Willems method significantly overestimated the age of boys (0.35 years (0.93)) and girls (0.17 years (0.88)). The Demirjian method significantly overestimated the age of boys (0.68 years (0.95)) and girls (0.73 years (0.94)). The Nolla method significantly underestimated age in boys (0.44 years (0.93)) and girls (0.82 years (0.98)). CONCLUSIONS: In the Spanish population, the use of the Demirjian method for legal and medical purposes is frequent. This study reveals that the Willems method is more appropriate due to its greater precision in estimating dental age.

Evaluation of the accuracy of the Nolla method for the estimation of dental age of children between 4-14 years old in Spain: A radiographic study.

The aim of this study was to estimate the age of subjects from their dental age by showing the different stages of tooth development using the Nolla method in a Spanish population sample considering the gender, age group, and the development of the two dental arches. The sample consisted of 604 orthopantomographs corresponding to Spanish children (male: 302 and female: 302) aged from 4 to 14 years old. The resulting chronological and dental ages were compared using Student's t-test. We obtained a good index of agreement between the evaluators and good internal consistency in the evaluation of the ages of the teeth. In general, the dental age estimates were lower than the chronological ages, obtaining an underestimation with the application of the Nolla method. In the male group, the average dental age of the maxillary teeth was 8.36 years and that of the mandibular teeth was 8.40 years, compared to the chronological age of 8.84 years in both cases. In the female group, the average dental age of the maxillary teeth was 7.76 years and that of the mandibular teeth was 7.88 years, compared to the chronological age of 8.70 years in both cases. On applying the Nolla method to our sample, a significant overestimation was observed only in children aged between 4 and 6.9 years. The Nolla method can be used as a complementary tool for estimating age in children of Spanish origin. The application of this method is more favourable in the case of individuals evaluated under the law applied to minors. In general, with this method, age is underestimated, but the calculations involved are reliable, and greater precision has been observed in male than in female. The data from this study can be used as a reference to determine the dental maturity of Spanish children and to estimate their ages.