Morphological analysis of the skeletal development in lateral cephalometric radiographs of HIV infected children ongoing Highly Active Antiretroviral Therapy

BACKGROUND: To investigate the skeletal development of HIV infected children through a morphological analysis of the cervical vertebrae (CV) in lateral cephalometric radiographs. MATERIAL AND METHODS: The sample consisted of 86 lateral cephalometric radiographs of male and female children aged between 6 and 14 years old. The radiographs were equally distributed in groups 1 (HIV infected children) and 2 (non-infected children, paired by sex and age). Two examiners analyzed the CV according to the method of Hassel and Farman (1995). Spearman correlation coefficient was used to associate age and skeletal development within groups, while Mann-Whitney test compared the skeletal development between groups. RESULTS: The correlation of age and skeletal development in group 1 reached 0.17, 0.27 and 0.27 (p > 0.05) for C2, C3 and C4, respectively, while in group 2 it reached 0.65, 0.54 and 0.60, respectively (p < 0.001). Differences were not significant between groups (p > 0.05). CONCLUSIONS: HIV infected and non-infected children showed a similar development of the CV. However, the weak correlation between age and CV development in HIV infected children highlights the need for careful decisions prior to therapeutic approaches - especially those founded on the prediction of skeletal development, such as maxillofacial surgeries, and orthopedic and orthodontic procedures

Avaliação radiográfica do desenvolvimento dental em portadores de diabetes mellitus 1 ­ enfoque clínico e pericial / Radiographic assessment of the dental development in patients with diabetes mellitus type 1 ­ clinical and forensic approach

Introdução: O diabetes mellitus do tipo 1 (DM1) é um distúrbio metabólico capaz de afetar o desenvolvimento do portador. O conhecimento deste tema permitirá ao Cirurgião-dentista planejar com maior segurança procedimentos clínicos que dependem da resposta biológica do paciente, e realizar perícias de estimativa de idade de forma mais precisa. Objetivo: Avaliar o desenvolvimento dental em portadores de DM1 correlacionando duas técnicas para estimativa de idade. Métodos: Foram analisadas 90 radiografias panorâmicas de indivíduos com idades entre 5-16 anos, distribuídas nos grupos caso (n=45) e controle (n=45). Foram avaliados os estágios de calcificação dos dentes 36 e 37 segundo Demirjian et al. (1973) e o irrompimento dental segundo Lewis e Garn (1960). Resultados: Para o dente 36, observou-se maior prevalência de indivíduos do grupo controle com dentes irrompidos no estágio H em relação ao grupo caso (75,6% e 71,1%, respectivamente). Para o dente 37, observou-se maior prevalência de indivíduos do grupo controle com dentes irrompidos no estágio G em relação ao grupo caso (40,0% e 35,6%, respectivamente). Diferença estatisticamente significante não foram observadas entre os grupos quando os métodos foram analisados independentemente (valores de p>0,05). Conclusão: Desenvolvimento dental similar foi observado entre os grupos caso e controle. Perícias forenses de estimativa de idade em pacientes DM1 devem priorizar métodos radiográficos que examinam os estágios de calcificação dental.

Introduction: Diabetes mellitus type 1 (DM1) is a metabolic disorder able to impact within development. The knowledge around this topic will allow the Dentist to plan safer clinical procedures that depend on the biological response of the patients, as well to performed age estimation expertises more accurately. Objective: To assess the dental development in DM1 patients correlating two techniques for age estimation. Methods: A sample of 90 panoramic radiographs of subjects aged between 5-16 years old, distributed in groups case (n=45) and control (n=45). Dental development was assessed considering the calcification stages of the teeth 36 and 37 according to Demirjian et al. (1973) and the dental eruption of the same teeth according to Lewis and Garn (1960). Results: For the tooth 36, more subjects were observed in the control group with erupted teeth in stage H than in the case group (75.6% and 71.1%, respectively). For the tooth 37, more subjects were observed in the control group with erupted teeth in stage G than in the case group (40.0% and 35.6%, respectively). Statistically significant differences were not observed considering the techniques separately (p>0.05). Conclusion: Similar dental development was observed between DM1 and control patients. Forensic expertises in DM1 patients could be performed using radiographic techniques that assess the dental calcification stages.