The dental pattern is defined as the combination of distinct codes assigned to describe specific tooth conditions including virgin, missing, and restored teeth that comprise the complete dentition or from discrete groups of teeth. This pattern can be then compared to the dentition of individual/s in an attempt to determine positive identification. The aims of the present investigation were to study and determine the diversity of dental patterns in Peruvian citizens based on a sample of panoramic radiographs. Digital panoramic radiographs of 900 adult Peruvian patients (450 female and 450 male) were evaluated to determine the dental patterns. The most frequent dental patterns found in the complete dentition, maxillae, upper-anterior and lower-anterior sextants were all-virgin-teeth (0.3%), all-extracted teeth (1.9%), all-virgin teeth (1%) and all-virgin-teeth (34.2% and 72.3%) respectively. The diversity was calculated by the use of the Simpson´s diversity index, the resulting values for the full-dentition, maxilla and mandible were over the 99.8% value and were similar to those previously reported in the scientific literature. This study demonstrates the positive benefit of dental patterns in the process of identification. Additionally a combination of codes is proposed that could prove useful in cases where a better radiographic description is required.
This case report describes a 29-year-old patient diagnosed with Gardner's syndrome who presented with missing teeth in the mandibular posterior region. Imaging revealed 28 odontomas (tooth-like structures) in the same area. Gardner's syndrome is a genetic disorder characterized by intestinal polyps, osteomas (bone growths), and soft tissue tumors. The patient underwent surgery to remove the odontomas. Multiple odontomas can indicate Gardner's syndrome, so patients presenting with odontomas should be screened for the syndrome. Dentists play an important role in early diagnosis of Gardner's syndrome due to its oral manifestations.
This study aimed to determine the prevalence of impacted maxillary canines in the Palestinian population visiting a dental center in Israel between 2006-2013. The researchers examined 4250 patient records and found an overall prevalence of impacted canines to be 3.7%, higher than previous studies. Specifically, the prevalence was 0.8% in males and 1.1% in females, suggesting a higher rate in females. Most impacted canines were palatally positioned. The results differed slightly from other studies, possibly due to differences in sample selection, study methods, and patient populations examined. Accurate assessment of an impacted canine's position is important to determine the appropriate treatment approach.
Veken et al-2016-international_endodontic_journalCarina Banica
This document reports on a study that investigated the prevalence of apical periodontitis (AP) and root filled teeth in a Belgian subpopulation using cone-beam computed tomography (CBCT) scans. The study reviewed 631 CBCT scans containing 11,117 permanent teeth. A total of 656 teeth (5.9%) showed signs of AP and 1,357 teeth (12.2%) were root filled. Root filled teeth had significantly more AP (32.7%) than non-root filled teeth (2.2%). The technical quality of root fillings also impacted the presence of AP, with inadequate fillings associated with higher AP prevalence. The results were comparable to other epidemiological studies.
Malposition of unerupted mandibular second premolar in children with cleft li...EdwardHAngle
Objective: To determine whether distoangular malposition of the unerupted mandibular second
premolar (MnP2) is more frequent in children with unilateral clefts of the lip and palate.
Materials and Methods: This retrospective study examined panoramic radiographs from 45 patients
with unilateral clefts of the lip and/or palate who had no previous orthodontics. A control
sample consisted of age- and sex-matched patients. The distal angle formed between the long
axis of MnP2 and the tangent to the inferior border was measured. The mean, standard deviation,
and range were calculated for the angles measured in the cleft and the control groups. The
significance of the differences between the means was evaluated by the paired t-test. The angles
of the cleft and noncleft sides were also measured and compared.
Results: The mean inclination of the MnP2 on the cleft side was 73.6°, compared with 84.6° in
the control group. This difference was highly significant statistically (P < .0001). The difference
in angles from the cleft and noncleft sides was 0.7°, not statistically significant. A significant association
was found between clefting and distoangular malposition of the developing MnP2, suggesting
a shared genetic etiology. This association is independent of the clefting side, ruling out
possible local mechanical effects.
Conclusion: Clinicians should be aware of the potential for anomalous development of MnP2 in
children with clefts.
This study evaluated the efficacy of two different root canal sealers - AH Plus and MTA Fillapex - in strengthening teeth during endodontic therapy. 75 single-rooted teeth were instrumented and divided into 3 groups: Group A used AH Plus sealer, Group B used MTA Fillapex sealer, and Group C was unfilled. Obturated teeth were embedded in resin and force was applied until fracture. Teeth filled with AH Plus required the most force (235.9N) to fracture, followed by MTA Fillapex (168.5N), with unfilled teeth fracturing at the least force (90.7N). The authors concluded that AH Plus provided greater strength than
This study examined the prevalence of impacted maxillary canines in the Arab population in Israel. The researchers reviewed records of 4250 patients and found 82 cases of impacted canines, a prevalence of 3.7%. Females had a higher prevalence than males, at 1.1% versus 0.8%. Most cases were unilateral, with the left side being more commonly impacted. The results suggest racial and genetic factors may influence canine impaction rates, as this population had a higher prevalence than previous studies in other areas. Early diagnosis and treatment of impacted canines can help guide them into proper alignment and avoid more complex treatment needs.
This case report describes the endodontic treatment of a mandibular first premolar tooth with an unusual anatomy of two roots and two root canals. Clinical examination and radiographs revealed the tooth had two separate roots and canals. The canals were chemomechanically prepared and obturated. Post-treatment radiographs showed successful resolution of symptoms and healing. While most mandibular first premolars typically have one root and canal, anatomical variations are not uncommon. Thorough radiographic examination and modification of access is important to locate and treat all canals for successful outcomes.
This meta-analysis evaluates the reliability of published evidence on regenerative endodontic procedures. It summarizes clinical and radiographic findings from studies on treating non-vital immature permanent teeth using regenerative techniques. The analysis finds good success rates for tooth survival and pathology resolution, but variable results for outcomes like apex closure and root development. Regenerative procedures are improving but factors important for success remain unclear, indicating more research is needed.
This case report describes a 29-year-old patient diagnosed with Gardner's syndrome who presented with missing teeth in the mandibular posterior region. Imaging revealed 28 odontomas (tooth-like structures) in the same area. Gardner's syndrome is a genetic disorder characterized by intestinal polyps, osteomas (bone growths), and soft tissue tumors. The patient underwent surgery to remove the odontomas. Multiple odontomas can indicate Gardner's syndrome, so patients presenting with odontomas should be screened for the syndrome. Dentists play an important role in early diagnosis of Gardner's syndrome due to its oral manifestations.
This study aimed to determine the prevalence of impacted maxillary canines in the Palestinian population visiting a dental center in Israel between 2006-2013. The researchers examined 4250 patient records and found an overall prevalence of impacted canines to be 3.7%, higher than previous studies. Specifically, the prevalence was 0.8% in males and 1.1% in females, suggesting a higher rate in females. Most impacted canines were palatally positioned. The results differed slightly from other studies, possibly due to differences in sample selection, study methods, and patient populations examined. Accurate assessment of an impacted canine's position is important to determine the appropriate treatment approach.
Veken et al-2016-international_endodontic_journalCarina Banica
This document reports on a study that investigated the prevalence of apical periodontitis (AP) and root filled teeth in a Belgian subpopulation using cone-beam computed tomography (CBCT) scans. The study reviewed 631 CBCT scans containing 11,117 permanent teeth. A total of 656 teeth (5.9%) showed signs of AP and 1,357 teeth (12.2%) were root filled. Root filled teeth had significantly more AP (32.7%) than non-root filled teeth (2.2%). The technical quality of root fillings also impacted the presence of AP, with inadequate fillings associated with higher AP prevalence. The results were comparable to other epidemiological studies.
Malposition of unerupted mandibular second premolar in children with cleft li...EdwardHAngle
Objective: To determine whether distoangular malposition of the unerupted mandibular second
premolar (MnP2) is more frequent in children with unilateral clefts of the lip and palate.
Materials and Methods: This retrospective study examined panoramic radiographs from 45 patients
with unilateral clefts of the lip and/or palate who had no previous orthodontics. A control
sample consisted of age- and sex-matched patients. The distal angle formed between the long
axis of MnP2 and the tangent to the inferior border was measured. The mean, standard deviation,
and range were calculated for the angles measured in the cleft and the control groups. The
significance of the differences between the means was evaluated by the paired t-test. The angles
of the cleft and noncleft sides were also measured and compared.
Results: The mean inclination of the MnP2 on the cleft side was 73.6°, compared with 84.6° in
the control group. This difference was highly significant statistically (P < .0001). The difference
in angles from the cleft and noncleft sides was 0.7°, not statistically significant. A significant association
was found between clefting and distoangular malposition of the developing MnP2, suggesting
a shared genetic etiology. This association is independent of the clefting side, ruling out
possible local mechanical effects.
Conclusion: Clinicians should be aware of the potential for anomalous development of MnP2 in
children with clefts.
This study evaluated the efficacy of two different root canal sealers - AH Plus and MTA Fillapex - in strengthening teeth during endodontic therapy. 75 single-rooted teeth were instrumented and divided into 3 groups: Group A used AH Plus sealer, Group B used MTA Fillapex sealer, and Group C was unfilled. Obturated teeth were embedded in resin and force was applied until fracture. Teeth filled with AH Plus required the most force (235.9N) to fracture, followed by MTA Fillapex (168.5N), with unfilled teeth fracturing at the least force (90.7N). The authors concluded that AH Plus provided greater strength than
This study examined the prevalence of impacted maxillary canines in the Arab population in Israel. The researchers reviewed records of 4250 patients and found 82 cases of impacted canines, a prevalence of 3.7%. Females had a higher prevalence than males, at 1.1% versus 0.8%. Most cases were unilateral, with the left side being more commonly impacted. The results suggest racial and genetic factors may influence canine impaction rates, as this population had a higher prevalence than previous studies in other areas. Early diagnosis and treatment of impacted canines can help guide them into proper alignment and avoid more complex treatment needs.
This case report describes the endodontic treatment of a mandibular first premolar tooth with an unusual anatomy of two roots and two root canals. Clinical examination and radiographs revealed the tooth had two separate roots and canals. The canals were chemomechanically prepared and obturated. Post-treatment radiographs showed successful resolution of symptoms and healing. While most mandibular first premolars typically have one root and canal, anatomical variations are not uncommon. Thorough radiographic examination and modification of access is important to locate and treat all canals for successful outcomes.
This meta-analysis evaluates the reliability of published evidence on regenerative endodontic procedures. It summarizes clinical and radiographic findings from studies on treating non-vital immature permanent teeth using regenerative techniques. The analysis finds good success rates for tooth survival and pathology resolution, but variable results for outcomes like apex closure and root development. Regenerative procedures are improving but factors important for success remain unclear, indicating more research is needed.
Clinical study of impacted maxillary canine in the Arab population in IsraelAbu-Hussein Muhamad
The objective of the present study was to determine the prevalence of impacted maxillary canine in patients in Arabs
Community in Israel (ARAB48,Israel) visiting our Center For Dentistry,Research & Aesthetics,Jatt,Almothalath,Israel,
4250 patients . This study comprises data from patients who attended the O.P.D.2200 patients between Jun. 2006 to Dec
2013. Patients were examined in order to detect the impacted maxillary canines by intraoral examination, palpation, dental
records and followed by radiographs. It was found that the prevalence of canine impaction was 0,8 % (N=4250), 1,6
(N=2200), 43,9 (N-82) in males and 1,1% (N=4250), 2,1 (N=2200), 56,1 (N-82) in females suggesting that prevalence of
impacted maxillary canines is more in females than males and it is statistically significant. The overall prevalence for
maxillary impacted canines was found to be 3,7 % (N=2200) which suggested that it is much higher than previous studies.
The results of this study were slightly different than other studies, while the dissimilarities may be attributed to the sample
selection, method of the study and area of patient selection, which suggest racial and genetic differences.
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
New insights on age related association between nasopharyngeal airway clearan...EdwardHAngle
This document summarizes a study that evaluated the relationship between adenoid hypertrophy (enlarged adenoids) and facial morphology in children. The study examined 200 children referred for suspected adenoid obstruction, dividing them into two age groups and four subgroups based on facial divergence. Measurements were made from lateral cephalograms to assess airway clearance and facial morphology. Results found smaller airway measurements and more divergent facial patterns in children aged 6 and under and those with severe facial divergence. The findings suggest earlier airway clearance may be needed in severely affected young children to prevent irreversible facial changes.
This systematic review compares the success rates of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. 9 studies met the inclusion criteria for review. The studies found that all three materials had similar success rates in terms of clinical symptoms. However, MTA and Endosequence BCRRM formed the apical barrier faster and allowed for single visit treatment, making them superior to calcium hydroxide which took 5-20 months. Further research is needed directly comparing MTA and Endosequence BCRRM.
This document discusses a study that assessed awareness and knowledge of forensic odontology among dental professionals in India. The study found that most participants (93.5%) had studied forensic odontology basics in undergraduate studies. However, around 78.4% were unaware of preserving dental records for future forensic needs. While 75.3% understood signs of child abuse and 56.3% could document bite marks, most (77.9%) did not know that dentists can be expert witnesses. The study concludes there is a general lack of forensic odontology knowledge and practice among Indian dental practitioners.
This study evaluated digital palmar dermatoglyphic patterns in patients with oral submucous fibrosis (OSMF) and oral leukoplakia. The study included 200 patients divided into 4 groups - group I had patients with oral leukoplakia, group II had patients with OSMF, group III had patients with habits but no lesions, and group IV was a control group without habits or lesions. Fingerprints and palm prints were taken digitally and analyzed qualitatively and quantitatively. The results found an increase in whorls, palmar patterns in the I2-I3 area, total finger ridge count, total triradius count, and a decrease in atd angle and a-b ridge
Forensic Odontology - A Science within a Scienceasclepiuspdfs
Forensic odontology uses dental evidence to assist legal authorities. It can identify unknown remains through dental records, estimate age, analyze bite marks, and examine orofacial trauma. Teeth can determine gender from size, DNA, or skull morphology. Dental records are compared to antemortem and postmortem records to identify remains. Mass disasters challenge identification but teeth are often preserved. Forensic dentists help identify victims and estimate other attributes to help investigations.
This document summarizes a study on locating impacted maxillary canines in patients. The study analyzed orthopantomogram x-rays of 1,956 patients and found 57 impacted maxillary canines in 47 patients. The mean angulation of the impacted canines was 29.54 degrees and the mean vertical distance from the occlusal plane was 13.1 mm. The study found no significant correlation between the angulation and vertical distance of impacted canines. Both factors are important individually in determining treatment complexity, but they influence treatment planning independently of each other.
This case report describes a 3-year-old child who suffered craniofacial trauma due to a wall collapse. The child presented with critical injuries including a laceration to the face, fractures to the mandible, occipital bone, and temporal bone. Computed tomography scans revealed displaced fractures of the mandible as well as fractures to the base of the skull. Due to the severity and need for ventilation, the child was referred to a higher level trauma center for multidisciplinary management and treatment of the craniofacial injuries.
This case report summarizes several cases where additional root canals were found during endodontic treatment that had initially been missed. It describes the complex root canal anatomy that can vary between different types of teeth and emphasizes that clinicians must be aware of potential extra canals. The report presents clinical cases where a second mesiobuccal canal, distobuccal canal, palatal canal, and second distal canal were successfully located and treated. It discusses techniques for identifying missed canals, including modifications to access cavities, use of magnification, explorers, stains, and transillumination. Locating all canals is important to achieve successful root canal treatment outcomes.
Dental age assessment (DAA): a simple method for children and emerging adultsBalachandar Kirubakaran
Dental age assessment (DAA) is a reliable method for estimating the age of children and emerging adults based on the developmental stages of their teeth visible in dental x-rays. This study developed an improved method for DAA using well-defined tooth development stage criteria extended to include third molars, assessed across a large sample of dental x-rays. A meta-analysis technique was used to integrate information from different tooth developmental stages observed in an individual to estimate their mean dental age and confidence interval. On average, estimated dental ages were about 3.5 months higher than actual chronological ages but with a maximum difference of 1.65 years. This meta-analysis approach provides a rapid and accurate estimation of individuals' ages from dental
Forensic Odontology is defined as that branch of dentistry which, in the interest of justice, deals with the proper handling and examination of dental evidence with proper evaluation and presentation of dental findings.
This study examined the prevalence of additional canals (MB2 and MB3) in the mesiobuccal root of maxillary molars. The study analyzed 136 maxillary molars undergoing root canal treatment. Additional canals were found in 90.44% of first maxillary molars, with 84.56% having an MB2 canal and 5.88% having an MB3 canal. 50.91% of second maxillary molars had additional canals, with 50.91% having an MB2 canal and 1.82% having an MB3 canal. The use of magnification, ultrasound, and micro-instruments aided in locating additional canals. Thorough knowledge of anatomical variations is important for successful root
This document provides an overview of the various branches of dentistry, including oral pathology, oral medicine and radiology, oral and maxillofacial surgery, pedodontics, periodontics, orthodontics, conservative and endodontics, prosthodontics, community dentistry, forensic odontology, and cosmetic dentistry. It describes the focus and procedures involved in each specialty area. The document was written by Dr. Manjula, a dental surgeon, as an informational overview of the field of dentistry.
The document discusses using the Iowa Oral Performance Instrument (IOPI) to assess orofacial strength in orthodontic cases. The IOPI is a reliable tool for evaluating structures like the tongue. While no articles reviewed used the IOPI specifically in orthodontics, its ability to measure tongue strength suggests it could be applicable. The document proposes procedures for using the IOPI to measure tongue strength, endurance, and lateralization in orthodontic patients. This would allow comparison of values before and after treatments like myofunctional therapy to objectively measure improvements.
The Impact of Advances in Post-Mortem Imaging on Forensic PracticeAnnex Publishers
Post-mortem imaging in the form of plain X-ray films has been in use for many years as an adjunct or occasionally as a substitute for autopsy. However, in the last two decades there has been increasing interest and investigation into the use of advanced techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in death investigation.
Abstract
Age estimation of unknown human cadavers is important in setting a crime investigation, such as homicide, suicide or in mass disaster because it can guide forensic investigators to the correct identity among a large number of possible matches. More and more the courts ask for medico-legal age estimations of unknown human cadavers by forensic dentistry. This research project in establishing the applicability of radiographic and morphological parameter's used in forensic dentistry in a Portuguese adult population. The main goal is to compare the chronological age with the dental age estimation by radiographic and morphological parameters. To achieve this objective, thirty-five single-rooted teeth were analysed. Radiographic analysis was made through the program of digital radiology software Kodak RVG intra-oral 2200 with exposure factors 60-70 KVp and 7mA. The morphological parameter, translucent dentin was assessed in intact and sectioned tooth. The relationship between the coefficients was calculated between the age and the ratios with the level of inclusion, p< 0.05. There was no statistically significant difference between the chronological age and the age estimation by each method. The coefficient of Pearson for the direct measurements of the translucent dentin methodology for sectioned teeth gives the better correlation with the age estimate (r=0.86).
Clinical study of impacted maxillary canine in the Arab population in IsraelAbu-Hussein Muhamad
The objective of the present study was to determine the prevalence of impacted maxillary canine in patients in Arabs
Community in Israel (ARAB48,Israel) visiting our Center For Dentistry,Research & Aesthetics,Jatt,Almothalath,Israel,
4250 patients . This study comprises data from patients who attended the O.P.D.2200 patients between Jun. 2006 to Dec
2013. Patients were examined in order to detect the impacted maxillary canines by intraoral examination, palpation, dental
records and followed by radiographs. It was found that the prevalence of canine impaction was 0,8 % (N=4250), 1,6
(N=2200), 43,9 (N-82) in males and 1,1% (N=4250), 2,1 (N=2200), 56,1 (N-82) in females suggesting that prevalence of
impacted maxillary canines is more in females than males and it is statistically significant. The overall prevalence for
maxillary impacted canines was found to be 3,7 % (N=2200) which suggested that it is much higher than previous studies.
The results of this study were slightly different than other studies, while the dissimilarities may be attributed to the sample
selection, method of the study and area of patient selection, which suggest racial and genetic differences.
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
New insights on age related association between nasopharyngeal airway clearan...EdwardHAngle
This document summarizes a study that evaluated the relationship between adenoid hypertrophy (enlarged adenoids) and facial morphology in children. The study examined 200 children referred for suspected adenoid obstruction, dividing them into two age groups and four subgroups based on facial divergence. Measurements were made from lateral cephalograms to assess airway clearance and facial morphology. Results found smaller airway measurements and more divergent facial patterns in children aged 6 and under and those with severe facial divergence. The findings suggest earlier airway clearance may be needed in severely affected young children to prevent irreversible facial changes.
This systematic review compares the success rates of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. 9 studies met the inclusion criteria for review. The studies found that all three materials had similar success rates in terms of clinical symptoms. However, MTA and Endosequence BCRRM formed the apical barrier faster and allowed for single visit treatment, making them superior to calcium hydroxide which took 5-20 months. Further research is needed directly comparing MTA and Endosequence BCRRM.
This document discusses a study that assessed awareness and knowledge of forensic odontology among dental professionals in India. The study found that most participants (93.5%) had studied forensic odontology basics in undergraduate studies. However, around 78.4% were unaware of preserving dental records for future forensic needs. While 75.3% understood signs of child abuse and 56.3% could document bite marks, most (77.9%) did not know that dentists can be expert witnesses. The study concludes there is a general lack of forensic odontology knowledge and practice among Indian dental practitioners.
This study evaluated digital palmar dermatoglyphic patterns in patients with oral submucous fibrosis (OSMF) and oral leukoplakia. The study included 200 patients divided into 4 groups - group I had patients with oral leukoplakia, group II had patients with OSMF, group III had patients with habits but no lesions, and group IV was a control group without habits or lesions. Fingerprints and palm prints were taken digitally and analyzed qualitatively and quantitatively. The results found an increase in whorls, palmar patterns in the I2-I3 area, total finger ridge count, total triradius count, and a decrease in atd angle and a-b ridge
Forensic Odontology - A Science within a Scienceasclepiuspdfs
Forensic odontology uses dental evidence to assist legal authorities. It can identify unknown remains through dental records, estimate age, analyze bite marks, and examine orofacial trauma. Teeth can determine gender from size, DNA, or skull morphology. Dental records are compared to antemortem and postmortem records to identify remains. Mass disasters challenge identification but teeth are often preserved. Forensic dentists help identify victims and estimate other attributes to help investigations.
This document summarizes a study on locating impacted maxillary canines in patients. The study analyzed orthopantomogram x-rays of 1,956 patients and found 57 impacted maxillary canines in 47 patients. The mean angulation of the impacted canines was 29.54 degrees and the mean vertical distance from the occlusal plane was 13.1 mm. The study found no significant correlation between the angulation and vertical distance of impacted canines. Both factors are important individually in determining treatment complexity, but they influence treatment planning independently of each other.
This case report describes a 3-year-old child who suffered craniofacial trauma due to a wall collapse. The child presented with critical injuries including a laceration to the face, fractures to the mandible, occipital bone, and temporal bone. Computed tomography scans revealed displaced fractures of the mandible as well as fractures to the base of the skull. Due to the severity and need for ventilation, the child was referred to a higher level trauma center for multidisciplinary management and treatment of the craniofacial injuries.
This case report summarizes several cases where additional root canals were found during endodontic treatment that had initially been missed. It describes the complex root canal anatomy that can vary between different types of teeth and emphasizes that clinicians must be aware of potential extra canals. The report presents clinical cases where a second mesiobuccal canal, distobuccal canal, palatal canal, and second distal canal were successfully located and treated. It discusses techniques for identifying missed canals, including modifications to access cavities, use of magnification, explorers, stains, and transillumination. Locating all canals is important to achieve successful root canal treatment outcomes.
Dental age assessment (DAA): a simple method for children and emerging adultsBalachandar Kirubakaran
Dental age assessment (DAA) is a reliable method for estimating the age of children and emerging adults based on the developmental stages of their teeth visible in dental x-rays. This study developed an improved method for DAA using well-defined tooth development stage criteria extended to include third molars, assessed across a large sample of dental x-rays. A meta-analysis technique was used to integrate information from different tooth developmental stages observed in an individual to estimate their mean dental age and confidence interval. On average, estimated dental ages were about 3.5 months higher than actual chronological ages but with a maximum difference of 1.65 years. This meta-analysis approach provides a rapid and accurate estimation of individuals' ages from dental
Forensic Odontology is defined as that branch of dentistry which, in the interest of justice, deals with the proper handling and examination of dental evidence with proper evaluation and presentation of dental findings.
This study examined the prevalence of additional canals (MB2 and MB3) in the mesiobuccal root of maxillary molars. The study analyzed 136 maxillary molars undergoing root canal treatment. Additional canals were found in 90.44% of first maxillary molars, with 84.56% having an MB2 canal and 5.88% having an MB3 canal. 50.91% of second maxillary molars had additional canals, with 50.91% having an MB2 canal and 1.82% having an MB3 canal. The use of magnification, ultrasound, and micro-instruments aided in locating additional canals. Thorough knowledge of anatomical variations is important for successful root
This document provides an overview of the various branches of dentistry, including oral pathology, oral medicine and radiology, oral and maxillofacial surgery, pedodontics, periodontics, orthodontics, conservative and endodontics, prosthodontics, community dentistry, forensic odontology, and cosmetic dentistry. It describes the focus and procedures involved in each specialty area. The document was written by Dr. Manjula, a dental surgeon, as an informational overview of the field of dentistry.
The document discusses using the Iowa Oral Performance Instrument (IOPI) to assess orofacial strength in orthodontic cases. The IOPI is a reliable tool for evaluating structures like the tongue. While no articles reviewed used the IOPI specifically in orthodontics, its ability to measure tongue strength suggests it could be applicable. The document proposes procedures for using the IOPI to measure tongue strength, endurance, and lateralization in orthodontic patients. This would allow comparison of values before and after treatments like myofunctional therapy to objectively measure improvements.
The Impact of Advances in Post-Mortem Imaging on Forensic PracticeAnnex Publishers
Post-mortem imaging in the form of plain X-ray films has been in use for many years as an adjunct or occasionally as a substitute for autopsy. However, in the last two decades there has been increasing interest and investigation into the use of advanced techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in death investigation.
Abstract
Age estimation of unknown human cadavers is important in setting a crime investigation, such as homicide, suicide or in mass disaster because it can guide forensic investigators to the correct identity among a large number of possible matches. More and more the courts ask for medico-legal age estimations of unknown human cadavers by forensic dentistry. This research project in establishing the applicability of radiographic and morphological parameter's used in forensic dentistry in a Portuguese adult population. The main goal is to compare the chronological age with the dental age estimation by radiographic and morphological parameters. To achieve this objective, thirty-five single-rooted teeth were analysed. Radiographic analysis was made through the program of digital radiology software Kodak RVG intra-oral 2200 with exposure factors 60-70 KVp and 7mA. The morphological parameter, translucent dentin was assessed in intact and sectioned tooth. The relationship between the coefficients was calculated between the age and the ratios with the level of inclusion, p< 0.05. There was no statistically significant difference between the chronological age and the age estimation by each method. The coefficient of Pearson for the direct measurements of the translucent dentin methodology for sectioned teeth gives the better correlation with the age estimate (r=0.86).
The document provides an overview of forensic odontology. It discusses how forensic odontology deals with dental evidence in legal cases. It also outlines some key aspects of forensic odontology including dental anatomy, bite mark analysis, and identifying unknown remains using dental records. The document then presents a case study example where dental records were used to identify victims in a house fire and help solve a criminal case by matching a bite mark to a suspect's dental records.
This document discusses the importance of diagnostic imaging in detecting hidden injuries from trauma or abuse. It provides examples of different types of injuries that may be detected on imaging, including:
1) Soft tissue injuries like swelling, lacerations, and pneumothoraces visible on CT or MRI scans.
2) Fractures like hidden fractures in abused children, fractures of different ages, and metaphyseal fractures of long bones seen on x-rays.
3) Foreign bodies like glass, knives, bullets and wires that may be retained following assaults, visible on radiographs.
Role of oral radiology in forensic dentistry [autosaved]/ oral surgery courses Indian dental academy
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Radiology plays an important role in forensic investigations by using various imaging techniques like x-rays, CT scans, MRI and ultrasound. It helps identify individuals by comparing ante-mortem and post-mortem images of bones, teeth and implants. It can detect and document injuries, determine the cause of death by locating bullets, fractures and foreign objects. Imaging helps determine if injuries are accidental or non-accidental in cases of child and domestic abuse. It is also used to study firearm injuries by locating bullet paths and fragments. Forensic radiology thus provides crucial medical evidence for legal investigations and proceedings.
Postmortem CT (PMCT) can be useful for evaluating traumatic injuries in deceased individuals. PMCT can detect a wide range of injuries, particularly craniofacial fractures, brain hemorrhages, thoracic injuries like hemothorax and pneumothorax, and skeletal fractures. It is often more sensitive than autopsy for bone injuries. However, PMCT has limitations and cannot replace autopsy, as it may miss some soft tissue injuries and natural causes of death. While complementary to autopsy, in some situations PMCT can provide sufficient information to determine cause of death without an invasive autopsy.
Radiographic analysis of dental development can be used to estimate age in both living and deceased individuals. Several radiological techniques examine features such as tooth formation, eruption, and root development to determine an approximate age range. Compared to other methods, radiography provides a simple, inexpensive way to estimate age through assessment of dental mineralization stages visible on x-rays. Radiographic indicators are particularly useful for estimating ages of children and adolescents. Combining knowledge of dental development standards with radiological examination allows for multifactorial age determination in forensic cases.
Forensic radiography uses medical imaging techniques like x-rays, CT scans, and MRIs to assist in legal investigations and identify remains. It has been used since the late 19th century. The main applications are identification of individuals by examining bones and teeth for characteristics like age, gender, and injuries or implants/prosthetics. Cause of death can also be determined by identifying foreign objects, injuries, trauma, or disease visible in images. Radiographers play a key role by properly positioning the subject and collecting high quality images that can provide evidence. As technology advances, the use of modalities like CT is increasing in forensic radiology due to benefits like improved scan quality and reduced time and costs.
Clinical study of impacted maxillary canine in the Arab population in IsraelAbu-Hussein Muhamad
The objective of the present study was to determine the prevalence of impacted maxillary canine in patients in Arabs Community in Israel (ARAB48,Israel) visiting our Center For Dentistry,Research & Aesthetics,Jatt,Almothalath,Israel, 4250 patients . This study comprises data from patients who attended the O.P.D.2200 patients between Jun. 2006 to Dec 2013. Patients were examined in order to detect the impacted maxillary canines by intraoral examination, palpation, dental records and followed by radiographs. It was found that the prevalence of canine impaction was 0,8 % (N=4250), 1,6 (N=2200), 43,9 (N-82) in males and 1,1% (N=4250), 2,1 (N=2200), 56,1 (N-82) in females suggesting that prevalence of impacted maxillary canines is more in females than males and it is statistically significant. The overall prevalence for maxillary impacted canines was found to be 3,7 % (N=2200) which suggested that it is much higher than previous studies. The results of this study were slightly different than other studies, while the dissimilarities may be attributed to the sample selection, method of the study and area of patient selection, which suggest racial and genetic differences.
This systematic review and meta-analysis aimed to determine the global prevalence of apical periodontitis (AP) and factors influencing prevalence. The review identified 114 studies involving over 34,000 individuals and 639,000 teeth. It found that 52% of individuals had at least one tooth with AP. The prevalence of AP was higher in dental clinics (57%) and hospitals (51%) than the general population (40%). Prevalence was also higher in people with systemic conditions (63%) versus healthy individuals (48%). Half of adults worldwide have at least one tooth with AP, demonstrating the hidden burden of endodontic disease globally.
This document discusses apical periodontitis, including its definition, causes, prognosis, and epidemiology. Some key points:
- Apical periodontitis is an inflammatory response to infection of the root canal system, which can include both acute and chronic phases.
- The prognosis of endodontic treatment depends on preventing apical periodontitis by eliminating root canal infection.
- Epidemiological studies show the prevalence of apical periodontitis varies widely between populations, from 20-80% depending on factors like access to dental care.
- Reasons for tooth extraction often include apical periodontitis and failed endodontic treatment, though historically it has not been well recognized as a disease. Progn
The document discusses the prognosis of endodontic therapy and retaining teeth. It defines prognosis as the anticipated outcome or recovery from a disease based on its usual course. The goal of endodontic treatment is to prevent and treat apical periodontitis by eliminating root canal infections. Left untreated, apical periodontitis can persist and progress from acute to chronic phases. Studies show a high prevalence of apical periodontitis, with rates varying significantly between countries. Factors like diabetes, lack of coronal coverage, and previous trauma can negatively impact prognosis. With effective treatment, the vast majority of teeth can be retained.
dealing with the proper handling, examination & evaluation of dental evidences and with the proper presentation of dental findings in the interest of justice.
Hypodontia in Permanent Dentition in Patients with Cleft Lip and PalateAbu-Hussein Muhamad
Hypodontia, or congenitally missing teeth, occurs more frequently in patients with cleft lip and/or palate compared to the general population. Several studies have found that unilateral clefts have a higher rate of hypodontia than bilateral clefts. The most common missing teeth are maxillary lateral incisors, particularly on the cleft side, and maxillary second premolars. Hypodontia rates range from 8-36.8% in cleft patients and increases with severity and extent of the cleft. Proper treatment of hypodontia in cleft patients involves orthodontics followed by prosthodontics.
This document summarizes a study that estimated dental age in 324 Croatian children (ages 6-16 years) using two methods: Demirjian's method and Haavikko's method. Dental development stages of 7 mandibular teeth were assessed on orthopantomograms. Demirjian's method overestimated age while Haavikko's underestimated age compared to chronological age. Both methods showed high correlation with chronological age (Demirjian's method r=0.93, Haavikko's method r=0.89). The study showed the two methods can be useful for clinical, scientific and forensic applications in the Croatian population.
This document provides an overview of forensic odontology, which is the application of dental science to legal investigations. It discusses how forensic odontologists can identify unknown remains and victims of mass disasters by comparing post-mortem dental records to ante-mortem records. Teeth can be used for identification because each person has a unique dental structure, and teeth are durable tissues that can withstand decomposition. Identification methods include comparative analysis of dental records as well as dental profiling to determine characteristics like ethnicity, gender, and age when records are unavailable. DNA analysis of dental pulp is also discussed as a method for identifying remains.
CEPHALOMETRIC NORMS FROM POSTEROANTERIOR RICKETTS’ CEPHALOGRAMS FROM HISPANIC...Iván E Pérez
Aim: The purpose of the present study was to describe the posteroanterior cephalometric norm values from Hispanic
Americans Peruvian non adults patients between years 2009 to 2010, identify possible differences between sexes and compare our results with similar studies in the literature.
Material and methods: Data from posteroanterior cephalograms from 318 patients (177 females and 141 males) between 9 and 18 years old were collected from our database; mean and standard deviation were calculated for each gender and age group.
Results: Independent samples T-test found statistically significant differences between males and females results in the intermolar width, right molar to maxillae distance, nasal width, nasal height, maxillary width, mandibular width and facial width.
Conclusions: statistically differences between sexes were found in seven from twelve transversal measurements. The norm values found in this study are similar to those reported by Ricketts’.
Supernumerary teeth, or extra teeth beyond the normal number, are a developmental dental anomaly that have been found to occur more frequently in patients with cleft lip and palate. This document reviews several studies that have examined the prevalence of supernumerary teeth in patients with cleft lip and/or palate, finding reported rates ranging from 11.7% to 29.2%. Multiple studies found the highest prevalence of supernumerary teeth occurred in the maxillary anterior region near the cleft site. The increased frequency of supernumerary teeth in cleft patients is thought to be related to the splitting of the dental lamina during cleft formation.
Prevalence of Tooth Agenesis in Orthodontic Patients at Arab Population in Is...Abu-Hussein Muhamad
This study examined the prevalence of tooth agenesis (hypodontia) in 500 orthodontic patients from the Arab population in Israel. The researchers reviewed panoramic radiographs and dental records to identify cases of one or more missing permanent teeth, excluding wisdom teeth. They found a prevalence of 2.6% hypodontia in this sample. The most commonly missing teeth were the mandibular second premolar and maxillary lateral incisor. This prevalence of hypodontia in the Arab population in Israel falls within the typical global range of 1.6-9.6%, providing baseline data on dental anomalies in this population.
orthodontic epidemiological indices
Occlusal Feature Index (Poulton & Aaronson, 1961)
Index of Tooth Position (Massler & Frankel, 1951)
Malalignment Index (Van Kirk & Pennel, 1959)
The Bjork Method (1964)
Summers’ Occlusal Index (1971)
The FDI method (Baume et al, 1973)
Little’s Irregularity Index (1975)
Handicapping Labio-lingual Deviation index (HLD) (Draker, 1960, 1967)
Swedish Medical Board Index (SMHB 1966; Linder Aronson, 1974, 1976)
Dental Aesthetic Index (DAI) (Cons et al, 1986)
Index of Orthodontic treatment Need (IOTN) (Brook & Shaw, 1989)
Index of Complexity, Outcome & Need (ICON) (Daniel & Richmond, 2000)
Peer Assessment Rating Index (PAR) (Richmond et al, 1992)
This study analyzed 175 cracked teeth in patients over a 5-year period. The goals were to examine the characteristics and distribution of cracked teeth, evaluate the survival rate of teeth receiving root canal treatment (RCT), and identify prognostic factors. Most cracked teeth were in older patients and located in lower second molars. Intact teeth and those with class I restorations had higher crack incidence. Of the 88 teeth receiving RCT, the 2-year survival rate was 90%. Deeper probing depths (>6mm) were associated with significantly lower survival rates after RCT.
This study evaluated the periodontal health status and prevalence of root caries in 200 Brazilian adults in Aracaju city. The outcomes demonstrated a mean of 4.54% missing teeth per patient, 29.72% bleeding score, 1.26 root caries, and a 9.21% root caries index. The most prevalent periodontal screening and recording scores were 2 for the mandibular sextants and 0-1 for other sextants, indicating gingivitis as the most common finding. Based on these results, the prevalence of periodontal disease and root caries was low in this population.
Prevalence of Supernumerary Teeth on Panoramic Radiographs in a Non-Adult Per...Iván E Pérez
ABSTRACT: The design of the present study was transversal and descriptive, the objective was to determine the prevalence and distribution of supernumerary teeth in panoramic radiography from Peruvians in Lima - Peru.Ê The panoramic radiography of 1754 non-syndromic patients between 3 to 20 years of age were evaluated in order to determine the presence of supernumerary teeth and associated variables like number of supernumerary teeth, affected jaw and region, type according to shape, type according to location, eruption status and complications. The prevalence of supernumerary teeth was 4.62% (81 patients, 113 supernumerary teeth), 2.22% in females (39 patients, 53 supernumerary teeth) and 2.4% and in the males (42 patients, 60 supernumerary teeth). A singly supernumerary tooth (72.8%), in the maxilla (72.8%) and the antero-superior region (55.8%) was the most frequent presentation; the conical (39%) and supplementary shape (25.6%) along with the anterior supernumerary teeth (34.5%) and parapremolar supernumerary teeth (31.9%) were the most frequent shape and location found; the intraosseous (46.9%) and impacted (24.8%) were the most frequent eruption status found; and the malposition of nearby teeth (38.1%) was the most frequent complication. The prevalence of supernumerary teeth in Peruvians was higher than that reported in the literature and the distribution of the supernumerary teeth associated variables was
similar to those reported in the literature.
Ray et al-1995-international_endodontic_journalCarina Banica
This study evaluated 1010 endodontically treated teeth to determine the relationship between periapical status and the quality of the root canal filling and coronal restoration. Teeth were evaluated based on the technical quality of the root filling (good or poor) and quality of the coronal restoration (good or poor). Periapical status was determined to be either presence or absence of inflammation. Teeth with good fillings and restorations had the highest rate of absence of periapical inflammation at 91.4%, while poor fillings and restorations had the lowest rate at 18.1%. Overall success rate was 61.1%. The quality of the coronal restoration had a greater association with periapical health than
Diagnostic ability of differential diagnosis in ameloblastoma and odontogenic...Quách Bảo Toàn
This study evaluated the diagnostic ability to differentiate between ameloblastoma and odontogenic keratocyst using different imaging modalities and observers with varying levels of experience. Six oral radiologists diagnosed 83 cases using panoramic radiograph only, CT only, or both combined. Their ability to differentiate the lesions was assessed using ROC analysis. Experienced observers performed best when using both panoramic and CT images together, followed by CT only, and worst with panoramic only. Less experienced observers performed worst with CT only. Combining imaging modalities and experience level of observers can improve accurate differentiation of these lesions.
Correlation of the interdental and the interradicular bone lossDr Gauri Kapila
This document discusses a study that aimed to correlate interdental and interradicular bone loss in patients with chronic periodontitis. The study used digital radiography to measure bone loss levels between teeth and between roots in 50 patients. It found a significant correlation between higher levels of interdental bone loss and interradicular bone loss. Specifically, interradicular bone loss of 0.8mm or more was only seen when interdental bone loss was 3.7mm or greater. The study concludes that assessing interdental bone loss could serve as a screening tool to detect early furcation involvement and guide more in-depth examination.
Similar to Dental Patterns in Peruvians: A Panoramic Radiography Study (20)
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
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Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
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Combination Therapies
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2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Dental Patterns in Peruvians: A Panoramic Radiography Study
1. JOURNAL of FORENSIC ODONTO-
STOMATOLOGY
VOLUME 33 Number 2 December 2015
9
SECTION IDENTIFICATION
Dental Patterns in Peruvians: A Panoramic
Radiography Study
Ivan E Perez1
1
Oral Radiology, CEROMA - Oral and Maxillofacial Radiology, Lima, Peru.
Corresponding author: iepl76@yahoo.com
The author declares to have no conflict of interest.
ABSTRACT
The dental pattern is defined as the combination of distinct codes assigned to describe specific tooth
conditions including virgin, missing, and restored teeth that comprise the complete dentition or from
discrete groups of teeth. This pattern can be then compared to the dentition of individual/s in an
attempt to determine positive identification. The aims of the present investigation were to study and
determine the diversity of dental patterns in Peruvian citizens based on a sample of panoramic
radiographs. Digital panoramic radiographs of 900 adult Peruvian patients (450 female and 450
male) were evaluated to determine the dental patterns. The most frequent dental patterns found in the
complete dentition, maxillae, upper-anterior and lower-anterior sextants were all-virgin-teeth (0.3%),
all-extracted teeth (1.9%), all-virgin teeth (1%) and all-virgin-teeth (34.2% and 72.3%) respectively.
The diversity was calculated by the use of the Simpson´s diversity index, the resulting values for the
full-dentition, maxilla and mandible were over the 99.8% value and were similar to those previously
reported in the scientific literature. This study demonstrates the positive benefit of dental patterns in
the process of identification. Additionally a combination of codes is proposed that could prove useful
in cases where a better radiographic description is required.
KEYWORDS: Forensic Dentistry, Panoramic Radiograph, Human Identification, Forensic
Anthropology
JFOS. December 2015, Vol.33, No.2 Pag 9-17
ISSN :2219-6749
2. Dental patterns in Peruvians: A panoramic radiography study. Perez.
10
INTRODUCTION
The process of identification is a prime
challenge in forensic science1
. It must be
based on reliable and objective
methodology together with technical and
scientific expertise to ensure that there are
no doubts about the outcome of the
identification process.2
The jaws and teeth, in certain cases, are the
most well preserved remains of the human
body and represent a useful and valuable
pieces of information in the process of
identification3
. The three most common
methods used for identification are; (1)
comparative identification (2)
reconstructive identification (3) DNA
profiling4
.
The methodology of comparative
identification is based on comparison of
ante mortem (AM) and post-mortem (PM)
records including dental charts
(odontograms), intra-oral and extra-oral
radiographs, clinical photographs, study
casts and dental prostheses5
. Positive
identification using this methodology is
often achieved with a high degree of
reliability and accuracy4
.
The dental pattern (DP) is defined as the
combination of distinct codes assigned to
specific tooth conditions namely virgin,
missing, filling and restored teeth on the
entire dentition, or groups of teeth; the
resulting pattern is noted and charted in
non-radiographic format6
; this can then be
used as a tool in the process of
identification. The use of DP has been
validated as an excellent mean of
individual identification7,8
. The high
diversity of DP has been demonstrated
both theoretically, by calculation of
possible combinations, and empirically by
analysis of large reference datasets. The
results suggest that the dental pattern of an
individual could often be of sufficient
value to be used for purposes of
identification and that the diversity of DP
could be comparable to the diversity seen
in mitochondrial DNA sequences6,8
.
Dental radiographs are often used in the
identification process. In some cases they
are often preferable to the use of DNA4,5
.
They are relatively simple and quick to
acquire and are cheaper than using DNA
based techniques. Dental radiographs
provide objective evidence that can be
used to identify commonalities of
anatomical features and dental treatment
provided up to a point in time4,9
.
Panoramic radiography (PR) provides a
complete view of the teeth, jaws10
and
numerous other features and structures
within in a single image11
. PR represents a
reliable source of information for victim
identification following incidents of mass
disaster, aircraft crash or terrorist attack
where there is pressure to identify large
numbers of victims as quickly as possible5
.
The diversity of DP in PR has been studied
on samples of Koreans3
and Indians10,12
respectively but there is a need for more
studies in DP to include additional distinct
populations3,10
. DP is closely related to the
dental health status and this depends on
age and the differences in the dental caries
levels (DMFT) between countries13
.
The diversity of dental patterns in
panoramic radiography has not been
studied in Latin America. The aims of this
investigation were to study the dental
patterns and determine their diversity in a
sample of panoramic radiographs of
Peruvian citizens.
MATERIAL AND METHODS
This is a retrospective study using digital
PR captured in a private dental radiology
centre in Lima, Perú, between 2013-2015.
The sample size was determined by
3. Dental patterns in Peruvians: A panoramic radiography study. Perez.
11
convenience and included all PRs taken
between 2013 and 2015 that matched the
following: (1) good image quality; (2)
patient older than 20 years of age; and (3)
presence of at least one tooth. The
radiographs of patients with cleft lip and/or
palate; orthodontic devices or completely
edentulous were excluded.
The DP from any PR was determined by
the investigator (IEP) using the codes
described by Lee3
(Table 1). All PRs were
acquired on a ProMax® Scara 2 panoramic
machine (Planmeca Oy, Helsinki, Finland)
and displayed in the ROMEXISTM
software v.3.6.0.R (Planmeca Oy,
Helsinki, Finland). To standardize the
image quality, the filters Revert-to-
original, Clarify and Sharpen-the-image-(3,
1.3) were applied, in this sequence, to the
radiographic image.
The DP diversity was calculated for the
full dentition-32 teeth, maxilla, mandible,
and the sextants upper-right-posterior
(UR), upper-anterior (UA), upper-left-
posterior (UL), lower-left-posterior (LL),
lower-anterior (LA) and lower-right-
posterior (LR) respectively.4
The
Simpson´s diversity index was calculated
to estimate the DP diversity in the sample
(Fig. 1), where Pi represents the frequency
of every DP found in the sample.
The DP data was grouped and analysed by
using the Statistical Package for Social
Sciences (SPSS®
) for Windows version 21
(SPSS Inc., Chicago, IL, USA).
The DP of the sample was determined by a
single operator. To assess the intra-
observer repeatability, the DP of 100
randomly-selected PR was determined in
two sessions separated by a period of 2
weeks. Cohen´s kappa coefficient was
calculated to be a value of 0.8 which
indicates substantial strength of agreement.
RESULTS
The sample size was composed of 900 PR
images (450 male and 450 females) taken
between 2013-2015 that matched the
inclusion criteria mentioned above. The
age distribution is described in Table 2.
The most frequent full-dentition DP was
all-virgin-teeth (3 patients – 0.3%), all-
teeth extracted in the maxilla (17 patients –
1.9%) and all-virgin teeth in the mandible
(9 patients – 1%). The most frequent DP in
the sextants was all-virgin-teeth and was
observed in the UA and LA sextants (308
patients – 34.2% and 651 patients – 72.3%
respectively). The results are described in
Table 3.
The number of different DPs (the sum of
all patterns) and individual DPs were 893
and 887 in the full-dentition, 826 and 800
in the maxilla and 834 – 802 in the
mandible. The diversity values calculated
for the full-dentition, maxilla, mandible
and the UR, UL, LR and LL sextants were
over the 99.8% value; the diversity value
for the UA and the LA sextants were
87.59% and 47.50% respectively (Tables 4
and 5).
The most commonly observed DPs, the
number of DPs and the diversity of the
DPs determined for the full dentition of 32
teeth, for the maxilla, for the mandible and
for the sextants are described in Tables 3, 4
and 5 respectively.
DISCUSSION
The DP has been studied in research using
dental charts obtained from both
Spaniards13
and Brazilians14
. The DP has
also been studied in PR obtained from both
Koreans3
and Indians10,12
. The overall
diversity values reported from both PR and
dental charts were 99.9%10
and 99.7%12
respectively for Indians, 99.92%3
for
Koreans; 98.2% for Americans (United
States)6
; 99.96% for Spanish13
and 98-99%
for Brazilians.18-14
.
4. Dental patterns in Peruvians: A panoramic radiography study. Perez.
12
Table 1 – Classified dental patterns seen in orthopantomography (PR) and their
corresponding codes
CODE DESCRIPTION
V (Virgin tooth) No evidence of dental disease or treatment.
X (Missing tooth) Extracted or congenital missing tooth.
I (Impacted tooth) Unerupted or impacted tooth.
D (Defect)
Defect by dental caries, tooth fracture or
fallen out fillings.
R (Residual root) Remained root due to severe dental caries.
T (Root canal treatment)
Root canal filled tooth by endodontic
treatment.
F (Filling) Filled tooth.
P (Prosthesis) Tooth with crowns.
Table 2 – The age and gender distribution of the sample (n=900)
AGE FEMALE (%) MALE (%) TOTAL (%)
20 - 29 121 (26.9) 100 (22.2) 221 (24.6)
30 - 39 88 (19.6) 111 (24.7) 199 (22.1)
40 - 49 76 (16.9) 69 (15.3) 145 (16.1)
50 - 59 54 (12) 62 (13.8) 116 (12.9)
60 - 69 61 (13.6) 53 (11.8) 114 (12.7)
70+ 50 (11.1) 55 (12.2) 105 (11.7)
TOTAL 450 450 900
Table 3 – The most frequent observed dental patterns observed in the full
dentition, maxillae and sextants (n=900)
AREA DP # %
FULL DENTITION-32 teeth VVVVVVVVVVVVVVVV
VVVVVVVVVVVVVVVV
3 0.3
MAXILLA XXXXXXXXXXXXXXXX 17 1.9
MANDIBLE VVVVVVVVVVVVVVVV 9 1.0
UR XXXXX 45 5.0
UA VVVVVV 308 34.2
UL XXXXX 41 4.6
LL XXXXX 24 2.7
LA VVVVVV 651 72.3
LR VVFFI 30 3.3
5. Dental patterns in Peruvians: A panoramic radiography study. Perez.
13
Table 4 - Number of different and individual dental patterns in the full dentition,
maxillae and sextants observed in the orthopantomography (n=900)
AREA # OF DIFFERENT DP # OF INDIVIDUAL DP
FULL DENTITION-32 teeth 893 887
MAXILLA 826 800
MANDIBLE 834 802
UR 404 266
UA 339 270
UL 587 444
LL 546 410
LA 142 107
LR 551 413
Table 5 - Diversity of the dental patterns in
orthopantomography of the sample (n=900)
AREA DIVERSITY (%)
FULL DENTITION-32 teeth 99.89
MAXILLA 99.81
MANDIBLE 99.85
UR 98.50
UA 87.59
UL 98.58
LL 98.55
LA 47.50
LR 98.51
This present study is the first in South
America to explore DP in PR and is the
second study of DP in Latin America; the
first study was that of Biazevic et al in
200114
. The diversity estimation in the
reviewed literature3,10,12,13,14
was the result
of pairwise comparison between each
pattern in the studied sample as described
by Adams BJ6
. The present study utilized
the Simpson´s Diversity Index which is
dependent of the frequency of each pattern
itself and not the result of pairwise
comparisons between datasets. The
diversity value found for Peruvians was
99.89% which confirms the greater
diversity of the DP forensic method for
personal identification in the studied
sample.
The most common DP observed in the full-
dentition was 32 virgin teeth for Indians
(10.3%10
and 9.3%12
) and 28 virgin teeth
and four third impacted molars for Koreans
(2%3
), the most common DP found in the
full-dentition on Peruvians was 32 virgin-
teeth (0.3% - 3 patients). The percentage of
individual DP for the full-dentition,
maxilla and mandible found in the
literature were 79%-57%-66% for
Indians10
and 91%-64%-60% for Koreans3
respectively; in this present study for
Peruvians the results were 99%-89%-89%.
The differences may be related to the
distinct levels of dental caries in the
studied populations (high in Peru, low in
the India and moderate in Korea
respectively)13,15
alongside with the
decrease in the number of restorative
interventions9
that may reduce the diversity
6. Dental patterns in Peruvians: A panoramic radiography study. Perez.
14
of the DP. The sample size can be a factor
too, especially in the group aged over 50
years because their higher burden of oral
disease16
which may influence the
diversification of the patterns.
The high diversity of the DP reported in
the literature implies there may be
sufficient information to enable personal
identification12
. The number of
theoretically possible combinations of the
codes utilized can be calculated as Cn
,
where C is the number of possible
characteristics (8 codes) and n is the
number of teeth considered (32). The
resulting number would be 832
or
79228162514264337593543950336
distinct patterns6
; this demonstrates that the
DP of one individual may be of sufficient
value to discriminate that individual.
The PR surpasses dental charting in respect
of the amount of available information
because it is an exact and objective
representation of the patient´s teeth and
surrounding bony structures11,17
whereas
dental charting is descriptive and prone to
errors, inaccuracies, deliberate
falsifications, side interchanges and other
mistakes.11,17,18,19
. During the course of the
study it was noted that the available
information might improve the description
if codes D, R, T, F and P were combined
into TD, PD, TR, FT and PT for specific
tooth conditions (Fig. 2). The studies of DP
in PR did not address this issue perhaps
because the samples studied had low
prevalence of caries and better access to
oral health services whereas the samples
studied in this paper came from a country
with a high prevalence of caries, worn-out
or unfinished treatments and unequal
access to oral health services.15
The
additional characteristics would augment
the number of theoretically possible
combinations from 832
to 1232
(the T code
is combined with D, R, F and P codes) or
3.4182189187166852111368841966125e+
34 possible combinations of the DP in PR.
Adams BJ6,8
states, that there is no need for
detailed records to increase the
discriminant power of comparative data14
.
Fig. 1: The Simpson´s index of diversity formula. pi represents the frequency of every pattern
observed in the sample.
The present study would confirm the
statement that when dental charting is
being used solely as the source of
information additional information
provided by PR may justify addition to the
DP codes. A study designed to compare
the diversity of clinical and radiographic
DP on a sample could be designed to
determine whether significant differences
exist when these two sources of
information are utilised.
Radiographic imaging techniques have
been progressing at a rapid rate over the
last decade with improvements in ease of
use, image acquisition time and image
resolution20
. The multi-sliced computed
tomography (MSCT) and cone beam
computed tomography (CBCT) -3D data-
is superior to panoramic and intraoral
radiography -2D data- because it can be
reformatted into a variety of images
(radiographic series, panoramic
radiography and 3D images)20,21
without
7. Dental patterns in Peruvians: A panoramic radiography study. Perez.
15
the need for an additional examination21
as
well as the free manipulation on different
axes that allows for a more precise
detection and landmarking of reference
points22
. Additionally the generated images
can be customized to closely match the
anatomic area, the FoV and, most
significantly, the angular orientation of the
AM images. In situations when AM
images are taken at non-standard angles,
the possibility to rotate the volume in the
three dimensions allows the forensic
odontologist to reformat the image to a
similar angulation increasing the likelihood
of a correct assessment of the anatomic
structures and restorations involved20
. The
utility of 3D reformatted images for
matching comparison has been reported by
Murphy et al. (OPG compared to
reformatted OPG)21
and Trochesset et al.
(periapical radiography compared to
reformatted intraoral-like radiography)20
.
Both studies found positive results with
respect to the matching comparison. A DP
can be determined in 3D reformatted
images and then contrasted with a PR but
this stage would not be necessary if a
matching comparison of the AM and PM
3D images could be performed.
Uniqueness can be interpreted as meaning
the existence of only one of its kind
(person, thing or trait)23
and, as a concept,
implies that there will never be a repetition
of what is being observed in any person,
thing or trait24
. It is recognised that this
hypothesis cannot be proven in sensu
stricto23,24
because it is physically
impossible to measure the number of
indeterminates23
that determine the concept
of uniqueness on a global basis. In the
human dentition, the concept of uniqueness
is described as the combination of
morphological and positional information
obtained from each tooth in respect of
comparison to every other dentition in the
world23,22
.
Fig. 2: Cropped PR showing examples of codes proposed for specific tooth conditions (in
parentheses): 21, 22, 23, and 24 (TR); 34 (PT); 43 (TD); 44 (FT); 45 (PD).
The DP methodology is based on a limited
number of possible combinations (upper
limit of millions). The possible
combinations can be increased by addition
or combination of codes for specific teeth
conditions. The possibility of repetitions
indicate that a DP cannot be unique
irrespective of the source of information
(dental charts, PR, 3D data or dental
photography) but that the diversity of DP’s
would allow further refinement to identify
those individuals who could possibly be
evaluated by other methodology. The
other methodology could include, for
example, CBCT and/or MSCT. Using this
8. Dental patterns in Peruvians: A panoramic radiography study. Perez.
16
strategy could improve the probability of a
match25
.
This paper has addressed the advantages of
using DP methodology. These advantages
include simplicity and the higher diversity
as reported in empirical and descriptive
studies currently available in the literature.
Against this background the DP is
proposed as a useful technique in the
identification process.
It must be noted that, in some cases, the
eventual outcome of an identification
process will be inconclusive. Nonetheless
there is a threshold, or series of thresholds,
that makes the likelihood of identity
proportionately higher or lower24
. Against
this background every source of additional
information is paramount.
CONCLUSIONS
The diversity of DPs has been
demonstrated in a sample from
Peruvian citizens
The overall diversity value for the full-
dentition of DPs of a sample of
Peruvian adults was 99.89% which is
similar to that from other countries as
published in the literature.
The differences for the individual DPs
of the full-dentition, maxilla and
mandible of the studied population
groups may be due to the distinct
dental caries levels that exist between
various countries.
A combination of codes for specific
tooth conditions is proposed as a way
to improve the description of the dental
patterns in panoramic radiography.
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