Marin Vodanović

Dental age estimation using Demirjian and Willems methods: Cross sectional study on children from the Former Yugoslav Republic of Macedonia

To evaluate applicability of Demirjian and Willems methods for calculating dental age of children in the Former Yugoslav Republic of Macedonia we analyzed panoramic radiographs of 966 children (485 female and 481 male, aged 6-13 years) treated at the University and Community Dental Clinics in Skopje using four Demirjian methods and a Willems method for determining dental ages. Intra-rater and inter-rater agreement of mineralization stages were 0.86 and 0.82, respectively. All methods significantly overestimated dental age when compared to the chronological age (p<0.001). In males, the lowest overestimation was shown using Willems method (0.52±0.87 years), followed by Demirjian methods from 1976 using PM1, PM2, M1, M2 teeth (0.69±0.92 years) and using I2, PM1, PM2, M2 teeth (0.80±0.98 years). The greatest overestimation were shown using Demirjian methods using 7 teeth from 1976 (0.92±0.99 years) and method from 1973 (1.06±1.07 years). In females, the lowest overestimation was shown using Willems method (0.33±0.83 years) than the Demirjian method using PM1, PM2, M1, M2 teeth (1.00±1.01 years), following methods from 1976 using 7 teeth (1.03±1.01 years) and I2, PM1, PM2, M2 teeth (1.12±0.96 years). The greatest overestimation was for method from 1973 using 7 teeth (1.17±0.98 years). Willems method was the most accurate while Demirjians methods for dental age calculation are not suitable on children from the Former Yugoslav Republic of Macedonia.

Cameriere's third molar maturity index in assessing age of majority

Estimation of chronological age of an individual is one of the main challenges in forensic science. Legally to be able to treat a person as a minor or an adult, it is necessary to determine whether their age of majority (if they are older or younger than 18, in most countries). Methods for estimating age are especially important when an individual in question lacks personal documents or other means of identification. As the dental age differs in various populations, the aim of this study was to evaluate applicability of third molar method for assessing age of majority in Croatia. Camerieres third molar maturity index (I3M) value of 0.08, measured by the open apices of the teeth, was verified in sample of 1336 panoramic images aged between 14 and 23 years. Chronological age gradually decreased as I3M increased in both genders. Males showed statistically significant advanced maturation when I3M was between 0.0 and 0.3 value. The results indicate that the sensitivity of the test for 0.08 value was 84.3% (95%CI 80.6%, 87.5%) for females and 91.2% (95%CI 88.7%, 93.1) for males. Specificity was 95.4% (95%CI 92.5%, 97.5%) and 91.9% (95%CI 88.8%, 94.3%). The proportions of accurately classified males were 88.8% and that of females 91.5%. The estimated post-test probabilities, of individuals, in other word the probability that a Croatian individual with an I3M<0.08 is 18 years or older is 94.5% for females, and 96.5% for males. With high accuracy, the third molar maturity index should be used as a determinant of the age of majority in Croatia.

Time of mineralization of permanent teeth in children and adolescents in Gaborone, Botswana

The mineralization sequence of permanent dentition can be used to assess the stage of development and age of individuals. The most commonly used methods are based on the assessment of developmental stages of target groups of teeth on one side of the lower jaw. When compared with the rest of the world, fewer studies have been done on dental age in Sub-Saharan Africa, particularly in the region of Southern Africa. The aim of this study was to determine the chronology of mineralization of permanent teeth by the evaluation of developmental stages according to the Demirjians method from 1973 and to evaluate dental age by using sex-specific self-weighted scores for dental stages and 50th percentile conversion tables of total maturity scores of seven mandibular teeth. We used a sample of panoramic radiographs (OPTs) of black African children and adolescents from the city of Gaborone, Botswana, with the aim of forming an appropriate sample to evaluate the development of the teeth in this socio-geographic environment. The final sample consisted of 1760 OPTs (807 males and 953 females) of individuals aged 6-23 years. The developmental stages of the all permanent teeth in the left side of the maxilla and the mandible were evaluated. Comparing the maxilla and the mandible, we found similar development within different stages for most of the teeth. In comparison to the average age at each stage of development, including the third molars between males and females, it is evident that females are slightly faster in developing permanent teeth, but without statistical significance for most of the developmental stages. Applying 50th percentile conversion tables for calculating the dental age for the first seven mandibular teeth, 616 OPTs of the children (299 males and 317 females), aged 6.08-16.80 years, were evaluated and their dental age was calculated. Mean dental age was overestimated in comparison to chronological age by 1.25±1.11 years and 0.72±1.02 years for males and females, respectively (p<0.001). These findings indicate that Demirjians method from 1973 is not suitable for routine use and that there is a need for establishing specific standards for Botswana children of black African origin for dental age estimation.

Periodontal diseases at the transition from the late antique to the early mediaeval period in Croatia

OBJECTIVE We tested the hypothesis that the transition from the late antique to the early mediaeval period in Croatia had a negative impact on the periodontal health. METHODS 1118 skulls were examined for dental calculus, alveolar bone resorption, fenestrations, dehiscences and root furcation involvement. RESULTS The prevalence of teeth with calculus varied from 40.7% in the LA sample of continental parts of Croatia to 50.3% in the LA sample of Adriatic Croatia. The prevalence of alveolar bone resorption ranged between 21.2% in the EM sample from continental Croatia and 32.3% in the LA sample from Adriatic Croatia. The prevalence of individuals with alveolar bone dehiscences varied from 8.6% in the LA sample from continental Croatia up to 15.0% in the EM sample from Adriatic Croatia. The prevalence of individuals with alveolar bone fenestrations varied from 21.5% in the LA sample from Adriatic Croatia up to 36.2% in the LA sample from continental Croatia. The prevalence of individuals with exposed root bifurcations or trifurcations varied from 9.0% in the EM sample from Adriatic Croatia up to 20.7% in the EM sample from continental Croatia. Statistically significant differences were found between samples. CONCLUSION The transition from the late antique to the early mediaeval period in Croatia did not have a negative impact on periodontal health. Studies of periodontal health of ancient populations should be performed to provide a better and more reliable reconstruction of living conditions in the past.

Orthodontic anomalies and malocclusions in Late Antique and Early Mediaeval period in Croatia

OBJECTIVE Malocclusions are relative infrequently analysed in bioarchaeological investigations and if investigated the samples are very small. This research provides analysis of orthodontic anomalies of even 1118 individuals from the Late Antique (LA) and Early Mediaeval (EM) period. Aims were to describe the prevalence of orthodontic anomalies in this historical period and to analyse which orthodontic anomalies are best suitable for bioarchaeological investigations. METHODS 1118 skulls were examined for anomalies of tooth number, tooth displacement (rotation, malposition, diastema and crowding) as well as for malocclusions. RESULTS The prevalence of hypodontia in the LA was 41.02% and 30.61% in the EM sample. Tooth displacement was noticed in 15.63% individuals from the LA and in 12.42% individuals from EM. About 26% of the LA sample and 7.19% of the EM sample were affected with tooth crowding and the difference was statistically significant. CONCLUSION Orthodontic anomalies affecting only one tooth or group of teeth are more suitable for examination in bioarchaeological investigations than orthodontic features requiring presence of both jaws and all or almost all teeth. Clinical investigation protocols and methodology should be adopted for bioarchaeological researches and international standards and recommendations should be established for this kind of investigation on skeletal remains.

Differences in articular-eminence inclination between medieval and contemporary human populations

The articular-eminence inclination is an important element in the biomechanics of the temporomandibular joint and the entire masticatory system; however, very little is known about this inclination in archaeological human populations. Therefore, the aim of this study was to determine the values of, in addition to the differences between, the articular-eminence inclination in medieval and contemporary human populations. The study was carried out on two dry skull groups. The first group consisted of 14 dry skulls from the medieval culture group Bijelo Brdo (BB) of East Croatia, and the other consisted of 137 recent dry skulls from the osteologic collection of the Institute of Anatomy (IA) in Zagreb. All BB skulls were dentulous, whereas the IA skulls were divided into dentulous and edentulous groups. The articular-eminence inclination was measured in relation to the Frankfurt horizontal plane on digital images of the skulls two lateral views using AutoCAD computer software. The mean value of the articular-eminence inclination in the BB sample group (49.57°) was lower, with a statistical significance (p<0.01), than those of the IA dentulous (61.56°), the IA edentulous (62.54°), and all the combined IA (61.99°) specimens. Because the values of the articular-eminence inclination can vary a lot with reference to the number of specimens and the different methods used for measuring, the obtained values yield only orientational information. Further investigations including a larger number of medieval specimens are needed to confirm the results obtained from this study.

Caries prevalence and periodontal status in 18th century population of Požega-Croatia

OBJECTIVE The aim was to examine dental and periodontal status of adult Croatian 18th century population and compare the results with available literature data. MATERIALS AND METHODS 104 specimens from the crypt of Požega cathedral were grouped into three female and three male groups according to age. Caries was determined by visual inspection and dental probe. Ante and post mortem teeth losses were recorded. Periodontal status was determined according to the length of exposed tooth root from alveolar crest to cemento-enamel junction. The presence of dehiscences and fenestrations was recorded on facial and oral plate of alveolar bone. RESULTS The whole sample exhibited ante- and post mortem teeth loss of 19.57% and 24.91%, respectively. The teeth most frequently lost postmortem were incisors. The canines were best preserved. The frequency of caries in both jaws was the highest in molars (26.63% in maxilla and 28.10% in mandible), whilst central incisors exhibited the least carious lesions (11.59 and 1.92%). The most frequently affected surfaces were occlusal, then proximal and facio-oral. The percentage of teeth with either moderate or considerable bone loss was higher in females. The frequency of considerable bone loss increased significantly with age. The frequency of dehiscences was 3.11%. It was higher in maxilla than in the mandible. The frequency of fenestrations was 5.65% and it was significantly higher in maxilla. CONCLUSIONS The results demonstrate poor oral health amongst 18th century population of continental Croatia, exhibiting high antemortem teeth loss, high periodontal disease frequency and occlusal and proximal caries frequency.

Timing of emergence of the first primary tooth in preterm and full-term infants

Variations in the timing of emergence of primary teeth are under strong genetic control, but there is also a significant contribution from external factors. The aim of this study was to evaluate the influence of preterm birth, birth weight and length, and feeding practices during the first 6 months of life on the timing of emergence of the first primary tooth. Data on pregnancy duration, birth weight and length, feeding practice, time of emergence and first emerged primary tooth were collected by electronic questionnaires. The study included 409 parents and 592 children of both genders. The sample was divided into two groups according to pregnancy duration (<37 weeks and ≥37 weeks), three groups according to feeding practice (exclusively breastfed, exclusively bottle fed, and a combination of breast feeding and bottle feeding), three groups by birth length (<50, 50-53, >53cm), and four groups by birth weight (<1500, 1500-2500, 2501-3500, >3500g). Data were analyzed considering chronological and postmenstrual age-which is the gestational age plus the infants chronological age at the month of emergence of the first primary tooth. The mean time of first primary tooth emergence was 7.55±2.67 months when chronological age was considered. The first emerged tooth in most cases was a lower incisor (82.33%). There was a statistically significant difference in the timing of the first tooth emergence between preterm and full-term groups when chronological age was considered (p<0.005). However, no difference was found when age was adjusted. The age of emergence of the first tooth differed significantly when feeding, weight, and length groups (p<0. 05) were taken into account. In conclusion, the study indicates that shortened gestational age and very low birth weight are predictors for later ages of emergence of the first primary tooth.

Motivacija za upis na studij i percepcija o karijeri među studentima Stomatološkog fakulteta Sveučilišta u Zagrebu

Purpose: Health care studies are usually considered to be complex, demanding and time consuming. The right motivation toward choosing a career in the health field is of utmost importance for the successful completion of studies. The aim of this study was to gain insight into the factors motivating students at the School of Dental Medicine University of Zagreb, Croatia and, also, to examine their career perceptions. Material and Methods: Based on specific questions from available literature, a questionnaire was designed and a total of 270 questionnaires were distributed to the first year students during 2013, 2014 and 2015. Results: A total of 206 students responded, for a response rate of 76.3%. 26.9% of students enrolled in dental studies because it was their first career choice; 16.4% of them believed that it is easy to find a regular job in dentistry. 9.9% of students thought that salaries are high in the field of dental medicine. 45.4% of the first year students were interested in a career in private practice after graduation. These results provide interesting clues to motivation and give additional insights into the expectations of students regarding their studies and profession. Conclussion: The obtained data can be used for the further improvements in the quality of dental study curricula and teaching process. Received: June 22, 2016 Accepted: August 15, 2016 Address for correspondence

Dental stigmata and enamel thickness in a probable case of congenital syphilis from XVI century Croatia

OBJECTIVE To analyse the dental remains of an individual with signs of congenital syphilis by using macroscopic observation, CBCT and micro-CT images, and the analysis of the enamel thickness. DESIGN Anthropological analysis of human skeletal remains from the 16th century archaeological site Park Grič in Zagreb, Croatia discovered a female, 17-20 years old at the time of death, with dental signs supportive of congenital syphilis: mulberry molars and canine defects, as well as non-specific hypoplastic changes on incisors. The focus of the analysis was on three aspects: gross morphology, hypoplastic defects of the molars, canines and incisors, as well as enamel thickness of the upper first and second molars. RESULTS The observed morphology of the first molars corresponds to the typical aspect of mulberry molars, while that of the canines is characterised by hypomineralisation. Hypoplastic grooves were observed on the incisal edges of all incisors. The enamel of the first molars is underdeveloped while in the second molars a thick-enamelled condition is observed. CONCLUSIONS Our observations for the dental and skeletal evidence are supportive to a diagnosis of congenital syphilis for this specimen from XVI century Croatia. The use of CT imaging helped documenting the diagnostic features and quantifying the effect of the dental stigmata on first molars.