Stages Of Dental Development Research Articles

A Deep-learning System for Diagnosing Ectopic Eruption

Objectives: To construct a diagnostic model for mixed dentition using a multistage deep-learning network to predict potential ectopic eruption in permanent teeth by integrating dentition segmentation into the process of automatic classification of dental development stages.Methods: A database was established by reviewing 1576 anonymous panoramic radiographs of children aged 6–12 years, collected at the Stomatology Hospital, xxxxxx. These radiographs were categorised as normal or ectopic eruption, with expert diagnoses serving as a benchmark for training and evaluating artificial intelligence (AI) models. Furthermore, tooth boundaries and dental development stages were manually annotated by three pediatric dentistry experts. The dataset was split into training, validation, and test sets at an 8:1:1 ratio.Results: The diagnostic performance of the deep-learning model was rigorously evaluated. The model demonstrated accuracy in tooth segmentation, with Intersection over Union, precision, sensitivity, and F1 scores of 0.959, 0.993, 0.966, and 0.979, respectively. Furthermore, its ability to identify tooth ectopic eruptions on panoramic radiographs, when compared to evaluations by three dentists. Based on McNemar's test, the model's specificity and accuracy in identifying ectopic tooth eruptions on the test dataset surpassed that of Dentist 1 (P < 0.05), while no significant difference was observed compared to the other two dentists. Besides, the deep learning model also showed its potential in classifying dental development stages, as tested against three different standards.Conclusions: The adaptability of the AI-enabled model in this study was demonstrated across multiple scenarios, with clinical validation highlighting its efficacy in diagnosing ectopic eruptions using a multistage deep-learning approach.Clinical Significance: Our findings provide new insights and technical support for the prevention and treatment of abnormal tooth eruption, laying the groundwork for predictive models for other prevalent pediatric dentistry conditions.

Effect of impaction on third molar development and age estimation – A study in a female black South African population

The impact of impaction on the development of third molars remains a subject of debate within the scientific literature, given the lack of consensus. Simultaneously, there has been a call for dental age estimation studies to consider population-specific factors. This research was conducted with the objective of examining the influence of impaction on the formation of third molars in a cohort of female individuals of black South African descent. The study population comprised 428 panoramic radiographs, focusing on females within the age range of 15 to 23.9 years. Within this sample, mandibular third molars were categorized based on their positioning into two groups: non-impacted and impacted. Dental development stages were assessed and classified according to Demirjian’s 8-level staging system. Descriptive statistics were performed. The outcomes of the independent t-test revealed statistically significant differences in developmental stages, specifically stage G for tooth #38 and stage F for tooth #48, suggesting that impaction had an impact on dental development, albeit not consistently across all developmental stages. Nonetheless, it's noteworthy that the minimum and mean ages across all developmental stages were higher among impacted teeth. In summary, our findings support the conclusion that mineralization of impacted mandibular third molars in South African female subjects proceeds at a slower pace compared to their non-impacted counterparts. Consequently, when estimating dental age in the context of South African females, it is advisable to prioritize non-impacted third molars whenever feasible.

Secular changes in dental development of Korean children aged 4 to 16 years over a 10-year period.

This study evaluated 10-year secular changes in dental maturity and dental development among Korean children. A retrospective analysis of panoramic radiograph samples from Korean children (4-16 years old) taken in 2010 and 2020 was conducted. The 2010 group consisted of 3491 radiographs (1970 boys and 1521 girls), and the 2020 group included 5133 radiographs (2825 boys and 2308 girls). Using Demirjian's method, dental maturity scores and dental developmental stages were assessed. For intra-observer reliability, Weighted Cohen's kappa was used, and Mann-Whitney U tests were performed to compare the 2020 and 2010 groups. A slight acceleration in dental maturity was observed in both boys and girls, with the difference being more noticeable in boys at an earlier age. Statistically significant differences were noted at ages 4, 5 and 7 for boys, and at age 6 for girls. Despite these differences, the individual dental development stages of 2020 and 2010 showed inconsistent trends with limited differences. Generally, girls demonstrate more advanced dental maturity than boys. A slight acceleration in Korean children's dental maturity was observed over a 10-year period when comparing the 2020 groups to the 2010 groups.

Dental Developmental Stages and Decayed, Missing, and Restored Teeth in Neurofibromatosis Type 1-affected Children and Adolescents.

Neurofibromatosis type 1 (NF1) is an autosomal dominant inherited tumor predisposition disease with a highly variable phenotype. The influence of the characteristic NF1 tumors (neurofibromas) on dentition has not yet been examined in detail. The aim of the study was to assess the dentition of NF1 children and adolescents, considering the symmetry of tooth development. The panoramic radiographs of 59 patients with a confirmed NF1 diagnosis were compared with 59 age-and-sex-matched controls. The stages of tooth development on the sides of the jaw, added to a score, were assessed. In addition, the number of filled or decayed teeth, and the number of retained or missing teeth were assessed. The tooth development of both study groups is symmetrical for almost all parameters and in the same developmental stage according to the sum score of the tooth development stages. Discrete developmental delays of teeth, in particular in the oral area of facial plexiform neurofibroma (PNF) are noticeable. NF1 patients' teeth showed less decay and more restorations than that of the control group. The facial PNF (FPNF) does not impair emergence of deciduous teeth. Development of dentition of NF1 patients does not differ from the general population. However, FPNF with oral tumor components often prevent mesial movement of permanent molars and premolars, so these teeth do not develop contact (spacing), hardly emerge or may stay retained in bone. Oral PNF may have a low-retarding effect on some tooth root development (e.g., wisdom teeth). This effect is negligible when comparing the affected and unaffected sides of the jaw and is probably non-specific. Key words:Neurofibromatosis type 1, plexiform neurofibroma, dentition, mixed dentition, symmetry, oral health, tooth development.

Анкетування як важливий інструмент для виявлення факторів впливу на затримку прорізування зубів

Aim. To identify risk factors for delayed eruption of permanent anterior teeth in children aged 7 to 14 years, based on clinical examination, radiological examination, parental/caregiver questioning. Materials and Methods. The study included Ukrainian children aged 7-14 years who had delayed eruption of permanent teeth. They were divided into two groups. Group I was composed of 56 (40.0%) children aged 7-9 years with early mixed dentition; Group II was made of 84 (60.0%) individuals aged 10-14 years who had the final stage of mixed dentition. After careful history taking and physical examination, a clinical examination was performed to identify abnormal positions of incisors or canines and to determine the condition of the oral cavity and the bite; a radiological examination included CBCT; and the children’s parents /caregivers were surveyed with the use of the questionnaire we had developed. Results. It has been established that the main risk factors for delayed eruption of permanent teeth are arch-length deficiency, recurrent colds, respiratory disorders, delay in chewing food, pathology in the first trimester of pregnancy, premature extraction of primary teeth, use of a pacifier, delayed loss of deciduous teeth, bad habits, allergies, formula and mixed feeding, orthodontic treatment in the parents’ history, ectopic teething, and injuries to the maxillofacial area in children. Conclusions. A comprehensive history taking, an appropriate determination of the stages of dental development and an assessment of the potential risks of delayed teething are of paramount importance in the diagnosis of pathology, as they allow for the prediction of future orthodontic complications. Key words: delayed eruption of permanent teeth, questionnaire, X-ray examination, dental trauma, ENT pathology, bad habits, CBCT, early loss of primary teeth, allergy, burdened family history, stressor.

Spontaneous space closure in patients treated with early extraction of the first permanent molar: a retrospective cohort study using radiographs.

To assess the success rate of spontaneous space closure after extraction of the first permanent molar (FPM) in the maxilla and the mandible, and to identify the factors that make spontaneous space closure most favorable in each. A retrospective records-based cohort study was conducted through a search of the database of the Public Dental Service, Stockholm County Council, Stockholm, for young adults born between 2000 and 2001, who underwent extraction of one or more FPM between 2006 and 2016. A total of 995 extracted teeth were identified, of which 203 teeth in 155 patients met the inclusion criteria. Of the 203 extracted teeth, 166 (81.8%) did not receive any orthodontic treatment. The success rate for space closure in orthodontically treated patients was 91.9%. The success rate for spontaneous space closure was 84.3%. All unsuccessful spontaneous space closure in the maxilla occurred in patients older than 12 years. The dental developmental stage of the second permanent molar (SPM) had a statistically significant association with spontaneous space closure in the mandible (P < .001). The success rate of spontaneous space closure was high (84.3%) and was higher in the maxilla (94.1%) than the mandible (74.1%). Age at time of extraction and dental developmental stage of the SPM were significant factors for successful spontaneous space closure in the maxilla and mandible, respectively.

Estimation of Mandibular Third Molar Development Using the Correlation in Dental Developmental Stages

This study aims to confirm the average chronologic age according to the developmental stages of the mandibular canine (L3), first and second premolars (L4, L5), and second and third molars (L7, L8) in children and adolescents, and to confirm the developmental stage of L3, L4, L5, and L7, which can estimate the development of L8. A total of 1,956 digital panoramic radiographs of healthy individuals aged between 6 and 15 years who visited Seoul National University Dental Hospital from January 2019 to December 2020 were selected. The developmental stages of L3, L4, L5, L7, and L8 on both sides were evaluated using the dental maturity scoring system proposed by Demirjian and Goldstein. The average age at which the follicle of L8 was first observed was around 9.34 ± 1.35 years and varied from 6 to 12 years. The possibility of agenesis of L8 was high when no traces of L8 were observed after the following stages: L3, L4, and L5 at the developmental stage F and L7 at the developmental stage E; the age was about 10 years. In estimating the development of L8, when only one tooth was considered, estimation accuracy with L5 was the highest, and there was no significant difference when all four teeth were included. This study showed the age distribution according to the developmental stages of L3, L4, L5, L7, and L8 in children and adolescents and confirmed the developmental stages of L3, L4, L5, and L7, which can be used to estimate the development of L8.

A correlation between the timing of skeletal maturity and dental development in black South African Patients

The growth potential of patients has a significant influence on the timing of orthodontic intervention and treatment modalities. Skeletal maturity and dental development are biological maturity indicators which can be used to determine the growth status of an individual.ObjectivesTo correlate the dental maturational stages of black South African individuals with the stages of skeletal maturation and to determine the diagnostic accuracy of using dental developmental stages to identify an individual’s skeletal maturity.DesignRetrospective, cross-sectional study.MethodsSkeletal maturity and dental development of 224 subjects were assessed using lateral cephalograms and panoramic radiographs, respectively. Statistical analyses included descriptive statistics, Spearman’s correlation coefficient and positive likelihood ratios (LHR).ResultsThe highest (rs =0.759, p&lt;0.001) correlation with skeletalmaturity was identified for the second molar and the lowest correlation (rs=0.662, p&lt;0.001) for the canine. Positive LHR&gt;10 combined with sensitivity and specificity testing revealed that the second premolar (stage E), second molar (stage F) and second molar (stage H) have the most significant diagnostic reliability to identify the pre-pubertal, pubertal and post-pubertal growth phases, respectively. ConclusionDental development is a valuable diagnostic tool to assess skeletal maturation. The calcification of the second molar (stage F) is predictive of the pubertal growth phase.

Criteria for early diagnosis of mandibular third molar agenesis based on the developmental stages of mandibular canine, first and second premolars, and second molar: a retrospective cohort study

BackgroundPermanent first molars with severe dental caries, developmental defects, or involved in oral pathologies are at risk of poor prognosis in children. Accordingly, using the third molar to replace the first molar can be a good treatment option when third molar agenesis is predicted early. Thus, this retrospective cohort study aimed to develop criteria for early detection of mandibular third molar (L8) agenesis based on the developmental stages of mandibular canine (L3), first premolar (L4), second premolar (L5), and second molar (L7).MethodOverall, 1,044 and 919 panoramic radiographs of 343 males and 317 females, respectively, taken between the ages of 6 and 12 years were included. All developmental stages of L3, L4, L5, L7, and L8 were analyzed based on the dental age, as suggested by Demirjian et al. The independent t-test was used to assess age differences between males and females. The rank correlation coefficients were examined using Kendall’s tau with bootstrap analysis and Bonferroni’s correction to confirm the teeth showing developmental stages most similar to those of L8s. Finally, a survival analysis was performed to determine the criteria for the early diagnosis of mandibular third molar agenesis.ResultsSome age differences were found in dental developmental stages between males and females. Correlation coefficients between all stages of L3, L4, L5, and L7 and L8 were high. In particular, the correlation coefficient between L7 and L8 was the highest, whereas that between L3 and L8 was the lowest.ConclusionIf at least two of the following criteria (F stage of L3, F stage of L4, F stage of L5, and E stage of L7) are met in the absence of L8 crypt, agenesis of L8 can be confirmed.

Evaluation of Relationship between Body Mass Index (BMI) and Dental Development in the Children in Age-group of 6-13 years of Malwa Region: A Cross-sectional Study.

To evaluate the relationship between body mass index (BMI) and dental development in the children in age-group of 6-13 years of Malwa region. A total of 250 orthopantomograms (OPGs) of children aged 6-13 years (130 males and 120 females) collected from the Department of Paediatric and Preventive Dentistry, Government College of Dentistry, Indore, Madhya Pradesh, India, who came for their routine dental treatment. The chronological age, height, and weight were recorded, followed by calculating the BMI of each patient using Centers for Disease Control and Prevention (CDC) growth charts. The dental age was calculated using Cameriere's method. The comparison of the dental and chronological age was done using Wilcoxon signed-rank test. The dental age of underweight patients was significantly lesser than that of the normal, overweight, and obese patients (p-value of <0.05). The dental age of the obese patients were greatest and significantly greater than that of the underweight, normal, and overweight patients (p-value of <0.05). Dental age is significantly associated with the BMI of children aged 6-13 years. The dental age of obese and overweight children is significantly greater than the chronological age. Predicting the stage of dental development and eruption periods in children with mixed dentition can help with the sequencing and timing of orthodontic, prosthodontic, and surgical procedures. Selkari V, Saxena A, Parihar A, et al. Evaluation of Relationship between Body Mass Index (BMI) and Dental Development in the Children in Age-group of 6-13 years of Malwa Region: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):333-337.

Preliminary study on genetic factors related to Demirjian's tooth age estimation method based on genome-wide association analysis.

The age determination of individuals, especially minors, is critical in forensic research. In forensic practice, dental age estimation is one of the most commonly used methods for determining age as teeth are easy to preserve and relatively resistant to environmental factors. Tooth development is affected and regulated by genetic factors; however, these are not incorporated into current commonly used tooth age inference methods, leading to unreliable results. Here, we established a Demirjian and a Cameriere tooth age estimation-based methods suitable for use in children in southern China. By using the difference between the inferred age and the actual age (MD) as the phenotype, we identified 65 and 49 SNPs related to tooth age estimation from 743,722 loci among 171 children in southern China through a genome-wide association analysis (p<0.0001). We also conducted a genome-wide association study on dental development stage (DD) using the Demirjian tooth age estimation method and screened two sets of SNP sites (52 and 26) based on whether age difference was considered. The gene function enrichment analysis of these SNPs found that they were related to bone development and mineralization. Although SNP sites screened based on MD seem to improve the accuracy of tooth age estimation, there is little correlation between these SNPs and an individual's Demirjian morphological stage. In conclusion, we found that individual genotypes can affect tooth age estimation, and based on different phenotypic analysis models, we have identified some novel SNP sites related to tooth age inference and Demirjian's tooth development stage. These studies provide a reference for subsequent phenotypic selection based on tooth age inference analysis, and the results could possibly be used in the future to make forensic age estimation more accurate.

Dental Age Estimation Using the Demirjian Method: Statistical Analysis Using Neural Networks

In children and adolescents, dental age estimation is performed with the development of the teeth. Various statistical analysis methods have been used to determine the relationship between age and dental maturity and develop an accurate method of age calculation. This study attempted to apply a neural network model for the statistical analysis of dental age estimation in children and evaluated its applicability. This study used 1196 panoramic radiographs of patients aged 3–16 years, and 996 and 200 were randomly classified into training and test sets, respectively. The dental maturity of the mandibular left teeth was evaluated using Demirjian's method, the neural network model using the backpropagation algorithm was derived using training sets, and the errors were evaluated using 100 radiographs of each male and female as test sets. In addition, multiple linear regression analysis was conducted on the same training set, and the error was calculated by applying it to the test set and comparing it with the error of the neural network model. In the neural network model, the mean absolute error (MAE) and root mean squared error (RMSE) were 0.589 and 0.783 in male subjects and 0.529 and 0.760 in female subjects, respectively. In the multiple linear regression model, the MAE and RMSE were 0.600 and 0.748 in male subjects and 0.566 and 0.789 in female subjects, respectively. When applying the neural network model to the statistical analysis of the dental developmental stage, the results were as accurate as those of conventional statistical analysis methods. This study’s approach is expected to be useful for estimating the ages of children.

Age Assessment through Third Molar Teeth Developmental Stage in Children

Age determination is important for forensic evaluation and for determining criminal responsibility. Based on the development of permanent teeth, the Demirjian staging evaluation key is commonly used in research for estimating age using teeth developmental stage. The purpose of the current study was to correlate the dental developmental age of third molar teeth with the chronological age of adolescent patients. This study evaluated 324 panorex images of Israeli patients aged 8–21 years with known birth dates and genders. The dental developmental stage was compared to the patient’s chronological age by gender and side (right/left and upper/lower jaws). This study also attempted to predict the patient’s age using the third molar developmental stage. The study included 179 male and 145 female patients. There was no statistical difference between the right and left sides of the upper or lower teeth. A strong correlation was found between third molar development and chronological age for both the maxilla and mandible. In 100% of cases, patients in developmental stage &gt;5 were over 12 years old in the maxilla and in 97% of cases, were over 12 years old in the mandible. Patients in developmental stage &gt;6 were over 14 years old in 100% of cases in both the maxilla and mandible. Patients in developmental stage &gt;7 were over 16 years old in 100% of cases in both the maxilla and mandible. This study found that third molars can be used to accurately estimate age in a narrow age range, with a strong correlation between third molar development and chronological age. Further research may be needed to understand the utility of this method and its possible usage in different countries around the world.

Subadult Age Estimation Using the Mixed Cumulative Probit and a Contemporary United States Population

The mixed cumulative probit (MCP), a new, flexible algorithm that accommodates a variety of mean and shape parameters in univariate models and conditional dependence/independence in multivariate models, was used to develop subadult age estimation models. Sixty-two variables were collected on computed tomography (CT) images of 1317 individuals (537 females and 780 males) aged between birth and 21 years from the United States sample in the Subadult Virtual Anthropology Database (SVAD). Long bone measurements (n = 18), stages of epiphyseal fusion and ossification (n = 28), and stages of dental development of permanent teeth (n = 16) were used in univariate, multivariate, and mixed models and compared using test mean log posterior (TMNLP), root mean squared error (RMSE), and percent accuracy on an independent test sample. Out of the six possible parameter combinations, all combinations were accounted for at least once in the data and conditionally dependent models outperformed the conditionally independent models. Overall, multivariate models exhibited smaller TMNLP and RMSE, and an overall greater stability in the age estimations compared to univariate models across all ages and independent of indicator type. Pre-optimized subadult age estimation models are freely available for immediate application through MCP-S-Age, a graphical user interface.

Managing compromised first permanent molars in children: minimally invasive treatment protocols for practitioners

Employing minimally invasive operative techniques to manage compromised first permanent molars is discussed as a treatment regimen to achieve a favourable medium-to long-term prognosis in modern paediatric dental management. It is known that patient cooperation, stage of dental development and eruption state, as well as chronological age and severity of tissue breakdown of the compromised tooth have an influence on the prognosis of treatment.CPD/Clinical Relevance: Understanding the various prognostic factors involving compromised first permanent molar teeth is essential if optimum treatment is to be provided.

Dental Age Estimation Standards for Hispanic Children and Adolescents in California

Background: In recent years, cross-border migrations have resulted in an increase in the number of unaccompanied children apprehended at the United States border, particularly in the state of California. The assessment of the chronological age of a child, in many instances, determines the type of services rendered within the medico-legal system. Age can be determined by using population-specific reference standards, preferably within a geographical area. However, such standards are not available for Hispanic children living in California. Aim: To present new standards by developing and validating a reference data set for dental age estimation in Hispanic children in California. Methods: For the reference dataset, a total of 705 dental panoramic radiographs of healthy children aged 7.00 to 13.99 years belonging to Hispanic ethnicity in California were obtained from the archives of a teaching hospital. All permanent teeth on the left side were scored in automated software, and the average at assessment was calculated for each stage of dental development. For the validation dataset, 133 radiographs that were not part of the reference dataset were obtained based on the above criteria. The difference between the chronological age (CA) and dental age (DA) estimated using the California Hispanic reference dataset was assessed using a paired t-test with a statistical significance of p &lt; 0.05. Results: The overall difference between the chronological age and dental age (CA-DA) was 0.03 years (1.56 weeks) for females and −0.10 years (−5.26 weeks) for males, and the difference was not statistically significant for children aged 8.00 to 12.99 years (p &gt; 0.05). Conclusions: The newly constructed dental reference data can be recommended for age estimation in children belonging to Hispanic ethnicity in California.

Correlation between Skeletal Maturation and Developmental Stages of Canines and Second Molars among Iranian Population.

Statement of the Problem: Growth assessment has become an important issue in many medical and dental fields. Determining the stages of dental development and skeletal maturation are essential methods in evaluation of growth phases.Purpose: This study aimed to assess the relationship between developmental stages of maxillary and mandibular canines and second molars by Nolla’s method and skeletal maturation stages by cervical vertebral maturation. In addition, diagnostic performances of dental developmental stages were evaluated to identify growth phases.Materials and Method: In this descriptive-analytical study, 201 digital panoramic and lateral cephalometry of children referred to the Orthodontic Department of Babol Dental School (8 to 15 years) were examined. The stages of dental development were determined by Nolla’s method, and the stages of skeletal development were determined by cervical vertebral maturation stages (CVMs). Positive likelihood ratio (LHR+) was used to determine the diagnostic performances to identify growth phases. The Kendall's Tau-b correlation coefficient was used to measure the association between the CVM stages and dental calcification stages. In this study, p ≤ 0.05 was considered significant.Results: The relationship between dental development and skeletal maturation in different teeth was significant (p ≤ 0.05). Kendall's Tau-b correlation coefficient between the stages of dental development and skeletal maturity in girls ranged from 0.578 - 0.634 and in boys ranged from 0.588 - 0.655. The right second molar in maxilla presented the highest correlation coefficient. The right and left second molars in maxilla and left second molar in mandible in stage 5 had the highest LHR+ to identify the pre-pubertal growth phase.Conclusion: Despite the high correlation coefficient between dental development and skeletal maturity, the LHR+ for determining growth stages in only a small number of teeth was more than 10.

Application of the London Atlas Software App 2nd edition for the radiographic assessment of dental development.

Assessing the dental development of children and adolescents is an important part of treatment planning. The radiographic visualization of dental developmental stages prior to age estimation is currently feasible by means of digital software apps. Testing the existing software tools is necessary to safeguard application in practice. This study applied the London Atlas Software App 2nd edition™ for dental age estimation in Brazilian children. The software was applied to 1.104 digital panoramic radiographs of females (n = 509) and males (n = 595) with ages between 6 and 15.99 years (mean = 10.88 ± 2.84 years). The sample included at least 100 individuals similarly distributed based on sex within 10 age categories of one year each (6├ 15.99) years. Metrics of errors were quantified between the estimated (EA) and chronological (CA) ages. The mean absolute errors among females and males were 0.56 and 0.60 years, respectively (overall = 0.58 years for the combined sample). The lower error values were observed in the age interval of 6 ├ 9.99 years. Error values above one year were detected in older age intervals (10 ├ 15.99 years). Statistically significant differences in dental development were not observed between females and males (p> 0.05). The London Atlas Software App 2nd edition led to specific error rates that can be acceptable for case-specific clinical applications. In the forensic field, caution is advised if the application is planned in the transition between late childhood and early adolescence - when third molars play a major role among the scarce developing teeth. Key words:Brazil, children, dental age estimation, forensic dentistry, radiology.

Orthodontic treatment need and occlusal traits in the early mixed dentition among 8-9-year old Saudi children.

The present study aimed to assess the prevalence of occlusal traits and to evaluate the orthodontic treatment need among children aged 8-9 years in Al Ahsa, Eastern region of Saudi Arabia. A descriptive cross-sectional study was conducted among 282 Saudi children who were randomly selected from those visiting dental outpatient clinics at the College of dentistry in King Faisal University, AlAhsa. All the children were evaluated using the DHC and AC components of Index of Orthodontic Treatment Need (IOTN). Descriptive statistics, chisquare test and Fisher's Exact test were used for data analysis with statistical significance set at p< 0.05. The most prevalent malocclusal trait was crowding (39.7%) followed by increased overjet (28.4%). About 30.9% and 17% of the children were in definite need for orthodontic treatment according to DHC and AC of IOTN, respectively. There was no statistical difference in the distribution of DHC (p=0.116) and AC (p=0.177) scores between the gender. This study demonstrated high percentage of malocclusal traits and orthodontic treatment need in the mixed dentition period among 8-9-year-old children in the Eastern region. Emphasis should be placed on early orthodontic screening and treatment in the mixed dentition stage of dental development.

Oral complications and dental management of childhood cancer: how does the dentist support integrated care?

Childhood cancer is one of the leading causes of childhood mortality. Cancer treatment carries significant orofacial morbidity. ##Objective The reader should understand the acute and long-term implications of cancer treatment on oral health. ##Background Cancer treatment can cause acute and long-term oral complications. Many of these complications are irreversible and dental effects can be seen into the permanent dentition. The severity of dental complications is dependent on the child’s age and stage of dental development at the time of cancer treatment, as well as the type and duration of cancer treatment. ##Conclusion Dental care for children with cancer is important. All dentists must have an awareness of the oral complications of oncology treatment and should be ready to provide appropriate care, including enhanced preventive care, for these patients.