Statement of the Problem:The face's architecture of dentate subjects has been studied to find a reliable guide for the selection of artificial anterior teeth. However, there is no consensus of data regarding a reference to estimate the width of artificial teeth.Purpose: The purpose of this study was to analyze whether there is a consistent relationship between the interalar distance (IAD) and the combined mesiodistal width of the six maxillary anterior teeth.Methods: Standardized digital photographs of 81 dentate Brazilian subjects were included in the sample. They were 37 men and 44 women (age 17 to 33). Through image processing software, the IAD and the distance between the tips of the maxillary canines were measured when viewed from the frontal aspect. Accurate casts were made to quantify the distance between the distal surfaces of the maxillary canines on a curve, by use of a flexible millimeter ruler. Nonparametric statistics were performed to analyze the results (p < 0.05). Results:The IAD when compared with the width of the six maxillary anterior teeth, on a straight line and on a curve, presented a ratio of 0.914 and of 1.305, respectively. The Wilcoxon test showed no significant difference between the calculated width values and the mesiodistal width measured on a curve and on a straight line (p = 0.986). Conclusion:The IAD, when increased by 31% of its value, can suggest the circumferential distance of the six maxillary anterior teeth. CLINICAL SIGNIFICANCEThe width of the nose, when measured in digital photographs, can be utilized as a reliable guide for the selection of the maxillary anterior teeth width. It can improve the esthetic result of the oral rehabilitation treatment for the edentulous patient by offering a natural dentofacial relation.(J Esthet Restor
The long saddles and the uniformly distributed loads demonstrated better distribution of stress on support structures.
This study aimed to assess the prevalence of lip print patterns among males and females, and to test the diagnostic accuracy of lip pattern analysis for sexual dimorphism in forensic dentistry. A systematic literature review was performed following the PRISMA guidelines. The search was performed in six primary databases and three databases to cover part of the grey literature. Observational and diagnostic accuracy studies that investigated lip print patterns through cheiloscopy for sexual dimorphism were selected. Risk of bias was assessed with the Joanna Briggs Institute (JBI) tool. Proportion meta-analysis using random effects was fitted to pool the accuracy of cheiloscopy. The odds of correctly identifying males and females was assessed through a random effects meta-analysis. GRADE approach was used to assess certainty of evidence. The search found 3,977 records, published between 1982 and 2019. Seventy-two studies fulfilled the eligibility criteria and were included in the qualitative analysis (n = 22,965 participants), and twenty-two studies were sampled for meta-analysis. Fifty studies had low risk of bias. Suzuki and Tsuchihashi’s technique was the most prevalent among studies. The accuracy of sexual dimorphism through cheiloscopy ranged between 52.7 and 93.5%, while the pooled accuracy was 76.8% (95% CI = 65.8; 87.7). There was no difference between the accuracy to identify males or females (OR = 0.71; 95% CI = 0.26; 1.99). The large spectrum of studies on sexual dimorphism via cheiloscopy depicted accuracy percentage rates that rise uncertainty and concern. The unclear performance of the technique could lead to wrong forensic practice.
Convolutional neural networks (CNN) led to important solutions in the field of Computer Vision. More recently, forensic sciences benefited from the resources of artificial intelligence, especially in procedures that normally require operator-dependent steps. Forensic tools for sexual dimorphism based on morphological dental traits are available but have limited performance. This study aimed to test the application of a machine learning setup to distinguish females and males using dentomaxillofacial features from a radiographic dataset. The sample consisted of panoramic radiographs (n = 4003) of individuals in the age interval of 6 and 22.9 years. Image annotation was performed with V7 software (V7labs, London, UK). From Scratch (FS) and Transfer Learning (TL) CNN architectures were compared, and diagnostic accuracy tests were used. TL (82%) performed better than FS (71%). The correct classifications of females and males aged ≥ 15 years were 87% and 84%, respectively. For females and males < 15 years, the correct classifications were 80% and 83%, respectively. The Area Under the Curve (AUC) from Receiver-operating Characteristic (ROC) curves showed high classification accuracy between 0.87 and 0.91. The radio-diagnostic use of CNN for sexual dimorphism showed positive outcomes and promising forensic applications to the field of dental human identification.
Pycnodysostosis (PYCD) is a rare autosomal recessive skeletal dysplasia arising from a change in the production of the cathepsin K enzyme and it is also known as Maroteaux-Lamy Syndrome. The main changes in the buccal and maxillofacial region are modifications of the facial bones (leading to the loss of the mandibular angle due to micrognathia), deep palate, premature and/or delayed tooth eruption, hypopneumatization of the maxillary sinuses, chin hypoplasia, hypercementosis, enamel hypoplasia, hyperdontia, incomplete dentin calcification, root hypoplasia, pulp chamber obliteration, and increased free functional space. This paper aims to report a case of a patient with PYCD, in which are highlighted the oral manifestations of this syndrome and present an option of oral rehabilitative treatment through a removable overdenture made on natural tooth of the patient. The technique of dental coating through overdenture is a simple, viable and conservative alternative for oral rehabilitation of patients with large maxillomandibular discrepancies, as in cases of pycnodysostosis, especially in the presence of increased free spacecharacteristic of patients with this syndrome. The result was quite satisfactory both aesthetically and functionally and provided a better life quality for the patient.
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