Objective: This study was aimed to investigate the reliability of a computer application for assessment of the stages of cervical vertebra maturation in order to determine the stage of skeletal maturity. Material and methods: For this study, digital lateral cephalograms of 99 subjects (52 females and 47 males) were examined. The following selection criteria were used during the sample composition: age between 9 and 16 years, absence of anomalies of the vertebrae, good general health, no history of trauma at the cervical region. Subjects with lateral cephalograms of low quality were excluded from the study. For the purpose of this study a computer application Cephalometar HF V1 was developed. This application was used to mark the contours of the second, third and fourth cervical vertebrae on the digital lateral cephalograms, which enabled a computer to determine the stage of cervical vertebral maturation. The assessment of the stages of cervical vertebral maturation was carried out by an experienced orthodontist. The assessment was conducted according to the principles of the method proposed by authors Hassel and Farman. The degree of the agreement between the computer application and the researcher was analyzed using by statistical Cohen Kappa test. Results: The results of this study showed the agreement between the computer assessment and the researcher assessment of the cervical vertebral maturation stages, where the value of the Cohen Kappa coefficient was 0.985. Conclusion: The computer application Cephalometar HF V1 proved to be a reliable method for assessing the stages of cervical vertebral maturation. This program could help the orthodontists to identify the stage of cervical vertebral maturation when planning the orthodontic treatment for the patients with skeletal disharmonies.

AIM: Children’s ages can be estimated by evaluating dental maturation of tooth growth and mineralization. Most commonly this is done by evaluating maturation of selected permanent teeth on dental pantomograms (DPTs). The aim of this research was to test the French-Canadian standards of dental maturation developed by Demirjian and Goldstein (1976) on children from Skopje. MATERIALS AND METHOD: Nine hundred and ninety six DPTs collected from healthy children were evaluated (481 boys, 485 girls aged 6.0 to 13.9 years). Mineralization of the crowns and roots of the seven permanent teeth from the left side of mandible were determined and dental age was then calculated the dental age using a maturation score based on the French- Canadian standards. RESULTS: A statistical difference was observed between the evaluated dental age and the chronological age of children (P < 0.001) with determination coefficients (R2) of 0.67 in boys and 0.63 in girls. The mean absolute errors (MAE) were 1.02 ± 0.74 years and 1.10 ± 0.79 years, and root mean squared errors (RMSE) were 1.12 and 1.17 years in boys and girls, respectively. Using a non-linear regression model, function formulae were established for boys [age = (ln (maturation score /(100 - maturation score) ) +4.350)/0.695 ] and girls [age = (ln (maturation score / (100 - maturation score)) +4.786)/0.785 ], which increased R2 up to 0.83 in boys and 0.85 in girls and decreased MAE to 0.62 ± 0.52 and 0.59 ± 0.46 years in boys and girls, respectively. RMSE was decreased to 0.81 and 0.75 years in boys and girls, respectively. CONCLUSION: New function formulae were established and tables were created to predic

Background: The purpose of this study was to compare dental age of hypodontic children with dental age of age- and sex-matched healthy children from general Croatian population. Methods: Dental maturity of 125 children (70 girls and 55 boys) with hypodontia, aged 7.1 to 14.6 years, was evaluated from panoramic radiographs, and compared to the number-matched, age-matched and sex- matched healthy children. Mean biological age of the children was 10.7 years. Dental stages were assessed using the Haavikko method. Dental age was calculated as the mean age of all teeth from all four quadrants except third molars, in accordance with the Finnish dental maturity reference values. Teeth that were missing in children with hypodontia were not evaluated in healthy controls. The teeth with completed growth and development were excluded from calculation of dental age. Paired t-test was used to establish group differences between hypodontic and healthy children of both sexes. Results and conclusion: In both groups of children, the Haavikko method underestimated the chronological age. In the sample of tested children with hypodontia, dental age significantly differ compared to sampled healthy controls and this suggests that tooth formation in children with hypodontia is delayed compared to healthy children.

Background chronological age of children with skeletal sagittal malocclusions, using dental age estimation methods, and to investigate whether dental age assessment methods produce comparable estimates of chronological age in skeletal Class I, II and III. Methods: The sample consisted of panoramic dental images and lateral cephalograms of 231 orthodontic patients (127 girls and 104 boys) ageing from 5.9 to 15.8 years, collected at the Department for Orthodontics, Faculty of Dentistry University in Sarajevo. Dental maturation was evaluated according to the Willems and Demirjian methods, while saggital skeletal relationship was evaluated using the ANB angle from lateral cephalograms. The ANOVA was used to evaluate the relationship between skeletal malocclusions and dental age estimates. Results: Dental age methods overestimated chronological age. The Demirjian method overestimated the age of girls by 1.24±1.03 years, and age of boys by 0.80±1.03 years. The Willems method overestimated the age of girls by 0.36±0.98 years, and that of boys by 0.44±0.98 years. No differences were found in estimates of chronological age using skeletal pattern methods (p>0.05). Conclusions: Dental age methods overestimated chronological age of sampled children, the Willems method yielded smaller estimation errors and is therefore suggested to be more appropriate for chronological age estimation than the Demirjian method. Based on this pilot study, there is no difference between dental maturation among different sagittal skeletal growth patterns. However, further studies with larger sample are required.

Svrha: Svrha istraživanja bila je pronaci poveznicu između eruptivnih stadija trecih maksilarnih i mandibularnih kutnjaka s lijeve i desne strane celjusti. Materijali i metode: Uzorak istraživanja ci- nilo je 529 ortopantomograma (OPG-a) – 264 (49, 9 %) pripadalo je muskom spolu, a 265 (50, 1 %) ženskom spolu u dobi između 8 i 25 godina. Sudionici su bili prema Olzeovoj metodi podijeljeni u sest dobnih skupina. Rezultati: Dobivene su visoke vrijednosti Spearmanova koeficijenta pove- zanosti između eruptivnih stadija lijevih i desnih maksilarnih i mandibularnih trecih molara. Izme- đu spolova nisu pronađene statisticki znacajne razlike u eruptivnim stadijima. Zakljucak: Prema dobivenim rezultatima za procjenu dentalne dobi u bosansko-hercegovackoj populaciji, preporu- cujemo Olzeovu metodu i trece mandibularne molare. Treba istaknuti da su moguce razvojne asi- metrije i da svaki dentalni antropolog mora biti svjestan te cinjenice. Svaka strana celjusti treba- la bi se posebno procjenjivati.

Adresa za dopisivanje Emir Sokic Mr.Sci. Sveuciliste u Sarajevu Elektrotehnicki fakultet Zavod za automatsku kontrolu i elektroniku Zmaja od Bosne bb., 71000 Sarajevo Bosna i Hercegovina Tel. 00387 61 798 874 esokic@etf.unsa.ba Sažetak Koristenjem radiograma istraživala se ucinkovitost razlicitih numerickih tehnika za poluautomatske procjene stupnja sazrijevanja vratnih kralježaka (CVM). Metode: Kefalogrami 211 pacijenata snimljeni su i spremljeni u digitalnom obliku. Nakon toga su, s pomocu posebno razvijenog softvera i tih pohranjenih radiograma, specijalisti ortodoncije oznacili i mjerili za svakog pacijenta nekoliko karakteristicnih kefalometrijskih obilježja. Rezultati su bili potrebni za automatsko određivanje stupnja sazrijevanja vratnih kralježaka s nekoliko numerickih tehnika, među kojima K znaci klasteriranje (grupiranje), a Fuzzy C – dusteriranje (rasipanje). Rezultati su uspoređeni s podacima koje su dobili specijalisti. Rezultati: Najbolji rezultati dobiveni su koristenjem Fuzzy C rasipanja. Tocna ocjena stupnja CVM-a iznosila je oko 70 posto, a procjena klase bila je visa od 99 posto. Zakljucak: Eksperimentalni rezultati pokazuju da se može razviti potpuno automatizirani sustav za procjenu i predviđanje stupnjeva CVM-a, premda jos treba rijesiti manje teskoce prije primjene u klinickoj praksi.

The aim of this cross-sectional retrospective study was to compare the accuracy of three radiographic methods for age estimation using orthopantomogram radiographs (OPGs) from developing children. OPGs of 2652 children (1214 boys and 1438 girls, aged 5.22–14.92 years) with 1474 children from Croatia and 1178 children from Bosnia and Herzegovina were examined and seven mandibular teeth from left side of mandible were assessed using Cameriere’s method by measurement of open apices in teeth, mineralization stages of four different teeth from right side of jaws using Haavikko’s adopted method based on Finnish children and Demirjian's mineralization stages of seven teeth from left side of mandible for Willems’ method with updated scoring based on Belgian children. The mean difference(±SD) in years between dental and chronological age (DA-CA) was calculated for each method. Results show that the most accurate method was by Cameriere (boys -0.08 ± 0.71, girls -0.03 ± 0.70 years), Haavikko’s method underestimated age more (boys -0.09 ± 0.80, girls -0.34 ± 0.75 years), while Willems’ method overestimated age (boys 0.51 ± 0.79, girls 0.28 ± 0.83 years). According to the analysis of variance, no statistically significant differences were found in results of DA-CA between children from Croatia and Bosnia and Herzegovina for each method. No statistically significant difference of DA-CA was found between boys and girls for Cameriere’s method, for Haavikko and Willems method there were statistically significant differences between genders. Statistically significant differences were found in results of DA-CA among different age groups for each method. Published results could be used in clinical, forensic and anthropological purposes when sample of children was used from specified countries.

The aims of this study were to evaluate adopted Haavikko method (1974) based on Finnish sample for dental age estimation in Bosnian-Herzegovian children and to create reference centile curves with LMS method for clinical, legal and forensic usage. Materials and methods In cross-sectional, retrospective study, the panoramic radiographs (OPGs) taken from 805 girls and 636 boys in Bosnia and Herzegovina, aged between 4 and 15 years, were studied. Method is based on scoring of four permanent teeth, 41, 44, 46, and 47 up to 10 years of age and and 13, 43, 44, and 47 in children over 10 years of age, with one of 12 mineralization stages. Dental age is than computed from the Haavikko’s tables as the mean of all four teeth. Kappa statistic and intraclass correlation coefficient (ICC) were used for testing intra- and inter-observer repeatability of mineralization stages and observed dental age by assessments of 10% (N=144) of OPGs. Results showed that Haavikko’s method underestimate the dental age in the BH children. Mean underestimation was -0.33 (SD 0.72) years in girls and -0.12(SD 0.82) years in boys. Cohen kappa scores were 0.79 for intra- and 0.80 for inter-observer agreement for mineralization stages and average measures for ICC for dental age were 0.98 for intra- and 0.90 for inter-observer agreement. In addition, 1st, 3rd, 5th, 50th, 95th, 97th and 99th centile curves of chronological age against the dental age were constructed for girls and boys separately using the LMS method by Cole and Green (LMS ChartMaker Software, Medical Research Council, UK), which could be used for age estimation in the BH children.

The aims of this study were to test the applicability of the two Demirjian’s self-weighted scores (1976) based on four teeth from left side of mandible in children in Bosnia and Herzegovina (BH) and to expand age prediction models for observed population. Materials and methods: In cross-sectional, retrospective study, the panoramic radiographs (OPGs) taken from 805 girls and 636 boys in Bosnia and Herzegovina, aged between 4 and 15 years, were scored following the two Demirjian’s scores based on ratings one of eight stages (A-H) of calcification of four different teeth from left side of mandible ; PM1, PM2, M1, M2 ; and I1, PM1, PM2, M2. Dental age was obtained by finding the age at which the 50th percentile value equals the maturity score. Kappa statistic and intraclass correlation coefficient (ICC) were used for testing intra- and inter-observer repeatability of mineralization stages and dental age by assessments of 10% (N=144) of OPGs. Results: Mean Cohen kappa values were 0.82 for intra- and 0.81 for inter-observer agreement of mineralization stages. ICCs were 0.980 for intra- and 0.978 for inter-observer repeatability for PM1, PM2, M1, M2 teeth and 0.982 for intra- and 0.981 for inter-observer repeatability for I1, PM1, PM2, M2 teeth. Both scores overestimates the dental age in the BH sample, the mean overestimations were 0.82(SD 0.97) year in girls and 0.53(SD 0.88) year in boys for PM1, PM2, M1, M2 teeth and 1.07(SD 0.94) year in girls and 0.67(SD 0.88) year for I1, PM1, PM2, M2 teeth. In addition, different regression models were tested for estimation of age as a function of maturity score for both scores and genders, separately.

Adresa za dopisivanje Ivan Galic Dom zdravlja Splitsko-dalmatinske županije Stomatoloska ordinacija – Kamenmost Kamenmost bb, 21262 Kamenmost Tel: +385 21 848 052 Fax: +385 21 848 052 igalic2@sfzg.hr Sažetak Određivanje dentalne dobi kod djece u razvoju važno je u pedodonciji, ortodonciji i forenzicnoj znanosti. Najcesce se primjenjuje postupak prema Demirjianu nastao na francusko-kanadskom uzorku djece 1973. godine na temelju Tanner-Whitehousova postupka (TW-a) procjene skeletne zrelosti. Svrha: Željela se ispitati tocnost Demirjianova postupka za određivanje dentalne dobi kod djece u Bosni i Hercegovini (BiH). Ispitanici i postupci: Prilagođene Demirjianove tablice razvojnih stadija sedam zuba s lijeve strane mandibule iz 1976. godine ispitane su na ukupno 1106 panoramskih snimki bosansko-hercegovacke djece (597 djevojcica i 509 djecaka dobi od 5 do 14 godina). Nakon toga je T-testom za zavisne uzorke dentalna dob bila uspoređena s kronoloskom. Rezultati: Razlika između dentalne i kronoloske dobi bila je u rasponu od 0,60 do 2,17 godina kod djevojcica i 0,63 do 2,60 kod djecaka. Rezultati upozoravaju na precijenjenost dentalne dobi u usporedbi s Demirjianovim standardima iz 1976. Zakljucak: Demirjianovi standardi za francusko-kanadsku djecu prema kojima se određuje dentalna dob nisu adekvatni za primjenu kod djece u Bosni i Hercegovini. Nužno je i dalje istraživati na vecem uzorku i odrediti specificne standarde za određivanje dentalne dobi kod bosansko-hercegovacke djece. Kljucne rijeci dob; određivanje pomocu zuba; Forenzicka stomatologija; radiologija, panoramska; Bosna i Hercegovina 1 Student doktorskog studija, Zavod za dentalnu antropologiju Stomatoloskog fakulteta Sveucilista u Zagrebu, Hrvatska PhD student, Department of Dental Anthropology School of Dental Medicine University of Zagreb, Croatia 2 Stomatoloski fakultet Sveucilista u Sarajevu, Bosna i Hercegovina School of Dental Medicine University of Sarajevo, Bosnia and Herzegovina Zdravstveni fakultet Sveucilista u Zenici, Bosna i Hercegovina Faculty of health, University of Zenica, Bosnia and Herzegovina 4 Medicinski fakultet Sveucilista u Banjaluci, Bosna i Hercegovina School of Medicine, University of Banja Luka, Bosnia and Herzegovina 5 Student doktorskog studija, Medicinski fakultet Sveucilista u Zagrebu, Hrvatska PhD student, School of Medicine, University of Zagreb, Croatia

Background: Therapy of patients with cleft lip and palate does not comprise only surgical closure of the cleft – it requires multidisciplinary approach in a dental treatment, with the aim to achieve aesthetically and functionally optimal results. Case report: 12-years-old patient, referred to the orthodontic clinic with surgically closed unilateral cleft lip and palate. After taking diagnostic records, the patient was scheduled for orthodontic treatment. Before banding, crown lengthening on first upper molar has been performed due to a short clinical crown. Length of active orthodontic treatment was 30 months, after which retainer has been placed, and patient scheduled for crown lengthening on upper left incisor and canine. Multiple tooth restorations have been performed on upper anterior region using adhesive, build - up technique (teeth 13, 21, 22, 23). Dental photography editing with image editing software enabled information about possible aesthetic solution for our patient. Follow up: Clinical evaluation of composite restorations has been performed using USPHS criteria. Functionality, pleasing aesthetic results and satisfied patient are outcome of 4 years long comprehensive dental treatment. (J Int Dent Med Res 2010; 3: (1), pp. 29-33 )