J Dental Surabaya

[Bartolome Beacham]

AUDYDental adalah Klinik Dokter Gigi Spesialis TERBESAR di Indonesia dengan komitmen memberikan layanan kesehatan gigi dan mulut yang expert, profesional, berkualitas, serta up-to-date dengan teknologi dental berstandar internasional.

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Objectives: Dental age estimation has been employed in a range of legal operations as well as catastrophe victim identification. Dental age estimation is regarded as an appropriate method for estimating a person's age because there is a high association between age and teeth. This study aims to assess the suitability of the Al Qahtani and Willems dental age estimation approaches for the Indonesian children and adolescent population.

Methods: A total of 150 panoramic radiographs of patients (75 boys and 75 girls, 6-17 years old) were obtained from the Department of Radiology, Airlangga University, Indonesia. One researcher analyzed estimated dental age (EDA) twice in a one-week time-lapse using the Willems and Al Qahtani methods. The statistical analysis of the present study was carried out using IBM SPSS Statistics version 25.0 (IBM, Armonk, NY, USA).

Results: The mean of this study's chronological age (CA) was 11.60 3.41. Using the Willems method, the mean difference between CA and EDA for boys and girls was -0.41 0.90. The mean difference between CA and EDA for boys and girls is 0.33 0.61 using the Al Qahtani method.

Conclusions: According to the findings of this investigation, the dental age estimation method proposed by Al Qahtani and Willems can be applied to the population in Surabaya. However, a comprehensive study is required when using this method because the data revealed significant statistical disparities between the two methods.

The applicability of dental age estimation has been expanded to meet a variety of medico-legal needs, law enforcement, and disaster victim identification. The objective of this study is to examine the applicability of the Willems method for Indonesian children.

Indonesia is a huge archipelagic country located in the Ring of Fire, which is vulnerable to catastrophes such as volcanic eruption, earthquakes, floods, and tsunamis (Geographic 2019). The National Disaster Management Agency (Badan Nasional Penanggulangan Bencana) has announced that 709 disasters occurred in Indonesia between January and February 2019, with over 396,000 refugees and 130 deaths (Badan Nasional Penanggulangan Bencana (BNPB) 2019).

For over 250 million of the population with a diversity of culture and religions, a suitable identification method is urgently needed to be adopted at an event of a mass disaster in Indonesia (Sahelangi and Novita 2012). Age estimation is one of the ways to identify an individual by classifying the victim according to their estimated ages. Age estimation is also required in the fields of law enforcement, immigrant cases (Pradella et al. 2017), sports competition (Timme et al. 2017), and marriage (Islam 1984).

The previous studies have demonstrated that the radiograph of hand-wrist and dental development is the most reliable method of assessing the biological age for children and adolescents (Greulich 1959). This study was proposed to analyze the applicability of the Willems dental age estimation method applied in Indonesian children, which is categorized as Mongoloid race.

The developmental stage of all seven left mandibular teeth was determined according to the Demirjian classification. If a mandibular tooth on the left side is missing, the corresponding tooth on the right side is used as a substitute. The stage of each tooth was then converted to scores using the Willems score chart and summed up to calculate an estimated dental age (EDA) of the subject (Koshy and Tandon 1998; Willems et al. 2001; Franco et al. 2013). Two observers assessed the tooth developmental stages on panoramic radiographs during two different periods.

All data, both CA and EDA, were then tabulated and analyzed using IBM SPSS Statistics version 23.0 (IBM, Armonk, NY, USA). Analysis of the discrepancy between CA and EDA of each group was investigated using paired sample t test, with a confidence interval of 95%.

In the scope of dental age estimation, the previous study by Olze et al. had reviewed various methods of dental development staging and found that the Demirjian method can define the chronological age accurately (Olze et al. 2005). In spite of that statement, another study suggested that the modification of the Demirjian method proposed by Willems showed higher accuracy in estimating age and has been tested in various populations (Willems et al. 2001, 2012; Grover et al. 2012; Ambarkova et al. 2014; Ye et al. 2014). The Willems method was considered to be applied in the Indonesian children population because of its accuracy, and there was no established dental age estimation method for Indonesian children.

A study by Willems in 2001 confirmed the substantial overestimation of the dental age in Belgian Caucasians using the original methods by Demirjian. It claimed that significant overestimation is due in theory to the different rates of dental development in different populations (Willems et al. 2001). Evaluation of dental development was considered as a reliable method for predicting age, as maturation events associated with tooth formation are less variable, and the mineralization of teeth is not affected by the external factors, such as crowding, retention, or early extraction of deciduous teeth (Chertkow and Fatti 1979; Maia et al. 2010; Latić-Dautović et al. 2017). As a developing country with a huge population, socioeconomic and nutritional status may affect the skeletal and dental growth of children in Indonesia (Cameriere et al. 2007).

Routine radiographs for dental treatment such as panoramic and periapical may be used as evidence in the forensic fields. Estimating the dental age in children can be done by defining the calcification and mineralization of teeth. Some combined methods, such as hand-wrist radiograph, might be necessary for further consideration and investigation of the dental age estimation.

The results of this study suggest that the dental age estimation method proposed by Willems can be applied accurately to the boy population in Surabaya, as there was no significant statistical difference. However, a thorough analysis might be necessary while applying this method to the girl population in Surabaya. A small number of subjects have been thought as one limitation in this study; hence, further studies with more samples will improve the reliability of the Willems method in Indonesia.

AK, SRA, and MIM contributed to the data collection and dental age assessment of the subjects. MSM, HU, AC, and AS are the supervisor of the present study. AK, MIM, and BNR contributed to the drafting of the manuscript. All authors have read and approved the final manuscript.

Ethical approval has been obtained from the Ethics Committee of the Faculty of Dental Medicine, Universitas Airlangga (KKEPK), Indonesia (permit number: 48/KKEPK.FKG/IV/2016), in accordance with the International Ethical Guidelines for Biomedical Research Involving Human Subjects by The Council for International Organizations of Medical Sciences (CIOMS).

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Background: Dental laboratory in Surabaya frequently make various kinds of the denture. But surely there is a case that was the most commonly accepted, to adjust to the needs of dental laboratories on the priorities of the work was done, it was necessary to give attention to the case that many common and must be taught to students Dental Technology. Purpose: To find an overview of the number the dentures received by the dental laboratory in Surabaya from 2013 until 2017. Method: The data used is secondary data from a dental laboratory in Surabaya from 2013 to 2017. Result: A request for flexible and RPDs porcelain, acrylic resin and metal in 5 years obtained tend to be stable in high demand, even ina given year a sharp increase in RPDs flexible and drastic decline on fixed porcelain denture. Instead of facing acrylics, fixed denture tends to stabilize at its lowest during the period. While the acrylic RPDs has increased significantly in the last two years, in contrast to metal frame dentures, which decreased at two years latest. Conclusion: Flexible denture significantly better than with acrylic resin conventional denture on parameters taken in this research. Fixed porcelain denture are mostly made by a dental laboratory when compared with a removable partial denture acrylic resin.

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