Dental Age Estimation by Different Methods in Patients With Cleft Lip and Palate

Study Overview
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Brief Summary
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The aim of this study is to investigate whether there is a significant difference in dental age between children with CLP and healthy controls using the Willems method, Cameriere European formula and London Atlas. It is aimed to create a new formula if there is a significant difference in dental age between children with CLP and healthy controls.

Detailed Description
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Dental age is widely evaluated by pedodontists, forensic dentists and orthodontists. While a delay in tooth development may be associated with growth retardation and learning difficulties, dental age determination can also be used for forensic age determination for children whose birth information is uncertain. A clear assessment of maturation in children with continued growth is important in establishing a dental treatment plan. There are two basic approaches to dental age determination in children: evaluation of eruption of teeth in the oral cavity, evaluation of the development and mineralization of crowns and roots on dental radiographs. In many methods, the developmental stages of different numbers of permanent teeth are used. The most commonly used method for determining dental age in children; is the Demirjian method that evaluates the development of seven left permanent mandibular teeth in eight stages (from A to H). Willems et al. In 2001, they modified the Demirjian method by conducting a study on the fact that it showed higher age determination in the Belgian Caucasian population. The adapted method was named the Willems method. It is stated that one of the advantages of this method is that it is a relatively simple system for determining tooth age. One of the most widely used methods of dental age determination recently is the European formula of Cameriere et al., which is calculated based on open apex. It has been reported that this method has been tested on different population groups, and the results are accurate and reliable. An atlas method was proposed by a group of London researchers in 2010. The Atlas shows all the teeth array images of certain age groups as a schematic series. Age determination is made by deciding which reference image matches the individual's panoramic radiography image more.

Official Title
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Evaluation of Dental Age of Children With Cleft Lip and Palate Using Willems Method, Cameriere European Formula, and London Atlas

Conditions
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Dental Age Estimation, Cleft Lip and Palate

Intervention / Treatment
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* Other: Diagnostic Test: Willems method
* Other: Diagnostic Test: Cameriere method
* Other: Diagnostic Test: London Atlas method


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 5-14 years old Healthy children Children with CLP Patients without missing left mandibular permanent teeth on panoramic radiography Exclusion Criteria: Children younger than 5 years old and older than 14 years (children that cannot be assessed by the Willems and Cameriere method) Poor quality panoramic radiography Patients who have received orthodontic treatment Patients who received restorative or endodontic treatment

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 14 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Children with CLP<br> | Other: Diagnostic Test: Willems method<br>* Willems method measures the developmental stages of the seven left permanent mandibular teeth and is frequently used for dental age estimation. The score of each stage is allocated, and the sum of the scores provides an evaluation of the subject's dental maturity.<br>Other: Diagnostic Test: Cameriere method<br>* Cameriere et al. designed a quantitative approach through a formula based on sex and the ratio between length and apex opening measurements of each lower left tooth.<br>Other: Diagnostic Test: London Atlas method<br>* The London Atlas requires the user to assess the tooth development and eruption and then match it to one of the 31 pictures of age categories.<br>|
| Healthy controls with gender-age match<br> | Other: Diagnostic Test: Willems method<br>* Willems method measures the developmental stages of the seven left permanent mandibular teeth and is frequently used for dental age estimation. The score of each stage is allocated, and the sum of the scores provides an evaluation of the subject's dental maturity.<br>Other: Diagnostic Test: Cameriere method<br>* Cameriere et al. designed a quantitative approach through a formula based on sex and the ratio between length and apex opening measurements of each lower left tooth.<br>Other: Diagnostic Test: London Atlas method<br>* The London Atlas requires the user to assess the tooth development and eruption and then match it to one of the 31 pictures of age categories.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation coefficient of Willems method | Dental age of children with Cleft Lip and Palate and healthy controls assessed by the correlation coefficient | day 1 | 
| Correlation coefficient of London Atlas method. | Dental age of children with Cleft Lip and Palate and healthy controls assessed by the correlation coefficient. | day 1 | 
| Correlation coefficient of Cameriere European formula. | Dental age of children with Cleft Lip and Palate and healthy controls assessed by the correlation coefficient. | day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dental age estimation in children with Cleft Lip and Palate | Dental age estimation in Turkish children | day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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children, dental age estimation, Cleft Lip and Palate, chronological age, London Atlas, Cameriere European Formula, Willems method