Dental maturity is associated with skeletal maturity, which is advanced in girls with central precocious puberty (CPP). We investigated the performance of dental maturity as a screening method for CPP using mandibular second premolar and molar calcification stages, assessed the associated anthropometric and laboratory factors, and evaluated pubertal response predictors using the gonadotropin-releasing hormone stimulation test (GnRHST) in prepubertal and pubertal girls. A prospective case-control study was conducted in girls, aged 7.0–8.9 years, classified into pubertal (peak luteinizing hormone [LH] after GnRHST ≥ 5 IU/L), prepubertal (peak LH < 5 IU/L), and control groups. Auxological and biochemical tests, panoramic radiographs, and GnRHSTs in participants with breast development were conducted. Dental maturity was assessed using the Demirjian index (DI). We included 103 girls (pubertal, 40; prepubertal, 19; control, 44). Chronological age (CA) was not significantly different between groups. Bone age (BA) and BA advancement was higher in the pubertal and prepubertal groups. Increased DI values at the mandibular second premolar and molar were significantly associated with CA, BA, BA advancement, height standard deviation score (SDS), peak LH after GnRHST, and insulin-like growth factor-I (IGF-I) (all P < 0.05). Moreover, odds ratio (OR) of the mandibular second premolar and molar (a DI value of ≥ E) for predicting a positive response to GnRHST was 8.7 (95% confidence intervals [CI], 2.9–26.1) and 5.2 (95% CI, 2.2–12.7), respectively. Dental maturity was a strong predictor for diagnosing CPP. Determining dental maturity in girls with suspected precocious puberty might help determine the performance of GnRHSTs.
Bicuspid ; Breast ; Case-Control Studies ; Diagnosis ; Female* ; Gonadotropin-Releasing Hormone* ; Humans ; Luteinizing Hormone ; Mass Screening ; Methods ; Molar ; Odds Ratio ; Prospective Studies ; Puberty, Precocious*

In published article by Li et al., an author's name was misspelled.

Bisphosphonates are widely used to treat osteoporosis, hypercalcemia of malignant tumor. Despite their clinical benefit, bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a newly documented complication to patients receiving these drugs and first recognized by Marx in 2003. Thus, consideration of prevention and needs regarding unequivocal treatment regimen have emerged. Recently, several authors emphasized reports on appropriate clinical availability of surgical approach. It serves to concern about guideline for surgical and conservative treatment modalities. So, it is the purpose of this paper to review the current literatures about treatment regimens of BRONJ.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Diphosphonates ; Humans ; Hypercalcemia ; Osteonecrosis ; Osteoporosis

PURPOSE: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. MATERIALS AND METHODS: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: 67 +/- 8, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. RESULTS: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type was similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). CONCLUSION: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.
Congenital Abnormalities ; Diagnosis ; Female ; Fractures, Compression ; Humans ; Incidence ; Male ; Osteoporosis ; Spine ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed, Single-Photon* ; Zygapophyseal Joint

PURPOSE: The aim of the present study was to investigate the disagreement of cephalometric analysis depending on the reference determination of midsagittal plane on three-dimensional computed tomography. MATERIALS AND METHODS: A total of 102 young women with class III dentofacial deformity were evaluated using three-dimensional computed tomography. The cranial and facial midsagittal planes were defined and the amounts of jaw deviation were calculated. The amounts of jaw deviation were compared with paired t-test (2-tailed) and Bland-Altman plot was drawn. RESULTS: The landmark tracing were reproducible (r> or =.978). The jaws relative to the cranial midsagittal plane were 10-17 times more significantly deviated than to the facial midsagittal plane (P<.001). Bland-Altman plot demonstrated that the differences between the amounts of jaw deviation from two midsagittal planes were not normally distributed versus the average of the amounts of jaw deviation from two midsagittal planes. CONCLUSION: The cephalometric analyses of facial asymmetry were significantly inconsistent depending on the reference determination of midsagittal plane. The reference for midsagittal plane should be carefully determined in three-dimensional cephalometric analysis of facial asymmetry of patients with class III dentofacial deformity.
Cephalometry ; Dentofacial Deformities ; Facial Asymmetry ; Female ; Humans ; Jaw ; Tomography, X-Ray Computed

PURPOSE: This study was performed to determine the optimal tile size for the fractal dimension of the mandibular trabecular bone using a tile counting method. MATERIALS AND METHODS: Digital intraoral radiographic images were obtained at the mandibular angle, molar, premolar, and incisor regions of 29 human dry mandibles. After preprocessing, the parameters representing morphometric characteristics of the trabecular bone were calculated. The fractal dimensions of the processed images were analyzed in various tile sizes by the tile counting method. RESULTS: The optimal range of tile size was 0.132 mm to 0.396 mm for the fractal dimension using the tile counting method. The sizes were closely related to the morphometric parameters. CONCLUSION: The fractal dimension of mandibular trabecular bone, as calculated with the tile counting method, can be best characterized with a range of tile sizes from 0.132 to 0.396 mm.
Bicuspid ; Fractals ; Humans ; Incisor ; Mandible ; Molar ; Trabecular Meshwork

PURPOSE: The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. MATERIALS AND METHODS: Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. RESULTS: The smallest difference between the calculated and the actual distance was 0.1+/-0.7 mm in Group 1/Method 3. The largest difference was -4.2+/-1.6 mm in Group 3/Method 2. In all groups, method 3 was the most accurate. CONCLUSION: Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.
Incisor ; Radiography, Dental ; Radiography, Panoramic ; Skull ; Tooth, Supernumerary

Coronoid impingement can cause limitation of mouth opening. In many cases, it appears to be related to the coronoid hyperplasia. We present a case of mouth opening limitation caused by coronoid impingement on the posterior surface of the zygomatic bone without coronoid hyperplasia. The bony changes in coronoid and zygoma including surface irregularity and discontinuity of the cortex and sclerotic change of inner medullary space were noted on computed tomography (CT) scans in different level of axial planes. Through another CT scans in open mouth position could demonstrate that those bony changes were caused by the contact of both surfaces against each other. In case coronoid impingement is suspected of the many possible causes, the open mouth CT scans will be needed to reveal the direct impingement of coronoid on zygoma even without coronoid hyperplasia.
Diagnosis* ; Hyperplasia ; Mouth ; Tomography, X-Ray Computed ; Trismus ; Zygoma

PURPOSE: The purpose of this study was to evaluate the effect of the kV on fractal dimension of trabecular bone in digital radiographs. MATERIALS AND METHODS: 16 bone cores were obtained from patients who had taken partial resection of tibia due to accidents. Each bone core along with an aluminum step wedge was radiographed with an occlusal film at 0.08 sec and with the constant film-focus distance (32 cm). All radiographs were acquired at 60, 75, and 90 kV. A rectangular ROI was drawn at medial part, distal part, and the bone defect area of each bone core image according to each kV. The directional fractal dimension was measured using Fourier Transform spectrum, and the anisotropy was obtained using directional fractal dimension. The values were compared by the repeated measures ANOVA. RESULTS: The fractal dimensions increased along with kV increase (p<0.05). The anisotropy measurements did not show statistically significant difference according to kV change. The fractal dimensions of the bone defect areas of the bone cores have low values contrast to the non-defect areas of the bone cores. The anisotropy measurements of the bone defect areas were lower than those of the non-defect areas of the bone cores, but not statistically significant. CONCLUSION: Fractal analysis can notice a difference of a change of voltage of x-ray tube and bone defect or not. And anisotropy of a trabecular bone is coherent even with change of the voltage of x-ray tube or defecting off a part of bone.
Aluminum ; Anisotropy* ; Fourier Analysis ; Fractals* ; Humans ; Tibia

Age Distribution ; Emergencies ; Emergency Medical Services ; Facial Bones ; Female ; Hemorrhage ; Humans ; Jaw Fractures ; Male ; Pulpitis ; Retrospective Studies ; Soft Tissue Injuries ; Surgery, Oral ; Temporomandibular Joint Disorders ; Tooth Injuries