The influence of motion artefacts on magnetic resonance imaging of the clavicles for age estimation

Purpose To determine how motion affects stage allocation to the clavicle's sternal end on MRI. Materials and methods Eighteen volunteers (9 females, 9 males) between 14 and 30 years old were prospectively scanned with 3-T MRI. One resting-state scan was followed by five intentional motion scans. Additionally, a control group of 72 resting-state scans were selected from previous research. Firstly, six observers allocated developmental stages to the clavicles independently. Secondly, they re-assessed the images, allocating developmental statuses (immature, mature). Finally, the resting-state scans of the 18 volunteers were assessed in consensus to decide on the "correct" stage/status. Results were compared between groups (control, prospective resting state, prospective motion), and between staging techniques (stages/statuses). Results Inter-observer agreement was low (Krippendorff alpha 0.23-0.67). The proportion of correctly allocated stages (64%) was lower than correctly allocated statuses (83%). Overall, intentional motion resulted in fewer assessable images and less images of sufficient evidential value. The proportion of correctly allocated stages did not differ between resting-state (64%) and motion scans (65%), while correctly allocated statuses were more prevalent in resting-state scans (83% versus 77%). Remarkably, motion scans did not render a systematically higher or lower stage/status, compared to the consensus. Conclusion Intentional motion impedes clavicle MRI for age estimation. Still, in case of obvious disturbances, the forensic expert will consider the MRI unsuitable as evidence. Thus, the development of the clavicle as such and the staging technique seem to play a more important role in allocating a faulty stage for age estimation

Willingness of dental professionals to participate in special care dentistry

Objectives: To assess dental professionals’ characteristics and willingness to participate in the future organization of Special Care Dentistry (SCD) for patients with motor disabilities (MD), patients with developmental disabilities (DD) and older adults (OA), in Flanders, Belgium. Methods: An online questionnaire survey around received education, providing care and future organization of SCD was performed between December 2020 and January 2021. Descriptive, bivariate (Mann-Whitney U Test, Pearson Chi-Square and Fisher’s Exact Test) and binomial logistic regression analyses were performed with profession (dentist of dental hygienist) as explanatory variable (adjusted for covariates years of experience and gender). The project was approved by the Ghent University Hospital ethics committee (B6702020000556). Results: The survey was completed by 308 dentists (response rate 7.7%) and 51 dental hygienists (response rate 35.2%). There was a higher proportion of male dentists (40.6% vs. 1.6%; P<0.001) and dentists had more years of experience (median 31; range [1-55]) than dental hygienists (median 1; range [0-25]; P<0.001). A higher proportion of dentists treated SCD patients (96.4% vs. 87.0%; P<0.05). The adjusted models revealed that a higher proportion of dental hygienists than dentists had received education about all included SCD target groups (MD: OR 6.21, 95%CI [2.37-16.29]; DD: OR 6.21, 95%CI [2.37-16.29]; OA: OR 3.70, 95%CI [1.40-9.75]). Furthermore, more dental hygienists were open to (a) receive future education about SCD patients (MD: OR 6.70, 95%CI [1.88-23.83]; DD: OR 5.13, 95%CI [1.43-18.37]; OA: OR 2.47, 95%CI [0.91-6.70]), (b) use mobile dental equipment (OR 5.41, 95%CI [2.33-12.54]) and (c) be part of an oral healthcare network for patients with MD (OR 4.09, 95%CI [1.52-11.00]), patients with DD (OR 4.88, 95%CI [1.82-13.10]) or older adults (OR 4.64, 95%CI [1.73-12.43]) in future. Conclusions The results suggest that dental hygienists are more open to play a role within the future organization of SCD in Flanders

Forensic age estimation based on development of third molars: a staging technique for magnetic resonance imaging

status: accepte

Review of the dental treatment backlog of people with disabilities in Europe

Aim: To describe the oral health and treatments needs of people with disabilities in Europe. Methods: A comprehensive literature search was conducted using Medline and Embase with a timeframe from January, 2008 till December, 2017 and citation tracking was done. Articles in English, French and Dutch were included. Results: Forty-two articles were included. A variety of oral health problems and treatment needs was seen. More untreated caries, less fillings, more extractions and less prosthetic rehabilitation were seen in people with disabilities compared to people without disabilities. Oral hygiene and periodontal conditions were poor. In people with disabilities, a higher risk for dental trauma, orthodontic problems and tooth wear was also detected. Discussion: Results need to be interpreted with caution because of the variety of people with disabilities included in this literature review. However, a backlog of treatment was a common finding in people with disabilities. Different factors contribute to their oral health and treatment needs. These determinants can be situated at the level of the person with a disability (biological factors), his/her lifestyle, the environment and the organization of oral healthcare. Training and motivating people with disabilities, their family and caregivers are suggested to improve their oral health. Furthermore training of dental students and dentists about the treatment needs and treatment possibilities in people with disabilities should be envisaged in order to make dentists feel more comfortable in treating this target group

Review of the dental treatment backlog of people with disabilities in Europe

Aim: The present research aims at reviewing the oral health conditions and treatment needs of people with disabilities in Europe. Methods: A comprehensive literature search was conducted using Medline and Embase with a timeframe from January 2008 until December 2017. Subsequently, a citation tracking was undertaken. Articles in English, French and Dutch were included. Results: Forty-two articles were included. A variety of oral health problems and treatment needs was reported. More untreated carious lesions, less restorations, a higher number of extractions and less prosthetic rehabilitations were seen in people with disabilities compared with other individuals without disabilities. The oral hygiene level and the periodontal conditions were poor. Moreover, a higher risk of dental trauma, orthodontic problems and tooth wear were reported. Discussion: Different determinants contribute to the oral health condition and treatment needs of people with disabilities. These determinants can be inherent in persons with a disability (biological factors), their lifestyle, the environment or the organization of oral health care. A treatment backlog was a common finding in people with disabilities. However, results need to be interpreted with caution because of the variety of people with disabilities included in this literature review. Proposed solutions can be put at the level of daily oral care, through oral health promotion programs and the creation of a supportive environment, but also at the level of dental attendance, facilitating the access to oral health care services and focusing the training of dental students and dentists. Conclusion: This comprehensive review clearly shows a dental treatment backlog in people with disabilities. Solutions require efforts from the caregivers and dental professionals