Dental age estimation with TWO different methods in pediatric patients with hypothyroidism

Hypothyroidism is an endocrinological disease known to have effects on growth and development such as delayed pubertal development, weak growth, dwarfism, delayed tooth eruption and delayed bone age. It is known that odontogenesis is frequently used in age determination practices and evaluation of maturity. Dental age determination is used in many fields such as pediatric endocrinology, forensic medicine, archeology, age determination of immigrant children of unknown age, determination of punishment according to age, treatment planning in dentistry and determination of dental maturity. In this study, it is aimed to contribute to the literature in all areas where dental age determination is used by presenting information about the dental development of children with hypothyroidism. In the study, 80 patients with hypothyroidism aged 5-13 and randomly selected 80 healthy patients, matching in terms of age and gender, were evaluated. Before the study, panoramic radiography analysis of 10% of the sample size, which were not included in the main research, was performed independently by two separate researchers who were calibrated for both methods. Panoramic radiographs of the patients included in the study were examined retrospectively, and dental age determination was made by Cameriere's and Nolla's methods. Two weeks after evaluation of all radiographs, randomly selected 10% of all panoramic radiographs included in the study were re-evaluated by the principal investigator. The conformity of the data obtained in the study to the normal distribution was carried out with the Kolmogorov-Smirnov test. Intra-class correlation coefficient was calculated for the purpose of inter-observer and intra-observer agreement analysis. While Mann Whitney U test is used for inter-group comparisons and Wilcoxon Signed Rank test is used for in-group comparisons, chi-square tests were applied to determine the relationship between hypothyroidism and differences in dental age calculated by both methods, less than 12 months and more than 12 months from chronological age. In all analyses, p<0.05 level was considered significant. In our study, as a result of the evaluations made for both regardless of gender and on the basis of gender, between hypothyroidism and control groups, according to the median values, no statistically significant difference was found in the differences between the chronological age and the dental age calculated by the Nolla's and Cameriere's methods (p>0.05). Among all the males and females included in our study, the differences between dental age calculated by the Nolla's method and chronological age was observed to be significantly behind the median values of the females' dental age compared to the males' (p<0.05). In our study, according to the median values of both patients with hypothyroidism (p<0.001) and control group (p<0.01) in females, it was concluded that the Cameriere's method calculated the dental age statistically significantly closer to the chronological age compared to the Nolla's method. In males, there was no statistically significant difference between the distinction between dental age calculated by both Nolla's method and Cameriere's method with respect to chronological age in both patients with hypothyroidism and control group (p>0.05). In our study, no statistically significant relationship was observed between patients with hypothyroidism and control group in both males and females in terms of changes up to ±12 months and more than ±12 months of the difference between dental age and chronological age calculated by both methods (p> 0.05). It was found that there was no statistically significant difference between patients with hypothyroidism and control group in terms of dental age evaluated by both methods, but the backward tendency of patients with hypothyroidism compared to control group should be carefully evaluated. However, although both methods have similar results, it is thought that the Cameriere's method may be more preferable than the Nolla's method in both female patients with hypothyroidism and healthy females. Keyword: Hypothyroidism, Dental age, Cameriere's method, Nolla's method