Comparative evaluation of dental age, bone age, and chronological age in the human immunodeficiency virus positive children

Kumar, Vinod; Patil, Kavitha; Munoli, Karishma

doi:10.4103/0975-7406.137395

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…It is possible these children will experience some 'catch-up' skeletal maturation on initiation of puberty, which may be more rapid in duration than individuals who are more advanced in maturation at the same age. The 6-month delay is less than that seen in Brazilian and Indian CWH on ART, aged 5-11 and 8-14 years respectively, who had an SMD of over one year, though these studies were smaller and did not include older adolescents, nor in India a comparator group [10,11].…”

Section: Discussionmentioning

confidence: 84%

“…Skeletal maturation is in uenced by several factors such as genetic ancestry and environmental factors like socio-economic deprivation, nutritional status (e.g., vitamin D and calcium intake), physical activity and co-morbid disease [4,6,9]. Studies have suggested that CWH may have delayed skeletal maturation despite ART [10,11]; however, none have been conducted in sub-Saharan Africa where the majority of CWH live. Given the impact of maturation on achieving genetic potential and consequently future health, it is important to understand how skeletal development progresses through puberty in males and females from sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

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The impact of HIV infection on skeletal maturity in peripubertal children in Zimbabwe: a cross sectional study

Nyakoko,

Gregson,

Westbury

et al. 2023

Preprint

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Introduction HIV infection and its treatment compromises skeletal development (growth and maturation). Skeletal maturity is assessed as bone age (BA) on hand and wrist radiographs. BA younger than chronological age (CA) indicates delayed development. We conducted a cross-sectional study to determine differences between BA and CA (i.e., skeletal maturity deviation [SMD]), and risk factors associated with SMD in peripubertal children with and without HIV established on antiretroviral therapy (ART) including use of tenofovir disoproxil fumarate (TDF). Methods Children with HIV taking ART for at least two years and a comparison group of HIV-negative children, aged 8-16 years and frequency-matched by age and sex, were recruited from HIV clinics and local schools in the same catchment area, in Harare, Zimbabwe. BA was assessed from non-dominant hand-wrist radiographs using the Tanner Whitehouse 3 method. Negative SMD values correspond to delayed development, i.e., BA younger than CA. Multivariable linear regression models determined factors associated with SMD overall, and in children with HIV. Results In total, 504 participants (54% males) were included; by design CA was similar in males and females, whether living with or without HIV. Mean (SD) SMD was more negative in CWH than in HIV-negative children in both males [-1.4(1.4) vs. -0.4(1.1) years] and females [-1.1(1.3) vs. -0.0(1.2) years]. HIV infection and weight-for-age Z-score<-2 were associated with more negative SMD in both males and females after adjusting for socio-economic status, orphanhood, pubertal stage, and calcium intake. Age at ART initiation was associated with SMD in females with those starting ART later more delayed: starting ART aged 4-8 years 1.14 (-1.84, -0.43), or over 8 years 1.47 (-2.30, -0.65) (p-value for trend <0.001). Similar non-significant trends were seen in males. TDF exposure was not associated with delayed development. Conclusion Perinatally-acquired HIV infection and being underweight were independently associated with delayed skeletal maturation in both males and females. Starting ART later was independently associated with skeletal maturation delay in females with HIV. Given the known effects of delayed development on later health, it is important to find interventions to ensure healthy weight gain through early years and in CWH to initiate ART as early as possible.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The impact of HIV infection on skeletal maturity in peripubertal children in Zimbabwe: a cross sectional study

Nyakoko,

Gregson,

Westbury

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Presently, the dental age and skeletal development stage are used as the main indices of skeletal growth and maturation in dental practice [ 19 ]. These two variables are more valuable in clinical assessments than chronological age and gender-related characteristics [ 11 ]. Vitamin D plays a fundamental role in the development, metabolism, and function of hard tissues; therefore, its deficiency contributes to growth retardation [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship of Vitamin D Deficiency with Cervical Vertebral Maturation and Dental Age in Adolescents: A Cross-Sectional Study

Azarbakhsh

Iranparvar

Tehranchi

et al. 2022

International Journal of Dentistry

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Background. Considering the high prevalence of vitamin D deficiency and its effect on growth and development, the assessment of the dental age and skeletal age with regard to vitamin D deficiency status could influence the treatment planning of growth modification treatment. This study aimed to assess the relationship between vitamin D deficiency, cervical vertebral maturation (CVM) as an indicator of skeletal age, and dental age in adolescent patients. Methods. In this cross-sectional study, the chronological age of 52 orthodontic patients aged between 10 and 14 years was recorded, and their serum level of vitamin D was determined using a radioimmunoassay test. The patients were then divided into three groups based on their serum vitamin D level: severe deficiency, moderate deficiency, and the control group with normal vitamin D. The panoramic radiographs of patients were assessed to determine their dental age using Demirjian’s method. CVM was determined on lateral cephalograms using Baccetti’s classification to specify the skeletal age. Data were analyzed using a t-test, linear regression, ordinal logistic regression, and Pearson’s correlation coefficient (at P < 0.05 , confidence interval = 95%). Results. Skeletal age showed a significant difference between the group with severe vitamin D deficiency and the control group ( P = 0.01 ); however, such difference was not observed between the group with moderate vitamin D deficiency and the control group ( P = 0.12 ). Dental age was not significantly different between the groups with vitamin D deficiency and the control group ( P = 0.26 for severe, and P = 0.39 for moderate deficiency). Conclusions. A less advanced skeletal maturation was observed in adolescents with severe vitamin D deficiency; however, dental development was not affected by this deficiency. Vitamin D status is better to be considered in decision-making for the initiation of growth modification orthodontic treatments.

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“…To our knowledge, no study was previously designed to assess the development of the CV in HIV patients. The available scientific literature is scarce and focuses on the radiographic assessment of the hand and wrist ( 21 , 22 ), the teeth ( 19 , 22 , 23 ) and the craniofacial bones ( 18 ). In the clinical practice, information on the skeletal development of HIV infected children through the CV is relevant for any therapeutic approach that requires that analysis and the prediction of growth.…”

Section: Discussionmentioning

confidence: 99%

Morphological analysis of the skeletal development in lateral cephalometric radiographs of HIV infected children ongoing Highly Active Antiretroviral Therapy

Possagno¹,

Franco²,

Paranhos³

et al. 2018

Med Oral

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BackgroundTo investigate the skeletal development of HIV infected children through a morphological analysis of the cervical vertebrae (CV) in lateral cephalometric radiographs.Material and MethodsThe sample consisted of 86 lateral cephalometric radiographs of male and female children aged between 6 and 14 years old. The radiographs were equally distributed in groups 1 (HIV infected children) and 2 (non-infected children, paired by sex and age). Two examiners analyzed the CV according to the method of Hassel and Farman (1995). Spearman correlation coefficient was used to associate age and skeletal development within groups, while Mann-Whitney test compared the skeletal development between groups.ResultsThe correlation of age and skeletal development in group 1 reached 0.17, 0.27 and 0.27 (p >0.05) for C2, C3 and C4, respectively, while in group 2 it reached 0.65, 0.54 and 0.60, respectively (p <0.001). Differences were not significant between groups (p >0.05).ConclusionsHIV infected and non-infected children showed a similar development of the CV. However, the weak correlation between age and CV development in HIV infected children highlights the need for careful decisions prior to therapeutic approaches – especially those founded on the prediction of skeletal development, such as maxillofacial surgeries, and orthopedic and orthodontic procedures. Key words:Cervical vertebrae, growth and development, HIV, radiology.

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Comparative evaluation of dental age, bone age, and chronological age in the human immunodeficiency virus positive children

Cited by 6 publications

References 15 publications

The impact of HIV infection on skeletal maturity in peripubertal children in Zimbabwe: a cross sectional study

The impact of HIV infection on skeletal maturity in peripubertal children in Zimbabwe: a cross sectional study

Relationship of Vitamin D Deficiency with Cervical Vertebral Maturation and Dental Age in Adolescents: A Cross-Sectional Study

Morphological analysis of the skeletal development in lateral cephalometric radiographs of HIV infected children ongoing Highly Active Antiretroviral Therapy

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