Pontos de corte para estabelecer as idades legais de 12 e 14 anos utilizando os índices de maturação do segundo e terceiro molar (I2m/I3m) no Brasil

• Autor(a) principal: Nóbrega, Johnys Berton Medeiros da
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/21267
• topic: Determinação da idade pelos dentes; Defesa da criança e do adolescente; Radiografia panorâmica; Age determination by teeth; Child advocacy; Radiography; Panoramic; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA

Children and adolescents will have different support and punishment when experiencing situations that classify them as defendants or victims. For definitions of these cases, age information is crucial. In view of the above, it's necessary to carry out studies in order to identify methodologies capable of estimating whether an individual has reached or not the legal ages of greatest relevance to civil and criminal law. The objective was to determine cutoff points capable of estimating legal ages of 12 and 14 years, using Maturation Index of the Second Molar (I2M) and Third Molar (I3M). This is an observational, cross-sectional study by analyzing panoramic radiographic images taken in the following states: Bahia, Pará, Goiás, Rio de Janeiro and Paraná. The project was previously submitted and approved by CEP (CAAE: 31776720.0.0000.5188). Universe was comprised of radiographs taken in accordance with 10 to 15 years, from 2013 to 2019. For sample calculation, a pilot study was carried out with 73 images using methodology applied in the subsequent data collection. From the calculation of the size of Cohen's d effect, the minimum number reached by the comparison group was 250. Sample was balanced by sex and region, with 125 images of each sex (n = 250), 50 of each region, taken for clinical and/or orthodontic diagnostic reasons and presenting the second and third left lower molars. No radiography was performed for this research. The sample selection was carried out by same researcher who performed sample blinding. All radiographs that were part of sample were added to a cloud bank shared with the researcher who collected data. The inter-examiner (k = 1,000; ICC = 0.963) and intra-examiner (k = 0.855; ICC = 0.996) agreement was found, where the gold standard for inter-examiner analysis was the originator of the I3M. Data collection followed the methodology originally proposed in I3M, from the measurement of the internal widths of the roots and longitudinal length of the teeth 37 and 38, using ImageJ® software. Data were analyzed in a descriptive and inferential manner (α <0.05), observing the diagnostic parameters for age (<or≥ 12 years; <or≥ 14 years) in univariate logistic regression of three variables: I2M, I3M and (I2MxI3M). The mean age was 12.35 (± 1.45) for both sexes. For 12 years, cutoff points found for I2M, I3M and I2MxI3M were 0.554 (AUC: 88.5%; 95%IC: 84.00-93.00), 0.519 (AUC: 77.8%; 95%IC: 76.1-79.5) and 0.699 (AUC: 88.4%; 95%IC: 84.5-92.3). For 14 years, cutoff x points found for I2M, I3M and I2MxI3M were 0.200 (AUC: 86.9%; 95%IC: 77.3-96.5), 0.148 (AUC: 79.3%; 95%IC: 78.0-80.5) e 0.162 (AUC: 86.2%; 95%IC: 76.7-95.7). Individually, cutoffs identified for the female sex were more accurate for the diagnosis of 12 years, and cutoffs that diagnosed better the age of 14 years were the male ones. The I2M showed best results for diagnosis of both ages. The cutoff points found in the values of I2M and I3M are sufficiently accurate for the practical application of expertise in the diagnosis of ages 12 and 14 years, between individuals of both sexes from 10 to 15 years in Brazil.