A Comparison of the Accuracy of Four Age Estimation Methods Based on Panoramic Radiography of Developing Teeth

Reliability of a forensic odontology method for age-at-death estimation in adults: A Mexican case study

This study aimed to evaluate the reliability of an age estimation method based on the pulp⁄tooth area ratio by assessing intra- and inter-examiner agreement across five observers at different intervals. Using the same X-ray device and technical parameters, 96 digital periapical X-ray images of upper and lower canines were obtained from 28 deceased people in Central America, whose age at death ranged from 19 to 49 years. Excellent and good agreement of results were achieved, and there were no statistically significant differences. The R2 value for upper teeth (54.0%) was higher than the R2 value for lower teeth (45.7%). The highest intraclass correlation coefficient value was 0.995 (0.993-0.997) and the lowest 0.798 (0.545-0.895). Inter-examiner agreement was high with values of 0.975 (0.965-0.983) and 0.927 (0.879-0.955). This method is adequate for assessing age in missing and unidentified people, including victims of mass disasters.

Association between dental age and malocclusions: a systematic review

BACKGROUND

The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions.

METHODS

The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023.

RESULTS

One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian's method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated.

CONCLUSION

DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail.

TRIAL REGISTRATION

This study was registered in the PROSPERO database (CRD42023454207).

Applying artificial intelligence to determination of legal age of majority from radiographic data

Forensic odontologists use biological patterns to estimate chronological age for the judicial system. The age of majority is a legally significant period with a limited set of reliable oral landmarks. Currently, experts rely on the questionable development of third molars to assess whether litigants can be prosecuted as legal adults. Identification of new and novel patterns may illuminate features more dependably indicative of chronological age, which have, until now, remained unseen. Unfortunately, biased perceptions and limited cognitive capacity compromise the ability of researchers to notice new patterns. The present study demonstrates how artificial intelligence can break through identification barriers and generate new estimation modalities. A convolutional neural network was trained with 4003 panoramic-radiographs to sort subjects into 'under-18' and 'over-18' age categories. The resultant architecture identified legal adults with a high predictive accuracy equally balanced between precision, specificity and recall. Moving forward, AI-based methods could improve courtroom efficiency, stand as automated assessment methods and contribute to our understanding of biological ageing.

Age estimation of children based on open apex measurement in the developing permanent dentition: an Egyptian formula

Background

Cameriere’s original formula based on open apex measurements is a reliable, clinically applicable method for dental age estimation in different populations children. Dental development may differ between Egyptian children and other ethnic populations which may affect dental age accuracy using Cameriere’s formula.

Aim

Firstly, to verify Cameriere’s original formula on large Egyptian children sample, secondly, to develop an Egyptian-specific formula based on Cameriere’s method.

Material and methods

A prospective cross-sectional study of 762 good quality Orthopantomograms (OPGs) of 5–15 aged healthy Egyptian children selected from Nile Delta governorates between August 2020 and December 2021. Chronological age (CA) was calculated by subtracting birth date from radiograph date. OPGs were analyzed for N0, S, Xi morphologic variables using Sidexis program after that dental age was calculated using Cameriere’s formula then compared to CA. Multiple linear regression model was used to adapt Cameriere’s formula to construct an Egyptian formula. The same sample was used to verify the new formula accuracy.

Results

A total of 1093 OPGs were collected; 762 OPGs which met inclusion criteria were analyzed. Cameriere’s original formula revealed − 0.59- and − 0.53-year underestimation of females and males dental age (DA) respectively (p < 0.001). Regression analysis using the morphologic variables showed that X4, X7, N0 contributed significantly to CA yielding Egyptian-specific formula. New formula showed − 0.12-year male underestimation and 0.1-year female overestimation (p > 0.05).

Conclusion

Egyptian formula was more accurate than Cameriere’s formula in Egyptian children.

Clinical relevance

Egyptian-specific formula decreases the gap between CA and DA, so a relative approximate age is obtained that helps proper diagnosis and treatment planning for orthodontic and pediatric dentistry problems.

The Cameriere, Haavikko, Demirjian, and Willems methods for the assessment of dental age in Croatian children

AIM

This study aimed to evaluate the accuracy and precision of the Cameriere European formula, Demirjian, Haavikko, and Willems methods for estimating dental age in a sample of children with permanent dentition in Croatia.

MATERIAL AND METHODS

The study consisted of a sample of 1576 panoramic radiographs; a sub-sample of 84 OPGs, in which all first seven mandibular teeth were maturated, was excluded from the study. A final sample of 1492 (704 males and 788 females) aged 6.0 to 13.9 years was evaluated. Seven mandibular teeth from the left side of the mandible were analyzed, and dental age (DA) was determined by the Cameriere European formula, Demirjian method from 1976, Haavikko, and Willems methods and compared to chronological age (CA). In addition, the mean age difference (DA-CA), the mean absolute error (MAE) between dental and chronological age, the percentage of the individuals of dental age within ± 0.25 to ± 2 years of chronological age, and intra-observer and inter-observer statistics were calculated.

RESULTS

The Cameriere European formula estimated the best dental age compared to the chronological age; the mean underestimation was - 0.4 years for both sexes, Haavikko underestimated by - 0.17 years, while Demirjian and Willems overestimated by 1.02 years and 0.48 years, respectively. The most significant difference showed the Demirjian method in 11-year-old and 12-year-old females. The MAE were 0.50 years, 1.01 years, 0.61 years, and 0.78 years in males and 0.51 years, 1.18 years, 0.61 years, and 0.70 years in females for the Cameriere European formula, Haavikko, Willems, and Demirjian methods, respectively. Furthermore, the Cameriere European formula showed the highest proportions of individuals with DA within ± 0.5 year difference of the CA, 61.5% in males and 59.6% in females. In addition, the Cameriere method showed the best intra-observer and inter-observer agreements.

CONCLUSIONS

Although the Demirjian method was used previously in Croatian children for legal, medical, and clinical purposes, the Cameriere European formula, Haavikko, and Willems were more accurate in the tested sample. According to our findings, the Cameriere European formula showed the best accuracy and precision in dental age assessment in Croatian children following Haavikko, and we recommend it as the method of the first choice in forensic and clinical analyses.

Validity of age estimation methods and reproducibility of bone/dental maturity indices for chronological age estimation: a systematic review and meta-analysis of validation studies

Several approaches have been developed to estimate age, an important aspect of forensics and orthodontics, using different measures and radiological examinations. Here, through meta-analysis, we determined the validity of age estimation methods and reproducibility of bone/dental maturity indices used for age estimation. The PubMed and Google Scholar databases were searched to December 31, 2021 for human cross-sectional studies meeting pre-defined PICOS criteria that simultaneously assessed the reproducibility and validity. Meta-estimates of validity (mean error: estimated age-chronological age) and intra- and inter-observer reproducibility (Cohen’s kappa, intraclass correlation coefficient) and their predictive intervals (PI) were calculated using mixed-effect models when heterogeneity was high (I² > 50%). The literature search identified 433 studies, and 23 met the inclusion criteria. The mean error meta-estimate (mixed effects model) was 0.08 years (95% CI − 0.12; 0.29) in males and 0.09 (95% CI − 0.12; 0.30) in females. The PI of each method spanned zero; of nine reported estimation methods, Cameriere’s had the smallest (− 0.82; 0.47) and Haavikko’s the largest (− 7.24; 4.57) PI. The reproducibility meta-estimate (fixed effects model) was 0.98 (95% CI 0.97; 1.00) for intra- and 0.99 (95% CI 0.98; 1.00) for inter-observer agreement. All methods were valid but with different levels of precision. The intra- and inter-observer reproducibility was high and homogeneous across studies.

Accuracy of Demirjian’s and Cameriere’s Methods for Age Estimation in 6- to 10-Year-Old Iranian Children Using Panoramic Radiographs

Objective

This study assessed the accuracy of Demirjian's and Cameriere's methods for age estimation in Iranian children using panoramic radiographs.

Materials and Methods

This cross-sectional study evaluated 212 panoramic radiographs of 6- to 10-year-old children retrieved from the archives of an oral and maxillofacial radiology department from 2011 to 2017. The chronological age of children at the time of radiography was determined by subtracting the date of radiography from their birth date. The developmental stage of 7 permanent left mandibular teeth was determined according to Demirjian's method. The stage of dental maturation was determined according to Cameriere's method by using the normalized values for 7 permanent left mandibular teeth and the number of teeth with complete root development. The error value of the two methods was calculated by comparing them with the actual chronological age of male and female children, and the absolute error values of the two methods were compared with paired t-tests.

Results

The mean error value of Demirjian's and Cameriere's methods was found to be 0.84 and −0.06 in girls and 0.93 and 0.04 in boys, respectively. Significant differences were noted in the absolute error of the two methods compared with the chronological age of male and female children (both Ps < 0.001).

Conclusion

In conclusion, this study indicated that Cameriere's method was more accurate than Demirjian's method for age estimation in Iranian children.

The Application of the Cameriere's Methodologies for Dental Age Estimation in a Select KwaZulu-Natal Population of South Africa

Background: The estimation of an individual’s age is a fundamental component of forensic odontology. Literary reports found that the efficiency of Cameriere methodology for age estimation varied among many population groups. Therefore, this study aimed to determine the applicability of the Cameriere methods to a select South African population of the KwaZulu-Natal (KZN) province. Materials and Methods: This cross-sectional retrospective study was conducted on 840 digital panoramic radiographs that met the inclusion criteria. Dental maturity was determined through the morphometric analysis of the seven left permanent mandibular and maxillary teeth in accordance with Cameriere et al. (2006). Moreover, the dental age was also calculated using the South African Black Bayesian formulae of the Cameriere method by Angelakopoulos et al. (2019). The paired sample t-test or Wilcoxon’s signed rank test assessed the significant difference between the chronological age and estimated dental age for the various formulae. A p-value < 0.05 was considered to be statistically significant. Results: The Cameriere et al. (2006) Italian formula and the South African Black Bayesian formulae of the Cameriere method by Angelakopoulos et al. (2019) underestimated and overestimated age in the South African Black and Indian population groups of the KZN province, respectively. Therefore, the authors generated a novel population-specific regression formulae (including and excluding third molars) using “step-wise regression analysis” and a “best-fit model” for the South African Black and Indian population groups of KZN. Conclusion: This study recommends that the population-specific formulae generated in this study be utilized in the KZN population to improve the accuracy of dental age estimation within this region.

Validation of the Italian, European, North German, Malaysian, and South African black formulas on Cameriere method using panoramic radiographs in Kenyan children

This study aimed to validate the accuracy of five different formulas based on the Cameriere method for age estimation in Kenyan children. We analyzed panoramic radiographs of 350 Kenyan children (184 males and 166 females) aged between 6 and 13 years. The dental development of each child was estimated by the analysis of the first seven left permanent teeth in the left mandible. Dental age was calculated by the Italian, European, North German, Malaysian, and South African black formulas previously published in peer-review journals. The children's mean chronological age (CA) was 9.34 ± 2.02 years and 9.26 ± 2.01 years for males and females. In males, the South-African formula overestimated CA least, by 0.12 years, followed by the Italian formula by 0.22 years, the European formula by 0.37 years, the Malaysian formula by 0.48 years, and the North-German formula overestimated the most, by 0.57 years. In females, the South-African formula underestimated CA by - 0.12 years. The Italian overestimated by 0.12 years, followed by the North-German formula by 0.29 years, the European formula by 0.31 years, and the Malaysian formula by 0.40 years. The Italian formula provided the best accuracy in the absolute difference within ± 1 year, by 75.72% and 75%, following the North-German formula by 66.47% and 70.27% for males and females, respectively. Therefore, the findings suggest that the Italian formula best estimates dental age in Kenyan children.

Evaluating the accuracy of two different age estimation methods in growing children in Navi Mumbai using Orthopantomograph: A radiographic study

BACKGROUND

Age estimation through dental maturity indicators is relatively more accurate, reliable, and valid for living as well as dead individuals. It acts as an important tool in diagnosis and treatment planning in clinical as well as in forensic dentistry. There are various methods to estimate the dental age. Out of which, Demirjian's method has been widely used in various populations. However, there is a dearth of literature on Indian population comparing Demirjian's method to Cameriere's method.

AIM

The purpose of this study was to evaluate the accuracy of Demirjian's and Cameriere's age estimation methods to chronological age in growing children using orthopantomograph (OPG).

SETTING AND DESIGN

The sample consisted of digital OPGs of 280 children in Navi Mumbai aged 5-16 years.

MATERIALS AND METHODS

Digital OPGs were used to assess the dental maturity of seven mandibular left teeth using Demirjian and Cameriere's method and were compared to the chronological age.

STATISTICAL ANALYSIS USED

Data were analyzed using Student's t tests.

RESULT

Irrespective of gender, dental age estimated by Cameriere's method (mean 10.23 ± 2.79 years), underestimated the chronological age (mean 11.74 ± 2.86 years) for overall population which showed statistically significant difference. Demirjian's method overestimated (mean 12.24 ± 3.06 years) the chronological age for the overall population but was statistically insignificant.

CONCLUSION

Demirjian's method is more closely in correlation with the chronological age of growing children as compared to the Cameriere method when applied to children of age 5-16 years in Navi Mumbai.

Age Estimation Using the Cameriere Methods of Open Apices: A Meta-Analysis

Purpose: To evaluate the actual variability of the mean difference between chronological and dental age using the Cameriere method of open apices and to test its accuracy in variable age groups. Method: We selected studies that contained data about the mean, standard deviation, and number of cases for chronological age, dental age and gender. We used a random-effects model. Statistical significance was estimated, at a p < 0.05, using prediction intervals. For the analysis of publication bias we used the funnel plot and Egger’s regression test for plot asymmetry. I² was used to test the presence of heterogeneity between studies. The Z test was used to test for statistical differences between subgroups, with p < 0.05 being considered statistically significant. We also used 95% for confidence intervals and prediction intervals. Results: In boys, the average difference between chronological and dental age was 0.44 (0.26–0.63) years, while in girls the average difference between chronological and dental age was 0.34 (0.19–0.49) years. In the 6–7 years age group and in the 14–15 years age group, there was a statistically significant difference between dental and chronological age. Our study shows that the Cameriere method is useful for estimating the chronological age, with errors of less than one year. Conclusions: The Cameriere method of evaluating dental age using open apices is sufficiently accurate for forensic practice, at least in the 7–14 age-interval.

Age estimation in the living: A scoping review of population data for skeletal and dental methods

Age estimation of living individuals has become a crucial part of the forensic practice, especially due to the global increase in cross-border migration. The low rate of birth registration in many countries, hence of identification documents of migrants, especially in Africa and Asia, highlights the importance of reliable methods for age estimation of living individuals. Despite the fact that a number of skeletal and dental methods for age estimation have been developed, their main limitation is that they are based on specific reference samples and there is still no consensus among researchers on whether these methods can be applied to all populations. Though this issue remains still unsolved, population information at a glance could be useful for forensic practitioners dealing with such issues. This study aims at presenting a scoping review and mapping of the current situation concerning population data for skeletal (hand-wrist and clavicle) and dental methods (teeth eruption and third molar formation) for age estimation in the living. Two hundred studies on the rate of skeletal maturation and four hundred thirty-nine on the rate of dental maturation were found, covering the period from 1952 and 2020 for a total of ninety-eight countries. For most of the western and central African countries there are currently no data on the rate of skeletal and dental maturation. The same applies to the countries of the Middle East, as well as the eastern European countries, especially as regard the skeletal development.

Dental age estimation: Demirjian's versus the other methods in different populations. A literature review

Age estimation is an important issue in forensic anthropology and odontology, since it is applied to both the living and the dead. Studies have shown that assessing tooth development using radiological methods is a reliable way to estimate age, especially in children. Demirjian's method is the most widely used estimation method for dental age evaluation. Over the years, many methods have been developed in order to asses which one predicts more accurately the age. In the literature, many populations were examined with these different methods and discordant results are described. This review aims to evaluate the studies in which Demirjian's method was compared with Willems', Cameriere's, Nolla's, Smith's, Haavikko's and Chaillet's methods in order to estimate the most accurate dental age estimation method in different populations. Using the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, the authors conducted a review of existing literature using three databases: PubMed, Google Scholar and Google Scopus.

Assessing the accuracy of Cameriere’s Indian-specific formula for age estimation on right and left sides of orthopantomogram

Background

Age estimation is of prime importance in forensic science and clinical dentistry. In children, age estimation can be done by skeletal maturity indicators like hand-wrist radiographs and dental age estimation. Skeletal maturity indicators compared with dental age estimation is limited as they are influenced by various environmental parameters, whereas calcification of teeth depends on genes rather than environmental factors. Many of the dental age estimation methods use extracted teeth, which are quite invasive, whereas Cameriere’s method is a recently introduced radiographic method first in European population; where in age estimation is done using open apices of teeth by orthopantomogram (OPG). Indian-specific formula was introduced later using permanent mandibular teeth on left side of jaw. The present study aimed to estimate the age and also to determine the accuracy of Cameriere’s method using Indian-specific formula on both right and left sides of mandible in Khammam population of South India and also to determine the side which can be efficient in determining age.

Methodology

The present study comprised radiographs of 50 subjects (25 boys and 25 girls) ranging from 5 to 15 years. The soft copies of the radiographs of selected subjects were retrieved from the computer attached to the digital orthopantomogram machine (Orthophos XG5; Sirona Dental Systems). The 7 left and right permanent mandibular teeth were assessed in OPGs. The number of teeth with closed apical and with open apical ends of roots was examined and measured. The values were tabulated based on the Cameriere method of age estimation using Indian-specific formula. Statistical analysis was done using paired t test and Karl Pearson’s correlation coefficient test.

Results

Comparison of dental age with chronological age in males showed non-significant results on both left and right sides of the OPG with a p value of 0.3765 and 0.3045, respectively. Likewise in females, p values of 0.2167 and 0.8089 were noted. When males and females were compared, non-significant results were obtained with a p value of 0.1613 in the age estimated on the left side of the OPG and a p value of 0.4322 on the right side of the OPG. Correlation test showed that left side of the OPG showed better results in determining age than the right side of the OPG with an r value of 0.9982 and 0.9485 in males and females, respectively.

Conclusion

Cameriere’s method of age estimation using Indian-specific formula proves to be an accurate and a reliable method which can be used to assess the chronological age of individuals. There is also a good correlation found between the chronological age and dental age of younger age group individuals.

Comparison of actual porcine tooth crown development stages and computer image analysis

Tooth developmental stage evaluation is important in dental and chronological age estimation, and it is important for accurate diagnoses and appropriate treatment in dental practice. It is routinely assessed by clinical observations and radiographic techniques. This study aimed at ascertaining tooth developmental stage judgments made by examiners and Mimics software according to the Nolla method with radiographs. Meanwhile, the true tooth developmental stages would be explored with histological analysis. Twenty freshly slaughtered porcine heads were collected and hemisected, and both the left and right mandibular samples were numbered. The developmental stages of the second and third permanent molars (M2 and M3) were evaluated by examiners and Mimics software analysis. The ratio of the radiopaque calcified area to the dental follicle (RCA/DF) at different stages was calculated. Both non-decalcified and decalcified samples were processed for histologic observation. The results showed significant differences between RCA/DF ratios from different developmental stages. There was a high positive correlation between the examiners' evaluation results and Mimics analysis results. Radiograph judgments and histology observation results were consistent from Stages 2-6. However, radiograph images of Stage 1 samples showed only crypts present, while under a surgical operating microscope, a bell-shaped tooth germ was observed. This was also confirmed by normal and hard tissue histology. In conclusion, radiograph judgments made by either examiners or Mimics software were both reliable. Mimics analysis can be a useful tool in evaluating tooth developmental stages. However, judgments need to be made cautiously in early developmental stages.

[Classification of the growth potential and consecutive treatment consequences for spinal deformities : When does what make sense?]

BACKGROUND

Adolescent idiopathic scoliosis is a three-dimensional spinal deformity with a curvature in the frontal plane (Cobb angle) of more than 10° without known underlying causes. During the phase of rapid growth, scoliosis deterioration is likely with an increase in the Cobb angle as well as deterioration of the rotational component. Accordingly, knowledge of the different stages of human growth is crucial for the treatment of adolescent idiopathic scoliosis.

CLASSIFICATION

There are a variety of classification systems helping to estimate the growth potential. In the following, on the one hand, the most common classification systems with regard to their availability, learning curve as well as accuracy with respect to the application in adolescent idiopathic scoliosis will be considered in more detail. On the other hand, based on the measured Cobb angles and the expected growth potential, a treatment algorithm for the management of adolescent idiopathic scoliosis will be presented.

The applicability of the Demirjian, Willems and Chaillet standards to age estimation of 5-15 year old Indian children

BACKGROUND

Demirjian's method of age estimation has been reported to overestimate age and Willems' method to give consistently more accurate results. Not enough, however, is known about the applicability of Chaillet's standards.

AIM

The present study aimed to compare the accuracy of Demirjian's, Willems' and Chaillet's standards in age estimation of 5 to 15 year-old Indian children.

DESIGN

In this cross-sectional observational study, three methods were compared for accuracy in estimating the age of 1200 Indian children aged 5-15 years.

RESULTS

Demirjian's method overestimated age by +0.24 ± 0.80 years, +0.11 ± 0.81years and +0.19 ± 0.80 years in boys, girls and the total sample, respectively. With Willems' method, overestimations of +0.09 ± 0.80 years, +0.08 ± 0.80 years and +0.09 ± 0.80 years were obtained in boys, girls and the total sample, respectively. Chaillet's method underestimated age by -0.12 ± 0.69 years, -0.45 ± 0.88 years and -0.25 ± 0.83 years in boys, girls and the total sample, respectively. Statistically significant differences were observed between dental and chronological ages with all methods (p < 0.001). Significant sex-based differences were observed only with Demirjian's and Chaillet's methods (p < 0.05).

CONCLUSION

Willems' method was the most accurate in age estimation, followed by Demirjian's and Chaillet's methods. While Demirjian's method was more accurate than Chaillet's in females, Chaillet's method better predicted the age of males.

Testing and comparing the accuracy of two dental age estimation methods on saudi children: Measurements of open apices in teeth and the London Atlas of Tooth Development

Evaluation of dental development is frequently performed to assess maturity and estimate age. The aim of this study was to test and compare the accuracy of two dental age estimation methods in a sample of Saudi children by using Cameriere's formula (measurements of mandibular teeth open apices) and The London Atlas of Tooth Development. Four hundred archived digital panoramic radiographs of healthy children (200 males and 200 females) between the ages of 6 to 15.99years attending the Pediatric Dental clinics of King Saud University, College of Dentistry, Riyadh, Saudi Arabia were used. The mean difference between the Estimated Age (EA) and Real Age (RA) was (-0.89years) for Cameriere's formula with a standard deviation of (±1.14years), and it was (-0.59years) with a standard deviation of (±1.45years) for The London Atlas. Both methods consistently underestimated the age. No statistically significant difference between the sexes was found in both methods In conclusion, the London Atlas was found to be slightly more accurate and easier to use than was Cameriere's formula.

The applicability of the original and revised Demirjian standards to age estimations of 5-15 year old Indian children

BACKGROUND

The Demirjian method has been the most widely tested method for the estimation of the dental age of children and adolescents. However, only three studies have compared Demirjian's original and revised seven-tooth methods, four-tooth method and alternate four-tooth method, none of them conducted on an Indian population.

AIM

The present study aimed to compare the applicability of the original and revised seven-tooth and four-tooth and alternate four-tooth standards for age estimation of 1200 Indian children aged 5-15 years old.

DESIGN

The study was designed as a retrospective cross-sectional study.

RESULTS

Demirjian's original seven-tooth method overestimated age by 0.64 ± 1.44, 0.75 ± 1.50 and 0.69 ± 1.46 years in boys, girls and the total sample, respectively. Demirjian's revised seven-tooth method overestimated age by + 0.24 ± 0.80, + 0.11 ± 0.81 and + 0.19 ± 0.80 years in boys, girls and the total sample, respectively. Demirjian's original four-tooth method overestimated age by 0.79 ± 1.59, 0.59 ± 2.77 and 0.72 ± 2.30 years in boys, girls and the total sample, respectively. Demirjian's alternate four-tooth method overestimated age by 1.31 ± 1.07, 1.20 ± 1.10 and 1.26 ± 1.08 years in boys, girls and the total sample, respectively. Statistically significant differences were observed between dental and chronological ages with all methods (p <0.001).  Significant gender-based differences were observed only with Demirjian's revised seven-tooth and original four-tooth methods (p <0.05).  Conclusion: The revised seven-tooth standards most accurately predicted the age of the study sample (mean prediction error = 2.28 months), followed by the original seven-tooth, four-tooth and alternate four-tooth standards. The Demirjian original seven-tooth method was significantly more accurate in boys compared to girls, while the reverse was true for the Demirjian revised seven-tooth and original four-tooth methods.

Comparison of Cameriere's and Demirjian's methods of age estimation among children in Kerala: a pilot study

The aim was to compare age estimation using Cameriere’s and Demirjian’s methods to chronologic age in children with mixed dentition in a rural population of Kerala. The present study comprised of 10 subjects of age range 7-12 years. Dental age was assessed using Cameriere’s and Demirjian’s methods and was compared to the chronologic age. Panoramic radiographs were used for assessment of dental age. Data were analysed using paired t-test. The mean of difference obtained was 0.92 and the pvalue was 0.172 which showed insignificant difference between the two methods. Cameriere’s method showed a positive linear correlation (0.6393) with chronologic age and was statistically significant (P=0.0171), whereas Demirjian’s method showed a negative correlation (–0.7598) and was statistically insignificant (P=0.9967). The present study indicated that Cameriere’s method is reliable for age estimation in our population and is more accurate than Demirjian’s method.

Identifying missing people: the contribution of forensic dentistry and DNA

Abstract Introduction Human identification is considered one of the major steps concerning missing people. The Forensic Anthropology Sector of Legal Medical Institutes identifies corpses. Forensic dentistry and DNA tests stand out among the existing standard tests. Objective This article aimed to evaluate human identification effectiveness through forensic dental examination performed in the forensic anthropology sector in a Forensic Medical Institute, comparing them with DNA analyses. Methodology This is a cross-sectional study using secondary data available in the department´s database, from 2008 to 2014, concerning identification procedures using forensic dentistry and DNA techniques. Result The analysis of the examinations eligible to this study (241) showed that DNA analysis was the method used for identification in 79.3% of the cases and forensic dental examinations were used in 20.7% of the cases. As for the type of biological material used during these examinations, unidentified corpses corresponded to 131 cases (53.9%), skeleton structures corresponded to 109 cases (44.9%) and there were 3 cases of body segments (1.2%). When analyzing the time spent to complete the tests, dental examinations were faster than DNA tests. The time spent for forensic dental examination does not depend on the type of dental documentation evaluated. Conclusion The analysis of the results in this study showed that human identification through forensic dentistry is effective, rapid and less costly, contributing to greater agility in solving issues related to locating missing people.

The Demirjian versus the Willems method for dental age estimation in different populations: A meta-analysis of published studies

BACKGROUND

The accuracy of radiographic methods for dental age estimation is important for biological growth research and forensic applications. Accuracy of the two most commonly used systems (Demirjian and Willems) has been evaluated with conflicting results. This study investigates the accuracies of these methods for dental age estimation in different populations.

METHODS

A search of PubMed, Scopus, Ovid, Database of Open Access Journals and Google Scholar was undertaken. Eligible studies published before December 28, 2016 were reviewed and analyzed. Meta-analysis was performed on 28 published articles using the Demirjian and/or Willems methods to estimate chronological age in 14,109 children (6,581 males, 7,528 females) age 3-18 years in studies using Demirjian's method and 10,832 children (5,176 males, 5,656 females) age 4-18 years in studies using Willems' method. The weighted mean difference at 95% confidence interval was used to assess accuracies of the two methods in predicting the chronological age.

RESULTS

The Demirjian method significantly overestimated chronological age (p<0.05) in males age 3-15 and females age 4-16 when studies were pooled by age cohorts and sex. The majority of studies using Willems' method did not report significant overestimation of ages in either sex. Overall, Demirjian's method significantly overestimated chronological age compared to the Willems method (p<0.05). The weighted mean difference for the Demirjian method was 0.62 for males and 0.72 for females, while that of the Willems method was 0.26 for males and 0.29 for females.

CONCLUSION

The Willems method provides more accurate estimation of chronological age in different populations, while Demirjian's method has a broad application in terms of determining maturity scores. However, accuracy of Demirjian age estimations is confounded by population variation when converting maturity scores to dental ages. For highest accuracy of age estimation, population-specific standards, rather than a universal standard or methods developed on other populations, need to be employed.