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Paddenberg E, Dees A, Proff P, Kirschneck C. Individual dental and skeletal age assessment according to Demirjian and Baccetti: Updated norm values for Central-European patients. J Orofac Orthop 2024; 85:199-212. [PMID: 36239773 PMCID: PMC11035409 DOI: 10.1007/s00056-022-00431-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/16/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Chronological age often differs from dental and skeletal age. With orthopantomograms and lateral cephalograms, dental and skeletal development can be determined according to the methods published by Demirjian et al. and Baccetti et al. However, gender and skeletal class as possible confounders were frequently not considered and available norm values are not up-to-date. This retrospective cross-sectional study thus aimed to evaluate effects of skeletal class and gender on dental and skeletal age of growing patients and to generate updated norm values for contemporary Central-European patients. METHODS A total of 551 patients were included in the dental and 733 in the skeletal age assessment, respectively. Dental analysis was based on tooth mineralisation stages in orthopantomograms (Demirjian) and skeletal age was defined by cervical vertebrae maturation stages (CVMS) in lateral cephalograms (Baccetti). Skeletal class was determined by the individualised ANB angle of Panagiotidis/Witt. With nonlinear regression analysis a formula for determining dental age was established. Effects of gender and skeletal class were evaluated and updated norm values generated. RESULTS Inter- and intrarater reliability tests revealed at least substantial measurement concordance for tooth mineralisation and CVMS. Demirjian stages and CVMS significantly depended on gender with girls developing earlier. Skeletal class significantly affected skeletal age only, but without clinical relevance. Updated norm values for dental age differed significantly from the original values of Demirjian and the values for skeletal age differed from those published by Baccetti. CONCLUSION Optimised norms, separated by gender, increase precision in determining individual dental and skeletal age during orthodontic treatment planning. Further studies analysing the effect of skeletal class on dental and skeletal development are needed.
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Affiliation(s)
- Eva Paddenberg
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Adrian Dees
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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El-Desouky SS, Kabbash IA. Age estimation of children based on open apex measurement in the developing permanent dentition: an Egyptian formula. Clin Oral Investig 2022; 27:1529-1539. [PMID: 36394611 PMCID: PMC10102106 DOI: 10.1007/s00784-022-04773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022]
Abstract
Abstract
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.
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Mónico LS, Tomás LF, Tomás I, Varela-Patiño P, Martin-Biedma B. Adapting Demirjian Standards for Portuguese and Spanish Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12706. [PMID: 36232005 PMCID: PMC9566317 DOI: 10.3390/ijerph191912706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Estimation of children's chronological age is highly important in human and forensic sciences. The Demirjian method has been reported as accurate for this purpose. The literature review shows some evidence that the accuracy of estimating chronological age via the Demirjian standards is not a straightforward process. The objective of this research is to analyze the reliability of the Demirjian standards in Portuguese and Spanish children and adolescents and adapt it to include sex and group age as contingent factors. METHODS Orthopantomographs of 574 Portuguese and Spanish male and female children and adolescents were employed to test the reliability of the Demirjian method. After testing for inter-rater consistency and age estimation using the Demirjian standards, multiple regression analysis was performed controlling for sex and age group. RESULTS The Demirjian standards overestimated chronological age for both sexes, mainly for females. Through the development of regression functions, more detailed dental age estimation was performed. The predictive capacities of the Demirjian method and the significant teeth varied as a function of children's age. The Demirjian global standard predicted over 65% of the variance of the chronological age. Taking a tooth-by-tooth approach, the predictive ability increased by over 70%. CONCLUSIONS The accuracy of estimating chronological age via the Demirjian method is not as reliable as it might appear, judging from the results found according to age group and according to sex crossed with age group.
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Affiliation(s)
- Lisete S. Mónico
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Universidade de Coimbra, 3000-115 Coimbra, Portugal
| | - Luís F. Tomás
- School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidad de Santiago de Compostela, 15703 Santiago de Compostela, Spain
| | - Inmaculada Tomás
- School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidad de Santiago de Compostela, 15703 Santiago de Compostela, Spain
| | - Purificación Varela-Patiño
- School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidad de Santiago de Compostela, 15703 Santiago de Compostela, Spain
| | - Benjamin Martin-Biedma
- School of Medicine and Dentistry, Health Research Institute Foundation of Santiago (FIDIS), Universidad de Santiago de Compostela, 15703 Santiago de Compostela, Spain
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Bunyarit SS, Nambiar P, Naidu MK, Ying RPY, Asif MK. Dental age estimation of Malay children and adolescents: Chaillet and Demirjian's data improved using artificial multilayer perceptron neural network. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Age estimation in the living: A scoping review of population data for skeletal and dental methods. Forensic Sci Int 2021; 320:110689. [PMID: 33561788 DOI: 10.1016/j.forsciint.2021.110689] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
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.
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Chaudhry K, Talwar M, Vanga NR, Lehl GK, Choudhary A, Patnana AK. A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability. Int J Clin Pediatr Dent 2020; 13:16-20. [PMID: 32581472 PMCID: PMC7299876 DOI: 10.5005/jp-journals-10005-1708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim The present study aimed to evaluate and compare the applicability of Demirjian, Willems, and Haavikko methods of dental age estimation in southeastern (Dravidian ethnicity) and northwestern regions (Aryan ethnicity) of the Indian population. Materials and methods The study includes the orthopantomographs (OPGs) of 303 individuals (173 males and 130 females) of age ranging from 5 to 14 years. The participants in the present research were evaluated under two study groups: group I: participants of the southeastern region and group II: participants of the northwestern region. Dental age was calculated using Demirjian, Willems, and Haavikko methods and compared with the chronologic age of each participant. The accuracy of dental age estimation methods was evaluated by mean absolute error. One-way analysis of variance (ANOVA) and Student's t tests were used to test the significant difference between the chronologic age and estimated dental ages. Results The Demirjian method showed overestimation, while Willems and Haavikko methods showed underestimation for boys and girls in both the ethnic groups of Indian population. The Willems method of dental age estimation showed comparatively more accurate and reliable results in both the ethnic groups of the Indian population. Conclusion The dental age estimation by Demirjian, Willems, and Haavikko methods showed no significant variation between the different ethnicities of the Indian population. Clinical significance The present research will be helpful in pedodontic, orthodontic, and forensic investigations for accurate and reliable dental age estimation in different parts of Indian population. How to cite this article Chaudhry K, Talwar M, Vanga NRV, et al. A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability. Int J Clin Pediatr Dent 2020;13(1):16–20.
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Affiliation(s)
- Kirti Chaudhry
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Manjit Talwar
- Department of Dentistry, Government Medical College and Hospital, Chandigarh, Haryana, India
| | - Narasimha Rv Vanga
- Department of Pedodontics and Preventive Dentistry, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Gurvanit K Lehl
- Department of Dentistry, Government Medical College and Hospital, Chandigarh, Haryana, India
| | - Ashish Choudhary
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Arun K Patnana
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Khdairi N, Halilah T, Khandakji MN, Jost-Brinkmann PG, Bartzela T. The adaptation of Demirjian’s dental age estimation method on North German children. Forensic Sci Int 2019; 303:109927. [DOI: 10.1016/j.forsciint.2019.109927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
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Halilah T, Khdairi N, Jost-Brinkmann PG, Bartzela T. Age estimation in 5–16-year-old children by measurement of open apices: North German formula. Forensic Sci Int 2018; 293:103.e1-103.e8. [DOI: 10.1016/j.forsciint.2018.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 09/11/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
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Sobieska E, Fester A, Nieborak M, Zadurska M. Assessment of the Dental Age of Children in the Polish Population with Comparison of the Demirjian and the Willems Methods. Med Sci Monit 2018; 24:8315-8321. [PMID: 30449880 PMCID: PMC6256839 DOI: 10.12659/msm.910657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Dental age is less affected than the bone age by nutritional and hormonal factors. The assessment of dental age in children is of value in clinical and forensic practice. The aims of this study were to compare the Demirjian method and the Willems method in the assessment of dental age in children in Poland and to consider the need to standardize dental age assessment. Material/Methods Polish children of Caucasian ethnicity (n=1,002) who were treated at a single orthodontic center between 1994–2016 included girls (n-540) and boys (n=462) aged between 4–17 years, and 1,002 panoramic radiographs were reviewed. Dental age was assessed using the Demirjian method and the Willems method, the findings of the two methods were compared with the chronological age of the study participants. Results Following statistical analysis, both the Demirjian method and the Willems method overestimated the dental age of the younger study participants, and underestimated the dental age of the older study participants. Both the Demirjian method and the Willems method had similar accuracy in estimating the chronological and dental age in the Polish population. Conclusions In the assessment of dental age in Polish children from panoramic radiographs, both the Demirjian method and the Willems method were accurate and should still be used as a method of choice. However, it seems reasonable to create international standards for the assessment of dentition maturity for this population to obtain a more acceptable range of error values between the dental age and chronological age.
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Affiliation(s)
- Ewa Sobieska
- Department of Orthodontics, Medical University of Warsaw, Warsaw, Poland
| | - Aneta Fester
- Department of Orthodontics, Medical University of Warsaw, Warsaw, Poland
| | - Marina Nieborak
- Department of Orthodontics, Medical University of Warsaw, Warsaw, Poland
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Quaremba G, Buccelli C, Graziano V, Laino A, Laino L, Paternoster M, Petrone P. Some inconsistencies in Demirjian's method. Forensic Sci Int 2018; 283:190-199. [PMID: 29310023 DOI: 10.1016/j.forsciint.2017.12.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/04/2017] [Accepted: 12/07/2017] [Indexed: 11/26/2022]
Abstract
Nowadays, given the massive migration movements toward and across EU countries, age assessment can be highly useful for estimating the real age of asylum seekers or in medico-legal assessments of age-disputed children charged with criminal acts. Demirjian et al.'s dental maturity score is currently a dental scoring system universally adopted for age assessment of unidentified children. Here we explore the biological compatibility of Demirjian's scores with respect to the estimation of certain chronological ages of forensic interest through an algorithm based on the theory of constrained graphs integrated with combinatory analysis. Rather than simply respect Demirjian's indications (direct method) on a sample of children, we followed a reverse procedure (indirect method) as follows: i. chronological age selection and identification of the corresponding maturity score (MS); ii. determination of all the possible combinations of dental maturity stages whose sum of the scores is equal to the MS under consideration; iii. checking for all such possible combinations the biological congruity of the state of maturity of each tooth compared to the chronological age initially chosen. By evidencing dental development inconsistencies, our mathematical approach explains why Demirjian's method typically overestimates age. Therefore, even if the method in question remains the recommended way to assess individual dental maturity, it should definitely be considered unsuitable for application in certain forensic scenarios, particularly as regards the most disputed age range 14-16 years.
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Affiliation(s)
- Giuseppe Quaremba
- Department of Advanced Biomedical Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy; Department of Industrial Engineering, Division of Mechanics and Energetics, University of Naples "Federico II"-21, Via Claudio, 80125 Naples, Italy.
| | - Claudio Buccelli
- Department of Advanced Biomedical Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy
| | - Vincenzo Graziano
- Department of Advanced Biomedical Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy
| | - Alberto Laino
- Department of Odontostomatological and Maxillo-Facial Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy
| | - Luigi Laino
- Department of Odontostomatological and Maxillo-Facial Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy
| | - Mariano Paternoster
- Department of Advanced Biomedical Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy
| | - Pierpaolo Petrone
- Department of Advanced Biomedical Sciences, University of Naples "Federico II"-5, Via Pansini, 80131 Naples, Italy
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Fins P, Pereira ML, Afonso A, Pérez-Mongiovi D, Caldas IM. Chronology of mineralization of the permanent mandibular second molar teeth and forensic age estimation. Forensic Sci Med Pathol 2017; 13:272-277. [DOI: 10.1007/s12024-017-9876-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 10/19/2022]
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Camacho-Basallo P, Yáñez-Vico RM, Solano-Reina E, Iglesias-Linares A. Five radiographic methods for assessing skeletal maturity in a Spanish population: is there a correlation? Acta Odontol Scand 2017; 75:106-112. [PMID: 27934543 DOI: 10.1080/00016357.2016.1265145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The need for accurate techniques of estimating age has sharply increased in line with the rise in illegal migration and the political, economic and socio-demographic problems that this poses in developed countries today. The methods routinely employed for determining chronological age are mainly based on determining skeletal maturation using radiological techniques. The objective of this study was to correlate five different methods for assessing skeletal maturation. MATERIALS AND METHODS 606 radiographs of growing patients were analyzed, and each patient was classified according to two cervical vertebral-based methods, two hand-wrist-based methods and one tooth-based method. Spearman's rank-order correlation coefficient was applied to assess the relationship between chronological age and the five methods of assessing maturation, as well as correlations between the five methods (p < 0.05). RESULTS Spearman's rank correlation coefficients for chronological age and cervical vertebral maturation stage using both methods were 0.656/0.693 (p < 0.001), respectively, for males. For females, the correlation was stronger for both methods. The correlation coefficients for chronological age against the two hand-wrist assessment methods were statistically significant only for Fishman's method, 0.722 (p < 0.001) and 0.839 (p < 0.001), respectively for males and females. CONCLUSIONS The cervical vertebral, hand-wrist and dental maturation methods of assessment were all found to correlate strongly with each other, irrespective of gender, except for Grave and Brown's method. The results found the strongest correlation between the second molars and females, and the second premolar and males. CLINICAL RELEVANCE This study sheds light on and correlates with the five radiographic methods most commonly used for assessing skeletal maturation in a Spanish population in southern Europe.
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Affiliation(s)
- Paula Camacho-Basallo
- Department of Stomatology, Craniofacial Research Group CTS353, University of Seville, Seville, Spain
- Department of Stomatology IV, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rosa-María Yáñez-Vico
- Department of Stomatology, Craniofacial Research Group CTS353, University of Seville, Seville, Spain
- Department of Stomatology IV, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Enrique Solano-Reina
- Department of Stomatology, Craniofacial Research Group CTS353, University of Seville, Seville, Spain
- Department of Stomatology IV, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Alejandro Iglesias-Linares
- Department of Stomatology, Craniofacial Research Group CTS353, University of Seville, Seville, Spain
- Department of Stomatology IV, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Wolf TG, Briseño-Marroquín B, Callaway A, Patyna M, Müller VT, Willershausen I, Ehlers V, Willershausen B. Dental age assessment in 6- to 14-year old German children: comparison of Cameriere and Demirjian methods. BMC Oral Health 2016; 16:120. [PMID: 27825336 PMCID: PMC5101672 DOI: 10.1186/s12903-016-0315-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to compare two frequently used dental age estimation methods for accuracy. METHODS A total of 479 panoramic radiographs in age groups 6-14 years from a German population were evaluated. The dental age of 268 boys and 211 girls was assessed by means of the method of Demirjian (1973) and Cameriere (2006) and compared with their actual chronological age. RESULTS Demirjan's method showed an overestimation of dental age compared to chronological age in all age groups for boys (mean difference -0.16, p = 0.010, range -0.35 to 0.09), age group 9 showed an underestimation. Using the same method for girls (mean difference -0.18, p = 0.008, range -0.45 to 0.13), an overestimation could also be shown in all age groups except for age groups 8 and 13. Results for Cameriere's method showed for boys (mean difference 0.07, p = 0.314, range -1.38 to 3.83) in age groups 6 to 11 an overestimation, but in age groups 12 to14 an underestimation. The results for girls (mean difference 0.08, p = 0.480, range -1.55 to 4.51) showed an overestimation for age groups from 6 to 10, and an underestimation in age groups 11 to 14. CONCLUSIONS The comparison shows an advantage of Demirjian's method for both genders. While Cameriere's method showed a higher inaccuracy in all age groups, Demirjian's method showed more appropriate results for dental age estimation of the investigated German population. To avoid errors in forensic age estimation and to prevent misidentifications for defendants in criminal processes, further studies of more precise methods for age estimation for the German population are required.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Benjamín Briseño-Marroquín
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Angelika Callaway
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Michael Patyna
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Victor Thomas Müller
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Ines Willershausen
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Vicky Ehlers
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
| | - Brita Willershausen
- Department of Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, Germany
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Nawaya FR, Burhan AS. Use of the Tooth Coronal Pulp Index for Recognition of the Pubertal Growth Period. J Contemp Dent Pract 2016; 17:884-889. [PMID: 27965495 DOI: 10.5005/jp-journals-10024-1948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM The present study aimed to investigate the association between the tooth coronal index (TCI) and the pubertal growth stages (PGS) for children and adolescents. MATERIALS AND METHODS A cross-sectional study was performed using retrospectively collected panoramic and hand-wrist radiographs of 262 individuals (125 males, 137 females). The coronal height (CH) and the coronal pulp cavity height (CPCH) of the left mandibular teeth were measured. Then the TCI for which was calculated according to Ikeda et al (1985). The estimated TCI for individuals with the following PGS after Fishman (1987) are: SMI 4 (S), SMI 5 (DP3 cap), SMI 6 (MP3 cap) and SMI 7 (Mp5 cap). The associations between the TCI and the PGS were investigated by correlation coefficient of Spearman's rho, and the validity values for the PGS were computed. RESULTS Significant correlations were noted between the simple TCI values for premolars and molars and the PGS, and the highest correlation was for the summed TCI for both first and second molars. Utilizing the validity values of the summed TCI for both first and second mandibular molars, the PGS can be predicted as follows: S stage when TCI is 49.17 or lesser, DP3cap stage when TCI is 43.52 or lesser, MP3cap stage when TCI is 36.73 or lesser, and Mp5cap stage when TCI is 26.84 or lesser. CONCLUSION The TCI values declined along with the maturational process in children and adolescents. The TCI for both first and second molars was the best predictor of the PGS. CLINICAL SIGNIFICANCE Panoramic photographs can be beneficial for prediction of the skeletal maturity and treatment planning without resorting to hand-wrist radiographs.
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Affiliation(s)
- Fehmieh R Nawaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus Countryside, Syria
| | - Ahmad S Burhan
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria, Phone: +963944302075, e-mail:
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Melo M, Ata-Ali J. Accuracy of the estimation of dental age in comparison with chronological age in a Spanish sample of 2641 living subjects using the Demirjian and Nolla methods. Forensic Sci Int 2016; 270:276.e1-276.e7. [PMID: 28029496 DOI: 10.1016/j.forsciint.2016.10.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/26/2016] [Accepted: 10/03/2016] [Indexed: 11/28/2022]
Abstract
Age estimation is an important procedure in forensic medicine and is carried out for a number of reasons. For living persons, age estimation is performed in order to assess whether a child has attained the age of criminal responsibility, in scenarios involving rape, kidnapping or marriage, in premature births, adoption procedures, illegal immigration, pediatric endocrine diseases and orthodontic malocclusion, as well as in circumstances in which the birth certificate is not available or the records are suspect. According to data from the UNHCR (United Nations High Commissioner for Refugees), the number of people seeking refugee status continued to increase in the last years, driven by the wars in Syria and Iraq, as well as by conflict and instability in Afghanistan, Eritrea and elsewhere. The objective of this study is to compare the accuracy of estimating dental age versus chronological age using the Nolla and Demirjian methods in a Spanish population. A final sample of 2641 panoramic X-rays corresponding to Spanish patients (1322 males and 1319 females) between 7-21 years of age was analyzed. Dental age was assessed using the Nolla and Demirjian methods, establishing comparisons with mean chronological age based on the Student t-test for paired samples, followed by the generation of a linear regression model. Both methods showed slight discrepancy between dental and chronological age. On examining the reproducibility of the Nolla and Demirjian methods, technical errors of 0.84% and 0.62%, respectively, were observed. On average, the Nolla method was found to estimate an age 0.213years younger than the chronological age, while the Demirjian method estimated an age 0.853years older than the chronological age. Linear combination of the mean Nolla and Demirjian estimates increased the predictive capacity to 99.2%. In conclusion the Nolla and Demirjian methods were found to be accurate in estimating chronological age from dental age in a Spanish population. The error was found to be greater in males than in females, and involved an over-estimation of age with the Demirjian method and under-estimation of age with the Nolla method. Combination of the Nolla and Demirjian methods for estimating chronological age from dental age affords a predictive capacity of over 99%, and is fast and easy to perform, and inexpensive.
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Affiliation(s)
| | - Javier Ata-Ali
- Public Dental Health Service, Arnau de Vilanova Hospital, Valencia, Spain; Department of Dentistry, European University of Valencia, Valencia, Spain.
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Brimacombe C, Kuykendall K, Nystrom P. Analysis of correlations between measures of skeletal development and dental mineralization inPan troglodytes. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 158:279-287. [DOI: 10.1002/ajpa.22790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 04/28/2015] [Accepted: 05/26/2015] [Indexed: 11/10/2022]
Affiliation(s)
- C.S. Brimacombe
- Department of Archaeology; University of Sheffield; Sheffield South Yorkshire S10 2TN UK
- Human Evolutionary Studies Program and Department of Archaeology; Simon Fraser University; Education Building 9635, 8888 University Drive Burnaby BC V5A 1S6 Canada
| | - K.L. Kuykendall
- Department of Archaeology; University of Sheffield; Sheffield South Yorkshire S10 2TN UK
| | - P. Nystrom
- Department of Archaeology; University of Sheffield; Sheffield South Yorkshire S10 2TN UK
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Carneiro JL, Caldas IM, Afonso A, Cardoso HFV. Is Demirjian’s original method really useful for age estimation in a forensic context? Forensic Sci Med Pathol 2015; 11:216-21. [DOI: 10.1007/s12024-015-9656-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
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Patnana AK, Vabbalareddy RS, V Vanga NR. Evaluating the reliability of three different dental age estimation methods in visakhapatnam children. Int J Clin Pediatr Dent 2015; 7:186-91. [PMID: 25709299 PMCID: PMC4335110 DOI: 10.5005/jp-journals-10005-1262] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/21/2014] [Indexed: 11/23/2022] Open
Abstract
UNLABELLED Dental age is important for treatment planning in the specialities of pedodontics and orthodontics. Although, Demirjian's method was considered standard for dental age estimation, it may not be reliable for all population. AIM The goal of the study was to evaluate the reliability of Demir-jian's, Haavikko's and Willems method of dental age estimation methods in Visakhapatnam (Andhra Pradesh, India) children. STUDY DESIGN One hundred and two children of 6 to 14 years old who underwent panaromic digital radiography for routine diagnostic purposes were included. Dental age was calculated using Demirjian's, Haavikko's and Willems methods and compared with chronologic age for each patient. RESULTS Dental age showed a significant overestimation by Demirjian's method with a mean difference of 0.55 year and underestimation by Haavikko's and Willems methods with a mean difference of 1.95 and 0.20 year respectively when compared with chronologic age. The mean difference between dental age and chronologic age was not significant in Willems method which shows a close relation between dental and chronologic ages. CONCLUSION The dental age estimation by Willems method is found to be more accurate than Demirjian's and Haavikko's methods in Visakhapatnam children. How to cite this article: Patnana AK, Vabbalareddy RS, Vanga NRV. Evaluating the Reliability of Three Different Dental Age Estimation Methods in Visakhapatnam Children. Int J Clin Pediatr Dent 2014;7(3):186-191.
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Affiliation(s)
- Arun Kumar Patnana
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Raja Sekhar Vabbalareddy
- Reader, Department of Pedodontics and Preventive Dentistry GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Narasimha Rao V Vanga
- Professor, Department of Pedodontics and Preventive Dentistry GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Tomás LF, Mónico LSM, Tomás I, Varela-Patiño P, Martin-Biedma B. The accuracy of estimating chronological age from Demirjian and Nolla methods in a Portuguese and Spanish sample. BMC Oral Health 2014; 14:160. [PMID: 25540020 PMCID: PMC4326296 DOI: 10.1186/1472-6831-14-160] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Age determination has great importance in many clinical decisions, being commonly used in odontopediatrics, orthodontics, pediatrics, and forensic medicine. The Nolla and Demirjian et al. methods have been used for these purposes. However, estimating chronological age by means of the dental mineralization stage is not a straightforward analysis, and it is fundamental to test the validity of these methods and their applicability to populations. In this article we intend to compare the accuracy of estimating chronological age from dental age measured with the Nolla and Demirjian methods in a Portuguese and Spanish sample, considering the variables of sex and age-group. METHODS The sample was composed of 821 orthopantomographs of healthy Portuguese (n = 270) and Spanish (n = 551) subjects from 4 to 34 years old. For the Nolla and Demirjian methods, seven mandibular left teeth were examined, staged according to the dental maturity scale of each method. We obtained a good index of inter-rater agreement, a good internal consistency for the teeth assessment, and a good temporal consistency. RESULTS Dental age was calculated for each method. The Demirjian et al. method tends to overestimate the real age of participants and the Nolla method tends to underestimate it. The accuracy of both methods varied between the sexes and age groups. Both methods were found to be more precise with males. As the age-group increases, the predictive capacities of both methods diminish. The Nolla method was more accurate than the Demirjian method in early and late childhood for both sexes. Neither method could predict chronological age in adults. CONCLUSIONS We can estimate chronological age for early and late childhood, through the Nolla and Demirjian methods, with the former showing greater predictive capacities than the latter. The Demirjian method tends to overestimate age and the Nolla method tends to underestimate it, leading to the importance of forming regression equations adapted to the population studied. Nolla and Demirjian formulas adapted to our sample were created as a function of sex and age-group.
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Affiliation(s)
- Luís F Tomás
- School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
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Karataş OH, Öztürk F, Dedeoğlu N, Çolak C, Altun O. Radiographic evaluation of third-molar development in relation to the chronological age of Turkish children in the southwest eastern Anatolia region. Forensic Sci Int 2013; 232:238.e1-5. [DOI: 10.1016/j.forsciint.2013.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 02/13/2013] [Accepted: 07/28/2013] [Indexed: 11/29/2022]
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Urzel V, Bruzek J. Dental age assessment in children: a comparison of four methods in a recent French population. J Forensic Sci 2013; 58:1341-1347. [PMID: 23822870 DOI: 10.1111/1556-4029.12221] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 07/09/2012] [Accepted: 09/03/2012] [Indexed: 11/29/2022]
Abstract
The aim of this study was to analyze the accuracy and the reliability of four methods of dental age estimation (Demirjian, Willems I, Willems II, and Chaillet standards) in a French population. Orthopantomograms of 743 children aged between 4 and 15 years were used. The Demirjian standards gave a consistent overestimation of dental age compared with chronological age (+0.45 and +0.46 years for girls and boys, respectively). We found that three modified methods were more accurate for both sexes than Demirjian's method: the Willems I method appeared to be more suitable when the sex and ethnicity are both known (-0.09 and +0.14 years for girls and boys, respectively); the Willems II method was more accurate for children of unknown sex (mean difference = 0.00 years), and the Chaillet method was found to be more accurate than the Demirjian method, but less accurate than the Willems I method (-0.59 and -0.18 years for girls and boys, respectively).
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Affiliation(s)
- Vanessa Urzel
- UFR d'Odontologie, Université Bordeaux 2, 16-20, cours de la Marne, Bordeaux, 33082, France
- CNRS, PACEA, UMR 5199, F-33400, Talence, France
| | - Jaroslav Bruzek
- CNRS, PACEA, UMR 5199, F-33400, Talence, France
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Vinicna 7, 12844 Prague 2, Czech Republic
- Department of Social and Cultural Anthropology, Faculty of Humanities, University of West Bohemia, Sedlackova 15, 30614 Plzeň, Czech Republic
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Abstract
OBJECTIVE The aim of this study was to evaluate the accuracy of Demirjian's method in estimating the dental age in Turkish children and to estimate the validity of Demirjian's standards for the studied population. MATERIALS AND METHODS Panoramic radiographs of 756 northwestern Turkish children aged 5-13 years were examined. The new method for dental age estimation for both genders was studied to determine the relationship between dental age, chronological age and Demirjian's scores. Descriptive statistics were used and analysis of correlation was carried out between chronological age, dental age and Demirjian's scores. The difference between dental age and the chronological age was determined with the paired t-test. RESULTS The results showed that northwestern Turkish children had delays in dental maturity. The new method was applied to Demirjian's scores and dental age scales for both genders were obtained. The tables were used to adapt Demirjian's scores to dental age determination in Turkish children using the new formula. CONCLUSIONS The developmental standards used by Demirjian are not suitable for northwestern Turkish children. The methods for determining dental development must have population-specific standards. The established gender-specific equations and the new tables are more appropriate for dental age assessment in northwestern Turkish children.
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Affiliation(s)
- Arzu Pinar Erdem
- Department of Pedodontics, Istanbul University, Capa, Istanbul, Turkey.
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A study of dental development in a Caucasian population compared with a non-Caucasian population. Eur Arch Paediatr Dent 2012; 12:26-30. [DOI: 10.1007/bf03262775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Liversidge HM. The assessment and interpretation of Demirjian, Goldstein and Tanner's dental maturity. Ann Hum Biol 2012; 39:412-31. [DOI: 10.3109/03014460.2012.716080] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rozylo-Kalinowska I, Kolasa-Raczka A, Kalinowski P. Reply. Eur J Orthod 2012. [DOI: 10.1093/ejo/cjs017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Applicability of Greulich and Pyle and Demirijan aging methods to a sample of Italian population. Forensic Sci Int 2012; 221:153.e1-5. [PMID: 22565117 DOI: 10.1016/j.forsciint.2012.04.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 03/12/2012] [Accepted: 04/12/2012] [Indexed: 11/23/2022]
Abstract
Age estimation in forensics is essential in cases involving both living and dead subjects. For living subjects, age estimation may be used to establish an individual's status as a minor in cases involving adoption, criminal responsibility, child pornography, and those seeking asylum. Criteria for age estimation in the living have recently been put forth by The Study Group on Forensic Age Diagnostics. The group has proposed guidelines with a three-step procedure: a physical examination and anthropometrical analysis; dental analysis by orthopantomogram (OPG); and X-ray study of the left hand and wrist. The board of FASE highlighted advantages and limits of each method, and suggested practical solutions concerning the age estimation process for adults and subadults. The aim of this study was to verify the applicability of the Greulich and Pyle, and Demirjian techniques on a sample group of Italians, whose ages were known, in determining the skeletal and dental age, in addition to evaluating the reliability of these techniques. 535 subjects between the ages of 7 and 15years were examined, each one undergoing both an orthopantomography (OPG) and radiography of the left wrist and hand. The data obtained underwent statistical analysis. The analyses have shown that a correlation exists between skeletal and dental age, and real age. Age estimation carried out using the Greulich and Pyle method has shown itself to be especially accurate on the Italian sample, particularly in the age ranges of 7-9years and 10.4-11.5years. The Greulich and Pyle method has shown itself to be reliable for the sample analyzed notwithstanding the ethnic differences between the original sample of reference and those analyzed in this study. Application of the Demirjian technique resulted in an overestimation of dental age. This difference is shown to be more highly significant in the higher age ranges. The combination of the Greulich and Pyle, and Demirjian methods have revealed a difference regarding real age, which turns out to be more modest in the younger age ranges and more significant in older subjects.
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Lee SS, Kim D, Lee S, Lee UY, Seo JS, Ahn YW, Han SH. Validity of Demirjian's and modified Demirjian's methods in age estimation for Korean juveniles and adolescents. Forensic Sci Int 2011; 211:41-6. [DOI: 10.1016/j.forsciint.2011.04.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 03/25/2011] [Accepted: 04/03/2011] [Indexed: 11/28/2022]
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Urzel V, Bruzek J. Validité des standards de Demirjian et Goldstein (1976) et de Chaillet et Demirjian (2004) pour l’estimation de l’âge des enfants du Sud-Ouest de la France. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.medleg.2011.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sexual dimorphism in teeth? Clinical relevance. Clin Oral Investig 2011; 16:395-9. [DOI: 10.1007/s00784-011-0537-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 02/25/2011] [Indexed: 10/18/2022]
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Abu Asab S, Noor SNFM, Khamis MF. The Accuracy of Demirjian Method in Dental Age Estimation of Malay Children. ACTA ACUST UNITED AC 2011; 32:19-27. [DOI: 10.1016/s0377-5291(12)70012-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The aim of this study was to evaluate the applicability of Demirjian's dental age assessment table in a sample of Southern Pakistani population and, if not applicable, to formulate a separate dental age table for Pakistani males and females. The study was conducted on the dental pantomographs of a sample size of 882 subjects (427 males and 455 females) ranging in age from 7 to 14 years. A paired t-test was used to assess any difference between chronological age and dental age assessed according to Demirjian's method. Logit function was used to make the relationship between dental maturity and chronological age and linear regression analysis with the equation X = [Ln {y/100 - y} - a]/b was used to generate dental age tables for Pakistani males and females. Dental age assessed according to Demirjian's method for this male sample was over-predicted in the 7 year and 11-15 year age group (P < 0.05). In the female sample, there was an over-prediction in all the age groups (P < 0.05). Statistically significant differences were found in chronological and dental age assessed by Demirjian's method for Pakistani males and females and thus, a new table was generated to convert dental maturity calculated according to Demirjian's method into dental age for the population.
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Affiliation(s)
- Rashna H Sukhia
- Department of Surgery, The Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
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Rai B, Kaur J, Jafarzadeh H. Dental age estimation from the developmental stage of the third molars in Iranian population. J Forensic Leg Med 2010; 17:309-11. [DOI: 10.1016/j.jflm.2010.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Accepted: 04/01/2010] [Indexed: 11/29/2022]
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Flores AP, Sanhueza MA, Barboza P, Monti CF. Study of Chilean Children’s Dental Maturation. J Forensic Sci 2010; 55:735-7. [DOI: 10.1111/j.1556-4029.2009.01274.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liversidge HM. Interpreting group differences using Demirjian's dental maturity method. Forensic Sci Int 2010; 201:95-101. [PMID: 20304571 DOI: 10.1016/j.forsciint.2010.02.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Accepted: 02/23/2010] [Indexed: 10/19/2022]
Abstract
Although Demirjian's method is designed to assess dental maturity at the individual level, significant differences between average dental age and real age for groups have been interpreted as population differences. The aim of this study was to describe the variation in maturity score for age and age for maturity score from a large collaborative database of children and discuss methods adapted for groups in light of this. Tooth stages from radiographs of 4710 males and 4661 females (age 2-18) were used and dental maturity scores calculated using Demirjian and Goldstein. The mean, standard deviation, standard error and 95% confidence intervals of maturity score by age group (6 and 12 months groups) and age by maturity score (5 points) groups were calculated. Adapted maturity curves from 13 published studies of boys from Europe, Middle East, Africa, India, China and South America were compared to the database. Most adapted curves at the 50th percentile from world regions fell within the 95% confidence intervals. Those that did not, were hampered by small sample size or poorly fitting curves. This is complicates by the inclusion of mature individuals. Few studies adapting Demirjian's method provide sufficient or appropriate statistics to compare maturation of individual teeth. The wide 95% confidence intervals for maturity score by age, age by maturity score, age of individual tooth stages and large number of sequences suggest that the significant differences in dental maturity score do not reflect any biological difference in the timing of tooth formation stages at the population level. Demirjian's dental maturity method is inappropriate to assess population differences in dental maturity and adapting scores for age or age for scores for different groups of children is probably unnecessary.
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Affiliation(s)
- H M Liversidge
- Queen Mary University of London, Barts & The London School of Medicine and Dentistry, Institute of Dentistry, Turner Street, London E1 2AD, United Kingdom.
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Qudeimat MA, Behbehani F. Dental age assessment for Kuwaiti children using Demirjian's method. Ann Hum Biol 2010; 36:695-704. [PMID: 19919504 DOI: 10.3109/03014460902988702] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Dental age can be estimated based on the level of tooth mineralization during the developmental process. Various methods of determining chronological and radiographical stages have been used for dental age estimation. AIM To test the validity of the standards of dental maturation of Demirjian and Goldstein (Ann Hum Biol 3:411-421, 1976) when applied to Kuwaiti children. SUBJECTS AND METHODS The sample was selected from healthy Kuwaiti children attending the routine and emergency dental clinics of the Faculty of Dentistry, Kuwait University. Good quality rotational pantomographs were obtained for 509 children (263 girls and 246 boys) between 3 and 14 years. Maturation of the seven permanent teeth on the left side of the mandible was determined according to the crown and root development stages described by Demirjian et al. (Hum Biol 45:211-227, 1973). RESULTS There were statistically significant differences in the mean of dental maturation between Kuwaiti and French-Canadian children (p<0.0001). Kuwaiti children were dentally delayed compared to the Canadian standards (mean dental maturation difference of 0.69 year, SD=1.25 years, CI=0.58-0.80). The mean delay in girls was 0.67 year (SD=1.30 years, CI=0.51-0.83) and in boys it was 0.71 year (SD=1.18 years, CI=0.56-0.86). Using a non-linear regression model, function formulae were developed for Kuwaiti girls and boys. CONCLUSION The standards of dental maturation described by Demirjian and Goldstein (1976) may not be suitable for Kuwaiti children.
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Affiliation(s)
- Muawia A Qudeimat
- Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait.
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Legović M, Sasso A, Legović I, Brumini G, Cabov T, Slaj M, Vancura I, Lapter M. The reliability of chronological age determination by means of mandibular third molar development in subjects in Croatia. J Forensic Sci 2009; 55:14-8. [PMID: 20002266 DOI: 10.1111/j.1556-4029.2009.01238.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine the development of the mandibular third molar and its relation to chronological age. The evaluated material consisted of 979 orthopantomograms of patients of Croatian Caucasian origin aged between 5.7 and 14.6 years. Third molar developmental stages were evaluated according to the stages proposed by Nolla. The frequencies of different stages of mineralization and the mean value of the mineralization of the mandibular third molars with regard to age, gender, and size of the mandible were determined and the coefficient of correlation determined between the age of the subject and the stage of development of the mandibular molars. Statistically significant correlation was determined between mineralization of the mandibular third molar and chronological age of the subjects (boys, mandibular left third molar r = 0.779, right third molar r = 0.793; girls, mandibular left third molar r = 0.746, right third molar r = 0.725). It can be concluded that the accuracy of age estimation based on Nolla's method is applicable for Croatian children.
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Affiliation(s)
- Mario Legović
- Department of Orthodontics, School of Medicine, University of Rijeka, Croatia
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The problem of aging human remains and living individuals: A review. Forensic Sci Int 2009; 193:1-13. [DOI: 10.1016/j.forsciint.2009.09.008] [Citation(s) in RCA: 384] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 09/08/2009] [Accepted: 09/14/2009] [Indexed: 11/17/2022]
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Dental age estimation in Spanish and Venezuelan children. Comparison of Demirjian and Chaillet's scores. Int J Legal Med 2009; 124:105-12. [PMID: 19859725 DOI: 10.1007/s00414-009-0380-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 09/29/2009] [Indexed: 10/20/2022]
Abstract
Orthopantomographs taken from 308 Spanish Caucasian and 200 Venezuelan Amerindian children, aged between 2 and 18 years, were analysed following the Demirjian's method. The aims of this study were to test the applicability of the Demirjian's method to two different sample populations, and to develop age prediction models for both populations using the original French Canadian scores described by Demirjian (1976) and the new multi-ethnic dental scores proposed by Chaillet et al. (2005) when the ethnic origin is unknown. Results showed that despite the good correlation between dental and chronological age, Demirjian's method overestimates the age in the Spanish Caucasian sample using both scores, the mean overestimation being higher when the Demirjian's scores were used than when the Chaillet's scale was applied. In the Venezuelan Amerindian sample, the opposite was found: Demirjian's method underestimates the age using both scores, the underestimation being higher when the Chaillet's scale was applied than when Demirjian's scale was used. New graphs were produced to convert the maturity scores to dental age for Spanish and Venezuelan children. With these graphs, the Demirjian's scores showed to be inadequate after the age of 12 in both populations, while Chaillet's scores offered useful information until 14 years of age.
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Campbell R, Weinshel R, Backeljauw P, Wilson S, Bean J, Shao M. Dental Development in Children with Growth Hormone Insensitivity Syndrome: Demirjian Analysis of Serial Panoramic Radiographs. Cleft Palate Craniofac J 2009; 46:409-14. [DOI: 10.1597/08-111.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: This study evaluates the effects of 8 years of insulinlike growth factor-I therapy on tooth development in patients with growth hormone insensitivity syndrome. Methods: Forty-nine panoramic radiographs were evaluated from eight patients (six boys, two girls). Seven teeth in the mandibular left region were graded according to the Demirjian system. Radiographs were taken at the start of insulinlike growth factor-I therapy and were continued at approximately yearly intervals for 8 years. Results: Three of six boys and one of two girls who began treatment with insulinlike growth factor-I at earlier ages experienced an increase in the rate of tooth development. One of six boys who began treatment with insulinlike growth factor-I at a later age had a slower rate of dental development. The patients had more rapid tooth maturation during the beginning of treatment. By the end of treatment, all patients had normal dental maturity for their age. Conclusions: Treatment of growth hormone insensitivity syndrome with insulinlike growth factor-I appears to lead to an increase in dental maturation, particularly in younger patients. After 8 years all patients had achieved normal dental development.
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Affiliation(s)
- Richard Campbell
- Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Randy Weinshel
- Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Philippe Backeljauw
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stephen Wilson
- Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Judy Bean
- Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mingyuan Shao
- Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio
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Butti AC, Clivio A, Ferraroni M, Spada E, Testa A, Salvato A. Haavikko's method to assess dental age in Italian children. Eur J Orthod 2009; 31:150-5. [DOI: 10.1093/ejo/cjn081] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Agurto Goya H, Satake T, Maeda T, Tanaka S, Akimoto Y. Dental age in Japanese children using a modified Demirjian method. PEDIATRIC DENTAL JOURNAL 2009. [DOI: 10.1016/s0917-2394(09)70157-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mani SA, Naing L, John J, Samsudin AR. Comparison of two methods of dental age estimation in 7-15-year-old Malays. Int J Paediatr Dent 2008; 18:380-8. [PMID: 18284472 DOI: 10.1111/j.1365-263x.2007.00890.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Numerous methods of age estimation have been proposed. The Demirjian method is the most frequently used, which was first applied in a French Canadian population in 1973. The Willems method is a modification of the above and was applied in a Belgian population in 2002. OBJECTIVES The objectives of this study were to test the applicability of the two methods, namely Demirjian and Willems, for age estimation in a Malay population, and to find the correlation between body mass index and the difference between the dental age and the chronological age. MATERIALS AND METHODS A cross-sectional study involving 214 boys and 214 girls, selected by a simple stratified random sampling method was carried out. The orthopantomograph was used to score the seven left mandibular teeth, and the calculated maturity score was used to obtain the Demirjian dental age. Willems dental age was estimated using the tables proposed in the Willems method. Results. The Demirjian method overestimated the age by 0.75 and 0.61 years, while the Willems method overestimated the age by 0.55 and 0.41 years among boys and girls, respectively. In boys, the body mass index was significantly correlated to the difference in age using the Willems method. CONCLUSION Further modification of either method is indicated for dental age estimation among the Malay population.
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Affiliation(s)
- Shani Ann Mani
- School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
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TeMoananui R, Kieser JA, Herbison GP, Liversidge HM. Estimating Age in Maori, Pacific Island, and European Children from New Zealand. J Forensic Sci 2008; 53:401-4. [DOI: 10.1111/j.1556-4029.2007.00643.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Al-Emran S. Dental Age Assessment of 8.5 to 17 Year-old Saudi Children Using Demirjian's Method. J Contemp Dent Pract 2008; 9:64-71. [DOI: 10.5005/jcdp-9-3-64] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Aim
The aim of this study was to assess the dental age in Saudi children aged 8.5 to 17 years using the Demirjian method.
Methods and Materials
Four hundred ninety panoramic radiographs of boys and girls were reviewed retrospectively. All children were placed in the age group closest to their chronological age. The dental age was scored on all seven left mandibular teeth by one examiner.
Results
Both boys and girls in age groups nine to 14 years showed advanced dental age compared to their chronological age which was found to be statistically significant except in age groups nine and 13 years. Saudi boys were 0.3 years and Saudi girls 0.4 years ahead, on average, of French-Canadian children as analyzed by the Demirjian method.
Conclusion
The standard values for French-Canadian children provided by Demirjian vary slightly for application to Saudi children. As a result, new graphs and tables were produced to convert these maturity scores, calculated by the Demirjian method, to the dental age for Saudi children.
Citation
Al-Emran S. Dental Age Assessment of 8.5 to 17 Year-old Saudi Children Using Demirjian's Method. J Contemp Dent Pract 2008 March; (9)3:064-071.
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Sisman Y, Uysal T, Yagmur F, Ramoglu SI. Third-Molar Development in Relation to Chronologic Age in Turkish Children and Young Adults. Angle Orthod 2007; 77:1040-5. [PMID: 18004924 DOI: 10.2319/101906-430.1] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Accepted: 12/01/2006] [Indexed: 11/23/2022] Open
Abstract
AbstractObjective: To assess estimation of chronologic age based on the stages of third-molar development following the eight stages (A–H) method of Demirjian et al and to compare third-molar development by sex and age with results of previous studies.Materials and Methods: The final sample consisted of 900 orthopantomograms from young Turkish subjects of known chronologic age (range, 8–25 years; mean age, 15.18 ± 4.81 years) and sex (380 males with a mean age of 14.51 ± 4.55; 520 females with a mean age of 15.67 ± 4.94). Statistical analysis was performed using the Mann-Whitney U-test and the Wilcoxon test between sex and age. Regression analysis was performed to obtain regression formulas for dental age calculation with the chronologic ageResults: Statistically significant differences (P < .05) in third-molar development between males and females were revealed regarding the calcification stages D and G. Third-molar genesis was attained earlier in males than in females. Statistical analysis showed a strong correlation between age and third-molar development for males (r2 = .65) and for females (r2 = .61). New equations (Age = 8.92 + 1.50 Development stage) were derived for estimating chronologic age.Conclusion: The use of third molars as a developmental marker is appropriate, especially when comparing the obtained standard deviation with other skeletal age calculation techniques.
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Affiliation(s)
- Yildiray Sisman
- a Assistant Professor and Department Chair, Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Tancan Uysal
- b Associate Professor and Department Chair, Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Fatih Yagmur
- c Assistant Professor, Department of Forensic Sciences, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sabri Ilhan Ramoglu
- d Research Fellow, Department of Orthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Rózyło-Kalinowska I, Kiworkowa-Raczkowska E, Kalinowski P. Dental age in Central Poland. Forensic Sci Int 2007; 174:207-16. [PMID: 17540524 DOI: 10.1016/j.forsciint.2007.04.219] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Revised: 04/12/2007] [Accepted: 04/25/2007] [Indexed: 11/23/2022]
Abstract
Precise evaluation of the developmental stage of a child is an integral part of both diagnosis and treatment of pediatric patients; it is also essential in forensic medicine and dentistry. Among radiological methods for dental age estimation in children the Demirjian's method is widely used, however original standards elaborated for the French-Canadian population are mostly not suitable for other populations. The aim of the study was to compare the dental age of children from the region of Mazovia (Central Poland) with the developmental standards presented by Demirjian, to analyse sexual dimorphism of dental age in the studied group and to estimate validity of the Demirjian's standards for the studied Polish population. The material consisted of clinical files and panoramic X-ray images of 994 children aged from 6 to 16 in good general health, without development impairments. Chronological ages of the patients were established. Next dental ages were estimated by means of the Demirjian method based on developmental maturity of seven left mandibular permanent teeth. It was found that the standards were significantly different from the chronological ages in the studied population, which means that dental development was considerably accelerated. The most significant acceleration was observed in girls aged 11 and 12, as well as in 13-year-old boys; in both groups a considerable acceleration of the dental age was seen in 6-year-olds. No statistically significant differences between dental ages of girls and boys were observed in particular age groups. There were devised gender-specific equations allowing for adaptation of original Demirjian's scores for estimation of dental age in the population of Mazovia (Central Poland). In conclusion, the developmental standards used by Demirjian are not suitable in the case of the population of children of Central Poland. Therefore, it is necessary to establish new tables for this population.
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Affiliation(s)
- Ingrid Rózyło-Kalinowska
- 2nd Department of Medical Radiology, Medical University of Lublin, ul. Dudzinskiego 42, 20-815 Lublin 56, Poland.
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Başaran G, Ozer T, Hamamci N. Cervical vertebral and dental maturity in Turkish subjects. Am J Orthod Dentofacial Orthop 2007; 131:447.e13-20. [PMID: 17418707 DOI: 10.1016/j.ajodo.2006.08.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Revised: 08/01/2006] [Accepted: 08/01/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the relationships between the stages of calcification of teeth and the cervical vertebral maturity stages in Turkish subjects. METHODS A retrospective cross-sectional study was designed. The final study population consisted of 590 Turkish subjects. Statistical analysis of the data was performed with computer software. Spearman rank order correlation coefficients were used to assess the relationship between cervical vertebral and dental maturation. For a better understanding of the relationship between cervical vertebral maturation indexes and dental age, percentage distributions of the studied teeth were also calculated. RESULTS Strict correlations were found between dental and cervical vertebral maturation of Turkish subjects. For males, the sequence from lowest to the highest was third molar, central incisor, canine, first premolar, second premolar, first molar, and second molar. For females, the sequence from lowest to the highest was third molar, canine, second premolar, first premolar, central incisor, first molar, and second molar. CONCLUSIONS Dental maturation stages can be used as a reliable indicator of facial growth.
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Affiliation(s)
- Güvenç Başaran
- Department of Orthodontics, Faculty of Dentistry, University of Dicle, Diyarbakir, Turkey.
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Azrak B, Victor A, Willershausen B, Pistorius A, Hörr C, Gleissner C. Usefulness of Combining Clinical and Radiological Dental Findings for a More Accurate Noninvasive Age Estimation. J Forensic Sci 2007; 52:146-50. [PMID: 17209927 DOI: 10.1111/j.1556-4029.2006.00300.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to establish correlations of clinical and radiological dental findings, alone or in combination, with chronological age in adults. Dental findings and orthopantomograms of 984 patients (aged 20-60 years; 524 females/460 males) were analyzed. DMF-T index and distance (alveolar bone level, ABL) between cemento-enamel junction and alveolar bone margin were recorded. Additionally, clinical and radiological findings at each tooth crown and root were collected according to the actual status of destruction and restoration, and a total score for each dentition (TSD) was calculated. After univariate correlation analysis, correlation coefficients for ABL and TSD were improved by using square root (sqrt). However, the determination accuracy was still not satisfactory; 90% of the residuals were in the range of about +/-10. The present study showed that clinical and radiological dental findings could not be used, not even in combination, for accurate age estimation as a single method, but that they could support other methods.
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Affiliation(s)
- Birgül Azrak
- Department of Restorative Dentistry, Johannes Gutenberg University, Mainz, Augustusplatz 2, D-55131 Mainz, Germany.
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Prieto JL, Barbería E, Ortega R, Magaña C. Evaluation of chronological age based on third molar development in the Spanish population. Int J Legal Med 2005; 119:349-54. [PMID: 15717200 DOI: 10.1007/s00414-005-0530-3] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Accepted: 01/26/2005] [Indexed: 10/25/2022]
Abstract
A cross-sectional study was carried out to assess chronological age estimation based on the stages of third lower molar development, following the eight stages (A-H) method of Demirjian et al. The final sample consisted of 1,054 orthopantomograms from Spanish individuals of known chronological age (range 14-21 years) and gender (462 males and 592 females). Results showed a stronger correlation for males (r(2)=0.54) than for females (r(2)=0.45). Root formation occurred earlier in males than females, in stages 5, 6 and 7. The mean difference between chronological and estimated age was -0.10 years (+/-1.23 SD) for left third molar, and -0.07 years (+/-1.22 SD) for right third molar, with slight variations regarding sex. Comparative tables are provided regarding medicolegal questions concerning age 18 prediction in the Spanish population, showing that legal age is reached in stage 7 (G) by women and in stage 8 (H) by men. No differences have been observed between sides (p<0.0001). Differences were observed between Spaniards and other previously studied populations. Third molar maturity takes place earlier in the Spanish than French-Canadian, Scandinavian, American, German, Japanese and South African populations and is more similar to US Hispanics in root development.
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Affiliation(s)
- José L Prieto
- Laboratory of Forensic Anthropology and Odontology, Instituto Anatómico Forense, Ciudad Universitaria s/n, 28040 Madrid, Spain.
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Abstract
UNLABELLED The development of wisdom teeth occurs within a definite period of time. The correlation of wisdom tooth development and chronological age has been frequently used for several purposes, e. g. the start of orthodontic treatment, estimates of age or, for legal and anthropological purposes. Wisdom teeth are frequently impacted in the bone. It has been argued that the impaction of wisdom teeth can cause a delay in root development. This thesis could have bearing on age estimations in teenagers and young adults and the timing of dental treatment. The aim of this study was to determine whether the impaction of wisdom teeth influences the velocity of root formation. MATERIAL AND METHODS The dental x-rays (orthopantomograms) of 1053 outpatients were evaluated (age: 14 to 24 years). The condition "impacted" or "not impacted" was registered for each wisdom tooth present. The impaction types were further classified. The data were then calculated using statistical tools. RESULTS The correlation between the developmental stages of wisdom teeth and the chronological age is high. However, neither any impaction type nor the whole group of retained wisdom teeth showed a statistically significant different course of root development compared to the root development of non-retained wisdom teeth. DISCUSSION This study provides evidence for the lack of bearing of wisdom teeth topography on the growth stages of the dental roots within definite time intervals, based on the evaluation of orthopantomograms only. Obviously, the variations of root formation in the selected chronological periods are greater than the variations attributable to possible periods of delay in root formation of retained wisdom teeth. These results could have some importance for the fields of dental anthropology and dentistry.
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Affiliation(s)
- Reinhard E Friedrich
- Klinik für Zahn-, Mund-, Kiefer- und Gesichtschirurgie (Nordwestdeutsche Kieferklinik), Universitätsklinikum Hamburg-Eppendorf, Universität Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
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