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Kar M, Sharma A, Dutta K, Puttanavar R, A S, Govindasamy E. Comparative evaluation of Willems and Cameriere methods of dental age estimation among 6-14 year old Bengali children. J Oral Biol Craniofac Res 2025; 15:433-439. [PMID: 40092367 PMCID: PMC11909424 DOI: 10.1016/j.jobcr.2025.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Revised: 02/01/2025] [Accepted: 02/11/2025] [Indexed: 03/19/2025] Open
Abstract
Background The knowledge of dental age estimation is essential to assess growth and development which aids in designing a treatment plan. Willems and Cameriere methods are the two most widely used approaches of dental age estimation. Aim The primary objective of this study was to evaluate the reliability and applicability of the two methods, among 6-14 year old children of Bengal populace. The secondary objective was to compare the efficacy of Sante DICOM Viewer and CorelDRAW Graphic Suite in assessing dental age by Cameriere method. Materials and methods The study sample encompassed 411 digital panoramic radiographs. Dental age was estimated using Willems and Cameriere methods. CorelDRAW Graphic Suite and Sante DICOM Viewer software were used for dental age estimation by Cameriere method. Paired t-test was applied for the inter group comparison. Pearson correlation coefficient was also used to measure the regression among all the groups. Results Dental age was overestimated by 0.286 years using Willems method (p = 0.001). However, there was no significant difference between dental ages estimated by Cameriere method using both software (p = 0.130). Conclusion Both the methods were equally applicable for age estimation in the targeted population. Cameriere method can be performed with equivalent accuracy using both software.
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Affiliation(s)
- Mehuli Kar
- Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth Deemed to be University, Pillaiyarkuppam, Puducherry, 607402, India
| | - Aruna Sharma
- Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth Deemed to be University, Pillaiyarkuppam, Puducherry, 607402, India
| | - Kaushik Dutta
- Department of Oral Medicine and Radiology, Guru Nanak Institute of Dental Sciences and Research, Panihati, Kolkata, 700114, India
| | - Rekha Puttanavar
- Department of Oral Medicine and Radiology, Guru Nanak Institute of Dental Sciences and Research, Panihati, Kolkata, 700114, India
| | - Sanguida A
- Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth Deemed to be University, Pillaiyarkuppam, Puducherry, 607402, India
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Shi L, Galić I, Anić-Milošević S, Banjšak L, Brkić H. Accuracy of second and third molar maturity indices, Olze, Haavikko, and Demirjian methods for 14- and 16-year-old age thresholds assessment in Croatian children and adolescents. Int J Legal Med 2024; 138:2411-2425. [PMID: 38987428 DOI: 10.1007/s00414-024-03278-0] [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: 05/15/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024]
Abstract
This study explores the reliability of four established legal age threshold estimation approaches in a Croatian sample. We applied Haavikko stages, Demirjian stages, Olze's third molar eruption stages, and second and third molar maturity indices measurement in 593 orthopantomograms of Croatian children and adolescents aged 11.00-20.99 years old. The left mandibular second and third molar were assessed. Logistic regression analysis was conducted to test the significance of predictive variables. Logistic Receiver operating characteristic (ROC) curves were performed to evaluate the classification ability of variables for estimating 14- and 16-year-old thresholds. The areas under the ROC curve (AUC), accuracy (Acc), sensitivity (Se), specificity (Sp), Positive Likelihood Ratio (LR +), Negative Likelihood Ratio (LR-), and Bayes post-test probability (Bayes PTP) were calculated to evaluate classification performance. Results suggest that the combination of I2M&I3M is the best classifier for the 14-year-old threshold (AUC = 0.879); for males alone, I2M is an even better classifier (AUC = 0.881). The highest Acc 80.1% (95%CI, 75.9%-83.9%), Bayes PTP 86.5% (95%CI, 82.8%-89.7%) and Sp 88.9% (95%CI, 83.0%-93.3%) were by I3M < 0.81 & I2M < 0.03 in total samples; the highest Acc 86.1% (80.6%- 90.6%), Bayes PTP 87.2% (95%CI, 81.7%- 91.4%) and Sp 87.8% (95%CI, 78.2%- 94.3%) were by I2M < 0.01 in males, Acc of Haavikko Ac and Demirjian H stage in second molar is very close with slightly lower Bayes PTP and Sp. I3M is a good classifier for 16-year-old threshold (AUC = 0.889). The cut-off value I3M < 0.34 can be used to classify the 16-year-old threshold with Acc of 80.6% (95%CI, 77.2%-83.7%), Sp of 83.4% (95%CI, 79.0%-87.3%), and 81.7% (95%CI, 78.4%-84.8%) Bayes PTP. In conclusion, to classify the 14-year-old threshold, a pair of cut-off values I3M < 0.81 & I2M < 0.03 can be used in Croatian females; I2M < 0.01, Demirjian H stage, Haavikko Ac stage in second molar, and the pair I3M < 0.81 & I2M < 0.03 can all be used in Croatian males. I3M < 0.34 can classify the 16-year-old threshold in Croatian populations.
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Affiliation(s)
- Lei Shi
- Department of Dental Anthropology and Chair of Forensic Dentistry, University of Zagreb School of Dental Medicine, 10000, Zagreb, Croatia
| | - Ivan Galić
- University of Split School of Medicine, 21000, Split, Croatia.
| | - Sandra Anić-Milošević
- Department of Orthodontics, University of Zagreb School of Dental Medicine, 10000, Zagreb, Croatia
| | - Luka Banjšak
- Department of Dental Anthropology and Chair of Forensic Dentistry, University of Zagreb School of Dental Medicine, 10000, Zagreb, Croatia
| | - Hrvoje Brkić
- Department of Dental Anthropology and Chair of Forensic Dentistry, University of Zagreb School of Dental Medicine, 10000, Zagreb, Croatia
- University Hospital Centre Zagreb, Zagreb, Croatia
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Franco A, Moreira DD, Cidade R, Machado M, Bueno J, Malschitzky C, Boedi RM. The Brazilian (FRANCO) method for dental age estimation: Willems' model revisited. Clin Oral Investig 2024; 28:495. [PMID: 39167103 DOI: 10.1007/s00784-024-05869-y] [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] [Received: 04/11/2024] [Accepted: 07/31/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVES This study aimed (I) to test the Willems' dental age estimation method in different geographic samples of the Brazilian population, and (II) to propose a new model combining the geographic samples in a single reference table of Brazilian maturity scores. MATERIALS AND METHODS The sample consisted of 5017 panoramic radiographs of Brazilian males (n = 2443) and females (n = 2574) between 6 and 15.99 years (mean age = 10.99 ± 2.76 years). The radiographs were collected from the Southeastern (SE) (n = 2920), Central-Western (CW) (n = 1176), and Southern (SO) (n = 921) geographic regions. Demirjian's technique was applied followed by Willems' method and the proposed Brazilian model. RESULTS Willems' method led to mean absolute errors (MAE) of 0.79 and 0.81 years for males and females, respectively. Root mean squared errors (RMSE) were 1.01 and 1.03 years, respectively. The Brazilian model led to MAE of 0.72 and 0.74 years for males and females, respectively, and RMSE of 0.93 years for both sexes. The MAE was reduced in 70% of the age categories. Differences between regions were statistically (p < 0.05) but not clinically significant. CONCLUSION The new model based on a combined population had an enhanced performance compared to Willems' model and led to reference outcomes for Brazilians. CLINICAL RELEVANCE Assessing patients' biological development by means of dental analysis is relevant to plan orthopedic treatments and follow up. Having a combined-region statistic model for dental age estimation of Brazilian children contributes to optimal age estimation practices.
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Affiliation(s)
- Ademir Franco
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Rua Dr José Rocha Junqueira 13, Swift Campinas, Block E Office 3, São Paulo, 045-755, Brazil.
- Department of Therapeutic Stomatology, Institute of Dentistry, Moscow, Russia.
| | | | - Rafael Cidade
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Marcos Machado
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Juliano Bueno
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Carolina Malschitzky
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Rua Dr José Rocha Junqueira 13, Swift Campinas, Block E Office 3, São Paulo, 045-755, Brazil
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Mizuno S, Ono S, Makino Y, Kobayashi S, Torimitsu S, Yamaguchi R, Chiba F, Tsuneya S, Iwase H. Mandibular torus thickness associated with age: Postmortem computed tomographic analysis. Leg Med (Tokyo) 2024; 69:102449. [PMID: 38669766 DOI: 10.1016/j.legalmed.2024.102449] [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] [Received: 05/21/2023] [Revised: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
Age estimation is an essential step in identifying human corpses. Several mandibular landmarks have been highlighted as skeletal sites for age estimation since aging causes morphological changes. Reports suggest that mandibular torus size may be associated with aging; however, thorough investigation has not been performed owing to the difficulty in measuring it. Therefore, this study aimed to determine the association between age and mandibular torus thickness using postmortem computed tomography data from Japanese corpses. This study included 2,792 corpses with mean (standard deviation) age of 58.0 (22.4) years (range, 0-101 years) and 67.6 % males. Further, 2,662 (95.3 %), 14 (0.5 %), 59 (2.1 %), and 57 (2.0 %) corpses were in the permanent, mixed, primary, and predental dentition periods, respectively. Multivariable analysis was performed to quantify the impact of age on mandibular torus thickness, adjusting for sex, height, weight, and occlusal contact status. The model also included an interaction term between age and occlusal status because of the potential effect modification by occlusion. Results of the multivariable regression analysis showed that mandibular torus thickness increased with age (the regression coefficients (95 % confidence interval) were 0.6 (0.2-1.0), 0.7 (0.3-1.0), 1.0 (0.6-1.4), 1.3 (0.9-1.7), 1.3 (0.8-1.8), and 1.1 (0.4-1.7) for age groups 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 years, respectively), especially in males with occlusal contact. A significant association between mandibular torus thickness and age, modified by occlusal status and sex, was identified. Therefore, data regarding the thickness of the mandibular torus and occlusal status may be useful for age estimation in human corpses.
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Affiliation(s)
- Satomi Mizuno
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan.
| | - Sachiko Ono
- Department of Eat-loss Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan.
| | - Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba Prefecture 260-8670, Japan.
| | - Susumu Kobayashi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan
| | - Suguru Torimitsu
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba Prefecture 260-8670, Japan.
| | - Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba Prefecture 260-8670, Japan.
| | - Fumiko Chiba
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba Prefecture 260-8670, Japan.
| | - Shigeki Tsuneya
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba Prefecture 260-8670, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Chiba Prefecture 260-8670, Japan.
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Pereira CP, Rodrigues A, Augusto D, Santos A, Nushic V, Santos R. Dental age assessment and dental scoring systems: combined different statistical methods. Int J Legal Med 2024; 138:1533-1557. [PMID: 38538730 DOI: 10.1007/s00414-024-03216-0] [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] [Received: 12/20/2023] [Accepted: 03/19/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Age Estimation has been considered as a human basic right, carried out through the use of tables for dental age assessment based on the chronology of tooth eruption. As such, the final aim of this investigation is to create tables with applicability to the Portuguese population, for the different scoring systems used and combined different statistical approaches. MATERIALS AND METHODS For this purpose, dental age assessment was achieved in all four third molars, using different scoring systems, in a total sample of 626 orthopantomograms (324 females, 302 males), aged between 12 and 25 years old, from the database population of Lisbon North University Hospital Center, approved by the Ethic Committee. RESULTS The values of validation showed excellent results both on precision and on reproducibility. Mostly all methods showed statistically significant differences between the estimated age and the chronological age and, therefore, the presence of estimation errors. Kullman's and Mincer's methods are the ones with best applicability in the Portuguese population, in the lower third molars. The reliability measures (sensitivity, specificity and accuracy) values decrease as age increases. CONCLUSION A combination of the scoring systems as a protocol for dental age assessment in Portuguese nationality was established. Tables, for all the scoring systems used, were made with applicability in the Portuguese population.
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Affiliation(s)
- Cristiana Palmela Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal.
- Grupo Análise Forense, Centro de Estatística e Aplicações da Universidade de Lisboa, Bloco C6 - Piso 4, Lisboa, 1749-016, Portugal.
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
- Grupo FORENSEMED, Centro UICOB, Faculdade de Medicina Dentária da Universidade de Lisboa. Cidade Universitária, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal.
| | - Ana Rodrigues
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal
- Grupo Análise Forense, Centro de Estatística e Aplicações da Universidade de Lisboa, Bloco C6 - Piso 4, Lisboa, 1749-016, Portugal
- Grupo FORENSEMED, Centro UICOB, Faculdade de Medicina Dentária da Universidade de Lisboa. Cidade Universitária, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal
| | - Diana Augusto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal
- Grupo Análise Forense, Centro de Estatística e Aplicações da Universidade de Lisboa, Bloco C6 - Piso 4, Lisboa, 1749-016, Portugal
- Grupo FORENSEMED, Centro UICOB, Faculdade de Medicina Dentária da Universidade de Lisboa. Cidade Universitária, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal
| | - Adriana Santos
- Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, Lisboa, 1600-277, Portugal
| | - Valon Nushic
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Rui Santos
- Grupo Análise Forense, Centro de Estatística e Aplicações da Universidade de Lisboa, Bloco C6 - Piso 4, Lisboa, 1749-016, Portugal
- Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro, Apt 4163, Edifício D, Leiria, 2411-901, Portugal
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Lin Y, Maimaitiyiming N, Sui M, Abuduxiku N, Tao J. Performance of the London Atlas, Willems, and a new quick method for dental age estimation in Chinese Uyghur children. BMC Oral Health 2022; 22:624. [PMID: 36544118 PMCID: PMC9773604 DOI: 10.1186/s12903-022-02652-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Numerous dental age estimation methods have been devised and practised for decades. Among these, the London Atlas and Willems methods were two of the most frequently adopted, however dependent on atlantes or tables. A new estimation method less reliant on external measurement could be efficient and economical. AIM This study aimed to evaluate the utility and applicability of the dental age estimation methods of London Atlas, Willems, and a new quick method that subtracts the number of developing teeth from the universal root mature age of 16 years in one of the lower quadrants reported in this work among Chinese Uyghur children. METHODS A comparative cross-sectional study was conducted. Subjects enrolled in the study were screened according to preset inclusion and exclusion criteria. The observer then obtained the dental age from the subjects' panoramic radiographs based on the estimated rules of the London Atlas, Willems, and a new quick method. Paired t-test was used to compare the accuracy and precision of the above three estimation methods. Independent-sample t-test was used to find the difference between gender. RESULTS Totally, 831 radiographs entered the analyses of this study. Among the three methods evaluated, the Willems method, in particular, showed a distinct underestimated tendency. The mean error of the dental age predicted by the London Atlas, the Willems method, and the quick method was 0.06 ± 1.13 years, 0.44 ± 1.14 years, and 0.30 ± 0.63 years, respectively. The mean absolute error was 0.86 ± 0.75 years according to the London Atlas, 1.17 ± 0.89 years under the Willems method, and 0.70 ± 0.54 years under our quick method. No significant difference was found between the chronological age and dental age using the London Atlas, generally for the 10 to 15 years group (p > 0.05), but our quick method for the 15-16 years children (p < 0.05) and Willems method (p < 0.001). CONCLUSION The London Atlas outperformed the Willems method with better accuracy and precision among 10-15 years Chinese Uyghur children. Our new quick method may be comparable to the London Atlas for children aged 10-14 and potentially become a more straightforward dental age prediction instrument.
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Affiliation(s)
- Yueting Lin
- grid.412523.30000 0004 0386 9086Department of General Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, No. 500 Qu Xi Road, Shanghai, 200011 China
| | - Nuerbiyamu Maimaitiyiming
- grid.412631.3Department of Cariology and Endodontics, The First Affiliated Hospital of Xinjiang Medical University (The Affiliated Stomatology Hospital of Xinjiang Medical University), Ürümqi, Xinjiang China
| | - Meizhi Sui
- grid.412523.30000 0004 0386 9086Department of General Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, No. 500 Qu Xi Road, Shanghai, 200011 China ,Department of Stomatology, Kashgar Prefecture Second People’s Hospital, Kashgar, Xinjiang China
| | - Nuerbiya Abuduxiku
- Department of Stomatology, The First People′s Hospital of Kashgar Prefecture, No. 66 Yingbin Avenue, Kashgar, Xinjiang 844000 China
| | - Jiang Tao
- grid.412523.30000 0004 0386 9086Department of General Dentistry, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, No. 500 Qu Xi Road, Shanghai, 200011 China
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