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Fulltext Age estimation using development of third molars in South Indian population: A radiological study

Priyadharshini KI, Idiculla JJ, Sivapathasundaram B, Mohanbabu V, Augustine D, Patil S

J Int Soc Prev Community Dent, 2015 May;5(Suppl 1):S32-8.
PMID: 25984465 DOI: 10.4103/2231-0762.156522

To assess the estimation of chronological age based on the stages of third molar development following the eight stages (A-H) method of Demirjian et al. in Chennai population of South India.

Matched MeSH terms: Age Determination by Teeth
Demirjian's method is unsuitable for dental age estimation

Jayaraman J, Roberts G

Forensic Sci Med Pathol, 2016 12;12(4):532-533.
PMID: 27669714
Matched MeSH terms: Age Determination by Teeth*
Fulltext The accuracy of demirjian method in dental age estimation of malay children

Abu Asab S, Noor SN, Khamis MF

Singapore Dent J, 2011;32(1):19-27.
PMID: 23739283 DOI: 10.1016/S0377-5291(12)70012-3

This study is aimed to evaluate the accuracy of Demirjian method in estimating the chronological age of male and female Kelantanese Malay children between 6 and 16 years of age and to establish a new dental age (DA) curve if the Demirjian method was not found to be accurate. About 905 panoramic radiographs of healthy Malay children between 6 and 16 years of age were collected from the radiographic unit in the Hospital Universiti Sains Malaysia (HUSM) and the orthodontic clinic in Hospital Kota Bharu (HKB). Children who had any disease affecting the dental development, or have agenesis in the lower arch and poor quality radiographic images were excluded. The results showed that Demirjian method overestimated the chronological age (CA) by 1.23 years for boys and 1.20 years for girls and it was less accurate for the Kelantanese Malay children. Thus new standard curve were produced and tested on external samples. Results showed that the mean difference between the chronological age and DA is about 0.17 years for boys and 0.11 years for girls. DA was more advanced in the Kelantanese Malay boys and girls as compared to French-Canadian children in all age groups. It is concluded that the Demirjian method tends to be less accurate in estimating the chronological age in Malay children. The new curve that was produced is more applicable to the Kelantanese Malay children.

Matched MeSH terms: Age Determination by Teeth*
Testing the accuracy of Bedek et al's new models based on 1-to-7 mandibular teeth for age estimation in 7-15 year old south Indian children

Sheriff SO, Medapati RH, Ankisetti SA, Gurrala VR, Haritha K, Pulijala S, et al.

J Forensic Odontostomatol, 2020 Sep 30;2(38):22-39.
PMID: 33174535

The goal of long term research on age assessment is to focus on the strengths and weaknesses of existing reliable methods of age estimation. In cases of age estimation when all teeth are present, maximum accuracy can be obtained using a 7 tooth model. Demirjian's system and Willems models require all seven mandibular teeth in the lower left quadrant for age assessment. Unfortunately, these methods cannot be applied in children with hypodontia. In 2019, Bedek et al., from Croatia, developed new models of age estimation based on a combination of one to seven mandibular teeth. In the present study, we tested the accuracy of the newly developed models for age estimation in South Indian children. Tested in parallel with Willems models, the accuracy of the new models was tested in terms of mean difference, mean absolute error (MAE) and percentage of correct estimations within intervals of +0.5 and +1 years. In terms of mean difference between chronological age (CA) and estimated dental age (DA), all models along with Willems models have underestimated the CA except Bedek et al's 6 tooth model where overestimation of CA was seen in boys. For MAE and percentage of correct estimations, the new models performed better than Willems models. With regards to our results, it can be concluded that the new models for dental age calculation are accurate and suitable. Therefore, we may encourage their use for age estimation in South Indian children, particularly in individuals with hypodontia or when multiple teeth are missing.

Matched MeSH terms: Age Determination by Teeth*
Accuracy of Kvaal's radiographic and translucent dentinal root techniques of extracted teeth in Malay adults for dental age estimation

Ramli UIS, Muhd US, Mohd Yusof MYP

J Forensic Odontostomatol, 2021 Aug 30;2(39):38-44.
PMID: 34419944

The use of teeth to estimate the age of unknown bodies provides much help especially in skeletal remains with no soft tissues left for identification. However, dental age estimation utilizing degenerative changes in teeth like dentinal translucency is often hampered with large margin of error. This study aims to compare the accuracy of Kvaal's radiographic method (intraoral periapical radiograph) with modified Bang-Ramm dentinal root translucency method in estimating dental age in Malay adults. One-hundred teeth of maxillary and mandibular incisors and canine were collected following dental extraction. Date of birth, date of extraction, gender and ethnicity were documented prior to extraction. All teeth were assessed using two methods of dental age estimation: 1) The equation from Kvaal's radiographic method and 2) Formula from modified Bang-Ramm dentinal root translucency method. The results from the age estimation were compared to the chronological age of the persons from whom the teeth were extracted. The average dental age estimated using both methods significantly correlated with the chronological age for both men and women. Overestimation and underestimation with mean absolute error up to 13 years and 15 years was observed in modified Bang-Ramm and Kvaal, respectively. The estimated age calculated from both methods also showed increasing standard deviation as the patient gets older. From the obtained results it is reasonable to conclude that modified Bang-Ramm method gives better accuracy for dental age estimation in Malay adults.

Matched MeSH terms: Age Determination by Teeth*
Fulltext Accuracy of different dental age assessment methods to determine chronological age among children with special needs

Ismail AF, Adnan NH, Suhaidi NNS, Mokhtar IW, Yusof MYPM, Mallineni SK

J Indian Soc Pedod Prev Dent, 2024 Jan 01;42(1):64-70.
PMID: 38616429 DOI: 10.4103/jisppd.jisppd_47_24

AIM: This study aimed to validate the accuracy of dental age (DA) based on the dental development of permanent teeth in children with special needs using Demirjian, Willems, and London Atlas methods and to correlate the dental and chronological age (CA) of children with special needs in Malaysia.
MATERIALS AND METHODS: The panoramic radiographic images belonging to children with special needs from the two teaching dental hospitals in Malaysia aged between 5 and 16 years were included in the study. The evaluation was performed by two observers using three methods (London Atlas, Demirjian, and Willems methods) to estimate the accurate DA. The outcome was determined by comparing the mean of the DA and CA.
RESULTS: A total of 52 panoramic radiographs were available for the analysis. The London Atlas and Demirjian methods overestimated the DA with a mean of 0.05 and 0.20 years, respectively, while the Willems method underestimated by 0.19 years. The London Atlas method was highly precise and accurate, while Demirjian and Willems methods were the least precise and accurate.
CONCLUSION: The London Atlas method of DA estimation is highly accurate and valid for children with special needs in the Malaysian population, followed by the Willems and Demirjian methods.

Matched MeSH terms: Age Determination by Teeth*
Reliability and validity of five radiographic dental-age estimation methods in a population of Malaysian children

Kumaresan R, Cugati N, Chandrasekaran B, Karthikeyan P

J Investig Clin Dent, 2016 Feb;7(1):102-9.
PMID: 25048008 DOI: 10.1111/jicd.12116

OBJECTIVE: To evaluate the reliability and validity of Demirjian's, Willems, Nolla's, Haavikko's, and Cameriere's radiographic methods of dental-age estimation in a population of Malaysian children.
METHODS: A total of 426 dental panoramic radiographs of 5-15-year-old Malaysian children were included in the study. The mean age error and absolute age error for all the methods were calculated and their usability analyzed.
RESULTS: The Nolla, Willems. and Demirjian methods overestimated the dental age with a mean of 0.97, 0.54, and 0.54 years, respectively, while the Cameriere and Haavikko methods underestimated by 0.41 and 1.31 years, respectively. The Cameriere method was highly precise and accurate in the population of Malaysian children, whereas the Haavikko and Demirjian methods were the least precise and accurate.
CONCLUSIONS: The Cameriere method of dental-age estimation is highly valid and reliable for Malaysian population, followed by the Willems and Nolla methods.

Matched MeSH terms: Age Determination by Teeth*
Assessing the probability of having attained 16 years of age in juveniles using third molar development in a sample of South Indian population

Saranya K, Ponnada SR, Cheruvathoor JJ, Jacob S, Kandukuri G, Mudigonda M, et al.

J Forensic Odontostomatol, 2021 Apr 30;1(39):16-23.
PMID: 34057154

Juvenile crime or delinquency has been increasing at an alarming rate in recent times. In many countries, including India, the minimum age for criminal responsibility is 16 years. The present study aimed to estimate the probability of a south Indian adolescent either being or being older than the legally relevant age of 16 years using Demirjian's tooth formation stages. Orthopantomograms (OPG) of 640 south Indian adolescents (320 boys and 320 girls) aged between 12 and 20 years were retrospectively analyzed. In each OPG, Demirjian's formation stage of the mandibular left third molar was recorded and the data was subjected to statistical analysis. Descriptive and Pearsons correlation statistics were performed. The empirical probabilities were provided relative to the medico-legal question of predicting 16 years of age. The distribution of age throughout the 10th, 25th, 50th, 75th and 90th percentile follows a logical distribution pattern horizontally and vertically. Pearson's correlation statistics showed a strong positive correlation between the Demirjian's stages and age for both sexes. Therefore, it can be concluded that stage "F" can be used to predict the attainment of age equal to or older than 16 years with a probability of 93.9% for boys and 96.6% for girls.

Matched MeSH terms: Age Determination by Teeth*
Modified method of dental age estimation of Malay juveniles

Bunyarit SS, Jayaraman J, Naidu MK, Yuen Ying RP, Danaee M, Nambiar P

Leg Med (Tokyo), 2017 09;28:45-53.
PMID: 28772147 DOI: 10.1016/j.legalmed.2017.07.009
Matched MeSH terms: Age Determination by Teeth/methods*
Performance of Willem's dental age estimation method in children: A systematic review and meta-analysis

Mohd Yusof MYP, Wan Mokhtar I, Rajasekharan S, Overholser R, Martens L

Forensic Sci Int, 2017 Nov;280:245.e1-245.e10.
PMID: 28958768 DOI: 10.1016/j.forsciint.2017.08.032

Through numerous validation and method comparison studies on different populations, the Willems method exhibited a superior accuracy. This article aims to systematically examine how accurate the application of Willems dental age method on children of different age groups and its performance based on various populations and regions. A strategic literature search of PubMed, MEDLINE, Web of Science, EMBASE and hand searching were used to identify the studies published up to September 2014 that estimated the dental age using the Willems method (modified Demirjian), with a populations, intervention, comparisons and outcomes (PICO) search strategy using MeSH keywords, focusing on the question: How much Willems method deviates from the chronological age in estimating age in children? Standardized mean differences were calculated for difference of dental age to chronological age by using random effects model. Subgroup analyses were performed to evaluate potential heterogeneity. Of 116 titles retrieved based on the standardized search strategy, only 19 articles fulfilled the inclusion criteria for quantitative analysis. The pooled estimates were separately kept as underestimation (n=7) and overestimation (n=12) of chronological age groups for both genders according to primary studies. On absolute values, females (underestimated by 0.13; 95% CI: 0.09-0.18 and overestimated by 0.27; 95% CI: 0.17-0.36) exhibited better accuracy than males (underestimated by 0.28; 95% CI: 0.14-0.42 and overestimated by 0.33; 95% CI: 0.22-0.44). For comparison purposes, the overall pooled estimate overestimated the age by 0.10 (95% CI: -0.06 to 0.26) and 0.09 (95% CI: -0.09 to 0.19) for males and females, respectively. There was no significant difference between the young and older child in subgroup analysis using omnibus test. The mean age between different regions exhibited no statistically significant. The use of Willems method is appropriate to estimate age in children considering its accuracy among different populations, investigators and age groups.

Matched MeSH terms: Age Determination by Teeth/methods*
Validity of Demirjian and Willems methods for dental age estimation for Malaysian children aged 5-15 years old

Nik-Hussein NN, Kee KM, Gan P

Forensic Sci Int, 2011 Jan 30;204(1-3):208.e1-6.
PMID: 20869825 DOI: 10.1016/j.forsciint.2010.08.020

BACKGROUND: One of the most commonly used method for dental age assessment is the method reported by Demirjian and coworkers in 1973. It was later modified by Willems and coworkers whereby they “performed a weighted ANOVA” in order to adapt the scoring system.
AIM: To evaluate the applicability of Demirjian and Willems methods for dental age estimation for Malaysian children and to correlate the accuracy of the findings with the chronology of tooth development of premolars and second molars.
MATERIALS AND METHODS: A total of 991 dental panoramic radiographs of 5-15-year-old Malaysian children were included in the study. The mean Demirjian and Willems estimated ages were compared to the mean chronological age.
RESULTS: The mean chronological age of the sample was 10.1±2.8 and 9.9±3.0 years for males and females respectively. Using the Demirjian method, the mean estimated dental age was 10.8±2.9 years for males and 10.5±2.9 years for females. For Willems method, the mean estimated age was 10.3±2.8 years males and 10.0±3.0 years respectively.
CONCLUSIONS: Willems method was more applicable for estimating dental age for Malaysian children. Overestimation in Demirjian method could be due to advanced development of second bicuspids and molars.

Matched MeSH terms: Age Determination by Teeth/methods*
Comparison of two methods of dental age estimation in 7-15-year-old Malays

Mani SA, Naing L, John J, Samsudin AR

Int J Paediatr Dent, 2008 Sep;18(5):380-8.
PMID: 18284472 DOI: 10.1111/j.1365-263X.2007.00890.x

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.

Matched MeSH terms: Age Determination by Teeth/methods*
Application of third molar development and eruption models in estimating dental age in Malay sub-adults

Mohd Yusof MY, Cauwels R, Deschepper E, Martens L

J Forensic Leg Med, 2015 Aug;34:40-4.
PMID: 26165657 DOI: 10.1016/j.jflm.2015.05.004

The third molar development (TMD) has been widely utilized as one of the radiographic method for dental age estimation. By using the same radiograph of the same individual, third molar eruption (TME) information can be incorporated to the TMD regression model. This study aims to evaluate the performance of dental age estimation in individual method models and the combined model (TMD and TME) based on the classic regressions of multiple linear and principal component analysis. A sample of 705 digital panoramic radiographs of Malay sub-adults aged between 14.1 and 23.8 years was collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage the TMD and TME, respectively. The data was divided to develop three respective models based on the two regressions of multiple linear and principal component analysis. The trained models were then validated on the test sample and the accuracy of age prediction was compared between each model. The coefficient of determination (R²) and root mean square error (RMSE) were calculated. In both genders, adjusted R² yielded an increment in the linear regressions of combined model as compared to the individual models. The overall decrease in RMSE was detected in combined model as compared to TMD (0.03-0.06) and TME (0.2-0.8). In principal component regression, low value of adjusted R(2) and high RMSE except in male were exhibited in combined model. Dental age estimation is better predicted using combined model in multiple linear regression models.

Matched MeSH terms: Age Determination by Teeth/methods*
Age estimation using third molar development

Phrabhakaran N

Malays J Pathol, 1995 Jun;17(1):31-4.
PMID: 8907002

Teeth are the most durable structures in the human body. The pattern of their development has been used as a credible technique of age determination of unidentified bodies. Dental age estimation is by comparison of the dental status of an individual with published dental surveys. The third molars are the last teeth to erupt and are regarded as the most variable in the dentition. Nevertheless, radiographs depicting their growth have been used to determine the chronological age. A case for actual need for age estimation using a developing third molar is presented here.

Matched MeSH terms: Age Determination by Teeth/methods*
Dental age estimation in Malay children based on all permanent teeth types

Yusof MY, Thevissen PW, Fieuws S, Willems G

Int J Legal Med, 2014 Mar;128(2):329-33.
PMID: 23370574 DOI: 10.1007/s00414-013-0825-8

The applicability of the Willems et al. model was verified on a collected sample of Malay (Malaysian nationality) children. This sample was split in a reference sample to develop a Malay-specific prediction model based on the Willems et al. method and in a test sample to validate this new developed model. Next, the incorporation of third molars into this model was analyzed. Panoramic radiographs (n = 1,403) of Malay children aged between 4 and 14.99 years (n = 702) and subadults aged between 15 and 23.99 years (n = 701) were collected. The left mandibular seven permanent teeth of the children were scored based on the staging technique described by Demirjian and converted to age using the Willems et al. method. Third molar development of all individuals was staged based on the technique described by Gleiser and Hunt modified by Kohler. Differences between dental age and chronological age were calculated and expressed in mean error (ME), mean absolute error (MAE), and root mean square error (RMSE). The Willems et al. model verified on the collected Malay children overestimated chronological age with a ME around 0.45 year. Small differences in ME, MAE, and RMSE between the verified Malay-specific prediction model and the Willems et al. model were observed. An overall neglected decrease in RMSE was detected adding third molar stages to the developed permanent teeth model.

Matched MeSH terms: Age Determination by Teeth/methods*
Development of a Reference Data Set (RDS) for dental age estimation (DAE) and testing of this with a separate Validation Set (VS) in a southern Chinese population

Jayaraman J, Wong HM, King NM, Roberts GJ

J Forensic Leg Med, 2016 Oct;43:26-33.
PMID: 27441983 DOI: 10.1016/j.jflm.2016.07.007

BACKGROUND: Many countries have recently experienced a rapid increase in the demand for forensic age estimates of unaccompanied minors. Hong Kong is a major tourist and business center where there has been an increase in the number of people intercepted with false travel documents. An accurate estimation of age is only possible when a dataset for age estimation that has been derived from the corresponding ethnic population. Thus, the aim of this study was to develop and validate a Reference Data Set (RDS) for dental age estimation for southern Chinese.
MATERIALS AND METHODS: A total of 2306 subjects were selected from the patient archives of a large dental hospital and the chronological age for each subject was recorded. This age was assigned to each specific stage of dental development for each tooth to create a RDS. To validate this RDS, a further 484 subjects were randomly chosen from the patient archives and their dental age was assessed based on the scores from the RDS. Dental age was estimated using meta-analysis command corresponding to random effects statistical model. Chronological age (CA) and Dental Age (DA) were compared using the paired t-test.
RESULTS: The overall difference between the chronological and dental age (CA-DA) was 0.05 years (2.6 weeks) for males and 0.03 years (1.6 weeks) for females. The paired t-test indicated that there was no statistically significant difference between the chronological and dental age (p > 0.05).
CONCLUSION: The validated southern Chinese reference dataset based on dental maturation accurately estimated the chronological age.

Matched MeSH terms: Age Determination by Teeth*
Age estimation from structural changes of teeth and buccal alveolar bone level

Koh KK, Tan JS, Nambiar P, Ibrahim N, Mutalik S, Khan Asif M

J Forensic Leg Med, 2017 May;48:15-21.
PMID: 28407514 DOI: 10.1016/j.jflm.2017.03.004

Forensic odontology plays a vital role in the identification and age estimation of unknown deceased individuals. The purpose of this study is to estimate the chronological age from Cone-Beam Computed Tomography (CBCT) images by measuring the buccal alveolar bone level (ABL) to the cemento-enamel junction and to investigate the possibility of employing the age-related structural changes of teeth as studied by Gustafson. In addition, this study will determine the forensic reliability of employing CBCT images as a technique for dental age estimation. A total of 284 CBCT images of Malays and Chinese patients (150 females and 134 males), aged from 20 years and above were selected, measured and stages of age-related changes were recorded using the i-CAT Vision software. Lower first premolars of both left and right side of the jaw were chosen and the characteristics described by Gustafson, namely attrition, secondary dentine formation and periodontal recession were evaluated. Linear regression analysis was performed for the buccal bone level and the R values obtained were 0.85 and 0.82 for left and right side respectively. Gustafson's characteristics were analysed using multiple regression analysis with chronological age as the dependent variable. The results of the analysis showed R values ranged from 0.44 to 0.62. Therefore it can be safely concluded that the buccal bone level highly correlated with the chronological age and is consequently the most suitable age-related characteristic for forensic age estimation.

Matched MeSH terms: Age Determination by Teeth/methods*
Application of the Kvaal method for adult dental age estimation using Cone Beam Computed Tomography (CBCT)

Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Nurul F, Kanagasingam S, Franklin D, et al.

J Forensic Leg Med, 2016 Nov;44:178-182.
PMID: 27821308 DOI: 10.1016/j.jflm.2016.10.013

Different non-invasive methods have been proposed for dental age estimation in adults, with the Kvaal et al. method as one of the more frequently tested in different populations. The purpose of this study was to apply the Kvaal et al. method for dental age estimation on modern volumetric data from 3D digital systems. To this end, 101 CBCT images from a Malaysian population were used. Fifty-five per cent were female (n = 55), and forty-five percent were male (n = 46), with a median age of 31 years for both sexes. As tomographs allow the observer to obtain a sagittal and coronal view of the teeth, the Kvaal pulp/root width measurements and ratios were calculated in the bucco-lingual and mesio-distal aspects of the tooth. From these data different linear regression models and formulae were built. The most accurate models for estimating age were obtained from a diverse combination of measurements (SEE ±10.58 years), and for the mesio-distal measurements of the central incisor at level A (SEE ±12.84 years). This accuracy, however is outside an acceptable range in for forensic application (SEE ±10.00 years), and is also more time consuming than the original approach based on dental radiographs.

Matched MeSH terms: Age Determination by Teeth/methods*
Quantification of secondary dentin formation based on the analysis of MDCT scans and dental OPGs in a contemporary Malaysian population

Hisham S, Abdullah N, Noor MHM, Franklin D

Leg Med (Tokyo), 2019 02;36:59-66.
PMID: 30415193 DOI: 10.1016/j.legalmed.2018.11.004
Matched MeSH terms: Age Determination by Teeth/methods*
Dental age estimation in Malaysian adults based on volumetric analysis of pulp/tooth ratio using CBCT data

Asif MK, Nambiar P, Mani SA, Ibrahim NB, Khan IM, Lokman NB

Leg Med (Tokyo), 2019 Feb;36:50-58.
PMID: 30415192 DOI: 10.1016/j.legalmed.2018.10.005

Forensic odontology plays an important role in human identification and dental age estimation is an integral part of this process. The aim of the study was to investigate the association between chronological age and pulp/tooth volume ratio in a Malaysian population (Malays and Chinese) from cone-beam computed tomography (CBCT) scans, enhanced with Mimics software. Three hundred CBCT scans of 153 males and 147 females, aged between 16 and 65 years were divided into 5 age groups. Volumetric analysis of the pulp/tooth ratio was performed in maxillary left canines, maxillary right canines and maxillary right central incisors. Simple linear regression and Pearson correlation analysis indicated the strongest coefficient of correlation (R) values for maxillary right central incisors (0.83) followed by maxillary right canines (0.74) and maxillary left canines (0.73). Fisher's Z test indicated that dental age estimation is gender independent. The derived regression equations were further validated on an independent group of 126 teeth. The results indicated mean absolute error (MAE) values of 6.48 and 8.58 years for maxillary right central incisors and maxillary canines respectively. It was also noticed that MAE values were higher among the age groups ranging from 46 to 65 years. This study showed that a volumetric change in the pulp cavity with age is a valuable assessment method for dental age estimation among Malaysian population.

Matched MeSH terms: Age Determination by Teeth/methods*

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