MyMedR

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: Radiography, Panoramic

Validation of Cameriere's third molar maturity index alone and in combination with apical maturity of permanent mandibular second molar for indicating legal age of 14 years in a sample of South Indian children

Balla SB, Banda TR, Galic I, N NM, Naishadham PP

Forensic Sci Int, 2019 Apr;297:243-248.

PMID: 30844636 DOI: 10.1016/j.forsciint.2019.02.009

The aims of the present study were to validate the discriminatory potential of Cameriere's third molar maturity index (I3M) cut-off value of I3M

Matched MeSH terms: Radiography, Panoramic

Fulltext Unilateral short root anomaly: an incidental finding on routine radiographic examination

Ponraj RR, Sarah Samson R, Nayak VS, Mathew M

BMJ Case Rep, 2021 Jan 18;14(1).

PMID: 33462052 DOI: 10.1136/bcr-2020-239438

Matched MeSH terms: Radiography, Panoramic*

Uncommon radiological findings: a case report

Tandjung YR, Hong CP, Nambiar P, Ibrahim N

Int Dent J, 2007 Jun;57(3):173-6.

PMID: 17695738

A 50-year-old friendly and attractive Chinese lady was examined by the Primary Care Unit, Faculty of Dentistry, University of Malaya. Her requests for treatment included implants and crowns. Two periapical radiographs of teeth 16 and 48 were taken to aid diagnosis. Interestingly, pin-like radio-opaque objects were found over the crown of the impacted tooth 15 and also tooth 17. These objects were initially interpreted as silver points or radiographic artifacts but further investigation employing panoramic radiography revealed the distribution of more radio-opaque objects in the orofacial region. Based on a review of the literature and the opinion of experienced radiology and oral surgery lecturers, these foreign radio-opaque objects were diagnosed as susuks or charm needles.

Matched MeSH terms: Radiography, Panoramic*

Fulltext Transcervical approach to the removal of a deep-seated giant submandibular calculus and the submandibular gland

Goh LC, Chitra BK, Shaariyah MM, Ng WS

BMJ Case Rep, 2016 Oct 28;2016.

PMID: 27793872 DOI: 10.1136/bcr-2016-217514

Sialolithiasis is among the most common disease affecting the major salivary glands whereby the submandibular gland or its duct is affected in the majority of cases. We report a case of the surgical removal of a giant sialolith along with the submandibular gland using the transcervical approach and its clinical outcome.

Matched MeSH terms: Radiography, Panoramic

Tooth mineralization stages as a diagnostic tool for assessment of skeletal maturity

Surendran S, Thomas E

Am J Orthod Dentofacial Orthop, 2014 Jan;145(1):7-14.

PMID: 24373650 DOI: 10.1016/j.ajodo.2013.09.007

The objective of this study was to determine whether dental calcification can be used as a first-level diagnostic tool for assessment of skeletal maturity.

Matched MeSH terms: Radiography, Panoramic/methods

Third molar maturity index (I3M) assessment according to different geographical zones: a large multi-ethnic study sample

Angelakopoulos N, De Luca S, Oliveira-Santos I, Ribeiro ILA, Bianchi I, Balla SB, et al.

Int J Legal Med, 2023 Mar;137(2):403-425.

PMID: 36520207 DOI: 10.1007/s00414-022-02930-x

Identification of living undocumented individuals highlights the need for accurate, precise, and reproducible age estimation methods, especially in those cases involving minors. However, when their country of origin is unknown, or it can be only roughly estimated, it is extremely difficult to apply assessment policies, procedures, and practices that are accurate and child-sensitive. The main aim of this research is to optimize the correct classification of adults and minors by establishing new cut-off values for four different continents (Africa, America, Asia, and Europe). For this purpose, a vast sample of 10,701 orthopantomographs (OPTs) from four continents was evaluated. For determination and subsequent validation of the new third molar maturity index (I3M) cut-off values by world regions, a cross-validation by holdout method was used and contingency tables (confusion matrices) were generated. The lower third molar maturity indexes, from both left and right side (I3ML and I3MR) and the combination of both sides (I3ML_I3MR) were calculated. The new cut-off values, that aim to differentiate between a minor and an adult, with more than 74.00% accuracy for all populations were as follows (I3ML; I3MR; I3ML_I3MR, respectively): Africa = (0.10; 0.10; 0.10), America = (0.10; 0.09; 0.09), Asia = (0.15; 0.17; 0.14), and Europe = (0.09; 0.09; 0.09). The higher sensitivity (Se) was detected for the I3ML for male African people (91%) and the higher specificity (Sp) of all the parameters (I3ML; I3MR; I3ML_I3MR) for Europeans both male and female (> 91%). The original cut-off value (0.08) is still useful, especially in discriminating individuals younger than 18 years old which is the goal of the forensic methods used for justice.

Matched MeSH terms: Radiography, Panoramic

The variability of lower third molar development in Northeast Malaysian population with application to age estimation

Johan NA, Khamis MF, Abdul Jamal NS, Ahmad B, Mahanani ES

J Forensic Odontostomatol, 2012 Jul;30(1):45-54.

PMID: 23000811

This study aimed to assess the variability of the lower third molar (tooth 38 and 48) development in Northeast Malaysian population with respect to the side of dentition, to generate age prediction models and to compare the outcome with other studies. A total of 1080 orthopantomograms of Northeast Malaysian population aged between 14 and 25 years (540 males and 540 females) from the Hospital Universiti Sains Malaysia's archive which met the inclusion and exclusion criteria were selected and the maturity stages of tooth 38 and 48 were scored using Demirjian's stages (A-H). The findings showed a wide variation of the development of lower third molars in the Northeast Malaysian population. The roots developed earlier in males than in females. The development of the dentition on opposite sides of the mandible was synchronously in females and males. A multiple regression analysis shows that 71.1% of variance in age was explained by sex and developmental stage of tooth 48. An age prediction model was generated from the regression analysis: [Age = 7.117 + 1.907*(stage of tooth 48) - 0.432*(sex)] with mean prediction errors between -0.17 to 3.14 years. The obtained data in the current study are useful for references and determining age of unidentified human remains for identification investigation.

Matched MeSH terms: Radiography, Panoramic

The safety zone for mini-implant maxillary anchorage in Mongoloids

Wey MC, Shim CN, Lee MY, Jamaluddin M, Ngeow WC

Aust Orthod J, 2012 May;28(1):17-21.

PMID: 22866589

This study aimed to establish a safety zone for the placement of mini-implants in the buccal surface between the second maxillary premolar (PM2) and first maxillary molar (M1) of Mongoloids.

Matched MeSH terms: Radiography, Panoramic

The location of the mental foramen in a selected Malay population

Ngeow WC, Yuzawati Y

J Oral Sci, 2003 Sep;45(3):171-5.

PMID: 14650583

Knowledge of the position of the mental foramen is important both when administering regional anesthesia and performing periapical surgery in the mental region of the mandible. This study determines the position of the mental foramen in a selected Malay population. One hundred and sixty nine panoramic radiographs of Malay patients retrieved from a minor oral surgery waiting list were selected to identify the normal range for the position of the mental foramen. The foramen was not included in the study if there was any mandibular tooth missing between the lower left and right first molars (36-46). The findings indicated the most common position for the mental foramen was in line with the longitudinal axis of the second premolar (69.2%) followed by a location between the first and second premolar (19.6%). The right and left foramina were bilaterally symmetrical in three of six recorded positions in 67.7% patients. The mental foramen was most often in line with the second premolar.

Matched MeSH terms: Radiography, Panoramic

The correlation between crestal bone resorption and implant stability during healing period using resonance frequency analysis

Al-Juboori MJ, AbdulRahaman SB, Hassan A

Implant Dent, 2013 Aug;22(4):351-5.

PMID: 23811720 DOI: 10.1097/ID.0b013e318296583d

To detect the correlation between crestal bone resorption and implant stability during healing period using resonance frequency analysis (RFA).

Matched MeSH terms: Radiography, Panoramic/methods

The clinical anatomy of accessory mandibular canal in dentistry

Ngeow WC, Chai WL

Clin Anat, 2020 Nov;33(8):1214-1227.

PMID: 31943382 DOI: 10.1002/ca.23567

The mandibular canal is a conduit that allows the inferior alveolar neurovascular bundle to transverse the mandible to supply the dentition, jawbone and soft tissue around the gingiva and the lower lip. It is not a single canal but an anatomical structure with multiple branches and variations. The branches are termed accessory, bifid or trifid canals depending on their number and configuration. A bifid mandibular canal is an anatomical variation reported more commonly than the trifid variant. Because of these variations, it is of the utmost importance to determine the exact location of the mandibular canal and to identify any branches arising from it prior to performing surgery in the mandible. This article reviews the prevalence, classification and morphometric measurements of these accessory mandibular canals, emphasizing their clinical significance.

Matched MeSH terms: Radiography, Panoramic

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: Radiography, Panoramic*

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: Radiography, Panoramic

Fulltext Susuk or charm needle: a strange object detected on orthodontic diagnostic radiographs

Varghese E, Samson RS, Nagraj SK, Chandrappa PR

BMJ Case Rep, 2017 Nov 01;2017.

PMID: 29092975 DOI: 10.1136/bcr-2017-222497

Matched MeSH terms: Radiography, Panoramic

Fulltext Root-crown ratios of permanent teeth in Malay patients attending HUSM Dental Clinic

Norisa Othman, Haslina Taib, Norehan Mokhtar

Archives of Orofacial Sciences, 2011;6(1):21-26.

MyJurnal

The objectives of this study were to determine the normal mean value of the root-crown (R/C ratios) in Malay patients and their variations by gender and dental arch from orthopantomogram radiographs (OPGs). Two thousand nine hundred and twenty teeth with fully developed roots were measured from 112 OPGs. Subjects with history of maxillofacial trauma or orthodontic therapy were excluded. The mean age of the subjects was 19.1 (SD 2.08) years old for males while females 18.9 (SD 2.19) years old in the range from 15 to 22 years old. The intra-examiner reproducibility of the assessment method was good (Intraclass correlation coefficient 0.81). Results of this study showed that there was no significant difference between R/C ratios of males and females groups. However, the ratios of the antagonist teeth for both males and females were significantly greater in the mandible than in the maxilla (p

Study site: Dental clinic, Hospital Universiti Sains Malaysia

Matched MeSH terms: Radiography, Panoramic

Reliability of panoramic-radiograph to determine the position of third-molar from inferior-alveolar-canal

Azizah Ahmad Fauzi, Mohamed Ebrahim Parker, Norval E., Phrabhakaran N

Sains Malaysiana, 2017;46:59-65.

Cone-beam-computed-tomography (CBCT) has been useful in providing insights of relevant anatomy prior to surgical
procedures, including the assessment of the proximity of impacted mandibular-third-molar to the inferior-alveolar-canal
(IAC). It is important to understand the reliability of conventional panoramic-radiograph in the assessment of this criterion
since it is more commonly used as first line radiographic approach due to its availability and lower radiation dose. This
study aimed to investigate the reliability of conventional panoramic-radiograph in the evaluation of the proximity of
impacted mandibular-third-molar root tip to the IAC by correlating the results with CBCT. A total of 65 root tips of impacted
mandibular-third-molars that had both panoramic radiographs and CBCT images were included in this retrospective study.
Two trained observers participated in all image evaluations. A prepared standard 1 cm ruler was used to measure the
proximity of the third-molar root apices to the IACs. Measurements recorded in this study were categorized into positive
(root apex above a roof of IAC), zero (root apex was superimposed on IAC) and negative (root apex below a roof of IAC).
Data analysis was carried out using student t-test. In this study, both observers recorded statistically significant differences
in the measurement between third-molars root apices and the IAC from panoramic radiographs and CBCT images. The low
reliability of panoramic radiograph to assess the vertical proximity between these two anatomical structures suggests
the importance of additional assessment with CBCT in cases where panoramic radiograph shows superimposition of the
third molar root on the roof of the canal and presence of root below the roof of the IAC.

Matched MeSH terms: Radiography, Panoramic

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: Radiography, Panoramic*

Fulltext Reliability and limitations of permanent tooth staging techniques

Abdul Rahim AH, Davies JA, Liversidge HM

Forensic Sci Int, 2023 May;346:111654.

PMID: 37011430 DOI: 10.1016/j.forsciint.2023.111654

Reliability, or repeatability, of permanent tooth staging techniques is usually expressed as Cohen's Kappa. This single value obscures information about the quantity and allocation of disagreements. In this study we assess and compare intra-observer reliability of permanent tooth staging techniques described by Nolla, Moorrees et al. and Demirjian et al. The sample was panoramic radiographs of healthy dental patients made up of 100 males and 100 females aged 6-15 years. All permanent teeth on the left side (excluding third molars) were scored twice. Weighted Kappa and percentage agreement were calculated. Results show Kappa values for all teeth combined as 0.918, 0.922 and 0.938 for Demirjian (number of teeth N = 2682), Nolla (N = 2698) and Moorrees (N = 2674) respectively. A comparison of Kappa values between upper and lower teeth showed marginally higher values for upper incisors and lower molar for all three scoring methods. Small differences in Kappa values were noted between tooth types with the upper first molar having smaller values than other teeth. Percentage agreement ranged from 81 % (Moorrees), 86 % (Nolla) to 87 % (Demirjian). Tooth stage differences between first and second assessments were not more than one stage. Our findings show that Demirjian scoring is marginally more reliable than Nolla or Moorrees. We suggest that (1) data for reliability are tabulated in full to show the quantity and allocation of disagreement between first and second readings, and (2) that the reliability sample is sufficiently large with a wide age range to include multiple different tooth stages.

Matched MeSH terms: Radiography, Panoramic

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: Radiography, Panoramic*

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