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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: Tooth/growth & development
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: Tooth/growth & development*
Comparison of dental maturation in Hong Kong Chinese and United Kingdom Caucasian populations

Jayaraman J, Roberts GJ

Forensic Sci Int, 2018 Nov;292:61-70.
PMID: 30269046 DOI: 10.1016/j.forsciint.2018.09.005

Understanding dental maturation in ethnically distinct populations is important in forensic age estimations and the presence of population differences in dental maturation was highly debated. No such comparison had been performed between two major populations; Caucasian and Chinese. This study aims to analyze and compare the maturation of permanent teeth from a sample of Caucasian and Chinese populations. Dental panoramic radiographs of subjects aged 2-24years belonging to United Kingdom (UK) Caucasian and Hong Kong (HK) Chinese populations were obtained from a teaching hospital. The teeth were scored and reference datasets were developed separately for males and females. Statistical significance was set at p<0.05 and independent sample t-test was conducted between the average ages at assessment for each stage of development for all the teeth in both groups. The HK Chinese were dentally advanced than the UK Caucasians by an average of 5 months, however, reverse trend was observed in third molars (p<0.05). These findings must be considered whilst utilising population specific reference dataset for dental age estimation.

Matched MeSH terms: Tooth/growth & development*

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