Dental Age Assessment in Children: A Comparison of Four Methods in a Recent French Population

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).     

Age estimation in children by measurement of open apices in tooth roots: Study of a Mexican sample

The aim of this cross-sectional study was to test the accuracy of Cameriere's European formula for age assessment in a large sample of Mexican children. The accuracy of dental age estimation was defined as how closely real age, measured as the difference between chronological age (CA) and dental age (DA), could be predicted. Digitalized orthopantomographs of 502 Mexican children (254 girls and 248 boys), aged between 5 and 15 years, were analyzed. The seven left permanent mandibular teeth were evaluated using Cameriere's method. Intra- and inter-observer variability for this technique was tested on a small random sample. Dental age was estimated for each individual and compared with known chronological age. Accuracy was measured as the difference between known chronological age and dental age and tested for significance with the mean prediction error (ME). The standard deviation and 95% confidence interval of the mean difference were also calculated. ME was 0.63 years for girls and 0.52 years for boys. ME was found to be slightly overestimated by 0.10 years for girls, but was correctly estimated for boys with an accuracy of 0.00. In conclusion, this method is very useful and may be recommended for practical application both in clinical dentistry and forensic procedures on the Mexican population.     

Age Estimation from the Teeth Using a Modified Demirjian System*

Abstract: The estimation of age at time of death is often an important step in the identification of human remains. The purpose of this study was to test the applicability of the Demirjian system on a sample of the Sydney child population and to develop and test age‐prediction models using a large sample of Sydney children (1624 girls, 1637 boys). The use of the Demirjian standards resulted in consistent overestimates of chronological age in children under the age of 14 by as much as a mean of 0.99 years. Of the alternative predictive models derived from the Sydney sample, those that provided the most accurate age estimates are applicable for the age ranges 2–14 years, with R‐square = 0.94 and a 95% confidence interval of ±1.8 years. The Sydney‐based standards provided significantly different and more accurate estimates of age for that sample when compared to the published standards of Demirjian.     

青少年手腕骨骨龄与生活年龄的差异观察

目的比较以不同骨龄标准所评价的青少年手腕骨骨龄与生活年龄的差异,观察生长发育长期变化对青少年年龄推测的影响。方法从中国5座大中城市抽取11464名（男5873,女5591）3～18岁汉族正常青少年儿童,并另随机抽取950名（男516,女434）12～18岁骨发育正常的汉族青少年作为验证样本。按CHN法和RC法骨龄标准评价手腕部X线片骨龄,并对不同方法评价的骨龄及生活年龄进行统计学分析。结果各年龄组CHN法骨龄中位数大于RC骨龄,其差异具有显著性意义（P〈0．05）。验证样本中,在男12—16．5岁、女12～14．5岁之间,CHN骨龄减生活年龄之差值分别为0．35—1．00岁和0．57～1．16岁（P〈0．01）;RC骨龄减生活年龄的差值分别为-0．26—0．23岁和-0．27～0．06岁（P〉0．05）。在男17～18岁、女15～17岁之间,CHN骨龄减生活年龄的差值分别为-0．52～-1．05岁和-0．16～-1．13岁（P〈0．05）,RC骨龄减生活年龄的差值分别为-0．35～-0．48岁和-0．22～-0．79岁（P〈0．05）。结论CHN法骨龄高于生活年龄,在大部分年龄组RC骨龄与生活年龄基本一致。     

Dental Age Estimation: A Test of the Reliability of Correctly Identifying a Subject Over 18 Years of Age Using the Gold Standard of Chronological Age as the Comparator

This study was designed to test the reliability of using the third molars to demarcate between child and adult status. A total of 2000 dental panoramic tomographs were used for assessment of the calculated age using the 8‐stage system of tooth development and applied to all four third molars. The LL8 was also assessed using this 8‐stage system. For each tooth development stage, the Normal distribution and percentile summary data were estimated. The calculated dental age compared with the chronological age was statistically significantly different (p < 0.001) for both females and males giving underestimates of the true age. Comparison of single tooth dental age and chronological age was only slightly different. The most important finding is that the assignment to above or below the 18‐year threshold, in the age range 17 years to 19 years, could be wrong on up to 50% of occasions.     

To evaluate the utility of smaller sample sizes when assessing dental maturity curves for forensic age estimation

Dental maturation and chronological age estimation were determined from 144 healthy Western Australian individuals aged 3.6-14.5 years. The results were compared with Farah et al.'s previous study which comprised a larger heterogeneous sample of Western Australian individuals (n = 1450). Orthopantomograms were analyzed with the application of Demirjian and Goldstein's 4-tooth method based on eight stages of dental mineralization. Analysis of variance revealed no significant differences in dental maturity scores in each age group among the males in both studies; similar results were seen in the females. Paired t-tests showed no statistical significance overall between chronological and estimated ages for the males in our sample (p = 0.181), whereas the females showed significant differences (p < 0.001). Our results show that smaller samples may be used when assessing dental maturity curves for forensic age estimation.     

RUS-CHN图谱骨龄评价法用于推侧青少年年龄

目的探讨RUS-CHN(RC)图谱评价法用于13~18岁青少年年龄推侧的应用价值。方法4 424名(男2 272,女2 152)13~18岁正常城市汉族青少年,以简化RUS-CHN法建立手腕骨发育等级图谱。另以1 048名(男530,女518)13~18岁青少年为检验样本,比较不同方法骨龄与生活年龄的差异。结果RUS-CHN图谱法可仅评价桡骨、尺骨远端和第III指的4块掌指骨骺。检验样本中男14~17岁、女13~16岁年龄组,RC图谱法骨龄与生活年龄之间的差异均无统计学显著性(W ilcoxon符号秩和检验,P>0.05),对男18岁、女17岁组出现显著性差异的可能原因进行了讨论。结论RUS-CHN图谱法骨龄适用于男13~18岁、女13~17岁青少年的年龄推测。     

Dental and Chronological Age in Children Under Oncological Treatment

The current oncology treatment has improved the survival of children with several types of cancer, and the effect of radiotherapy and/or chemotherapy treatment on dental maturation in comparison with chronological age is not widely known. The aim of this work was to evaluate and compare the impact of radiotherapy and/or chemotherapy treatment during dental maturation with chronological age in Chilean children diagnosed with cancer. Study Design was cross‐sectional study on children diagnosed with different types of cancer and treated with radiotherapy and/or chemotherapy when they were ages of 0.1 to 13 years. Demirjian tables for both girls and boys are used to determine the dental age. The association between chronological and dental age was highly significant. Nevertheless, a linear relation between chronological and dental age was not observed when the data were stratified by BMI and type of treatment. This study confirmed that dental age is an indicator of chronological age but that other variables, such as body mass index, in children with cancer could be confounder variables. Thus, further studies are necessary to investigate the influence of BMI on tooth eruption/maturation in children under oncological treatment.     

Dental age assessment: the applicability of Demirjian method in eastern Turkish children

In the literature, little is known about the applicability of this method in Turkish children. The aim of this study was, therefore, to evaluate the reliability of Demirjian method of age estimation when used for eastern Turkish children. A retrospective study was performed on a sample of panoramic radiographs taken from 807 healthy eastern Turkish children. The stages of dental maturity of the mandibular left seven permanent teeth for each subject using the eight radiographic dental maturity stages demonstrated by Demirjian were evaluated. A paired t-test was used for statistical analysis. The mean difference between the chronological and dental ages ranged from 0.2 to 1.9 years in girls and from 0.4 to 1.3 years in boys. The differences between the chronological and dental ages were statistically significant in all age groups. The applicability of Demirjian method is not suitable for eastern Turkish population.     

河南省安阳市6-15周岁汉族人牙龄的研究

目的建立利用牙齿钙化程度推断未成年人年龄的方法。方法选取河南省安阳市1575名（男性900名,女性675名）6～15周岁人群的全口曲面断层影像片,依照牙齿钙化分级标准对下颌恒牙钙化程度进行评分分级;所得数据经SPSS13．0软件统计分析,建立根据牙齿钙化程度推断年龄的方程;采用拟合优度检验、模型方差分析、回归系数检验和共线性诊断、残差分析对方程的合理性进行检验及盲测。结果下颌同名牙间钙化分级评分值无统计学差异（P〉0．05）,而下颌同名牙性别间钙化评分值在部分年龄组存在差异（P〈0．05）;下颌恒牙的钙化程度与年龄相关系数r均大于0．7;所建方程模型调整决定系数均大于0．8,估计值标准误男性为0．92岁至1．04岁、女性为0．92岁至1．00岁;推测年龄与真实年龄的平均误差男性为0．433±0．288岁、女性为0．502±0．297岁。结论本研究建立的方法在推断相关地区、相关年龄段人群的年龄推断中有较好的应用前景。     

Accuracy of different dental age estimation methods on Turkish children

Tooth development is widely used to estimate age or maturation. Dental age estimation is so important for various research works. Numerous methods have been described to estimate dental age based on the dental maturation. The aims of this study were to decide the best method to estimate dental age on Turkish children by reviewing several methods and to illustrate the differences among the methods and to assist future studies. The records of Turkish children between the ages of 7 and 13 years who visited the Department of Pediatric Dentistry of the Faculty of Dentistry of the Süleyman Demirel University in Isparta, Turkey were reviewed and a total of 425 healthy children with complete records, satisfactory panoramic radiographs, similar socio-economic background and ethnic origin were included. Panoramic radiographs were examined with Nolla's, Haavikko's and Demirjian's methods. Dental age was calculated for each method, and the differences between the estimated dental age and the chronological age were compared with paired t-test and Wilcoxon signed rank test. The accuracy of three methods was obtained with ICC (intraclass correlation coefficient). An under-estimation of the dental age was observed by using Nolla's and Haavikko's methods (boys -0.53±0.95, girls -0.57±0.91, both -0.54±0.93; boys -0.60±0.80, girls -0.56±0.81, both -0.58±0.80, respectively) and an over-estimation of the dental age was observed by using Demirjian's method (boys 0.52±0.86, girls 0.75±0.90, both 0.64±0.89). Haavikko's method was more accurate in the dental age estimation compared to the other methods. All of the three methods are not completely suitable for Turkish children and establishment of the population-specific standards is essential and crucial.     

The Reliability of the Greulich and Pyle Atlas When Applied to a Modern Scottish Population

This study examines the reliability of age estimation utilizing the Greulich and Pyle atlas in relation to a modern Scottish population. A total of 406 left‐hand/wrist radiographs (157 females and 249 males) were age‐assessed using the Greulich and Pyle atlas. Analysis showed that there was a strong correlation between chronological age and estimated age (females R² = 0.939, males R² = 0.940). When age groups were broken down into year cohorts, the atlas over‐aged females from birth until 13 years of age. The pattern for males showed that the atlas under‐estimated age until 13 years of age after which point it consistently over‐aged boys between 13 and 17 years of age. This study showed that the Greulich and Pyle atlas can be applied to a modern population but would recommend that any analysis takes into account the potential for over‐ and under‐aging shown in this study.     

The Reliability of Chronological Age Determination by Means of Mandibular Third Molar Development in Subjects in Croatia*

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.     

Accuracy of Three Age Estimation Methods in Children by Measurements of Developing Teeth and Carpals and Epiphyses of the Ulna and Radius

Abstract: The aim of this study was to compare the accuracy of three methods for age estimation in children: the measurements of open apices in tooth roots (T), the ratio between the total area of carpal bones and epiphyses of the ulna and radius (HW), and the combined method (THW). The sample consisted of 288 Caucasian Italian children (152 boys and 136 girls) aged between 5 and 15 years. Accuracy was determined as the difference between estimated age and chronological age, and accuracy was assessed by analyzing individuals’ orthopantomograms and hand‐wrist radiographs. Accuracies were 0.41 years for girls and 0.54 years for boys with the THW method; for the HW method, 1.00 years for girls and 0.92 years for boys; and for the T method, 0.62 years for girls and 0.71 years for boys. THW is the most accurate technique for age estimation in these children.     

中国汉族6-18周岁男性牙齿生长发育的年龄研究

目的研究牙齿钙化程度与年龄的关系,建立利用牙齿钙化程度推断中国汉族6～18周岁男性年龄的办程。方法通过对6568名6～18周岁汉族男性全口曲面断层影像上牙齿的钙化程度进行评分;将分级值及其对应年龄输入SPSS软件进行分析,建立推断年龄的方程模型;从研究样本外随机抽取已知年龄的样本160例进行卣测,,结果同名牙齿钙化评分值侧别间秩合检验结果P〉0．05;下颌左侧恒牙钙化评分值与年龄相关分析结果r值均存0．7以上,下颌同名牙间相关系数r均在0．9以上;所建回归模型拟合优度R^2=0．828,估计值标准误为1．23岁;阿测平均洪差为0．423±0．269岁。结论本研究所建立的方法准确可靠,可用于中国汉族6～18周岁男性人群的年龄推断。     

Dental age estimation in Belgian children: Demirjian's technique revisited.

Aim: The purpose of this study was to evaluate the accuracy of Demirjian's dental age estimation in children in a Belgian Caucasian population and to adapt the scoring system in case of a significant overestimation as frequently reported. We selected 2523 orthopantomograms of 1265 boys and 1258 girls, of which 2116 (1029 boys and 1087 girls) were used for estimating the dental age with the Demirjian's technique. The 407 other orthopantomograms were beyond the original age limit. A second sample of 355 orthopantomograms was used to evaluate the accuracy of the original method and the adapted method. A signed-rank test was performed to search for significant age differences between the obtained dental age and the chronological age. A weighted ANOVA was performed in order to adapt the scoring system for this Belgian population. The overestimation of the chronological age was confirmed. The adapted scoring system resulted in new age scores expressed in years and in a higher accuracy compared to the original method in Belgian Caucasians.     

Excretion of Delta9-tetrahydrocannabinol in sweat

The aims of this study were: first, to determine the accuracy of the Cameriere method for assessing chronological age in children based on the relationship between age and measurement of open apices in teeth and, second, to compare the accuracy of this method with the widely used Demirjian et al. method and with the method proposed by Willems et al. Orthopantomographs taken from white Italian, Spain and Croatian children (401 girls, 355 boys) aged between 5 and 15 years were analysed following the Cameriere, Demirjian and Willems methods. The difference between chronological and dental age was calculated for each individual and each method (residual). The accuracy of each method was assessed using the mean of the absolute values of the residuals (mean prediction error). Results showed that the Cameriere method slightly underestimated the real age of children. The median of the residuals was 0.081 years (interquartile range, IQR=0.668 years) for girls and 0.036 years for boys (interquartile range, IQR=0.732 years). The Willems method showed an overestimation of the real age of boys, with a median residual error of -0.247 years and an underestimation of the real age of girls (median residual error=0.073 years). Lastly, the Demirjian method overestimated the real age of both boys and girls, with a median residual error of -0.750 years for girls and -0.611 years for boys. The Cameriere method yielded a mean prediction error of 0.407 years for girls and 0.380 years for boys. Although the accuracy of this method was better for boys than for girls, the difference between the two mean prediction errors was not statistically significant (p=0.19). The Demirjian method was found to overestimate age for both boys and girls but the mean prediction error for girls was significantly greater than that for boys (p=0.024), and was significantly less accurate than the Cameriere method (p<0.001). The Willems method was better than that of Demirjian (p=0.0032), but was significantly less accurate than that of Cameriere (p<0.001).     

中国汉族6～18周岁女性人群牙齿生长发育的年龄研究

目的研究牙齿钙化程度与年龄的关系,建立利用牙齿推断中国汉族女性人群年龄的方程。方法通过对6923名6～18周岁汉族女性儿童及青少年全口曲面断层影像下颌恒牙的钙化程度进行评分;将分级值及其对应的年龄输入SPSS软件进行分析,最终建立推断年龄的方程模型;从研究样本外随机抽取已知年龄的样本181例进行肓测。结果牙齿钙化评分值与年龄相关分析结果相关系数r均大于0．6,同名牙评分值侧别间统计分析结果P〉0．05且相关系数r均大于0．93,方程拟合优度检验R^2=0．789,估计值标准误为1．28岁,盲测结果与真实年龄的平均误差为0．421±0．272岁。结论本研究所建立的方法在推断中国汉族女性6～18周岁群体年龄方面有良好的应用前景。     

Age Estimation from Radiographic Images of the Knee

This study examines the reliability of age estimation utilizing the Pyle and Hoerr atlas in relation to a modern Scottish population. The knee radiographs of 442 individuals (168 females, 274 males) were age assessed using the Pyle and Hoerr atlas. Analysis showed that there was a strong correlation between chronological age and estimated age (females R² = 0.968, males R² = 0.952). For females, the atlas method was most accurate between the ages of 9 and 15 years of age with an underage of 2.27 months and an overage of 2.38 months. For males, the atlas consistently overestimated age from the age of 9 years to the age of 16 years from between 0.14 and 8.81 months. The standard deviation for females was 9.86 months and for males was 10.75 months. This study showed that the Pyle and Hoerr atlas can be applied to a modern population with small modifications.