Comparison of three methods to estimate dental age in children.

OBJECTIVES: In 1973, Demirjian and colleagues introduced a staging for tooth mineralization. Staging of the teeth of the left mandible generates a dental maturity score and an estimate of dental age. An update of this method was published in 2001 by Willems and colleagues. The London Atlas (2008) is another method used to assess dental age. This study compared the precision of these three methods for forensic age estimation. MATERIALS AND METHODS: A total of 500 panoramic images of 251 boys and 249 girls aged 6-16 years had dental maturity evaluated by the same observer using the London Atlas and the methods of Demirjian and Willems. Individuals with syndromes potentially affecting dental maturation were excluded. The three methods were compared with respect to their precision in estimating chronological age. RESULTS: Age estimates using Willems' method were significantly more precise than those obtained using Demirjian's method, while estimates obtained using the London Atlas method were comparable with both the others. The highest precision was obtained using the average of age estimates from Willems' method and the London Atlas. CONCLUSIONS: To estimate age in individuals suspected of being below 16 years of age, we suggest first applying the London Atlas then computing age from the Demirjian stages of particular teeth using Willems' method, and finally using the average age estimate of both methods. CLINICAL RELEVANCE: Combining the London Atlas and Willems' scoring method provides more precise estimates of dental age than the current practice of applying a single preferred method.

Testing the London atlas for age estimation in Thai population.

Objectives: To test the London atlas for dental age (ADA) estimation in Thai population.Materials and methods: The London atlas for age estimation was tested in 111 digital panoramic radiographs of children (57 ♂ and 54 ♀) aged between 4.00 and 15.99 years. The difference between chronological age (CA) and ADA was investigated using a paired subjects t-test. The significance of the difference between CA and ADA was tested using the F-tests of the one-way ANOVA. The analysis of variance considered the effects of sex, age group and the interaction between sex and age group. Other analyses included the difference of ADA by age group and the comparison between CA and ADA by sex. SPSS Statistics 24 was used for all analyses (SPSS Inc., Chicago, IL).Results: ADA correlated to CA with a discrepancy of 1.3 years maximum. There was no significant effect of sex (F (1, 87)=0.278, p = .600), age group (F (11, 87)=1.032, p = .426) and sex and age group (F (11, 87)=1.238, p = .275) between CA and ADA.Conclusions: The estimates of dental ages correlate and reasonably reflect the CAs of Thai children and adolescents for both males and females from age 4.00 to age 15.99.

Application of the London Atlas of Tooth Development and Eruption in Panoramic Xrays for the Age Estimation.

BACKGROUND: The age estimation of the individual by the forensic experts ascertains the chronological age of an individual. The possibility that the person being examined may be younger or older than a certain age threshold makes this process crucial, as it will establish whether or not the person is an adult under the law. The aim of this study was to test the applicability of the London Atlas of tooth development and eruption in Nepalese subset population. METHODS: The London Atlas for age estimation was tested in 350 digital panoramic radiographs from the patients between four and twenty-four years visiting Tribhuvan University Teaching Hospital, Institute of Medicine, Nepal. RESULTS: The mean values of the estimated age were higher in both the sexes, which was statistically not significant. Both the sexes showed an excellent positive correlation, and was significant with a p value of <0.001. The age estimation upto 10 years group classification was nearly accurate with less than 1 and 2.5 years variation in males and females respectively. The accuracy was good in 16-18 years group with maximum deviation of ±2.5 years. The accuracy was poor in more than 18 years group, as the variability was more than 5 years. CONCLUSIONS: The London Atlas method was best suited for less than 18 years of age and was not very accurate in the age group of 13-14 and 14-15 years where most of the polymorphisms were noted.

Validation of London Atlas for forensic age estimation in Koreans by comparing with Lee's and Willems' methods.

This cross-sectional study aimed to evaluate the applicability of the London Atlas for age estimation in the Korean population by comparing with Lee's and Willems' methods. Dental ages of 475 orthopantomographs from Korean individuals aged 4-15 years (mean 10.32 ± 3.31 years) were estimated using the London Atlas, Lee's and Willems' methods. Correlation between dental and chronological age was determined using Pearson's correlation coefficient, and the statistical difference between dental and chronological age was analyzed using a paired t-test. The bias (mean differences), mean absolute error, and root mean square error between dental and chronological age, stratified by age groups and estimation methods, were calculated. Differences in bias and absolute error between sexes were scrutinized using an independent-samples t-test. Age estimates of the three tested methods were combined and compared to those of each individual method. The London Atlas and Willems methods resulted in overestimations, whereas the Lee method led to an underestimation on the entire sample. The overall accuracy was observed in the order of Lee's method, the London Atlas, and Willems' method. The London Atlas demonstrated superior consistency of estimation performance across age groups and no significant differences in estimation performance between sexes. The combination of estimates from the London Atlas and Lee's method resulted in an enhancement in bias and accuracy. We conclude that the London Atlas, due to its bias and accuracy comparable to Lee's and Willems' methods, is applicable for forensic practice in the Korean population.

Comparison of Demirjian's comprehensive chart with the London atlas of tooth development in children and adolescents: a pilot study.

Dental age estimation has its application in various subdisciplines of medicine and dentistry. New methods of dental age (DA) estimation are emerging and it is important that we compare different methods to determine which one is more closely related to the chronological age. Demirjian's method is one of the most widely used techniques and has been tested in various ethnic populations globally. In 2016, another approach to DA estimation is the London atlas of human tooth development and eruption. No study has compared Demirjian's comprehensive chart and London atlas method in the Indian population. Hence, in the current study, we estimated DA using Demirjian's comprehensive chart and London atlas method for association with the known chronologic age in children and adolescent population. The study also attempted to determine if sexual dimorphism existed in DA estimated by the two methods. Estimation was performed for both methods on 100 orthopantomogram records (50 males and 50 females, aged 6-16 years) of orthodontic patients. The data were compared and analysed using paired t-tests. There was an overestimation of DA by Demirjian's comprehensive chart on an average of +1.3 years in males and +0.5 years in females, whereas using London atlas, it was +1.4 years in males and +0.5 years in females. The mean of underestimation was -0.6 years in males and -0.8 years in females using Demirjian's comprehensive chart, whereas it was -0.8 years in males and -0.5 years in females. A statistically significant difference (P < 0.0001) was found when mean chronological age (11.6 ± 2.6) years of the participants was compared with DA estimated using either Demirjian's comprehensive chart (12.3 ± 2.8) years or London atlas (11.8 ± 2.9) years. The trends in this pilot study point towards more accuracy of London atlas over Demirjian's method when done using comprehensive chart for estimating DA. In summary, the results of the current pilot study indicates greater accuracy of London atlas method over Demirjian's comprehensive chart method for estimating DA in Indian population. This finding should be validated by conducting similar studies using larger sample, on diverse Indian ethnic populations, for applicability in pedodontic, orthodontic, and forensic domains. Key points: No study has compared Demirjian's comprehensive chart and London atlas method in the Indian population.The dental age estimated by London method was closer to chronological age as compared to Demirjian's method in our study sample.Significant difference was found in chronological age and estimated age using London atlas method in both males and females.

Assessing Children's Dental Age with Panoramic Radiographs.

(1) Background: The aim of the study was to assess the dental age of the subjects and compare it to their chronological age; to assess the dominant tooth for evaluation of dental age; and to investigate possible individual differences between the left and right side of the dental arch. (2) Methods: This study involved evaluating panoramic radiographs of patients aged 7-13 years. A separate assessment was performed for each tooth according to the degree of germ development. Each subject's dental age was estimated. (3) Results: The study involved evaluating 349 panoramic radiographs. No difference was found between stages of tooth development on the right side and left side. Correlation between the stages of tooth development and the chronological age was found to be highest in the second permanent molar teeth. The age can be predicted with the estimated age of tooth #37 and the gender of the patient. (4) Conclusions: The chronological age of children aged 7-13 may be estimated based on a modified seven-stage London Atlas of tooth development, where the most accurate landmark(s) of use are second molars.

Employing the London Atlas in the Age Estimation of a Select South African Population.

Dental age estimation in the living and deceased is a fundamental aspect of forensic sciences, civil cases, medico-legal proceedings and clinical dentistry. Accordingly, this study aimed to validate the accuracy and reproducibility of the London Atlas in a select South African sample of KwaZulu-Natal. In this cross-sectional study, 760 digital panoramic radiographs (n = 760) aged between 5.00 and 23.99 years were retrospectively reviewed through consecutive sampling. Each radiograph was assessed and assigned a dental age in accordance with the London Atlas of Human Tooth Development and Eruption by AlQahtani et al. (2010). The London Atlas overestimated age with a mean difference of -0.85 to -1.26 years in the selected South African sample of KwaZulu-Natal. A statistically significant difference between the chronological and estimated dental ages was recorded. Furthermore, the South African Black and Indian males had a higher overestimation of age than their female counterparts, with a mean difference of 0.13 and 0.07 years, respectively. This overestimation was less in the South African Indian population in comparison to the SA Black population. This outcome resulted in the creation of the KZN population- and sex-specific charts and atlases for the two selected cohorts of KwaZulu-Natal. The KZN Atlases were found to be more accurate in the selected sample, with a mean absolute error of 0.57 years and no statistically significant differences between the chronological and estimated dental ages.

Dental age estimation in children that have undergone antineoplastic treatment.

OBJECTIVE: Even though many studies have been performed to estimate DA in general population, limited research has been performed concerning medical compromised populations such as childhood cancer survivors. The aims of this case-control study were (a) to estimate dental age in a population of children that have undergone antineoplastic treatment with three different methods and (b) to compare it with the estimates from healthy subjects (control group). MATERIALS AND METHODS: Seventy-three oncology patients and equal number of healthy control subjects from the Pediatric dentistry Department had their dental age estimated through recent orthopantograms using Dermijian's, Willems' and London Atlas methods. All OPGs randomly assessed by two calibrated observers. Mean age difference was calculated. Intraclass Correlation Coefficient was used to assess intra-observer reliability and the Concordance Correlation Coefficient used to assess inter-observer reliability. RESULTS: Concerning the CCS group 35 subjects (48%) were males and 38 (52%) were females, with an overall mean chronological age 10.95 years, ranging between 5.37 and 15.83 years. Intra- and inter-examiner reliability was exceptional for all methods. Mean DA differences in both groups and were not statistically sinificant regardless of the method used. The marginally lower values when males and females were investigated separately is basically due to the corresponding reduction of the sample size. CONCLUSION: An overestimation of DA observed in both groups by all methods was not significant. All three methods produced highly accurate comparable results when it comes to estimate the actual chronological age in both groups (CCS and control subjects) regardless of gender.

Accuracy of the London Atlas, Haavikko's Method and Cameriere's European Formula of dental age estimation in Turkish children.

Age estimation is a mandatory procedure when the chronological age is unknown or uncertain. Dental development is the preferred characteristic for estimating a child's age. There are many methods for dental age estimation, but their reliability can differ between populations. This study compared the accuracy of three of these methods-the London Atlas (LA), Haavikko's method (HM), and Cameriere's European formula (CF)-in Turkish children living in northwestern Turkey. Panoramic radiographs of 980 children from northwestern Turkey aged between 6.00 and 14.99 years were examined for the whole study group and separately for different ages and sexes by all three methods. Statistical differences between chronological age and dental age were tested using the paired sample t-test and the Wilcoxon signed-rank test. The LA, HM, and CF accuracies were determined based on the mean absolute error. Spearman's rank correlation coefficient showed that the correlation between chronological age and dental age for both sexes was linear for all methods. The LA overestimated the chronological age by 0.09 years, while HM and CF underestimated it by 0.49 and 0.11 years, respectively. The difference between dental age and chronological age was significant in all samples, for all methods, except for the LA in boys. When boys, girls, and the total sample were evaluated, values with the lowest mean absolute error were obtained by HM and were statistically significant in all three groups. Therefore, HM is more accurate than the LA and CF for dental age estimation in Turkish children living in northwestern Turkey.

Testing and comparing the accuracy of two dental age estimation methods on saudi children: Measurements of open apices in teeth and the London Atlas of Tooth Development.

Evaluation of dental development is frequently performed to assess maturity and estimate age. The aim of this study was to test and compare the accuracy of two dental age estimation methods in a sample of Saudi children by using Cameriere's formula (measurements of mandibular teeth open apices) and The London Atlas of Tooth Development. Four hundred archived digital panoramic radiographs of healthy children (200 males and 200 females) between the ages of 6 to 15.99years attending the Pediatric Dental clinics of King Saud University, College of Dentistry, Riyadh, Saudi Arabia were used. The mean difference between the Estimated Age (EA) and Real Age (RA) was (-0.89years) for Cameriere's formula with a standard deviation of (±1.14years), and it was (-0.59years) with a standard deviation of (±1.45years) for The London Atlas. Both methods consistently underestimated the age. No statistically significant difference between the sexes was found in both methods In conclusion, the London Atlas was found to be slightly more accurate and easier to use than was Cameriere's formula.

Age estimation in Portuguese population: The application of the London atlas of tooth development and eruption.

Chronological age estimation from the dental parameters is becoming increasingly important. The London atlas of tooth development is the most recent developed method and represents a modification of the previous older methods. The aim of this study was to evaluate the accuracy of the London atlas for the dental age estimation in the Portuguese population. The study sample included 736 radiographic images (498 females and 238 males) of Portuguese origin, patients of Dental Clinic of Superior Institute of Health Sciences Egas Moniz and Dental Medicine Faculty, University of Lisbon. The age range of the individuals was between 3 and 24 years. Estimated age was compared with the chronological age using the paired t-test. The results showed that there was no statistically significant difference between left and right side of the jaw (p>0.05). Both sides showed an average overestimation of age by one month approximately. Moreover, the significant difference between chronological and estimated age was not observed in the females. However, the significant difference was observed in a sample coming from males (right: p=0.008; left: p=0.003). Our results showed that the London atlas can be potentially used as a tool for age estimation. However, the difference between sexes clearly suggests that separate charts should be made for each sex. Further studies, which will have as a final goal the development of a new method for age estimation using dental parameters, are needed.