Study of secondary dentine deposition in central incisors as an age estimation method for adults.

This work aimed to assess the pulp/tooth area ratio's utility in the upper central incisors using orthopantomograms. A convenience sample of 801 adult patient orthopantomograms was studied. Image J® software was used to measure the pulp/tooth area ratio, and a regression model was developed. Our results conclude that the methodology assessing upper incisors' pulp/tooth area ratio using orthopantomograms can lead to age overestimation and statistically significant differences between chronological and estimated age. For those over 50, no correlation between pulp/tooth area ratio and chronological age was found, suggesting that this may be the upper limit of this technique in this population. This methodology may not be suitable for age estimation, particularly in older adults.

A Digital Radiographic Study of Age Estimation Using Area-specific Formula in Odisha Population.

AIM: The aim of the article was to evaluate the feasibility of pulp/tooth area ratio in three mandibular teeth, namely left canine, left first premolar, and left second premolar (33, 34, and 35), as an indicator of age using digital panoramic radiograph and Kvaal's parameters. The study also aimed at computing an area-specific formula for age estimation in Odisha population. MATERIALS AND METHODS: Observation and analysis of 50 digital orthopantomographs (OPGs) and clinical data of patients were made. These images were saved as high-resolution JPEG files. Using the Adobe Photoshop CS3 (extended) image editing software program (Adobe Systems Inc, San Jose, California, United States), the pulp/tooth area ratio of 33, 34, and 35 was analyzed. These ratios were substituted in Odisha population-specific formula, derived using principal component regression analysis. RESULTS: The mean chronological age was 33.24 years. Principal component regression analysis was used to derive multiple regression formulae for individual teeth as well as a combined formula. R2 (coefficient of determination) for combined three mandibular teeth was highest (0.7769) with a standard error of 4.5969 years and thus was a better predictor of age in the population of Odisha. In terms of an individual tooth, comparison between chronological and predicted age revealed that left second mandibular premolar (35) had highest correlation to actual age. Karl Pearson's correlation coefficient showed correlation between age and the mean of ratios from combined three mandibular teeth was stronger than that of single tooth. CONCLUSION: In the present study, second left mandibular premolar showed highest correlation to actual age when used alone. The use of three teeth in combination increased the correlation. This Odisha-specific formula showed promising results and can be used for forensic applications in this population. CLINICAL SIGNIFICANCE: Using three different teeth for age estimation proved to be a better predictor of age in the Odisha population. Moreover, the obtained formula can act as a standard and be used for anthropological or forensic investigations in the said population.

Tooth dimensions and body size in a Pygmy population.

Background: The relationship between tooth size and stature has been analysed extensively at the interspecies level but has received less attention at the intraspecies level. The relationship between these two parameters does not seem to be the same among modern human populations.Aim: The aim of this study is to analyse the relationship between tooth dimensions and body measurements in the Baka Pygmies.Subjects and methods: Height, weight, and tooth dimensions were obtained for 45 adult Baka females and 17 males from Le Bosquet (Cameroon). Correlations were obtained between the variables and compared to results for other human populations.Results: The Baka population is distinctive in the small number of significant correlations. Only two buccolingual diameters among Baka females show any significant correlation with height. The lack of significant correlations between tooth dimensions and body dimensions among the Baka means that changes in body size are accompanied by random variations in tooth dimensions.Conclusion: The absence of correlations may be accounted for by the impact of environmental effects on the somatic growth of the Baka producing a Pygmy phenotype adapted to live in the forest. It is worth noting that many correlations become significant when sexes are pooled.

Radiological tooth/pulp ratio in canines and individual age estimation in a sample of adult neolithic skeletons from Italy.

OBJECTIVES: The estimation of an individual's age at the time of death is one of the most important components in anthropological studies and is the basis for demographic studies on ancients. However, the different methods commonly used in anthropology for adult age estimation at death provide results with a high level of uncertainty. The consequence is the inability to develop demographic studies with a good degree of reliability. A non-destructive method currently available is the analysis of the apposition of secondary dentine on which Cameriere's method is based. MATERIALS AND METHODS: The purpose of this work was age estimation using Cameriere's method on a sample of 18 adult Neolithic skeletons from four sites in Southern Italy (Apulia): Carpignano, Masseria della Marina, Samari and Serra Cicora. The estimates derived from the study of mandibular and maxillary canines were compared with the age ranges obtained with commonly used anthropological indicators: fusion of cranial sutures, degree of tooth wear, remodelling of the pubic symphysis and the auricular surface of the ilium. The latter two provide intervals which encompass the ages estimated with Cameriere's method. RESULTS: The results show that the population was composed of individuals of advanced age, even beyond the age of 50, hardly distinguishable by other methods. DISCUSSION: This finding may support the hypothesis that individuals aged 50+ are rare in prehistoric skeletal samples due to the unreliability of classical anthropological methods, not only because they were actually rare in prehistoric populations, or absent for taphonomical reasons.

Reliability of Radiovisiography and Cytomorphometry in Determining the Age of an Individual: A Clinical Comparative Study.

The oral cavity can be explored as an area to identify the impacts of aging. Exfoliative cytology is a painless, rapid, and effective method for collecting intact cells from various epithelial layers for microscopic examination. Therefore, the current study's objective was to determine the average cell size using morphometric analysis and radiovisiography (RVG) to estimate an individual's age utilizing buccal smears and the pulp/tooth ratio. A software program was utilized to determine the cell size using exfoliative cytology, and the pulp and tooth area was measured using RVG of mandibular canine with the help of an image analysis software. Appropriate statistical tests were performed using IBM SPSS statistical software for Windows (version 25). The patient's chronological age, pulp area, and the associated pulp-tooth area ratio values were determined, along with Karl Pearson's correlation coefficient. It was discovered by using a paired t-test to compare chronological age to the age deduced from cell size and pulp-tooth area ratio. According to the current study, age estimation could be done based on average cell size, pulp size, and pulp-tooth area ratio for forensic odontology. Studies with bigger sample sizes and diverse population would help achieve definitive conclusions about the reliability of this particular method.

Nanocurcumin-containing Spongy Membrane for Improving the Quality of Hard and Soft Tissues in the Extracted Tooth Area: A Double-Blind Split- Mouth Clinical Trial Study.

BACKGROUND: The assessment of the hard and soft tissue conditions is part of the overall dental treatments. AIM: In this study, we investigated nano curcumin-containing membranes to improve the quality of the hard and soft tissues in the extracted tooth area as a clinical trial study. METHODS: After the patient was selected following the inclusion and exclusion criteria, the patients who had teeth extracted from both sides of the mouth (split mouth) on the side of the intervention received a membrane containing nanocurcumin, and on the control side, no material was placed in the socket. For data analysis, SPSS software version 24 was used. A significance threshold was deemed to be less than 0.05 in terms of probability. RESULTS: Two months after tooth extraction, during implant placement, the average gingival thickness on the "intervention side," was 3.1±0.34 mm, while the average gingival thickness on the "control side" was 2.6±0.42 mm. Then, the membrane could improve the quality of soft tissue (P< 0.0001). As another outcome, the application of this membrane did not significantly affect bone repair in these patients compared to the control group (P = 0.72). However, the histology data revealed that the newly generated bone of the intervention group was seen close to the membrane, demonstrating the osteoconductive ability of the membrane. CONCLUSION: Based on the obtained results, the newly developed membrane can be used to improve the quality of hard and soft tissues in the extracted tooth area. Nonetheless, more efforts in nanocurcumin dosage adjustment are needed for hard tissue regeneration in future studies.

Reliability of a forensic odontology method for age-at-death estimation in adults: A Mexican case study.

This study aimed to evaluate the reliability of an age estimation method based on the pulp/tooth area ratio by assessing intra- and inter-examiner agreement across five observers at different intervals. Using the same X-ray device and technical parameters, 96 digital periapical X-ray images of upper and lower canines were obtained from 28 deceased people in Central America, whose age at death ranged from 19 to 49 years. Excellent and good agreement of results were achieved, and there were no statistically significant differences. The R2 value for upper teeth (54.0%) was higher than the R2 value for lower teeth (45.7%). The highest intraclass correlation coefficient value was 0.995 (0.993-0.997) and the lowest 0.798 (0.545-0.895). Inter-examiner agreement was high with values of 0.975 (0.965-0.983) and 0.927 (0.879-0.955). This method is adequate for assessing age in missing and unidentified people, including victims of mass disasters.

Age Estimation Using the Pulp-to-Tooth Area Ratio in an Indian Population Using Cone-Beam Computerised Tomography (CBCT): A Retrospective Study.

BACKGROUND: Age estimation, whether for living or deceased individuals, is crucial in forensic sciences. Traditionally, the pulp-to-tooth area ratio determined from periapical radiographs has been employed as a non-invasive method for estimating age. Cone-beam computed tomography (CBCT) represents a newer technique, providing three-dimensional images of teeth in living individuals. AIM: This study aims to estimate age using the pulp-to-tooth area ratio of four teeth (the permanent maxillary central incisor, lateral incisor, canine, and first premolar. STUDY DESIGN: The study included ninety subjects ranging in age from 18 to 70 years. CONCLUSION: This study concluded that the correlation between actual age and estimated age varied across different tooth types. There was a strong positive correlation between the maxillary right central incisor and maxillary right canine tooth, while the maxillary left canine tooth exhibited a slightly weaker but still positive correlation. This indicates that the maxillary right central incisor and maxillary right canine tooth are the most reliable for estimating age. Additionally, the study found that the linear regression results for estimating age based on the pulp-to-tooth area ratio, categorised by sex and each type of tooth, showed strong associations between age and the ratio for the maxillary left central incisor and maxillary left canine teeth in males, and for the maxillary left central incisor in females.

Comparing the pulp/tooth area ratio and dentin thickness of mandibular first molars in different age groups: A cone-beam computed tomography study.

CONTEXT: Mandibular first molar frequently requires endodontic treatment. Understanding age-related changes in pulp-dentin complex and root canal morphologies is essential for successful endodontic and restorative treatments. AIM: This study aimed to compare pulp/tooth area ratio (PTAR) and dentin thickness (DT) in mandibular first molars in different age groups through cone-beam computed tomography (CBCT) imaging. SUBJECTS AND METHODS: One hundred CBCT images of mandibular first molar were divided into five groups; age 20-29, 30-39, 40-49, 50-59, and 60 years old and older. Axial images were used to determine PTAR at Level A (furcation), Level B (between Levels A and C), and Level C (half distance between the furcation and apex of the root). The minimum DT of the distal wall of mesiobuccal (MB) and mesiolingual (MLi) canal and mesial wall of distal canal at 2 and 3 mm under the furcation was measured. STATISTICAL ANALYSIS USED: Analysis of variance was used to determine differences among age groups. RESULTS: PTAR was determined to reduce as age increases, showing a significant difference among the age groups at Levels A, B, and C of both roots (P < 0.05). The minimum DT was found to increase with age, demonstrating a significant difference among the age groups of MB and MLi canal at 2 and 3 mm (P < 0.05). No statistically significant difference was observed in the mesial DT of distal canal. CONCLUSIONS: The reduction of PTAR and the increasing DT were confirmed with advanced age.

Digitized Morphometric Analysis using Maxillary Canine and Mandibular First Molar for Age Estimation in South Indian Population.

BACKGROUND: In recent years, the estimation of age in living individuals have become important to solve judicial or civil problems. Secondary dentin deposition occurs as the age advances and can be measured by calculating the reduction in pulp chamber through Noninvasive radiograph techniques. AIM: The aim is to derive precise population specific formulae for age estimation. MATERIALS AND METHODS: Digitalized Orthopantomography of 150 subjects, was retrieved. The subjects were divided into study and test group. Pulp tooth area ratio was recorded from the maxillary canine and pulp chamber crown root trunk height ratio was recorded from a mandibular first molar. STATISTICAL ANALYSIS: Regression equation was derived from study group subjects and this equation was used to estimate the age of subjects in the test group. RESULTS: No significant differences were seen between mean chronological age and mean estimated age (p-value- 0.157). Mean Absolute Error (MAE) was estimated to be 2.76 years. The percentage of estimated ages in test sample < ± MAE was 72%. The difference was higher in the group I and II (p-value- 0.001 and 0.002). CONCLUSION: The equation derived from the anterior and posterior teeth together gave more accurate results in the present study. The prediction accuracy can further be enhanced by using multiple teeth or by utilizing other linear measurements in the same teeth.

Age estimation using exfoliative cytology and radiovisiography: A comparative study.

INTRODUCTION: Age estimation is one of the essential factors in establishing the identity of an individual. Among various methods, exfoliative cytology (EC) is a unique, noninvasive technique, involving simple, and pain-free collection of intact cells from the oral cavity for microscopic examination. OBJECTIVE: The study was undertaken with an aim to estimate the age of an individual from the average cell size of their buccal smears calculated using image analysis morphometric software and the pulp-tooth area ratio in mandibular canine of the same individual using radiovisiography (RVG). MATERIALS AND METHODS: Buccal smears were collected from 100 apparently healthy individuals. After fixation in 95% alcohol, the smears were stained using Papanicolaou stain. The average cell size was measured using image analysis software (Image-Pro Insight 8.0). The RVG images of mandibular canines were obtained, pulp and tooth areas were traced using AutoCAD 2010 software, and area ratio was calculated. The estimated age was then calculated using regression analysis. RESULTS: The paired t-test between chronological age and estimated age by cell size and pulp-tooth area ratio was statistically nonsignificant (P > 0.05). CONCLUSION: In the present study, age estimated by pulp-tooth area ratio and EC yielded good results.

Age assessment in canine and premolar by cervical axial sections of cone-beam computed tomography.

Age estimation in adults is a challenge in both anthropological and forensic situations compared to sub-adults age estimation. The present study explored, for the first time, the cervical zone of single rooted teeth. The deposition of secondary dentin is responsible for a decrease in the volume of the dental pulp cavity with aging, and therefore is often used as an age indicator. The current study aimed at estimating the chronological age among adults by measuring the pulp/dentin area ratio (physiological ratio) by axial sections at cervical region of maxillary canine and mandibular second premolar. The sample consisted of 120 cone beam CT images of 120 Tunisians whose age ranged from 22 to 67, from the database of a private clinic of radiology. The first axial section of chosen teeth without enamel was selected. Linear regression models were derived for canine, premolar and for all variables to predict the age. They indicated that dentin deposition on canine and premolar have almost the same correlation with age (r=-0.838 and -0.837 respectively). The residual standard errors (RSE), when these regression equations applied for the entire sample, were ranged between 8.27, 8.29 and 7.06 for canine, premolar and for all variables respectively. Tested for younger ages (from 22 to 44years) the RSE decreased considerably and thus ranged between 4.32, 4.72 and 4.05. The outcomes of this study show that the physiological ratio is a useful variable for assessing age with a satisfying accuracy.

On the relationship between enamel band complexity and occlusal surface area in Equids (Mammalia, Perissodactyla).

Enamel patterns on the occlusal surfaces of equid teeth are asserted to have tribal-level differences. The most notable example compares the Equini and Hipparionini, where Equini have higher crowned teeth with less enamel-band complexity and less total occlusal enamel than Hipparionini. Whereas previous work has successfully quantified differences in enamel band shape by dividing the length of enamel band by the square root of the occlusal surface area (Occlusal Enamel Index, OEI), it was clear that OEI only partially removes the effect of body size. Because enamel band length scales allometrically, body size still has an influence on OEI, with larger individuals having relatively longer enamel bands than smaller individuals. Fractal dimensionality (D) can be scaled to any level, so we have used it to quantify occlusal enamel complexity in a way that allows us to get at an accurate representation of the relationship between complexity and body size. To test the hypothesis of tribal-level complexity differences between Equini and Hipparionini, we digitally traced a sample of 98 teeth, one tooth per individual; 31 Hipparionini and 67 Equini. We restricted our sampling to the P3-M2 to reduce the effect of tooth position. After calculating the D of these teeth with the fractal box method which uses the number of boxes of various sizes to calculate the D of a line, we performed a t-test on the individual values of D for each specimen, comparing the means between the two tribes, and a phylogenetically informed generalized least squares regression (PGLS) for each tribe with occlusal surface area as the independent variable and D as the dependent variable. The slopes of both PGLS analyses were compared using a t-test to determine if the same linear relationship existed between the two tribes. The t-test between tribes was significant (p < 0.0001), suggesting different D populations for each lineage. The PGLS for Hipparionini was a positive but not significant (p = 0.4912) relationship between D and occlusal surface area, but the relationship for Equini was significantly negative (p = 0.0177). λ was 0 for both tests, indicating no important phylogenetic signal is present in the relationship between these two characters, thus the PGLS collapses down to a non-phylogenetic generalized least squares (GLS) model. The t-test comparing the slopes of the regressions was not significant, indicating that the two lineages could have the same relationship between D and occlusal surface area. Our results suggest that the two tribes have the same negative relationship between D and occlusal surface area but the Hipparionini are offset to higher values than the Equini. This offset reflects the divergence between the two lineages since their last common ancestor and may have constrained their ability to respond to environmental change over the Neogene, leading to the differential survival of the Equini.

Age estimation by pulp-to-tooth area ratio using cone-beam computed tomography: A preliminary analysis.

BACKGROUND: Age estimation of living or deceased individuals is an important aspect of forensic sciences. Conventionally, pulp-to-tooth area ratio (PTR) measured from periapical radiographs have been utilized as a nondestructive method of age estimation. Cone-beam computed tomography (CBCT) is a new method to acquire three-dimensional images of the teeth in living individuals. AIMS: The present study investigated age estimation based on PTR of the maxillary canines measured in three planes obtained from CBCT image data. SETTINGS AND DESIGN: Sixty subjects aged 20-85 years were included in the study. MATERIALS AND METHODS: For each tooth, mid-sagittal, mid-coronal, and three axial sections-cementoenamel junction (CEJ), one-fourth root level from CEJ, and mid-root-were assessed. PTR was calculated using AutoCAD software after outlining the pulp and tooth. STATISTICAL ANALYSIS USED: All statistical analyses were performed using an SPSS 17.0 software program. RESULTS AND CONCLUSIONS: Linear regression analysis showed that only PTR in axial plane at CEJ had significant age correlation (r = 0.32; P < 0.05). This is probably because of clearer demarcation of pulp and tooth outline at this level.

Estimación de edad mediante la relación área pulpa/diente en caninos mandibulares: estudio en una muestra chilena utilizando el Método de Cameriere / Dental age estimation by pulp/tooth ratio in mandibular canines: study in a Chilean sample by Camerierer's Method

La estimación de edad compone un aspecto importante en investigaciones forenses. Diferentes métodos se han descrito en odontología forense basadas en la correlación entre la edad y estructuras dentales. Cameriere et al. proponen un método cuantitativo para estimación de edad en adultos, a partir de la evaluación de la relación del área pulpa/diente, en base a la aposición de dentina secundaria. El objetivo del estudio fue desarrollar modelos de regresión para la estimación de edad dental mediante la relación área pulpa/diente en caninos inferiores en una muestra Chilena. Se analizaron 212 radiografías periapicales digitales (RPD) (86 hombres y 126 mujeres) de caninos mandibulares mediante el programa Image J para establecer el área de la pulpa y el diente. Se registraron los datos de sexo y edad de las RPD seleccionadas en forma ciega. Fueron desarrollados modelos de regresión lineal simples para la estimación de edad. El coeficiente de determinación para R33 fue 27,8 % y de 29,6 % para R44, con un error absoluto medio de 11,02 años y 10,37 años respectivamente. El análisis de ANOVA no mostró diferencias estadísticamente significativas para las relaciones área pulpa/diente de caninos según sexo (p> 0,05). Según los resultados obtenidos, la metodología propuesta por Cameriere et al. es fiable para estimar la edad dental mediante la relación área pulpa/diente en adultos. Sin embargo, en los modelos de regresión desarrollados para la población Chilena, se puede afirmar que el ajuste indicado por los coeficientes de determinación muestran incerteza entre las variables área pulpa/diente y edad cronológica en caninos inferiores, por lo tanto se sugiere considerar otros métodos adicionales para estimar edad en esta población.

Age estimation is an important aspect In forensic investigations. Different methods in forensic odontology based on the correlation between age estimation in adults, from the analysis of the pulp/tooth area, based on the apposition of secondary dentine. The aim of the study was to develop regression models for the dental age estimation by the relation pulp/tooth area, in lower canines in a Chilean sample, using digital peri-apical radiographs (DPR) applying Cameriere's method. We analyzed 212 DPR (86 males and 126 females) mandibular canines through Image J program to measure the pulp/tooth area. Age and sex information was obtained of the DPR's blindly selected. We developed simple linear regression models for age estimation. The coefficient of determination to R33 was R2 age and dental structures have been described. Cameriere et al. proposed a quantitative method for 27.8 % and R2 29.6 % to R44, with a mean absolute error of 11.02 years, to R33 and 10.37 years to R44. ANOVA analysis showed no statistically significant differences for the pulp/tooth relation area of canines according to sex (p> 0.05). According to the results, the Cameriere's et al., method is reliable for dental age estimation according to pulp/tooth ratio in adults. However, in the regression models developed for Chilean population, it can be stated that the adjustment indicated by the coefficients of determination, show uncertainty between the pulp / tooth area and chronological age in lower canines, therefore it is suggested to use additional estimation methods for age in this population.

Age estimation using pulp/tooth area ratio in maxillary canines-A digital image analysis.

INTRODUCTION: Determination of age of a subject is one of the most important aspects of medico-legal cases and anthropological research. Radiographs can be used to indirectly measure the rate of secondary dentine deposition which is depicted by reduction in the pulp area. MATERIALS AND METHODS: In this study, 200 patients of Karnataka aged between 18-72 years were selected for the study. Panoramic radiographs were made and indirectly digitized. Radiographic images of maxillary canines (RIC) were processed using a computer-aided drafting program (ImageJ). The variables pulp/root length (p), pulp/tooth length (r), pulp/root width at enamel-cementum junction (ECJ) level (a), pulp/root width at mid-root level (c), pulp/root width at midpoint level between ECJ level and mid-root level (b) and pulp/tooth area ratio (AR) were recorded. All the morphological variables including gender were statistically analyzed to derive regression equation for estimation of age. RESULTS: It was observed that 2 variables 'AR' and 'b' contributed significantly to the fit and were included in the regression model, yielding the formula: Age = 87.305-480.455(AR)+48.108(b). Statistical analysis indicated that the regression equation with selected variables explained 96% of total variance with the median of the residuals of 0.1614 years and standard error of estimate of 3.0186 years. CONCLUSION: There is significant correlation between age and morphological variables 'AR' and 'b' and the derived population specific regression equation can be potentially used for estimation of chronological age of individuals of Karnataka origin.

Accuracy and reliability of pulp/tooth area ratio in upper canines by peri-apical X-rays.

Due to the real need for careful staff training in age assessment, in order to improve capacity, consistency and competence, new research on the reliability and repeatability of methods frequently used in age assessment are required. The aim of this study was twofold: first, to test the accuracy of this method for age estimation; second, to obtain data on the reliability of this technique. A sample of 81 peri-apical radiographs of upper canines (44 men and 37 women), aged between 19 and 74years, was used; the teeth were taken from the osteological collection of Sassari (Sardinia, Italy). Three blinded observers used the technique in order to perform the age estimation. The mean real age of the 81 observations was 37.21 (CI95% 34.37 40.05), and estimated ages ranged from 36.65 to 38.99 (CI95%-Ex1 35.42; 41.28; CI95%-Ex2 33.89; 39.41; CI95%-Ex3 35.92; 42.06). The module differences found by the three observers were 3.43, 4.24 and 4.45, respectively for Ex1×Ex2, Ex1×Ex3 and Ex2×Ex3. The module differences observed among real and observed ages were 2.55 (CI95% 1.90; 3.20), 2.22 (CI95% 1.65; 2.78) and 4.39 (CI95% 3.80; 5.75), respectively for Ex1, Ex2 and Ex3. No differences were observed among measurements. This technique can be reproduced and repeated after proper training, since it was found high reliability and accuracy.

Age estimation by using dental radiographs.

BACKGROUND: Estimation of age is important in forensic sciences as a way to establish the identity of human remains. Of the various parts of the body used in age estimation, teeth are the least affected by the taphonomic process. Their durability means that they are sometimes the only body part available for study. Several methods of age estimation have been studied using bone and teeth, and among them, tooth wear and apposition of secondary dentine are the currently available non-destructive methods. OBJECTIVES: The purpose of the study was to determine the age of adults by using Kvaal's method as well as to establish the relationship of chronological age and dental age with its reliability and limitations on digital panoramic radiographs. MATERIALS AND METHODS: The present study was based on panoramic radiographs that consisted of two groups. One hundred orthopantomographs with Kvaal's criteria (Group A) and 50 orthopantomographs without Kvaal's criteria (Group B) were included. Various parameters were measured and the result was analyzed by means of SPSS-12.0 program statistical data. RESULT AND CONCLUSION: On the basis of Kvaal's criteria, the difference between chronological age and real age was 8.3 years. This suggests that the accuracy of this method depends on the precision of measurements and quality and number of the orthopantomographs.