Reliability and limitations of permanent tooth staging techniques.

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.

A radiographic study estimating age of mandibular third molars by periodontal ligament visibility.

BACKGROUND: Visibility of the periodontal ligament of mandibular third molars (M3) has been suggested as a method to estimate age. AIM: To assess the accuracy of this method and compare the visibility of the periodontal ligament in the left M3 with the right M3. The sample was archived panoramic dental radiographs of 163 individuals (75 males, 88 females, age 16-53 years) with mature M3's. MATERIALS AND METHODS: Reliability was assessed using Kappa. Accuracy was assessed by subtracting chronological age from estimated age for males and females. Stages were cross-tabulated against age stages younger than and at least 18 and 21 years of age. Stages were compared in the left M3 and right M3. RESULTS: Analysis showed excellent intra-observer reliability. Mean difference between estimated and chronological ages was 7.21 years (SD 5.16) for left M3 and 7.69 (SD 6.08) for right M3 in males and 6.87 (SD 5.83) for left M3 and 8.61 (SD 6.58) for right M3 in females. Minimum ages of stages 0 to 2 were younger than previously reported, despite a small sample of individuals younger than 18. The left and right M3 stage differed in 46% of the 85 individuals with readings from both side and estimated age differed from -10.5 to 12.2 years between left and right. CONCLUSION: Accuracy of this method was between 6 and 8 years with an error of 5 to 6 years. The number of individuals with mature M3 apices younger than 18 years was small. The stage of visibility of the periodontal ligament differed between left and right in almost half of our sample with both teeth present. Our findings question the use of this method to estimate age or to discriminate between age younger and at least 18 years.

A radiographic study of the mandibular third molar root development in different ethnic groups.

BACKGROUND: The nature of differences in the timing of tooth formation between ethnic groups is important when estimating age. AIM: To calculate age of transition of the mandibular third (M3) molar tooth stages from archived dental radiographs from sub-Saharan Africa, Malaysia, Japan and two groups from London UK (Whites and Bangladeshi). MATERIALS AND METHODS: The number of radiographs was 4555 (2028 males, 2527 females) with an age range 10-25 years. The left M3 was staged into Moorrees stages. A probit model was fitted to calculate mean ages for transitions between stages for males and females and each ethnic group separately. The estimated age distributions given each M3 stage was calculated. To assess differences in timing of M3 between ethnic groups, three models were proposed: a separate model for each ethnic group, a joint model and a third model combining some aspects across groups. The best model fit was tested using Bayesian and Akaikes information criteria (BIC and AIC) and log likelihood ratio test. RESULTS: Differences in mean ages of M3 root stages were found between ethnic groups, however all groups showed large standard deviation values. The AIC and log likelihood ratio test indicated that a separate model for each ethnic group was best. Small differences were also noted between timing of M3 between males and females, with the exception of the Malaysian group. These findings suggests that features of a reference data set (wide age range and uniform age distribution) and a Bayesian statistical approach are more important than population specific convenience samples to estimate age of an individual using M3. CONCLUSION: Some group differences were evident in M3 timing, however, this has some impact on the confidence interval of estimated age in females and little impact in males because of the large variation in age.

Accuracy of dental age estimation charts: Schour and Massler, Ubelaker and the London Atlas.

Dental age estimation charts are frequently used to assess maturity and estimate age. The aim of this study was to assess the accuracy of estimating age of three dental development charts (Schour and Massler, Ubelaker, and the London Atlas). The test sample was skeletal remains and dental radiographs of known-age individuals (N = 1,506, prenatal to 23.94 years). Dental age was estimated using charts of Schour and Massler, Ubelaker, and The London Atlas. Dental and chronological ages were compared using a paired t-test for the three methods. The absolute mean difference between dental and chronological age was calculated. Results show that all three methods under-estimated age but the London Atlas performed better than Schour and Massler and Ubelaker in all measures. The mean difference for Schour and Massler and Ubelaker was -0.76 and -0.80 years (SD 1.27 year, N = 1,227) respectively and for the London Atlas was -0.10 year (SD 0.97 year, N = 1,429). Further analysis by age category showed similar accuracy for all three methods for individuals younger than 1 year. For ages 1-18, the mean difference between dental and chronological ages was significant (P < 0.05) for Schour and Massler and Ubelaker and not significant (P > 0.05) for the London Atlas for most age categories. These findings show that the London Atlas performs better than Schour and Massler and Ubelaker and represents a substantial improvement in accuracy of dental age estimation from developing teeth.

Estimating age and the likelihood of having attained 18 years of age using mandibular third molars.

OBJECTIVE: Age estimation methods using mandibular third molar (M3) root formation were tested. Diagnostic accuracy of M3 to predict age 18 was tested. DESIGN: Methods were tested on a target sample of 300 dental panoramic radiographs (age 11-25). Diagnostic accuracy was assessed on separate reference data (n = 1,663, age 9-25). Root stage was the diagnostic test predicting 18 years of age. METHODS: Root stage of M3 was assessed and age estimated (n = 157) using published methods that use Demirjian or Moorrees root stages. The difference between dental and known ages was assessed. Diagnostic tests and likelihood ratios were calculated for reference data. MAIN OUTCOME MEASURE: Mean difference (bias), standard deviation and absolute mean difference between dental age and known ages. Likelihood ratio of age 18, given M3 root stage. RESULTS: Only six of 37 methods estimated age with bias not significant to zero. Mean absolute difference between dental and known age for these methods ranged from 1.45 to 1.97 years. Standard deviation of bias for all methods was around 2 years and 95% confidence interval of estimated age is ± 4 years. The best methods using Demirjian and Moorrees stages are detailed. Likelihood ratio of being at least 18 if M3 was mature was 13.61. If M3 was 'A1/2' (apex half closed) or mature, on the balance of probabilities, estimated age was at least 18. CONCLUSION: Most methods using M3 root formation estimate age with significant bias. If M3 is mature, age 18 is more than likely attained.

Willems II. Non-gender-specific dental maturity scores.

Demirjian's dental maturity scoring system has been adapted for a Belgian Caucasian population for males and females. The purpose of this study was to adapt Demirjian's dental maturity scoring system from a Belgian Caucasian population to provide non-gender-specific scores. We selected 2116 orthopantomograms of 1029 boys and 1087 girls aged 3-16 years. A weighted ANOVA was performed in order to adapt the scoring system for this Belgian population. A second test sample of 273 orthopantomograms of individuals with immature dentitions aged 3-16 years was used to evaluate the accuracy of the original method, gender-specific scores and non-gender-specific scores of the adapted method. Mean/median difference between dental age and real age was calculated as well as other measures of accuracy. 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.

Brief communication: The London atlas of human tooth development and eruption.

The aim of this study was to develop a comprehensive evidence-based atlas to estimate age using both tooth development and alveolar eruption for human individuals between 28 weeks in utero and 23 years. This was a cross-sectional, retrospective study of archived material with the sample aged 2 years and older having a uniform age and sex distribution. Developing teeth from 72 prenatal and 104 postnatal skeletal remains of known age-at-death were examined from collections held at the Royal College of Surgeons of England and the Natural History Museum, London, UK (M 91, F 72, unknown sex 13). Data were also collected from dental radiographs of living individuals (M 264, F 264). Median stage for tooth development and eruption for all age categories was used to construct the atlas. Tooth development was determined according to Moorrees et al. (J Dent Res 42 (1963a) 490-502; Am J Phys Anthropol 21 (1963b) 205-213) and eruption was assessed relative to the alveolar bone level. Intraexaminer reproducibility calculated using Kappa on 150 teeth was 0.90 for 15 skeletal remains of age <2 years, and 0.81 from 605 teeth (50 radiographs). Age categories were monthly in the last trimester, 2 weeks perinatally, 3-month intervals during the first year, and at every year thereafter. Results show that tooth formation is least variable in infancy and most variable after the age of 16 years for the development of the third molar.

Interpreting group differences using Demirjian's dental maturity method.

Although Demirjian's method is designed to assess dental maturity at the individual level, significant differences between average dental age and real age for groups have been interpreted as population differences. The aim of this study was to describe the variation in maturity score for age and age for maturity score from a large collaborative database of children and discuss methods adapted for groups in light of this. Tooth stages from radiographs of 4710 males and 4661 females (age 2-18) were used and dental maturity scores calculated using Demirjian and Goldstein. The mean, standard deviation, standard error and 95% confidence intervals of maturity score by age group (6 and 12 months groups) and age by maturity score (5 points) groups were calculated. Adapted maturity curves from 13 published studies of boys from Europe, Middle East, Africa, India, China and South America were compared to the database. Most adapted curves at the 50th percentile from world regions fell within the 95% confidence intervals. Those that did not, were hampered by small sample size or poorly fitting curves. This is complicates by the inclusion of mature individuals. Few studies adapting Demirjian's method provide sufficient or appropriate statistics to compare maturation of individual teeth. The wide 95% confidence intervals for maturity score by age, age by maturity score, age of individual tooth stages and large number of sequences suggest that the significant differences in dental maturity score do not reflect any biological difference in the timing of tooth formation stages at the population level. Demirjian's dental maturity method is inappropriate to assess population differences in dental maturity and adapting scores for age or age for scores for different groups of children is probably unnecessary.

Timing of human mandibular third molar formation.

BACKGROUND: Population differences in tooth formation using radiographs can be determined if the entire developmental sequence of a single tooth is studied. The only developing tooth visible radiographically from initiation to root completion is the third molar or wisdom tooth. AIM: The timing of mandibular third molar formation was documented for two groups of children in England and two in South Africa. SUBJECTS AND METHODS: Panoramic radiographs of White and Bangladeshi children from London and Black African and Cape Coloured children from South Africa were examined (age 5-24). Mean age of entering third molar stages (crypt appearance to root completion) was calculated using logistic regression and compared between sex and group using a t-test. RESULTS: Average age of third molar stages was significantly (p < 0.001) later in three groups for almost all stages of the third molar compared to Black children. The average age of entering initial mineralization ranged from 7.97 to 9.74 years while average age of apex closed was 19.27-20.88. CONCLUSION: These results show for the first time a significant difference in the timing of maturation of the mandibular third molar between groups with South African Black children being earlier than other groups.

Accuracy of age estimation in children using radiograph of developing teeth.

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).

Timing of Demirjian's tooth formation stages.

BACKGROUND: Global differences in Demirjian et al.'s method of assessing dental maturity are thought to be due to population differences. AIM: The aim of this study was to investigate the timing of individual tooth formation stages in children from eight countries. RESEARCH DESIGN: This was a meta-analysis of previously published data from retrospective cross-sectional studies of dental maturity. METHOD: Data of mandibular permanent developing teeth from panoramic radiographs (Demirjian's stages) were combined from Australia, Belgium, Canada, England, Finland, France, South Korea and Sweden (n = 9002, ages 2-16.99 years). Age-of-attainment was calculated using logistic regression for each group by sex and meta-analysis of the total. Overlapping 95% confidence intervals of the means was interpreted as no significant difference. RESULTS: Mean ages for each group and total were significantly different in 65 out of 509 comparisons (p < 0.05). Some of these were of small sample size but there was no consistent pattern. Apex closure of the first molar was significantly later in children from Quebec and this might explain differences found in the dental maturity score. CONCLUSIONS: These results suggest no major differences in the timing of tooth formation stages between these children. This fails to explain previous findings of differences using Demirjian's dental maturity method.

Accuracy of age estimation of radiographic methods using developing teeth.

Developing teeth are used to assess maturity and estimate age in a number of disciplines, however the accuracy of different methods has not been systematically investigated. The aim of this study was to determine the accuracy of several methods. Tooth formation was assessed from radiographs of healthy children attending a dental teaching hospital. The sample was 946 children (491 boys, 455 girls, aged 3-16.99 years) with similar number of children from Bangladeshi and British Caucasian ethnic origin. Panoramic radiographs were examined and seven mandibular teeth staged according to Demirjian's dental maturity scale [A. Demirjian, Dental development, CD-ROM, Silver Platter Education, University of Montreal, Montreal, 1993-1994; A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45 (1973) 211-227; A. Demirjian, H. Goldstein, New systems for dental maturity based on seven and four teeth, Ann. Hum. Biol. 3 (1976) 411-421], Nolla [C.M. Nolla, The development of the permanent teeth, J. Dent. Child. 27 (1960) 254-266] and Haavikko [K. Haavikko, The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study. Proc. Finn. Dent. Soc. 66 (1970) 103-170]. Dental age was calculated for each method, including an adaptation of Demirjian's method with updated scoring [G. Willems, A. Van Olmen, B. Spiessens, C. Carels, Dental age estimation in Belgian children: Demirjian's technique revisited, J. Forensic Sci. 46 (2001) 893-895]. The mean difference (+/-S.D. in years) between dental and real age was calculated for each method and in the case of Haavikko, each tooth type; and tested using t-test. Mean difference was also calculated for the age group 3-13.99 years for Haavikko (mean and individual teeth). Results show that the most accurate method was by Willems [G. Willems, A. Van Olmen, B. Spiessens, C. Carels, Dental age estimation in Belgian children: Demirjian's technique revisited, J. Forensic Sci. 46 (2001) 893-895] (boys -0.05+/-0.81, girls -0.20+/-0.89, both -0.12 y+/-0.85), Demirjian [A. Demirjian, Dental development, CD-ROM, Silver Platter Education, University of Montreal, Montreal, 1993-1994] overestimated age (boys 0.25+/-0.84, girls 0.23+/-0.84, both 0.24 y+/-0.86), while Nolla [C.M. Nolla, The development of the permanent teeth, J. Dent. Child. 27 (1960) 254-266] and Haavikko's [K. Haavikko, The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study, Proc. Finn. Dent. Soc. 66 (1970) 103-170] methods under-estimated age (boys -0.87+/-0.87, girls -1.18+/-0.96, both -1.02 y+/-0.93; boys -0.56+/-0.91, girls -0.79+/-1.11, both -0.67 y+/-1.01, respectively). For individual teeth using Haavikko's method, first premolar and second molar were most accurate; and more accurate than the mean value of all developing teeth. The 95% confidence interval of the mean was least for mean of all developing teeth using Haavikko (age 3-13.99 years), followed by identical values for Demirjian and Willems (sexes combined).

Reproducibility of radiographic stage assessment of third molars.

UNLABELLED: The aim of this study was to determine intra- and inter-observer variability of the developing third molar from panoramic radiographs. Formation of third molars was assessed according to stages described by modified Demirjian et al.'s methods: Moorrees et al. [C.F.A. Moorrees, E.A. Fanning, E.E. Hunt, Age variation of formation stages for ten permanent teeth, J. Dent. Res. 42 (1963) 1490-1502] and Solari and Abramovitch [A.C. Solari, K. Abramovitch, The accuracy and precision of third molar development as an indicator of chronological age in Hispanics, J. Forensic Sci. 47 (2002) 531-535]; in addition, data were also analysed unmodified, i.e. Haavikko [K. Haavikko, The formation and alveolar and clinical eruption of the permanent teeth, an orthopantomograph study, Proc. Finn. Dent. Soc. 66 (1970) 104-170] and Demirjian et al. [A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45 (1973) 211-227]. The sample was a random selection of 73 panoramic radiographs from patients aged 8-24 years. After training, the left maxillary and mandibular third molars were scored on two separate occasions without knowledge of previous scores. Cohen's Kappa and percentage agreement were calculated for each method, for maxillary, for mandibular third molars and combined. Percentage agreement for stages was also calculated. Intra-observer agreement was greater for mandibular third molars compared to maxillary third molars, and better for methods with fewer stages. Kappa values indicated good agreement for most methods; the best was Demirjian et al.'s method for mandibular third molar with very good agreement (K = 0.80) for the first author, good agreement for the second author (K = 0.75) and good agreement between observers (K = 0.75). The stages with best agreement were Demirjian's stage E [A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45 (1973) 211-227] and Moorrees et al.'s stage Cc and R1/4 [C.F.A. Moorrees, E.A. Fanning, E.E. Hunt, Age variation of formation stages for ten permanent teeth, J. Dent. Res. 42 (1963) 1490-1502]. CONCLUSIONS: Having clearly defined stages and fewer stages allowed better reproducibility of third molar formation.

A radiographic study of tooth development in hypodontia.

OBJECTIVE: To investigate the radiographic development of permanent teeth in a group of children (66 females and 69 males, aged 3.08-15.02 years) with agenesis of one or more permanent teeth compared to a matched group. DESIGN: Tooth formation of all developing permanent teeth was assessed using Haavikko's method (1970) from dental panoramic tomographs. The difference between dental and chronological age was tested using a paired t-test. The correlation between the difference of dental and chronological age and severity of hypodontia was investigated using Spearman correlation test. In addition, radiographs of all children with only one single missing tooth in one quadrant and no more than two agenesis in total (N=59), were analyzed using the non-parametric Wilcoxon sign test, in order to investigate if the development of the teeth adjacent to the site of the agenesis was effected. RESULTS: Tooth formation in children with hypodontia was significantly delayed compared to the matched group (p<0.001). The mean difference was 1.51 years (S.D. 1.37 years). The severity of the hypodontia effected the magnitude of the delay (p<0.01). The teeth adjacent to the site of the agenesis were significantly delayed compared to the corresponding teeth in the matched group (p<0.01). CONCLUSION: These results confirm that the development of permanent teeth in children with hypodontia is different when compared with a matched group.

Epidermolysis bullosa and dental developmental age.

OBJECTIVES: The dental development of permanent mandibular teeth in a small group of children with dystrophic epidermolysis bullosa (DEB) was assessed from radiographs and compared to a healthy, age-and-sex-matched control group. METHODS: This was a retrospective radiographic cross-sectional study. The sample consisted of a group of 44 children aged between 4 and 15 years with DEB and healthy, age-and-sex-matched controls. Two quantitative methods of assessing tooth formation were used: (1) a combination of information about tooth length and apex width; and (2) the use of tooth length to predict age. Panoramic radiographs were digitized in order to determine tooth length and apex width. Dental age was calculated, and the difference with real age was tested with Student's t-test. RESULTS: The dentition of both the DEB and control groups was slightly delayed. Using the first method, the delay was 0.34 +/- 0.87 years for the DEB group and 0.29 +/- 0.97 years for the control group. Using the second method, the delay was 0.49 +/- 1.18 years for the DEB group and 0.23 +/- 0.62 years for the control group. This delay was not statistically significant for either method. CONCLUSIONS: The dental formation of permanent mandibular teeth in the group of children with DEB was not significantly different to that found in the control group.

Variation in crown and root formation and eruption of human deciduous teeth.

The aim of this study was to document variation of deciduous tooth formation and eruption. The material comprises 121 individuals of known or estimated age (using tooth length) from Spitalfields in London, and radiographs of 61 healthy living children aged 2-5 years. Other skeletal material from two medieval Scottish archaeological sites (Whithorn, N=74; Newark Bay, N=59) was also examined. Stages of crown and root formation as well as eruption (alveolar, midway, and occlusal levels) were assessed for each developing maxillary and mandibular tooth from radiographs or direct vision. Age of attainment for individual stages was calculated by probit analysis, and these data were also adapted for use in estimating age. The timing of crown completion was similar to previously reported studies, but apex completion times were later. Analysis of data relative to the first and second molars at the two stages D (crown complete) and F (root length > or =crown height) allowed comparison with the Scottish material. No significant differences were observed between population groups for tooth formation or eruption. These data fill several gaps in the literature, and will be useful in assessing maturity and predicting age during early childhood.

The accuracy of three methods of age estimation using radiographic measurements of developing teeth.

The accuracy of age estimation using three quantitative methods of developing permanent teeth was investigated. These were Mörnstad et al. [Scand. J. Dent. Res. 102 (1994) 137], Liversidge and Molleson [J. For. Sci. 44 (1999) 917] and Carels et al. [J. Biol. Bucc. 19 (1991) 297]. The sample consisted of 145 white Caucasian children (75 girls, 70 boys) aged between 8 and 13 years. Tooth length and apex width of mandibular canine, premolars and first and second molars were measured from orthopantomographs using a digitiser. These data were substituted into equations from the three methods and estimated age was calculated and compared to chronological age. Age was under-estimated in boys and girls using all the three methods; the mean difference between chronological and estimated ages for method I was -0.83 (standard deviation +/-0.96) years for boys and -0.67 (+/-0.76) years for girls; method II -0.79 (+/-0.93) and -0.63 (+/-0.92); method III -1.03 (+/-1.48) and -1.35 (+/-1.11) for boys and girls, respectively. Further analysis of age cohorts, found the most accurate method to be method I for the age group 8.00-8.99 years where age could be predicted to 0.14+/-0.44 years (boys) and 0.10+/-0.32 years (girls). Accuracy was greater for younger children compared to older children and this decreased with age.

Growth of permanent mandibular teeth of British children aged 4 to 9 years.

PRIMARY OBJECTIVE: The aim of this study was to investigate ethnic differences and describe tooth formation of mandibular permanent teeth in a group of London children. RESEARCH DESIGN: The design was cross-sectional retrospective study. SAMPLE AND METHOD: The sample was a non-random group of healthy British children (n = 521) attending a dental hospital. The children aged between 4 and 9 years were of Bangladeshi or white Caucasian origin. Developing permanent mandibular teeth were staged from radiographs according to criteria described by Demirjian, Goldstein and Tanner (1973, Human Biology, 45, 211-227). Data were grouped in 6-month intervals and analysed using probit analysis. Formation was also expressed relative to stages of the first permanent molar (M1) and the distribution of stages tested between the groups and sexes using Mann Whitney U-test. RESULTS: Tooth formation was not significantly different between the two ethnic groups. Girls attained almost all stages of tooth formation earlier than boys; in addition, the canine showed significant advancement relative to M1 formation in girls (p < 0.05). CONCLUSIONS: These findings failed to demonstrate an ethnic difference in tooth formation in these children.

Crown formation times of human permanent anterior teeth.

One gap in knowledge of human dental-growth standards is the age at which crown fractions of anterior permanent teeth are attained. The aim of this study was to document stages of crown formation for permanent incisors and canines from a small skeletal collection of known age. The source was C18th and C19th coffin-buried skeletal material from Spitalfields in London; developing teeth from 50 individuals with recorded age-at-death (range 0-5.40 years) and 56 unaged individuals were assessed. Teeth were dissected and crown height measured directly. Each developing crown was assigned to the nearest average fraction (C14, C12, C34, Cc). These fractions were calculated from the total crown height of unworn completed teeth from this sample. Median age for C12 of the permanent upper central incisor was 1.34 years (n=16) and for the canine was 2.52 years (n=16). Data on crown formation are also presented in relation to permanent lower first molar stages C12, C34 and Cc. When M(1) was at stage C34 the modal stage for I(1) was C34 and for other incisors and canines was C12. Although the sample is small, these results fill an important gap in tooth chronology and add to knowledge of growth variation in early childhood.

Dental maturation of 18th and 19th century British children using Demirjian's method.

AIM: To compare dental age with chronological age in a group of children born approximately 200 years ago and a group of modern children. METHODS: Dental maturation of 15 skeletal remains (range 3.0-15.1 years) of London children of known age-at-death was compared to an age and sex matched control group of contemporary children (n = 30). The method of Demirjian, Goldstein and Tanner (1973, 1976, 1978) was used to assess maturity. RESULTS: The difference between dental age (DA) and chronological age (CA) for both groups was not significant, suggesting similar maturation over 200 years, however, many of the younger children from Spitalfields were dentally delayed. Several of the younger individuals from both groups had a dental age less than the lowest limit of this scale (2.5 years), highlighting one pitfall of this method. CONCLUSION: These results suggest that this method is not entirely suitable for younger children.