Association between dental age and malocclusions: a systematic review.

BACKGROUND: The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions. METHODS: The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023. RESULTS: One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian's method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated. CONCLUSION: DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail. TRIAL REGISTRATION: This study was registered in the PROSPERO database (CRD42023454207).

Machine Learning Supported the Modified Gustafson's Criteria for Dental Age Estimation in Southwest China.

Adult age estimation is one of the most challenging problems in forensic science and physical anthropology. In this study, we aimed to develop and evaluate machine learning (ML) methods based on the modified Gustafson's criteria for dental age estimation. In this retrospective study, a total of 851 orthopantomograms were collected from patients aged 15 to 40 years old. The secondary dentin formation (SE), periodontal recession (PE), and attrition (AT) of four mandibular premolars were analyzed according to the modified Gustafson's criteria. Ten ML models were generated and compared for age estimation. The partial least squares regressor outperformed other models in males with a mean absolute error (MAE) of 4.151 years. The support vector regressor (MAE = 3.806 years) showed good performance in females. The accuracy of ML models is better than the single-tooth model provided in the previous studies (MAE = 4.747 years in males and MAE = 4.957 years in females). The Shapley additive explanations method was used to reveal the importance of the 12 features in ML models and found that AT and PE are the most influential in age estimation. The findings suggest that the modified Gustafson method can be effectively employed for adult age estimation in the southwest Chinese population. Furthermore, this study highlights the potential of machine learning models to assist experts in achieving accurate and interpretable age estimation.

Machine learning assessment of dental age classification based on cone-beam CT images: a different approach.

OBJECTIVES: Machine learning (ML) algorithms are a portion of artificial intelligence that may be used to create more accurate algorithmic procedures for estimating an individual's dental age or defining an age classification. This study aims to use ML algorithms to evaluate the efficacy of pulp/tooth area ratio (PTR) in cone-beam CT (CBCT) images to predict dental age classification in adults. METHODS: CBCT images of 236 Turkish individuals (121 males and 115 females) from 18 to 70 years of age were included. PTRs were calculated for six teeth in each individual, and a total of 1416 PTRs encompassed the study dataset. Support vector machine, classification and regression tree, and random forest (RF) models for dental age classification were employed. The accuracy of these techniques was compared. To facilitate this evaluation process, the available data were partitioned into training and test datasets, maintaining a proportion of 70% for training and 30% for testing across the spectrum of ML algorithms employed. The correct classification performances of the trained models were evaluated. RESULTS: The models' performances were found to be low. The models' highest accuracy and confidence intervals were found to belong to the RF algorithm. CONCLUSIONS: According to our results, models were found to be low in performance but were considered as a different approach. We suggest examining the different parameters derived from different measuring techniques in the data obtained from CBCT images in order to develop ML algorithms for age classification in forensic situations.

Technical note: RP Atlas-an unprecedented proposal for a Brazilian population dental development chart based on the London atlas.

Age estimation methods through developmental atlases are simplified by image comparison using radiographs. Atlas-based methods have been utilized to create population-specific charts addressing population diversity. To tackle the absence of a dedicated atlas for the Brazilian population, the objective of the present study was to create a new atlas for dental development in Brazil based on the London Atlas chart. The new atlas (RP Atlas) is based on the median of tooth development, eruption, and resorption in individuals aged 5 to 23. The sample (567 individuals) was divided between females (n = 290) and males (n = 277). The RP Atlas was handcrafted, scanned, colored, and clustered in two atlases divided by sex. The development of a specific atlas for the Brazilian population has the potential to enhance the accuracy of age estimation in forensic scenarios, notably in a mixed country like Brazil. Further research is needed to assess the suitability of the newly developed atlas for the Brazilian population.

Age estimation in adults by canine teeth: a systematic review of the Cameriere method with meta-analysis on the reliability of the pulp/tooth area ratio.

The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults.

Dental age estimation by assessing the pulp volume of five teeth in a peruvian population using cone beam computed tomography images / Estimación de la edad dental evaluando el volumen pulpar de cinco dientes utilizando imágenes de tomografías computarizadas de haz cónico en una población peruana

Abstract Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients (females (134), males (97), age: 12-60 years) were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The Pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.

Resumen La estimación de la edad dental en personas vivas y cadáveres es muy importante para la Odontología Forense, sobre todo en casos de identificación en investigaciones legales y sociales. El objetivo del estudio fue estimación de la edad dental mediante la medición del volumen pulpar de imágenes dentales en tomografía computarizada de haz cónico (TCHC) de pacientes peruanos. Fueron analizadas 231 TCHC de pacientes entre 12 a 60 años a más. (Mujeres (134), hombres (97)) se dividieron en seis grupos de edad (12-19, 20-29, 30-39, 40-49, 50-59, 60 años a más). El análisis volumétrico de la pulpa dental se realizó en un total de 1155 dientes (caninos superiores, incisivos centrales superiores izquierdos, primeros molares superiores izquierdos y primeros premolares inferiores izquierdos), mediante el software Romexis® 5.3.3.5. El análisis de regresión lineal mostró un coeficiente de determinación del 30% que sugiere una correlación débil entre la relación del volumen pulpar de los dientes y la edad. El volumen pulpar de los caninos superiores derecho e izquierdo disminuyó a medida que aumentaba la edad y el volumen pulpar en dientes de personas de 60 años a más fue el más bajo. Sin embargo, se pueden proponer estudios futuros para incluir una gran muestra homogénea de dientes en diferentes categorías y grupos de edad para confirmar la correlación y establecer una ecuación de regresión confiable.

Dental age estimation in Indonesian adults: An investigation of the maxillary canine pulp-to-tooth volume ratio using cone-beam computed tomography.

Purpose: This study was performed to develop a linear regression model using the pulp-to-tooth volume ratio (PTVR) ratio of the maxillary canine, assessed through cone-beam computed tomography (CBCT) images, to predict chronological age (CA) in Indonesian adults. Materials and Methods: A sample of 99 maxillary canines was collected from patients between 20 and 49.99 years old. These samples were obtained from CBCT scans taken at the Universitas Padjadjaran Dental Hospital in Indonesia between 2018 and 2022. Pulp volume (PV) and tooth volume (TV) were measured using ITK-SNAP, while PTVR was calculated from the PV/TV ratio. Using RStudio, a linear regression was performed to predict CA using PTVR. Additionally, correlation and observer agreement were assessed. Results: The PTVR method demonstrated excellent reproducibility, and a significant correlation was found between the PTVR of the maxillary canine and CA (r=-0.74, P<0.01). The linear regression analysis showed an R2 of 0.58, a root mean square error of 5.85, and a mean absolute error of 4.31. Conclusion: Linear regression using the PTVR can be effectively applied to predict CA in Indonesian adults between 20 and 49.99 years of age. As models of this type can be population-specific, recalibration for each population is encouraged. Additionally, future research should explore the use of other teeth, such as molars.

A Importância dos Métodos de Determinação das Idades Esquelética e Dentária na Ortodontia e Odontopediatria ­ uma Revisão de Literatura / The Importance of Methods for Determination of Squeletal and Dental Age in Orthodontics and Pediatric Dentistry ­ a Literature Review

O estágio de desenvolvimento humano é intimamente relacionado à sua maturidade óssea ou dentária, sendo essencial para a escolha do tratamento de alterações dentofaciais em crianças e adolescentes por ortodontistas e odontopediatras. Existem diversos indicadores biológicos para determinar a maturação do indivíduo, como a idade cronológica e as alterações hormonais, porém esses indicadores podem sofrer interferências. Visando uma determinação de desenvolvimento e dos picos de crescimento mais precisa, para um melhor diagnóstico e plano de tratamento, foram desenvolvidos diversos métodos para determinar a idade esquelética e a idade dentária, sendo estes a avaliação da maturação carpal, da morfologia das vértebras cervicais, da fusão óssea da sincondrose esfeno-occipital e da sutura palatina mediana, bem como dos estágios da calcificação dentária. A avaliação das radiografias de mão e punho é o padrão ouro da predição da idade esquelética, e sua correlação com outros métodos já é evidente. Sendo assim, é possível utilizar a avaliação das vértebras cervicais e das idades dentárias de Nolla e Demirjian.

The stage of human development is closely related to bone or dental maturity, being essential for the choice of treatment for dentofacial changes in children and adolescents by orthodontists and pediatric dentists. There are several biological indicators to determine an individual's maturation, such as chronological age and hormonal changes, but these indicators can suffer interference. Aiming at a more accurate determination of development and growth peaks, for a better diagnosis and treatment plan, several methods have been developed to determine skeletal age and dental age, these being the assessment of carpal maturation, the morphology of the cervical vertebrae, bone fusion of the spheno-occipital synchondrosis and the median palatal suture, as well as the stages of dental calcification. The evaluation of hand and wrist radiographs is the gold standard for predicting skeletal age, and its correlation with other methods is already evident. Therefore, it is possible to use the assessment of cervical vertebrae and dental ages by Nolla and Demirjian.

Dental characteristics on panoramic radiographs as parameters for non-invasive age estimation: a pilot study.

The dental characteristics created by acquired dental treatments can be used as age estimators. This pilot study aimed to analyze the correlation between the number of teeth observed for dental characteristics and chronological age and to develop new non-invasive age estimation models. Dental features on panoramic radiographs (420 radiographs of subjects aged 20-89 years) were classified and coded. The correlation between the number of teeth for each selected code (codes V, X, T, F, P, and L) and age was observed, and multiple regression was performed to analyze the relationship between them. Eleven regression models with various combinations of dental sextants were presented. The model with the data from both sides of the posterior teeth on both jaws showed the best performance (root mean square error of 14.78 years and an adjusted R2 of 0.461). The model with all teeth was the second-best. Based on these results, we confirmed statistically significant correlations between certain dental features and chronological age. We also observed that some regression models performed sufficiently well to be used as adjunctive methods in forensic practice. These results provide valuable information for the design and performance of future full-scale studies.

Dental age estimation using cone-beam computed tomography: A systematic review and meta-analysis.

Purpose: This systematic review aimed to investigate the correlation between chronological age and dental pulp volume in cone-beam computed tomography (CBCT). Materials and Methods: The literature was searched in 4 databases (PubMed, Scopus, Web of Science, and Google Scholar). Within each study, the outcome of interest was the correlation (r) between chronological age and pulp volume. A random-effect meta-analysis was conducted. Subgroup analysis was carried out according to sex and tooth type. Results: Of 5693 identified studies, 27 fulfilled the inclusion criteria and were selected for meta-analysis. These articles focused on single-rooted teeth (n=21), multi-rooted teeth (n=6), maxillary teeth (n=14), mandibular teeth (n=6), and maxillary and mandibular teeth (n=12). The relationship between chronological age and dental pulp volume was examined in the entire population (r=-0.67), men (r=-0.75), and women (r=-0.77) in single- and multi-rooted teeth. The results of the total population analysis showed a relatively strong negative relationship between age and pulp volume. Conclusion: This study suggested that CBCT is a reliable and repeatable tool for dental age estimation. A strong inverse relationship was observed between pulp chamber volume and age. Further studies on the correlation between chronological age and pulp volume of multi-rooted teeth may be beneficial.

Age Estimation Using the Tooth Coronal Index on Mandibular First Premolars on Digital Panoramic Radiographs in an Indian Population.

Objectives: Age estimation is a crucial aspect of forensic odontology, and the Tooth Coronal Index (TCI) has been widely used for forensic purposes in determining age. The aim of this research was to evaluate the effectiveness of TCI in age estimation. Materials and Methods: A retrospective study was conducted, and TCI was calculated for the mandibular first premolar in 700 digital panoramic radiographs. Age was divided into five groups: 20-30 years, 31-40 years, 41-50 years, 51-60 years, and >61 years. Bivariate correlation was used to establish the relationship between TCI and age. Linear regression was calculated for the different age groups and genders. Inter-observer reliability and agreement were assessed using one-way ANOVA. P-values less than 0.05 were considered statistically significant. Results: Comparison of the mean difference from actual age showed underestimation in males aged 20-30 years and overestimation in males over 60 years of age. The least difference between actual and calculated age was found in females aged 31-40 years. Inter-age comparison using ANOVA for females demonstrated a statistically highly significant difference from actual age in all age groups (P<0.01), with the highest mean in females aged 51-60 years and the lowest in females aged 31-40 years. Inter-group comparison of mean TCI revealed statistically non-significant differences in males and statistically highly significant differences in females (P<0.01). Conclusion: Age estimation using TCI on mandibular first premolars can be recommended as an easy, non-invasive, and less time-consuming method. This study suggests that regression formulas were more accurate for males aged 31-40 years.

Comparison of Dental and Skeletal Age Estimating Methods in Children.

Objectives: Estimating age is a crucial determinant of forensic science. Various methods have been used to estimate dental age (DA) and skeletal age (SA).The aim of the current study was to compare the Cameriere's DA method with the Cameriere's SA method in estimating CA in children. Materials and methods: A total of 216 radiographs of 130 females and 86 males (between 9 to 14.99 years of age) were evaluated in northwestern Turkey. DA was calculated on the panoramic images using Cameriere's open-apex method. SA was determined on the lateral cephalograms using the fourth cervical vertebrae method by Cameriere. The DA, SA, and CA data were compared using a paired t-test and Wilcoxon test. Results: The mean CA of all groups was calculated as 12.96±0.30, the mean DA of 12.74±0.68 and the mean SA of 12.89±0.89. In males, the DA method presented an underestimation between ages of 14.00 and 14.99 (p<0.05) and an overestimation between ages 9.00 and 11.99 (p<0.05). In females, the DA method showed an underestimation in the 13.00- and 14.99-year-old age groups (p<0.05) and an overestimation in the 10.00- and 11.99-year-old age groups (p<0.05). The SA method revealed a significant underestimation in females between the ages of 13.00 and 14.99 and in males between the ages of 14.00 and 14.99 (p<0.05). Conclusions: The SA estimation method may provide more accurate results compared to the DA method with children of both sexes aged between 9.00 to 12.99 in the determination of CA.

Relationships between Dental Topography, Gross Wear, and Bang and Ramm/Liversidge and Molleson Age Estimates for a Sample of Human Premolar Teeth.

Objectives: Molar crown wear is often used in bioarchaeological research as a proxy for age at death. However, a small number of researchers have used premolars or compared the application of different methods of relative age estimation. Material and methods: Using a sample of 197 previously extracted maxillary first premolars from US dental patients, we considered three protocols for estimating age: the Bang and Ramm/Liversidge and Molleson (BRLM) age estimate method, occlusal topographic analysis, and the Smith system of macrowear scoring. A previous study utilizing the Bang and Ramm method yielded an age estimate range of 9.4 to 10.8 years for the sample. Results: Our analyses showed no associations between occlusal topography parameters (occlusal slope, relief, or faceting) and BRLM age estimates, but some concordance was found between Smith scoring and BRLM ages estimates and between Smith scoring and occlusal topography parameters. Conclusion: The results of the present study suggest that relationships between gross tooth wear, tooth shape, and dental age estimates are complex, and available methods should be considered together to gain a more comprehensive understanding of how teeth change their shape with wear throughout the lifecourse.

30 years of the ABFO study: Reproduction in a Brazilian sample.

The ABFO study on third molar development is a benchmark in the scientific literature of dental age estimation. In its 30th anniversary, the study has been reproduced in the present external validation. Standardized comparative outcomes were obtained and discussed across studies. The sample consisted of 1.087 panoramic radiographs of Brazilian females (n=542, 49.87%) and males (n=545, 50.13%) between 14 and 22.9 years. All available third molars were classified into developmental stages following Mincer's adaptation of Demirjian's system (8 sequential stages, from A to H). The mean chronological age of individuals within each stage was assessed. The probability of an individual being ≥ 18 years was calculated for each third molar, sex and stage. Maxillary and mandibular third molars showed a similar development with an agreement between stages of about 90%. In general, males developed 0.5 years (6 months) earlier than females. The probability of being an adult increased considerably when at least one third molar is in stage G. Maxillary third molars had higher coefficients of determination (right: 0.704; left: 0.702), showing that statistical models with these teeth could explain better the age estimation outcomes. The reproducibility of the ABFO study on third molar development led to reference tables and probability measures for the studied Brazilian population.

Chronology of permanent teeth mineralization in Brazilian individuals: age estimation tables.

BACKGROUND: Age is important in forming the uniqueness of individuals. When chronological age is not available, age estimation is required, particularly in court cases. The mineralization chronology of permanent teeth is a valuable tool for age estimation of subadults. This study aimed to evaluate the mineralization stages of permanent teeth of Brazilian subjects from imaging exams, using the classification by Moorrees et al. modified by the authors, to verify the existence of correlation between the chronology of mineralization stages and sex and to prepare numerical tables of the chronology of dental mineralization stages for Brazilian individuals. METHODS: Digital panoramic radiographs of 1100 living Brazilian individuals of both sexes, aged between 2 and 25 years, born between 1990 and 2018, from the image bank of a Dental Radiographs and Documentations clinic located in the city of Araraquara, SP, Brazil. The images were evaluated according to the level of crown and root development and classified according to the stages proposed by Moorrees et al. (Am J Phys Anthropol 21: 205-213, 1963) adapted by the authors. All analyses were performed in the R software. Descriptive and exploratory analyses were performed on all data. For intra- and inter-examiner analyses, the rate of agreement and Kappa statistics at a 95% confidence interval were used. Kappa was interpreted according to Landis and Koch. RESULTS: Only upper and lower canines showed significant differences between the sexes (p < 0.05), with higher average ages for men. The findings were presented in tables, as well as age estimates with 95% confidence intervals for each mineralization stage and each tooth. CONCLUSION: In the present study, we evaluated the mineralization stages of permanent teeth of Brazilian subjects from digital panoramic radiographs and found no correlation between the chronology of mineralization stages and sex, except for canines. From the obtained results, numerical tables of the chronology of dental mineralization stages were prepared.

Semi-supervised automatic dental age and sex estimation using a hybrid transformer model.

Teeth-based age and sex estimation is an important task in mass disasters, criminal scenes, and archeology. Although various methods have been proposed, most of them are subjective and influenced by observers' experiences. In this study, we aimed to develop a deep learning model for automatic dental age and sex estimation from orthopantomograms (OPGs) and compare to manual methods. A large dataset of 15,195 OPGs (age range, 16 ~ 50 years; mean age, 29.65 years ± 9.36 [SD]; 10,218 females) was used to train and test a hybrid deep learning model which is a combination of convolutional neural network and transformer model. The final performance of this model was evaluated on additional independent 100 OPGs and compared to the manual method for external validation. In the test of 1413 OPGs, the mean absolute error (MAE) of age estimation was 2.61 years by this model. The accuracy and the area under the receiver operating characteristic curve (AUC) of sex estimation were 95.54% and 0.984. The heatmap indicated that the crown and pulp chamber of premolars and molars contain the most age-related information. In the additional independent 100 OPGs, this model achieved an MAE of 3.28 years for males and 3.79 years for females. The accuracy of this model was much higher than that of the manual models. Therefore, this model has the potential to assist radiologists in automated age and sex estimation.

Age estimation using London Atlas methodology: A systematic review and meta-analysis.

Age estimation is a fundamental competence of Forensic Anthropologists and Odontologists. The London Atlas is a dental development chart by AlQahtani et al. (2010) that gained recent notoriety due to its applicability in forensic scenarios. This study aimed to answer, by a systematic review of literature and meta-analysis, the following question: "on average, what is the deviation between real and estimated ages, when applying the London Atlas method in sub-adults?". This study was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO). Five electronic databases were screened (PubMed, SciELO, Scopus, Web of Science, and LILACS), and active search was carried out. The quality assessment was performed by means of Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. The initial search resulted in 1021 studies, from which 24 filled the inclusion criteria. For the meta-analysis, 17 studies provided sufficient data. Out of these, eleven studies enabled meta-analysis of mean absolute difference values. Standardized mean differences were 0.02 years for MD and 0.78 for MAD. Analysis of subgroups was also accomplished by sex, and did not indicated heterogeneity between males and females. The London Atlas is an accurate age estimation method, presenting acceptable error and bias values worldwide. Despite the high heterogeneity of the studies, majority of studies presented a low risk of bias. Meta-analysis showed a non-significant and slight tendency of overestimating age, in total. Sub-group analysis showed modestly better results for boys than girls.

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.

Comparison of Accuracy Between Pulp/Tooth Ratio and Tooth Coronal Index Methods for Dental Age Estimation Using Digital Panoramic Radiographs

ABSTRACT Objective: To evaluate the reliability and the accuracy of Tooth Coronal Index (TCI) and Pulp/Tooth Ratio (PTR) methods in dental age estimation using digital panoramic radiography. Material and Methods: In this cross-sectional study, 237 dental panoramic images were collected. The two methods (TCI and PTR) were applied to all left mandibular first and second molars based on inclusion and exclusion criteria. In order to analyze the acquired data, statistical methods were used. The estimated ages derived by exclusive formula were compared to the chronological age, and the error ranges for each indicator were measured to determine their accuracy. Results: There were negative correlations between PTR in the first molar (r=-0.89) and in the second molar (r=-0.788), as well as TCI in the first molar (r=-0.587) and in the second molar (r=-.242). In this study, we found that the Pulp/Tooth Ratio (PTR) accuracy rate for mandibular first and second molar teeth was 79.21% and 62.09 %, respectively, although the Tooth Coronal Index (TCI) value for these teeth was 34.45% and 5.85%. Conclusion: Pulp/Tooth Ratio and Tooth Coronal Index are potential age estimation indices. Although PTR was the more accurate one in our study. The results also demonstrated that indices related to the first molar tooth could be used to estimate age with greater accuracy and validity.

Age Estimation and Sex Determination Using Raman Spectra of Human Dentine.

Objectives: This study aimed to determine the sex and estimate the age of individuals by analysing Raman spectra obtained from extracted teeth dentine. Material and methods: A total of 25 male and 26 female extracted teeth were collected, disinfected, and fixed in auto acrylate before being cut near the cervical margin. The inclusion criteria were non endodontically treated teeth with the cervical third of the tooth crown preserved. The exposed dentine was recorded using a Raman spectrometer, with 100 scans per dentine site in the spectral range of 3500 to 200 cm-1 and a resolution of 4 cm-1. Background-corrected, normalized, and decomposed spectra were subjected to principal component analysis using MATLAB 2010 (The MathWorks, Natick, MA, USA). To assess age differences, prominent vibrational bands were observed and statistically analyzed, while sex differentiation employed the T-test on acquired data, exploring vibrational bands with significant intensity differences. Results: The obtained results revealed a segmentation of spectra in the male sample group based on the age of teeth at extraction, with an accuracy of age estimation at 7.0048 years. A similar segmentation was observed in the female sample group, with an accuracy of 9.3863 years. Conclusion: The recorded spectra were organized into datasets and analyzed with principal component analysis, demonstrating the feasibility of sex determination and age estimation using Raman spectra of teeth. Differences in classification accuracy between sexes may be attributed to hormonally-mediated differences in the biochemical composition of dentine between males and females. The findings of this study can provide valuable insights into methods for forensic and anthropological applications.