Comparison of two methods of dental age estimation in 7-15-year-old Malays

Background. Numerous methods of age estimation have been proposed. The Demirjian method is the most frequently used, which was first applied in a French Canadian population in 1973. The Willems method is a modification of the above and was applied in a Belgian population in 2002.
Objectives.  The objectives of this study were to test the applicability of the two methods, namely Demirjian and Willems, for age estimation in a Malay population, and to find the correlation between body mass index and the difference between the dental age and the chronological age.
Materials and Methods.  A cross-sectional study involving 214 boys and 214 girls, selected by a simple stratified random sampling method was carried out. The orthopantomograph was used to score the seven left mandibular teeth, and the calculated maturity score was used to obtain the Demirjian dental age. Willems dental age was estimated using the tables proposed in the Willems method.
Results.  The Demirjian method overestimated the age by 0.75 and 0.61 years, while the Willems method overestimated the age by 0.55 and 0.41 years among boys and girls, respectively. In boys, the body mass index was significantly correlated to the difference in age using the Willems method.
Conclusion.  Further modification of either method is indicated for dental age estimation among the Malay population.     

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.     

Assessment of dental maturity of children aged 3.5 to 13.5 years using the Demirjian method in an Iranian population

Radiographs of developing teeth are commonly used to assess dental maturity. The method for assessment of dental maturity first described by Demirjian is widely used and accepted. The aim of this study was to assess the accuracy of the Demirjian method in an Iranian population in order to compare the difference in dental maturity between these children with the data obtained in Canadian children and to determine whether there is a correlation between dental maturity and BMI-for-age. In this study, the orthopantomographs of 519 healthy children (264 boys and 255 girls) aged 3.5-13.5 years were reviewed and the dental age was determined by the Demirjian method. The chronological ages of the children were obtained by subtracting their birthdates from the date of taking the radiograph. Height and weight measurements were also recorded and the data were analyzed using SPSS-16 software. The Demirjian method overestimated the age by 0.15 and 0.21 years in boys and girls, respectively. Paired t-test analysis showed that these differences were statistically significant (P = 0.001). The increase in mean age difference initiated from the underweight group towards the overweight group, but this correlation was not statistically significant (P = 0.094). Based on the amount of differences between estimated dental age and chronological age in this investigation, the Demirjian method seems to be clinically applicable in the Iranian population.     

应用Demirjian法测定北京地区6～16岁儿童的牙龄

目的评估Demirjian法测定北京地区儿童牙龄的准确度并对其进行修正。方法应用Demirjian法测定276名北京地区儿童(男131名,女145名)的牙齿成熟指数和牙龄,比较牙龄和实际年龄的差异;将牙齿成熟指数和年龄进行曲线拟合,建立两者间的数学模型。结果Demirjian法测定的牙龄比实际年龄平均高估了0.31a(女性)、0.26a(男性),差异有显著性;牙齿成熟指数(y)与年龄(x)成指数关系。结论修正后的Demirjian法更适合于测定北京地区儿童的牙龄。     

Dental maturation in British children: are Demirjian's standards applicable?

Objective . The objective of this study was to determine if the standards of dental maturation of Demirjian et al . (1973, 1976) are applicable to British children.
Design . The design was cross-sectional, retrospective.
Sample and method . The sample comprised 521 London children of Bangladeshi and white Caucasian (English, Welsh and Scottish) origin aged between 4 and 9 years. Dental age was assessed by crown and root stages of seven mandibular teeth from rotational pantomographs. Dental age was compared to chronological age using a t -test.
Results . Differences in dental maturation between the two ethnic groups were not significant. British children as a group were dentally advanced compared to the Canadian standards. The mean (± standard deviation) advancement in girls was 0·51 ± 0·79 years and in boys was 0·73 ± 0·73 years.
Conclusions . The standards of dental maturation described by Demirjian et al . (1973, 1976) may not be suitable for British children.     

Dental maturity as an indicator of chronological age: radiographic evaluation of dental age in 6 to 13 years children of Belgaum using Demirjian methods

The study was designed to determine dental age from orthopantomograph using Demirjian method and to investigate applicability of Demirjian method for estimation of chronological age in children of Belgaum. The sample for the study consisted of 197 subjects between 6-13 years of age. When Demirjian method was applied to Belgaum children, mean difference between true and assessed age for males showed overestimation of 0.14 years (51 days) and females showed overestimation of 0.04 years (15 days). Demirjian method showed high accuracy when applied to Belgaum children.     

Demirjian法测定成都地区8-16岁青少年牙龄

目的评估Demirjian法测定成都地区青少年牙龄的准确度并对其进行修正。方法应用Demirjian法测定445名成都地区8～16岁汉族青少年牙齿成熟指数及牙龄,比较测得牙龄与实际年龄的差异;将牙齿成熟指数与实际年龄进行曲线拟合,建立两者问的数学模型。结果Demirjian法测得牙龄比实际年龄平均高估：其差异为女性0．67岁,男性0．52岁,其差异有统计学意义;牙齿成熟指数与实际年龄呈指数关系;根据修正后方程所得牙龄与实际年龄平均差异为女性0．15岁,男性-0．08岁,其差异无统计学意义。结论Demirjian法不能直接用于测定成都地区青少年牙龄,应用时需对其进行修正。     

Dental maturity in Finnish children, estimated from the development of seven permanent mandibular teeth

Overall dental maturity was studied semilongitudinally in a group of 248 healthy children born in Helsinki in 1968-73. In all, 738 orthopantomograms were taken of these children at ages of 2.5-16.5 years. Overall dental maturity was estimated by the method of Demirjian and Goldstein, which is based on the development of seven left mandibular permanent teeth. The aim of the study was to construct dental maturity curves for Finnish children and to compare their dental maturity with that of French-Canadian children studied by the same method. The Finnish children were more advanced in dental maturation than French-Canadian children (p less than 0.01). In boys the advancement was seen at the age of 5-10 years and in girls at the age of 4-12 years. These findings suggest differences in overall dental maturity among white population groups.     

Dental age table for a sample of Pakistani children

The aim of this study was to evaluate the applicability of Demirjian's dental age assessment table in a sample of Southern Pakistani population and, if not applicable, to formulate a separate dental age table for Pakistani males and females. The study was conducted on the dental pantomographs of a sample size of 882 subjects (427 males and 455 females) ranging in age from 7 to 14 years. A paired t-test was used to assess any difference between chronological age and dental age assessed according to Demirjian's method. Logit function was used to make the relationship between dental maturity and chronological age and linear regression analysis with the equation X = [Ln {y/100 - y} - a]/b was used to generate dental age tables for Pakistani males and females. Dental age assessed according to Demirjian's method for this male sample was over-predicted in the 7 year and 11-15 year age group (P < 0.05). In the female sample, there was an over-prediction in all the age groups (P < 0.05). Statistically significant differences were found in chronological and dental age assessed by Demirjian's method for Pakistani males and females and thus, a new table was generated to convert dental maturity calculated according to Demirjian's method into dental age for the population.     

Dental development in subjects with thalassemia major

AIM: The aim of this study was to evaluate the dental development of patients with ss-thalassemia major and to compare it with unaffected children. METHODS AND MATERIALS: Panoramic radiographs of 44 thalassemic patients taken before the age of 16 years were examined. The subjects consisted of 29 males and 15 females ranging in age from 4.9 to 15.7 (mean = 10.8+/-2.9) years and 44 controls matched for age and sex. The seven left mandibular permanent teeth, second molar to central incisor, were rated on an eight stage scale using the methods described by Demirjian et al.10 The stage of each tooth was converted to the corresponding numeric value and then all values were added to obtain a dental maturity score which corresponded to a dental age. Dental and chronologic ages were compared using a paired t-test. The relationship between the chronologic age and the amount of delay was also determined. RESULTS: Thirty-nine patients had a delay in the development of their dentition. The mean developmental dental delay was found to be 1.01 years (p<0.05). The range in delay was from 0.1 to 2.9 years. There was no significant difference between the mean chronologic and dental age of the control group (p> 0.05). The amount of delay in dental development increases as the patient's age increased (p<0.05). Males were found to have a greater delay (mean 1.16 years) than females (mean delay 0.73 years), but this difference was not statistically significant. CONCLUSIONS: The delay in dental development in ss-thalassemia major varied according to the patient's age. This positive correlation parallels the general growth of thalassemic children.     

三种方法在南京地区儿童牙龄评估中的准确性

目的：：研究Demirjian、Willems、Haavikko三种方法评估南京地区儿童自然年龄的适用性和准确性。方法：本研究共纳入符合要求的南京市儿童全口曲面断层片450张(男性263张,女性187张),按照三种牙龄分期方法对左下颌7颗恒牙进行判读,查表得出牙龄,将所得牙龄与自然年龄进行配对t检验。结果：在评估南京地区儿童牙龄时Demirjian法平均高估0.50岁(男0.48岁、女0.53岁);Willems法平均高估0.02岁(男0.09岁、女-0.07岁);Haavikko法平均低估0.85岁(男0.87岁、女0.82岁);Haavikko第一磨牙法平均低估0.42岁(男性0.45岁、女性0.36岁);Haavikko中切牙法平均低估0.65岁(男0.66岁,女0.61岁)。结论：Willems法在评估南京地区儿童年龄时最为准确,其次为Demirjian法,Haavikko法准确性较差;应用Haavikko法单个牙齿进行牙龄评估时,第一磨牙、中切牙最为准确,并且其准确性高于原始Haavikko法。     

Applicability of Demirjian's method of age assessment in children of Davangere

The assessment of age is an important facet in providing information in demographic studies and is of clinical use to diagnose and plan the treatment. The objective of this study was to determine whether the standards of dental maturation given by Demirjian et al are applicable to Davangere children and to assess the relationship between the obtained dental age and skeletal age. The study group comprised of 151 healthy children of 6-15 years age. It was found that Davangere children were dentally more advanced. Demirjians method gave an over estimation of 1.20 +/- 1.02 years and 0.90 +/- 0.87 years in males and females respectively. The obtained dental age was found to be different from the skeletal age. It may be concluded that Demirjians method of dental maturation is not applicable to the children of Davangere.     

Validity of demirjian and nolla methods for dental age estimation for Northeastern Turkish children aged 5-16 years old

Objective: To evaluate the applicability of Demirjian and Nolla methods for northeastern Turkish population. Material and Method: A retrospective study was performed on panoramic radiographs of 673 subjects aged 5-15.9 years. The mean dental age (DA) according to the Demirjian and Nolla methods were compared to the mean chronological age (CA). Results: The mean CA of the study sample was 10.37±2.90 and 10.03±2.81 years for females and males, respectively. Using the Demirjian method, the mean estimated DA was 11.26±3.02 years for females and 10.87±2.96 years for males. For Nolla method, the mean estimated DA was 9.80±3.41 and 9.53±3.14 years for females and males, respectively. The mean differences between the CA and DA according to the Demirjian and Nolla methods were 0.86 and -0.54 years for total study sample. Conclusion: Nolla method was found to be a more accurate method for estimating DA in northeastern Turkish population.     

Validity of demirjian and nolla methods for dental age estimation for Northeastern Turkish children aged 5–16 years old

Objective: To evaluate the applicability of Demirjian and Nolla methods for northeastern Turkish population. Material and Method: A retrospective study was performed on panoramic radiographs of 673 subjects aged 5–15.9 years. The mean dental age (DA) according to the Demirjian and Nolla methods were compared to the mean chronological age (CA). Results: The mean CA of the study sample was 10.37±2.90 and 10.03±2.81 years for females and males, respectively. Using the Demirjian method, the mean estimated DA was 11.26±3.02 years for females and 10.87±2.96 years for males. For Nolla method, the mean estimated DA was 9.80±3.41 and 9.53±3.14 years for females and males, respectively. The mean differences between the CA and DA according to the Demirjian and Nolla methods were 0.86 and -0.54 years for total study sample. Conclusion: Nolla method was found to be a more accurate method for estimating DA in northeastern Turkish population. Key words:Dental age, demirjian method, nolla method, chronological age.     

Accuracy of population-specific Demirjian curves in the estimation of dental age of Saudi children

International Journal of Paediatric Dentistry 2012; 22: 125–131 Background. The Demirjian eight‐stage method is one of the principal methods used to quantify the degree of maturity from age 3 to 17. Aim. The objective of this study was to compare the accuracy of dental age of different population‐specific curves, derived using the Demirjian method, to the chronological age of Saudi children aged between 4 and 14. Design. Panoramic radiographic records of 176 children (91 boys and 85 girls), without any history of systemic disease, were assessed using the Demirjian method, and the dental age was calculated using curves designed for French‐Canadian, Belgian, Kuwaiti, and Saudi children. The difference from chronological age (DA–CA) for each curve was then statistically compared using ANOVA, and each of the curves was compared to the chronological age using multinomial regression modelling. Results. The results suggest that although population‐specific curves are more accurate in the prediction of age, a considerable variation within each population still exists. Conclusions. The Demirjian method offers great scope in fields that require the study of the pattern of growth rather than the accuracy of age estimation.     

Dental age estimation of Omani children using Demirjian's method

Dental age plays a significant role in forensic dentistry, orthodontics and paediatric dentistry, as well as in general diagnosis and treatment planning. Different methods have been developed to determine dental age. One of the most commonly used methods is Demirjian’s method, which was developed in 1973 from research on a large number of French-Canadian children. It is based on the degree of tooth mineralisation by examining the radiological appearance of the lower mandibular left quadrant. The purpose of this study was to assess the dental age of Omani children using Demirjian's method and evaluate the applicability of the method in dental age estimation for Omani children. The sample consisted of 485 digital panoramic radiographs of children (264 males, 221 females) aged between 4.6?years and 16.5?years, and obtained from the records of the Military Dental Centre in Oman. The data were analysed using SPSS. Paired t-tests, intraclass correlation coefficients (ICC) and difference-against-mean plots were used to compare the dental age calculated by Demirjian's method with chronological age. A single examiner scored the radiographs, and intra-observer reliability was evaluated using Cronbach's alpha on data from rescoring one out of every 20 radiographs. For boys, the mean difference between chronological age and dental age for all age groups was 0.10 (95% CI ?0.03 to 0.24). For girls, the mean difference between chronological age and dental age for all age groups was 0.05 (95% CI ?0.11 to 0.22). Difference-against-mean plots showed no evidence of differential bias by age. For boys, the ICC was 0.896 (95% CI 0.869–0.917); for girls, it was 0.886 (95% CI 0.854–0.911). Difference-against-mean plots for boys (Fig. 1) and girls (Fig. 2) showed some evidence of differential bias by age. In conclusion, the extent of the observed differences was sufficient for doubt to be cast upon the utility of Demirjian’s method for Oman, particularly when it is considered that the method’s most likely application would be in age determination for minors in the workforce.     

Childhood obesity and dental development

PURPOSE: The purpose of this study was to determine if increased body mass index (BMI) is associated with accelerated dental development in children ages 8 to 15. METHODS: The dental development ages of 104 children were determined using the Demirjian method and panoramic radiographs. Using the system developed by the International Obesity Task Force, BMI status was determined for each subject (63 normal weight, 23 overweight, and 18 obese subjects). The difference between chronologic age and dental age was analyzed against BMI, age, and gender using 3-way analysis of variance. RESULTS: Dental development was significantly accelerated with increased BMI, even after adjusting for age and gender (P < .01). The mean difference between chronologic and dental age among all subjects was 0.68 +/- 1.31 years. The mean dental age acceleration for overweight and obese subjects was 1.51 +/- 1.22 years and 1.53 +/- 1.28 years, respectively. CONCLUSIONS: Children who were overweight or obese had accelerated dental development, even after adjusting for age and gender. Accelerated dental development in obese children is an important variable to consider in pediatric dental and orthodontic treatment planning where timing is crucial.     

Effect of body mass index percentile on skeletal maturation of cervical vertebrae and hand-wrist and dental maturation

Abstract

Objective: The aim of this study was to evaluate the relationship between age- and gender-specific body mass index (BMI) percentile and skeletal and dental maturation in Turkish adolescents.

Materials and methods: A sample of 429 patients (171 males, 258 females aged between 7 and 17 years) was selected. Skeletal maturation was identified in the hand-wrist radiography by Björk, Grave and Brown (BGB), and the cervical vertebrae maturation (CVM) method defined by Hassel and Farman in lateral cephalometric radiography. Dental maturation was determined by the Demirjian method. BMI was calculated by reference curves used for Turkish children. A regression model was used for the relationship between BMI percentile and skeletal and dental maturation.

Results: There was no significant correlation between BMI and skeletal maturation of cervical vertebrae and dental maturation. A one-percentile increase in BMI percentile accelerates the increase of period (likelihood of being post-pubertal period) to 1.016 times (p?<?.05). Skeletal maturation of hand-wrist and cervical vertebrae and dental maturation were more prominent in females compared to males (p?<?.05). Males and females were not statistically significantly different in BMI percentile (p?=?.52).

Conclusions: BMI may be considered before deciding to estimate the skeletal and dental maturation in an individual by the relevant methods.     

A modification of the Demirjian method for age estimation in children

The Demirjian method for age estimation in children by means of dental development is widely used and forms a basis on which a universal dental maturity score can be calculated. This score is then translated into a chronological age with aid of tables specific for each population. Such tables are, however, available for only a few populations and usually not where age estimations are needed. In several studies on age estimation in children it has been found that the original studies by Demirjian and co-workers do not give enough information to allow the construction of corresponding tables for other populations. The main reason for this is that the regression lines in the original graphs were obtained by manual smoothing to combine the individual plots and the tables were thereafter compiled from these graphs. In an attempt to avoid manual, and more or less subjective, construction of the regression line, an attempt was made to fit the plots into a regression line by a series of predefined functions. The aim was to find a model with the best possible explanation factor of the correlation between dental maturity score and chronological age. A cubic function was found to give a good fit to the plots with an R2 of about 0.95. This modification of the original Demirjian method for age estimation of children is therefore recommended for the construction of population-specific tables. The use of a mathematical function also makes it possible to calculate confidence intervals to be used to describe the accuracy of an individual estimation.     

Dental age in Dutch children

Dental age was studied in a sample of 451 Dutch children (226 boys and 225 girls) according to the method of Demirjian. They were born between 1972 and 1993 and were between 3 and 17 years of age at the time a dental pantomogram (DPT) was obtained. All children were placed in the age group closest to their chronological age. All 451 DPTs were scored by one examiner. A subset of 52 DPTs was scored by a second examiner and the intra-class correlation coefficient (ICC) and Cohen's kappa were calculated. The ICC was 0.99 and Cohen's kappa 0.68. Boys and girls were analysed separately.A significant difference was found between chronological age and dental age. On average, the Dutch boys were 0.4 years and the girls 0.6 years ahead of the French-Canadian children analysed by Demirjian. Therefore, the French-Canadian standards were not considered suitable for Dutch children.New graphs for the Dutch population were constructed using a logistic curve with the equation Y = 100*{1/(1 + e(-alpha(x - x0)))} as a basis. The 90 per cent confidence interval was calculated. To determine whether the logistic curve was correct, a residual analysis was carried out and scatter plots of the differences were made. The explained variance was 93.9 per cent for the boys and 94.8 per cent for the girls. Both the residual analysis and the scatter plots indicated that the logistic curve was appropriate for use with Dutch children. In addition to the graphs, tables were produced which transfer the maturity scores calculated by the method of Demirjian into Dutch dental age.