Permanent tooth stages assessment of panoramic radiographs and lateral cephalograms

Objective This study assessed the accuracy of Demirjian's and Cameriere's methods for age estimation in Iranian children using panoramic radiographs. Materials and Methods This cross-sectional study evaluated 212 panoramic radiographs of 6- to 10-year-old children retrieved from the archives of an oral and maxillofacial radiology department from 2011 to 2017. The chronological age of children at the time of radiography was determined by subtracting the date of radiography from their birth date. The developmental stage of 7 permanent left mandibular teeth was determined according to Demirjian's method. The stage of dental maturation was determined according to Cameriere's method by using the normalized values for 7 permanent left mandibular teeth and the number of teeth with complete root development. The error value of the two methods was calculated by comparing them with the actual chronological age of male and female children, and the absolute error values of the two methods were compared with paired t-tests. Results The mean error value of Demirjian's and Cameriere's methods was found to be 0.84 and −0.06 in girls and 0.93 and 0.04 in boys, respectively. Significant differences were noted in the absolute error of the two methods compared with the chronological age of male and female children (both Ps < 0.001). Conclusion In conclusion, this study indicated that Cameriere's method was more accurate than Demirjian's method for age estimation in Iranian children.

Residents’ journal review

Condylar guidance can be determined using the clinical and radiographic methods. The present study was conducted to determine condylar guidance using the protrusive interocclusal wax method, panoramic radiographs, and lateral cephalogram. The aim of the study was to compare the correlation between sagittal condylar guidance with protrusive interocclusal method, panoramic radiographs, and lateral cephalogram. The present study was conducted on 82 dentulous subjects (males 41, females 41). In all subjects, interocclusal registration values and condylar guidance values were measured using panoramic radiographs and lateral cephalograms. The mean ± SD protrusive interocclusal registration value on the left side was 34.01 ± 1.2 mm and 34.08 ± 1.4 mm on the right side. The panoramic radiographs showed 35.12 ± 1.6 mm on the left side and 35.16 ± 1.7 mm on the right side. The mean ± SD protrusive interocclusal registration values on the left side was 34.01 ± 1.2 mm on the left side and 34.08 ± 1.4 mm on the right side. Lateral cephalogram showed 34.35 ± 1.3 mm on the left side and 34.67 ± 1.6 mm on the right side. There was a significant difference between the methods (p < 0.05). Sagittal condylar guidance can be evaluated using protrusive interocclusal method. Along with it, other methods such as panoramic radiographs and lateral cephalogram may also be used for recording condylar guidance. Lateral cephalogram and panoramic radiographs may be reliable in determining condylar guidance, which can be used in orthodontic treatment planning.

To develop and evaluate a deep learning-based model for automatic dental age estimation using the Demirjian method on panoramic radiographs, and to compare its performance with the traditional manual approach. A total of 4,800 panoramic radiographs (mean age: 10.64 years) were used to train, validate, and test a YOLOv11-based deep learning model for tooth development staging. Model performance was evaluated using precision, recall, F1 score, and mAP metrics. In addition, a separate dataset of 650 individuals (325 females, 325 males) was used to compare chronological age, manual Demirjian assessments, and AI-assisted estimations through repeated-measures ANOVA and linear regression analysis. The model achieved its highest performance in the 2nd Molar-H group (Precision: 0.99, Recall: 1.0, F1: 0.995), and its lowest in the 1st Molar-B group (Precision: 0.471, F1: 0.601). Both manual and AI-assisted Demirjian methods significantly overestimated chronological age (p < 0.001), but no significant difference was observed between them (p = 0.433). Regression analysis indicated a weak but statistically significant relationship between age and prediction error, more pronounced in the AI-assisted model (R² = 0.042). The AI-assisted system demonstrated comparable accuracy to the manual Demirjian method and showed higher performance in later stages of tooth development. The developed Python script and graphical interface allow for rapid, scalable, and user-friendly application of the method. While the system shows promise for use in clinical and forensic settings, broader validation with diverse populations and alternative model architectures is recommended before clinical deployment.

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

Introduction: Gonial angle is used widely in orthodontic tracing and is a significant indicator to diagnose the growth pattern in patients. Lateral cephalograms and panoramic radiographs both effectively determine the gonial angle. A definite variation exists when the gonial angle is determined using three different mandibular planes as described by Tweed, Steiner, and Down, respectively. The aim of this study was to evaluate, which gonial angle (obtained from Tweed's, Steiner's or Down's mandibular plane) on lateral cephalogram has the value closest to that obtained on a panoramic radiograph. Materials and Methods: A total of 300 patients between 12 and 29 years of age were selected. Panoramic and lateral cephalometric radiographs were obtained. On panoramic radiograph, gonial angle was determined by tangent of inferior border of mandible and most distal aspect of ascending ramus and condyle and compared with the value of each gonial angle obtained using three mandibular planes as described by Tweed, Steiner and Downs on lateral cephalogram. Levene's and Independent samples t -test were done for comparison. Results: Difference between gonial angles determined by Tweeds mandibular plane on lateral cephalogram and panoramic radiograph was statistically insignificant ( P > 0.05). Conclusion: Of the three commonly used mandibular planes in measuring gonial angles, the value obtained with Tweeds mandibular plane seems to be more reliable.

Regional odontodysplasia: Orthodontic treatment and transplantation of premolars

Introduction: Radiographs are effective tools in assessing the stages of bone maturation in dentistry. The cervical vertebral maturation method is a proven effective tool in assessing the adolescent growth spurt than hand-wrist radiographs in an individual. Assessment of dental calcification stages are a reliable method for determining dental maturity. Panoramic imaging can be used as the primary imaging modality for assessing maturity if a correlation can be found out between tooth calcification stages and cervical vertebral maturation stages. This study was conducted to determine the correlation between dental maturity stage and cervical vertebral maturity stage and to estimate predictor variables for cervical vertebral maturation stages (CVMS) stratified by gender in a tertiary hospital setting. Materials and Methods: A descriptive study was conducted among patients accessing orthodontic care in radiology outpatient clinic, Oral Medicine and Radiology department, Government Dental College Thiruvananthapuram for a period of 15 months. Participants were selected between the ages of 8 and 16 years. Panoramic radiographs and lateral cephalograms were used to determine dental maturity stages using Demirjian method and CVMS using Bacetti and Franchi method, respectively. Results: One hundred patients (males = 46, females = 54) were included in the study; the spearman rank order correlation revealed significant relationship. The correlation ranged from 0.61 to 0.74 for females and 0.48 to 0.51 for males. Second premolar showed highest correlation and canine the lowest for both females and males. Stage G of mandibular second premolar signifies the pubertal growth period in this study population. By ordinal regression model, G stage of second premolar was found to be a significant predictor in males and stage H followed by G and F in females for the age group of 12–14 years. Conclusion: Dental maturation stages were significantly correlated with CVMS. The development stages of mandibular second premolar had the strongest correlation with cervical vertebral maturity in both males and females. G stage of mandibular second premolar can be clinically used as a maturity indicator in the pubertal growth period. Moreover, G stage of second premolar can be used as a significant predictor for the age group of 12–14 years in both males and females.

Introduction: Gonial angle is an important parameter of the craniofacial complex which is generally used to evaluate the vertical parameters and symmetry of the facial skeleton. Gonial angle can be measured in both orthopantomogram (OPG) and lateral cephalograms. Due to the superimpositions seen while measuring the bilateral strucuture on lateral cephalograms, reliable measurement of the gonial angle becomes difficult. This study is done to clarify the possible application of orthopantomogram (OPG) for evaluating angular measurement of the mandible specifically gonial angle by comparing with lateral cephalogram.&#x0D; Materials and Method: All the patients (104) being treated from January 2018 to August 2020 in department of Orthodontics in Nepal Medical College were included in the study. Gonial angle measurements were made on lateral cephalograms and orthopantomograms of 104 patients – 54 males and 50 females with mean age of 22.20 ± 3.25 years. Patients aged 15-35 years were included in the study. Data was processed in SPSS version 16.0.&#x0D; Result: Mean Gonial angle in lateral cephalogram was greater than mean gonial angle in OPG and this difference was found to be statistically significant (p-value &lt; 0.05). The difference in mean gonial angle was found to be statistically significant when compared between right gonial angle in OPG and gonial angle in lateral cephalogram (p-value &lt; 0.05) and also between left gonial angle in OPG and gonial angle in lateral cephalogram (p-value &lt; 0.05).&#x0D; Conclusion: When gonial angle values obtained from both sides of OPG were compared, no statistically significant difference was found. Significant differences were found when gonial angle values obtained from OPG right and left sides were compared with that of lateral cephalogram.

Objective: Measuring the gonial angle is an essential diagnostic tool for identifying craniofacial disorders. In this study, gonial angle measurements from panoramic radiographs and lateral cephalograms of individuals with skeletal class I malocclusion were compared. The study also attempts to determine which radiography method is best suited for precisely determining the gonial angle. Methods: Lateral cephalograms and panoramic radiographs of 70 orthodontic patients (34 males, 36 females; mean age: 16.8 years) were selected from the department&amp;#39;s archive. On the lateral cephalograms, SNA, SNB, ANB, GoGn-SN, and gonial angle measurements were made; on the panoramic radiographs, measurements of the right and left gonial angles were made. Gender differences were analyzed using Student t-tests, and Pearson&amp;#39;s correlation analysis was used to assess the relationship of angles. The reliability of measurements was evaluated by calculating repeatability coefficients. Results: The lateral cephalogram&amp;#39;s mean gonial angle value was 126.4 ± 4.75, and in the panoramic radiography was 124.8 ± 5.39 on the right side, and 125.1 ± 5.67 on the left side. The differences between the gender in terms of GoGn-SN and gonial angle in lateral cephalogram were statistically significant (P &lt; .05). The correlation between the gonial angle in lateral cephalogram and panoramic radiography was determined to be significant. Conclusion: Panoramic radiographs can accurately assess the gonial angle, just like lateral cephalograms. The advantage of using panoramic radiographs is that they allow easy measurement of both side angles without the need for superimposition of anatomical landmarks. Cite this article as: Uslu-Akçam Ö. Gonial angle measurement: Panoramic radiography or lateral cephalogram? Essent Dent. 2024;3(1):8-14.

The relation between dental age and cervical vertebral maturation in orthodontic patients aged 8 to 16 years: A cross-sectional study

To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Observational study. OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. No significant differences were found in the magnification factor of the left and right side of the mandible. Compared with a lateral cephalogram, the OPT had comparable reliability in measuring mandibular distances condylion-gonion, gonion-menton, and condylion-menton. No significant differences were observed between the x-ray assistants in taking the OPTs and lateral cephalograms or in repositioning the skulls. Significant differences were found between orthodontists and maxillofacial surgeons for landmark measurements. An OPT is as reliable as a lateral cephalogram for linear measurements of the mandible (condylion-gonion, gonion-menton, and condylion-menton).

INTRODUCTION: The external gonial angle which plays significant role in the diagnosis of craniofacial disorders is routinely measured from lateral cephalogram and orthopantogram. But how far these radiograph methods are reliable for the measurements of external gonial angle is a question which has been of much interest to investigators. AIMS AND OBJECTIVES: To compare and discover any difference between the values of gonial angle obtained from the lateral cephalogram and orthopantogram and also between the values of the male and female.To determine the value of external gonial angle in Assamesse population. MATERIALS AND METHOD: The study was conducted on the lateral cephalogram and orthopantogram of 30 female and 30 male patients having Class-I skeletal malocclusion within the age group of 18-30 years. Each lateral cephalogram and orthopantogram was traced twice and average value of each parameter was taken as the data. RESULTS: In the study, the mean values of external gonial angle was 120.18 degree in panoramic radiograph and 121.75 degree in lateral cephalogram with no significant difference found in gonial angles obtained from lateral cephalogram and orthopantogram between two genders. CONCLUSION: The Gonial angle is an important parameter of the craniofacial complex which gives an indication about the vertical parameters and symmetry of the facial skeleton which can be correctly measured by both lateral cephalogram and orthopantogram (OPG) Keywords: Gonial angle, lateral cephalogram, orthopantogram(OPG), Assamesse population.

Dental age estimation using four Demirjian's, Chaillet's and Willems' methods in Kosovar children.

Age estimation through dental maturity indicators is relatively more accurate, reliable, and valid for living as well as dead individuals. It acts as an important tool in diagnosis and treatment planning in clinical as well as in forensic dentistry. There are various methods to estimate the dental age. Out of which, Demirjian's method has been widely used in various populations. However, there is a dearth of literature on Indian population comparing Demirjian's method to Cameriere's method. The purpose of this study was to evaluate the accuracy of Demirjian's and Cameriere's age estimation methods to chronological age in growing children using orthopantomograph (OPG). The sample consisted of digital OPGs of 280 children in Navi Mumbai aged 5-16 years. Digital OPGs were used to assess the dental maturity of seven mandibular left teeth using Demirjian and Cameriere's method and were compared to the chronological age. Data were analyzed using Student's t tests. Irrespective of gender, dental age estimated by Cameriere's method (mean 10.23 ± 2.79 years), underestimated the chronological age (mean 11.74 ± 2.86 years) for overall population which showed statistically significant difference. Demirjian's method overestimated (mean 12.24 ± 3.06 years) the chronological age for the overall population but was statistically insignificant. Demirjian's method is more closely in correlation with the chronological age of growing children as compared to the Cameriere method when applied to children of age 5-16 years in Navi Mumbai.