Demirjian Method Research Articles

Relationship between chronological age, dental age, and body height using Demirjian method among children aged 4-14 years in Pune - A radiographic study.

The assessment of dental age is useful in the planning of orthodontic treatment, in pediatric dentistry, pediatric endocrinology, and forensic medicine. It is essential for a pediatric dentist to formulate treatment plan and it is a source of complementary information for pediatrician. Changes in the body proportion and composition are the essential elements of growth, especially maturation. The present study was aimed to correlate the chronological age, dental age, and body height in children from Pune region of Maharashtra, India. : Four hundred and thirty-one panoramic radiographs of 177 boys and 254 girls in the age group of 4-14 years were obtained. Chronological age was assessed by recording date of birth. Dental age assessment was done using orthopantamogram following the method described by Demirjian. Body height was recorded using a measuring tape. Chronological age and dental age showed significant positive correlation between male and female sample, i.e., r = 0.905 for males and r = 0.901 for females. Statistically significant correlation was observed between calculated dental age and body height. In the present study, it can be concluded that the Demirjian method of dental age assessment showed high accuracy when applied to pediatric population in Pune.

Correlating the Age Estimated by Nolla's Method and Modified Demirjian Method with Cervical Vertebral Maturation Index: A Cross-Sectional Study

Introduction: Among various methods of dental age (DA) estimation, Demirjian method and Nolla’s method are commonly used. One of the methods of determining cervical vertebral morphology was given by Hassel and Farman. Indian age-specific modified Demirjian method by Acharya has not been utilized in the Hyderabad population, and the age derivation information is sparse. Objectives: To correlate the DA using modified Demirjian’s method and Nolla’s method using orthopantomograph with skeletal maturation by cervical vertebral maturation index (CVMI) method using lateral cephalogram. They were compared and correlated for assessing chronological age (CA) and determining the accuracy. Materials and Methods: Among 200 boys and girls (100 each) between 6 and 21 years, the DA was evaluated using orthopantomogram by Ashith Acharya’s modified Demirjian method and also by Nolla’s method. The skeletal maturation was assessed by CVMI method given by Hassel and Farman using lateral cephalogram. These were compared and correlated with CA. The data derived were statistically analyzed using SPSS software 20.0 version. Results: The maximum underestimation of age was found within the age group of 19–19.9 years using Ashith Acharya’s modified Demirjian method and 18-18.9 years using Nolla’s method with median values of −5.05 and −5.03, respectively. Statistically significant difference was found between CAs and cervical vertebral maturation stages in both genders (P = 0.000). The study showed that girls had a late dental development compared to corresponding cervical maturation. Conclusions: The methods of age estimation were not reliable in predicting the accurate age in the Indian population.

A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability.

ABSTRACTAimThe present study aimed to evaluate and compare the applicability of Demirjian, Willems, and Haavikko methods of dental age estimation in southeastern (Dravidian ethnicity) and northwestern regions (Aryan ethnicity) of the Indian population.Materials and methodsThe study includes the orthopantomographs (OPGs) of 303 individuals (173 males and 130 females) of age ranging from 5 to 14 years. The participants in the present research were evaluated under two study groups: group I: participants of the southeastern region and group II: participants of the northwestern region. Dental age was calculated using Demirjian, Willems, and Haavikko methods and compared with the chronologic age of each participant. The accuracy of dental age estimation methods was evaluated by mean absolute error. One-way analysis of variance (ANOVA) and Student's t tests were used to test the significant difference between the chronologic age and estimated dental ages.ResultsThe Demirjian method showed overestimation, while Willems and Haavikko methods showed underestimation for boys and girls in both the ethnic groups of Indian population. The Willems method of dental age estimation showed comparatively more accurate and reliable results in both the ethnic groups of the Indian population.ConclusionThe dental age estimation by Demirjian, Willems, and Haavikko methods showed no significant variation between the different ethnicities of the Indian population.Clinical significanceThe present research will be helpful in pedodontic, orthodontic, and forensic investigations for accurate and reliable dental age estimation in different parts of Indian population.How to cite this articleChaudhry K, Talwar M, Vanga NRV, et al. A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability. Int J Clin Pediatr Dent 2020;13(1):16–20.

Evaluation of chronological age based on third-molar development in the Serbian population

Background/Aim. Persons identification and their age assessment is necessary in vast number of cases and there are different methods used for such purposes. Numerous studies indicate that the third molar development could play a crucial role in identifying an individual`s age. The aim of this study was to determine the possibility for estimating the chronological age based on the third molar development stages in children and young adults in the Serbian population. Methods. A total of 570 Serbian patients aged 6?27 years were included in this study. Out of the total number of subjects, there were 248 males with an average age of 12.21 ? 3.91 years, and 332 females with an average age of 12.88 ? 4.06 years. Stages of dental formation were determined on orthopantomograms by comparing with standard Demirjian radiographic appearances. Results. Third molars mineralization occured more rapidly in males than in females. Most of the persons with third molar (the stage H development according to the Demirjian method) were older than 18 years. Conclusion. ?hird molar mineralization stages determination on orthopantomograms is useful additional method for determination of chronological age in living individuals. This finding might be important for forensic studies, focusing on the determination of the legally important ages. Variability among different ethnic groups has to be taken into consideration when applying this method. It is necessary to carry out extensive surveys on a larger sample in order to determine the norms for assessing the dental and chronological age of Serbian population.

Research Progress of Age Estimation Based on the Demirjian's Method.

In recent years, individual age estimation has gained increasing attention in forensic practice. Common age estimation methods mainly use developments of teeth and bones. Compared with bones, teeth are stronger and are highly resistant to external factors, therefore plays an important role in age estimation. Demirjian's method is one of the most commonly used methods to evaluate dental age and has been widely used in many countries. In this paper, the accuracy of its application in different populations is reviewed. It is found that compared with the chronological ages, most of the estimated ages are overestimated. By combining research results of many scholars and by analyzing, it can be assumed that this situation may be related with race, region, sex, etc.

Does nutrition have an effect on the timing of tooth formation?

The effect of nutritional status on the timing of permanent tooth formation is not well understood, despite clear evidence that systemic stresses result in enamel defects during tooth formation. This study investigated the effect of nutritional status (measured as BMI, height, weight, mid-upper arm circumference, and head circumference) on permanent tooth formation. This was a prospective cross-sectional study involving 642 (270 males, 372 females) healthy Black South African participants aged 5-20 years. The height and BMI were converted to z-scores using WHO z-score for age tables. The participants were grouped into underweight/short for age (<-2), normal (≥ - 2 to 2.0) and overweight/obese/tall for age (>2). Panoramic radiographs of the children were assessed using Demirjian's eight stages of permanent tooth formation and age was estimated using Demirjian's method. Probit regression analysis was used to calculate the mean age of attainment of the developmental stages for the left mandibular teeth (I2-M2). There was significant advancement in the age of attainment of the final (H) stage for the majority of permanent teeth in the overweight (mean male BMI 22.9; female 27.94) group compared to the underweight (p < .05). Negative binomial regression indicated that age, height, and BMI were significant predictors of the dental maturity score for males (p < .05), while age, height, weight, BMI and HC were significant predictors for females (p < .05). Nutritional status had a significant effect on the timing of tooth formation in males and females in the study population. The effect was mainly noticeable for children in the extremes of the spectrum of BMI z-scores.

Comparison of three methods to estimate dental age in children.

In 1973, Demirjian and colleagues introduced a staging for tooth mineralization. Staging of the teeth of the left mandible generates a dental maturity score and an estimate of dental age. An update of this method was published in 2001 by Willems and colleagues. The London Atlas (2008) is another method used to assess dental age. This study compared the precision of these three methods for forensic age estimation. A total of 500 panoramic images of 251 boys and 249 girls aged 6-16years had dental maturity evaluated by the same observer using the London Atlas and the methods of Demirjian and Willems. Individuals with syndromes potentially affecting dental maturation were excluded. The three methods were compared with respect to their precision in estimating chronological age. Age estimates using Willems' method were significantly more precise than those obtained using Demirjian's method, while estimates obtained using the London Atlas method were comparable with both the others. The highest precision was obtained using the average of age estimates from Willems' method and the London Atlas. To estimate age in individuals suspected of being below 16years of age, we suggest first applying the London Atlas then computing age from the Demirjian stages of particular teeth using Willems' method, and finally using the average age estimate of both methods. Combining the London Atlas and Willems' scoring method provides more precise estimates of dental age than the current practice of applying a single preferred method.

Jaw bones' involvement and dental features of type I and type III Gaucher disease: a radiographic study of 42 paediatric patients.

Gaucher disease (GD) is a lysosomal storage disease caused by an autosomal recessive inherited deficiency of the lysosomal enzyme glucocerebrosidase. The aim of this study is to describe jaw bones' involvement and dental radiographic features in paediatric Gaucher disease patients (type I and type III). The study population of this case-control study included: 42 Gaucher patients (study group) and 84 medically free children (control group). The radiographic images of both groups were analysed for the following findings: generalised bone rarefaction, localised rarefaction and enlarged bone marrow spaces, thinning of cortex, pseudocystic radiolucent lesions, anodontia and dental anomalies. Dental age assessment of Gaucher patients using the Demirjian's method was also performed. Generalised rarefaction showed almost similar percentages in both types of Gaucher disease cases. Localised rarefaction was noted in 30.77% and 18.75% of Gaucher disease type III and type I, respectively. Pseudocystic radiolucent lesions, thinning of cortex, anodontia and dental anomalies were more prevalent in type III Gaucher patients. The mean chronological and mean dental ages in both sexes of Gaucher patients were not statistically significant. Thinning of cortex, localised rarefaction and generalised rarefaction are the most common jaw bone findings in Gaucher patients.

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

This study aimed to assess the relation between the dental age of seven left mandibular teeth determined by the Demirjian's method and skeletal age determined by the Baccetti's method. This cross-sectional study evaluated 600 patients aged between 8-16 years, who were selected from those presenting to Orthodontics Department of Hamadan dental school and private orthodontic offices. The patients had good-quality panoramic radiographs and lateral cephalograms taken within 2 months of each other. Skeletal age was determined according to the cervical vertebral maturation (CVM) on lateral cephalograms. The dental age of seven left mandibular teeth was determined using the Demirjian's method. Data were analysed by the Spearman's and Pearson's correlation coefficients via SPSS 16. CVM had significant correlations with dental age (0.780) and chronological age (0.792). Accordingly, the strongest correlation was noted between CVM and the developmental stage of second molars in both males and females. In males, the highest correlation between dental age and chronological age was in CS5 stage (0.724) while, in females, the highest correlation between dental age and chronological age was in CS4 stage (0.651). Considering the correlation between skeletal age and dental calcification, dental age, especially the developmental stage of mandibular second molars, based on panoramic radiographs, can be served as a primary diagnostic tool for determining the skeletal maturity stage of patients.

Application of comprehensive chart for dental age estimation (DAEcc) based on demirjian method using orthopantograms: A pilot study

Demirjian 7-teeth method, most widely used for dental age estimation(DAE) has been simplified to a comprehensive chart (DAEcc) but not validated yet. This pilot study aimed to assess applicability of Demirjian 7-teeth method in National Capital Region (NCR) and validate DAEcc. 102 OPGs (51 males, 51 females, 6–16y) were evaluated for DAE in NCR population using original Demirjian method and DAEcc and compare it to chronological age. Resultsshowed significant mean underestimation of 8.4 months (0.7y) and 7.2 months (0.6y) for males and females respectively. The study validates DAEcc as no significant difference was found between estimated DAs using DAEcc and original Demirjian method (p=0.357).

Application of Demirjian's and Cameriere's Method in Dental Age Estimation of 8-16 Year Old Adolescents from Hunan Han Nationality.

Objective To apply Demirjian's and Cameriere's method for dental age estimation of adolescents from Hunan Han nationality, and compare the accuracy of the two methods. Methods A total of 480 orthopantomograms of?8-16 year?old adolescents from Hunan Han nationality?with no special diseases and good nutritional status were collected?by Xiangya Stomatological Hospital of Central South University from January, 2016 to July, 2017, among them 236 males and 244 females. The dental age of each adolescent was determined by Demirjian's method and Cameriere's method, respectively, and the paired t-test of the estimated dental age and the chronological age determined by the two methods was conducted by SPSS 20.0 software to compare the difference between estimated dental age and chronological age. Results Mean chronological age of males and females was 11.91 and 11.88 years, respectively. The estimated dental age determined by Demirjian's method showed an underestimate of chronological age by an average of 0.11 years （males） and 0.15 years （females）, while the estimated dental age determined by Cameriere's method showed an underestimate of chronological age by an average of 0.83 years （males） and 0.72 years （females）. Conclusion Demirjian's method is more accurate than Cameriere's method in dental age estimation of adolescents from Hunan Han nationality, therefore more suitable for dental age estimation of adolescents in this region.

Age Estimation Using Schour-Massler Method Compared to the Demirjian Method

Schour-Massler and Demirjian are methods used to estimate chronological age in dental radiographs by looking at the development of permanent teeth and the maturity of the dental age. Chronological age is based on date of birth. Dental age is the age based on the maturity of the teeth. Both of these methods have been widely used in previous studies, but have never been compared. The purpose of this study was to determine whether there are differences in age estimation using the Schour-Massler and Demirjian methods. This study was an observational analytic study with a cross sectional design. The research sample was 46 patients who came to USU General Hospital at the age of 10-16 years. This research was consist at the Radiology Unit of the Faculty of Dentistry, University of North Sumatra. The results of this study indicate the p value of the Wilcoxon test results with the p value for Schour-Massler p=0.090 &gt; 0.05 and Demirjian p=1,000. Both p values&gt; 0.05, there is no significant difference in assessing the estimated age using both methods, so Ha is accepted. In conclusion, the Schour-Massler and Demirjian methods provide estimates of age that are close to actual age, so there is no significant difference between the two methods.

A case-control study of dental abnormalities and dental maturity in childhood cancer survivors

The aim of this study was to evaluate dental abnormalities and dental maturity (DM) in the permanent dentition of childhood cancer survivors (CCSs) in comparison with that of healthy individuals. A retrospective, case-control study, with convenience sampling, evaluated 111 panoramic radiographs (PRs) of CCSs compared with 111 PRs of healthy individuals matched for age and gender. Dental anomalies (DAs) were associated with age of cancer diagnosis and type of antineoplastic treatment. DM was assessed by using the Demirjian method. A higher prevalence of microdontia, hypodontia, and dental root anomalies were present in CCSs compared with healthy individuals (P < .05). CCSs were the only individuals with 10 or greater DAs compared with healthy individuals. Microdontia was the only DA associated with age of cancer diagnosis less than 71 months (P < .05). Impacted teeth were associated with multimodal cancer treatment (P < .001). DM did not present a significant statistical difference between CCSs and healthy individuals (P > .05). CCSs had a higher prevalence of DAs without DM alteration compared with healthy individuals. Age of cancer diagnosis and type of treatment can influence the prevalence of some dental abnormalities.

Construction of Age Estimation Model of 18-Year-Olds in the Northern Chinese Population Based on the Development of Mandibular Second and Third Molars.

Objective To establish a linear relationship between age and the development process of the mandibular second, third molars in a northern Chinese population and test its accuracy in inferring whether the subject is over 18 years old. Methods The orthopantograms （OPGs） of 960 northern Chinese people aged between 10.00 to 25.99 years were selected. The gender, birth date, and date of the orthopantograms of each sample were recorded. The development stages of left mandibular second and third molars were divided with Demirjian method. The experimental group （760 individuals） constructed a Logistic regression equation to infer whether the subject is over 18 years old. The validation group （200 individuals） tested the accuracy of the equation. Results When only using third molar, the formula obtained for inferring whether the subject's age is over 18 years is： logit P1=-18.276+0.494 x1+2.953 x3. When combining the second and the third molars, the formula is： logit P2=-21.045+3.177 x1+0.619 x2+2.088 x3. （x1 stands for gender, male is marked as 1 and female is marked as 2; x2 and x3 stand for the development stage of second molar and third molar, respectively）. The accuracy rates of this equation in estimating whether ages of subjects from the validation group were over 18 years old for males and females were 88.0%-92.0% and 85.0%-88.0%, respectively. Conclusion The age estimation formulas based on the development of mandibular second and third molars have important value in judging whether the individual is over 18 years old. Meanwhile, the accuracy of age estimation can be improved by combining the development of second and third molars together.

Accuracy of Demirjian and Willems Methods for Age Estimation of Children from Northern Argentina

The dental development is widely used to estimate the chronological age; one method frequently used is that of Demirjian, applied in Franc-Canadian children, and the other is that of Willems, adapted from the first one to Belgian children. Demirjian uses scores according to the degree of calcification of the seven permanent mandible teeth of the left side; Willems adapts to years the scale of scores of Demirjian. Objective: To analyze the accuracy in determining the chronological age through the degree of dental calcification using the methods of Demirjian and of Willems in children from Tucumán, Argentina. Methods: 66 children (29 female and 37 male) who assisted to radiological studies previous to the dental treatment were selected. Panoramic X-rays were taken. Dental ages were calculated using the corresponding tables of the methods of Demirjian and Willems. Chronological ages were calculated between the date of birth and the date of the study. The statistical paired t-test was used. Results: Through the method of Demirjian the mean of the differences was 0.44 ± 0.96 for girls and 0.49 ± 1.02 for boys, being significant differences between both genders. The method of Willems was more accurate than that one of Demirjian (-0.08 ± 0.92 for girls and 0.19 ± 0.94 for boys), being no significant differences between the dental and the chronological ages. Conclusion: According to these results both methods could be used to estimate the chronological age through the observed dental calcification in radiographic images of children from northern Argentina. Nevertheless, greater statistical accuracy with the method of Willems would be reached for both genders.

Dental age assessment of 3-15-year-old Saudi children and adolescents using Demirjian's method-A radiographic study.

Dental age assessment plays a pivotal role in clinical practice, demographic studies, forensics, and courts of law but is affected by ethnic and geographic variations. The aim was to determine the population‐specific weighted scores needed when dental age is estimated using Demirjian's method for Saudi children and adolescents between the ages of 3 and 15 years. Design: A total of 298 panoramic radiographs were collected from Saudi Arabia. Dental age was assessed using Demirjian's method (1973). Chronological age was determined from the date of birth and the date on which the panoramic radiograph was taken for each individual. Between 3‐ and 15‐years age group, the Saudi boys had an estimated age of 9.07 ± 1.96 years and chronological age of 8.49 ± 2.30 years. The Saudi girls had an estimated age of 9.22 ± 1.93 years and chronological age of 8.78 ± 2.32 years. With Demirjian's method, the Saudi boys were 0.57 ± 1.48 years, and girls were 0.44 ± 1.66 years ahead of their chronological ages (p < .05). New population‐specific weighted scores were developed to convert dental age according to Demirjian's method into estimated ages in the contemporary Saudi Arabian population. This study can be used for further research and comparisons with other population groups, regions or communities.

Association between cervical vertebral maturation stages and dental calcification stages in patients with unilateral complete cleft lip and palate

The purpose of the study is to investigate the relationship between dental calcification stages (DCS) and cervical vertebral maturation stages (CVMS) in patients with unilateral complete cleft lips and palates (UCLP) and to provide a theoretical basis for the treatment time selection of cleft lip and palate (CLP) patients. A total of 123 UCLP patients and 215 non-CLP subjects were selected. The DCS of the left mandibular canine, premolar, and second molar in non-CLP subjects and on both cleft sides of UCLP patients were assessed utilizing the Demirjian method. CVMS was observed utilizing the Baccetti method. The results were analyzed by Spearman rank correlation, and the correlation coefficients were compared. There was a correlation between the CVMS and the DCS of the left mandibular canine, the first premolar, the second premolar, and the second molar in the non-CLP subjects and on both cleft sides of the UCLP patients (r=0.762-0.864, P<0.05; r=0.809-0.914, P<0.05, respectively). The correlation between the CVMS and the DCS of the mandibular first premolar was highest among the UCLP patients. Except for the first and the second premolars of UCLP females, the correlation between the DCS and the CVMS of the other teeth did not differ among the non-CLP subjects (P>0.05). DCS can be utilized as a biological index to determine the growth development statuses. The correlation between the CVMS and the DCS of the mandibular first premolar was the highest.

Estimation of the Chronological Age Through the Methods of Demirjian and Ubelaker in Peruvian Children

Objective: To determine the most effective dental age estimation method, Demirjian y Ubelaker, for estimating the chronological age in patients from 4 to 13 years of the National Institute of Child Health-Lima Peru. Materials and methods: Cross-sectional design with a sample consisting of 465 panoramic radiographs, 229 of male (49.2%) and 236 of female (50.8%). The estimated age was made using the protocol established in each method. The chronological age was established through the difference between the date of radiographic capture and the date of birth. The precision and accuracy of each method was established. The inferential analysis was performed with a level of significance of 5% through the Spearman correlation tests, Wilcoxon test. Results: It was proved that the Ubelaker method had 270 erroneous or mismatched cases and 195 coincidences while the Demirjian method had 360 erroneous cases and 105 coincidences between the estimated chronological age and dental age, finding significant differences in the estimation in each of the methods p=0.001 and p &lt;0.001 respectively. The accuracy obtained with Ubelaker was 0,112 and with Demirjian 1,039.

The Associations of Maternal and Neonatal Vitamin D with Dental Development in Childhood

BackgroundVitamin D influences the formation and mineralization of teeth. ObjectiveTo investigate the association of maternal and neonatal vitamin D concentrations with the dental development of 10-y-old children, in a population-based prospective cohort study among 3,770 mothers and children in the Netherlands. MethodsMaternal venous blood samples were collected in the second trimester (median 20.4 weeks of gestation; range: 18.5–23.2 wk) whereas umbilical cord blood samples were collected immediately after delivery (median 40.1 weeks of gestation; range 35.9–42.3 wk). Dental development was defined using the Demirjian method. Multivariate regression models were built to analyze the studied associations. ResultsHigh concentrations of 25-hydroxyvitamin D [25(OH)D] during midpregnancy (β: −0.04; 95% CI: −0.08, −0.01) and at birth (β: −0.06; 95% CI: −0.10, −0.02) were associated with a lower dental age in children. The children of mothers with severe vitamin D deficiency [25(OH)D <25.0 nmol/L] during midpregnancy exhibited a higher dental age (β: 0.14; 95% CI: 0.03, 0.24) and higher developmental stages of the mandibular first premolar (β: 0.32; 95% CI: 0.04, 0.60) compared with the children of mothers with optimal values of 25(OH)D (≥75.0 nmol/L). Children with vitamin D deficiency [25(OH)D 25.0–49.9 nmol/L] at birth exhibited a higher dental age (β: 0.11; 95% CI: 0.01, 0.20), higher developmental stages of the mandibular second premolar (β: 0.27; 95% CI: 0.02, 0.51), and higher developmental stages of the mandibular second molar (β: 0.24; 95% CI: 0.00, 0.48) compared with children with sufficient-to-optimal values of 25(OH)D (≥50.0 nmol/L) at birth. ConclusionHigher maternal and neonatal 25(OH)D concentrations are associated with decelerated dental development in childhood. The lower the vitamin D level during midpregnancy or at birth, the higher the dental age of children, and the higher the developmental stages of the mandibular teeth.

Applicability of Demirjian’s method for age estimation in a sample of Italian children with Down syndrome: A case-control retrospective study

Age estimation is widely applied in several clinical and forensic fields. The radiographic evaluation of dental development is one of the most accepted tools for this purpose. Among the different methods proposed, Demirjian’s method was the most extensively used and tested in the medical literature revealing that the original standards for the French–Canadian population tends to over-estimate the age of different population groups. The aims of this study were to evaluate the applicability of the Demirjian method in a sample of Italian children with Down syndrome (DS) and to compare the data with age and gender matched healthy subjects (non-DS). A retrospective study was performed on 146 orthopantomograms of DS individuals aged 6.3–16 years. The mean chronological age (CA) and the mean dental age (DA) were calculated. Using Cohen’s kappa statistics, the inter- and intra-examiner agreement was reported as good (k = 0.75) and very good (k = 0.86). The differences between CAs and DAs were statistically significant for males and females (Wilcoxon Signed Rank test; p < 0.05). The median overestimation was 0.6 years in males and 0.9 years in females. Demirjian’s method is unsuitable for dental age estimation in DS individuals. The same trend in overestimation was found in the control group. Comparing DS and non-DS subjects, the differences between DAs were not statistically significant for both males and females revealing that the dental development process is similar.