Demirjian Method Research Articles

Evaluation of the validity of Demirjian and Nolla methods in estimating chronological age in an Iranian population

<h3>Objective</h3> Due to demographic and ethnic-racial differences, each dental age estimation method should be examined in a limited population to evaluate the accuracy of the selected method. Therefore, this study aimed to evaluate the validity of Demirjian and Nolla methods in estimating the chronological age of an Iranian population of children aged 7 to 15 years in Tehran. <h3>Study Design</h3> This retrospective cross-sectional study was performed on 301 panoramic radiographs of children in the Radiology Department of the Shahid Beheshti University of Medical Sciences, School of Dentistry. Dental age was calculated by evaluating the seven left mandibular teeth using Demirjian and Nolla methodologies. Data were analyzed by using the Wilcoxon signed rank test and the intraclass correlation coefficient. <h3>Results</h3> By the Demirjian method, the mean differences between dental and chronological ages for girls, boys, and all samples were 1.784 ± 0.042, 1.704 ± 0.207, and 1.720 ± 0.024, respectively. Using Nolla's method, the mean difference between dental and chronological age for girls, boys, and all samples were -1.432 ± 1.742, -1.386 ± 1.87, and -1.492 ± 1.567 respectively. Intraclass correlation coefficients for the Demirjian and Nolla methods were 77% and 71%, respectively. <h3>Conclusion</h3> The Demirjian method is more accurate compared to the Nolla method for estimating age in the population of Iranian children in Tehran. <b>Statement of Ethical Review</b> Ethical review was sought and study was exempted from ethical review

Correlation of dental age, skeletal age, and chronological age among children aged 9-14 years

Background: Understanding growth, which may be one of the most elusive variances, is critical for diagnosis and therapy planning. It has been common practice to use a child's skeletal age or dental age as a proxy for their actual age. Multiple studies have looked at how various populations' dental and skeletal maturity rates correlate with chronological age. The current research aimed to replace skeletal age estimate with dental age estimation in the community. Methods: “In all, 104 samples were collected, with girls and boys each accounting for nearly half. Demirjian's method was used to calculate the patient's chronological age based on their teeth, while hand-wrist x-rays and Fishman's skeletal maturation index were used to calculate the patient's chronological age based on their bones.” Results: We used Spearman's position request connection coefficients to examine the correlation between skeletal and dental maturation. Mean ages of men and women are not fixed at 11.89 1.867 and 12.21 1.473 years, respectively. “Researchers found a strong relationship between chronological age and measures of dental and skeletal maturity (P 0.01). The correlation between dental and skeletal ages was statistically significant (P 0.001), with a connection value of 0.683 for males and 0.704 for women.”

Early extraction of the first permanent molars: a five-year follow-up study.

Early extraction of first permanent molars (FPMs) is generally considered successful when the second permanent molar and premolar come into contact, regardless of whether the patient has a healthy occlusion. In this study, we aimed to investigate cases in which early extraction had a successful prognosis. Study design: Pre-extraction orthopantomograms of children whose one or more FPMs were extracted were examined retrospectively. Post-extraction parameters such as status of the extraction gap, any other diastema formation, and midline shift were evaluated clinically and radiographically. For the dental age estimations, development levels of the teeth were scored using the Demirjian method and the developmental status of a particular tooth was calculated in years based on tables given by Willems et al. [2001]. The ICON index was used to determine the orthodontic treatment needs of patients. Descriptive analyses and the Kruskal-Wallis test were used for the statistical analysis of the data. Early extraction of FPM should be considered successful when there is no formation of any other diastema in the relevant quadrant, midline shift, or orthodontic treatment needs due to extraction.

Evaluation of the accuracy of Demirjian method in estimating chronological age

Evaluation of the accuracy of Demirjian method in estimating chronological age

Third Molar Development Reliability for Radiographic Age Estimation (Demirjian's Method)

Background: The determination of age after a person has died is a potential stage in the postmortem profiling process that leads to definitive identification. Demirjian's method, designed for use with children, establishes maturity scores as a function of age using eight developmental stages and polynomial functions to estimate age as a function of the score. Aim: This study's purpose was to examine the accuracy of age estimate by employing Demirjian's eight teeth approach following French maturity scores &amp; an Indian-specific formula generated from third molar growth phases by use of orthopantomograms. Materials and Methods: 30 participants, each with a known chronological age and gender, had dental panoramic tomograms taken, which were then assessed using Demirjian's standards. The Indian method and the Demirjian formula were used to calculate ages. The P values obtained from the statistical analysis, which included the Chi-square test and the ANOVA test, were statistically significant. Results: Both Indian and Demirjian's formulations had an average underestimate of age. Since the Indian method had a reduced mean absolute error, it may be used to estimate ages Additionally, females complete dental development sooner than boys do since they were faster to reach dental maturity. Conclusion: If population-specific formulae are developed using regression analysis and ethnic and environmental variance is taken into account, more accuracy may be attained. Keywords: chronological age, dental maturity, panoramic, radiographs, third molar,

Accuracy of age estimation with Demirjian and Nolla methods in Eastern Turkish children aged 3-17 years old.

Dental age assessment is one of the most reliable methods of chronological age estimation used for criminal, forensic and anthropologic purposes. This study aimed to determine how accurate it was to estimate the chronological age by looking at the dental age measured with the Nolla and Demirjian methods in a Turkish sample, based on the variables of gender and age-group. A retrospective study was performed on panoramic radiographs of 1587 subjects (774 females and 813 males), aged 3-17 years. The mean dental age according to the Demirjian and Nolla methods were compared to the mean chronological age (CA). Also, the percentage value of prediction of CA was determined by using the both methods. An under-estimation of the chronological age was observed by using Nolla's method (males -0.003, females -0.32, both -0.16) and an over-estimation of the dental age was observed by using Demirjian's method (males 0.61, females 0.75,both 0.68). Nolla's method was more accurate in the CA estimation than Demirjian's method in Eastern Turkish population.

A large sample-sized study on dental development of children treated at the Central Dental Clinic (OCEx) of the Brazilian Army.

To test and compare the performance of two radiographic methods for dental age estimation on a large sample of Brazilian boys and girls. The sample consisted of 1.990 panoramic radiographs of Brazilian children (age: 3-15.9years) equally balanced based on sex. The sample was distributed into ten age categories, each with up to 200 children. Age estimation was performed with Willems' (2001) and Demirjian's (1973) methods. Estimated (EA) and chronological (CA) ages were compared. The performances of the methods were quantified based on sex and age category. The overall differences between CA and EA for Willems' method in boys and girls were 0.06 and - 0.02, respectively. For Demirjian's method, the differences were 0.60 and 0.74, respectively. The overestimations of Demirjian's method were statistically significant (p < 0.001). Willems' method reached the best outcomes among children between 3 and 12years, while Demirjian's best performances were between the ages of 7 and 10years. Willems' method led to differences between CA and AE that were acceptable for clinical and forensic practice. Age estimation may guide clinical decisions based on treatment timing. Validating international tools is necessary to promote evidence-based practice and country-specific application. This study overcame the limitations of previous research to provide a more realistic perspective of the performance of age estimation methods in Brazilian children. Willems' method had a superior performance compared to Demirjian's method and led to outcomes that were better than most studies with the Brazilian population.

Use of the Demirjian method to estimate dental age in panoramic radiographs of patients treated at the Buenos Aires University School of Dentistry.

The aim of this study was to determine the difference between real age (RA) and dental age (DA) in boys and girls from the Autonomous City of Buenos Aires (C.A.B.A.) by analyzing digital panoramic radiographs from the database of the Imaging Department at the Buenos Aires University School of Dentistry, using the Demirjian Method (DM). The sample consisted of 508 panoramic radiographs of 6- to 14-year old Argentines (268 female and 240 male). The Demirjian method was used to estimate dental age from each panoramic radiograph, and the Wilcoxon test was applied to perform a comparative analysis with the real age recorded in the image database. Average RA was 9.36 years (SD 2.11), and average DA according to the Demirjian method was 10.45 years (SD 2.31). For females, RA was 9.25 (SD 2.12), and DA according to the DM was 10.40 years (SD 2.41). For males, RA was 9.46 (SD 2.10), and DA according to the DM was 10.50 years (SD 2.22). An inter-classcorrelationcoefficient(ICC) calculated as a correlation measure between dental age and real age was ICC = 1.09%. The ICC was 1.04% for the males and 1.15% for females. Significant differences were found between DA and RA (p<0.01) in general and according to sex. Real age was found to be lower than dental age in the study population from Buenos Aires City.

Validity of the Demirjian Method for Dental Age Estimation in Romanian Children.

Dental age assessment is useful in various medical fields. The Demirjian method for dental age estimation is one of the most widely used in the field of pediatric dentistry. The aim of this study was to verify the accuracy of the Demirjian method in determining age in a sample of girls and boys from Oradea, Romania. This retrospective and radiographic study was based on the evaluation of 1006 panoramic radiographs, belonging to 1006 patients (431 boys and 575 girls) with ages between 3 and 13.9 years from the city of Oradea, Romania. They were collected from three private dental practices from Oradea and were analyzed between 1 September 2021, and 10 November 2021. The patients were distributed into 11 age groups, each group spanning over one year (e.g., 3–3.9, 4–4.9). For the assessment of dental age, the Demirjian method was used, which is based on the evaluation of the developmental stages of the lower left permanent teeth. The mean chronological age of the patients was 9.496 ± 2.218 years, and the mean dental age was 10.934 ± 2.585 years. The overestimation of dental age was obtained in all age groups for the entire sample. As such, dental age was higher than chronological age, with values varying from 0.34 years in the 3–3.9 years age group to 1.7 years in the 10–10.9 years age group. In girls, dental age was higher than chronological age, with values varying from 0.46 years in the 3–3.9 years age group to 1.73 years in the 11–11.9 years age group, while in boys, the values varied from 0.15 years in the first age group to 2.02 years in the 10–10.9 years age group. The comparison of the differences between chronological age and dental age according to the gender of the patients revealed that the distribution of the differences was nonparametric in both groups according to the Shapiro–Wilk test (p < 0.05). The differences between the groups were not significant according to the Mann–Whitney U test. However, larger differences were identified for boys (1.46 years) than girls (1.417 years), with an overestimation of the dental age. The Demirjian method overestimated the age of the children included in the investigated sample, with different values for the different age groups investigated, and requires adaptations.

Investigation of salivary biomarkers as indicators of skeletal and dental maturity in children.

Estimation of patient's skeletal maturity in orthodontics is essential for the diagnosis and treatment planning. The aim of the study was to investigate the potential use of metabolic fingerprint of saliva for bone growth and tooth development estimation. Saliva samples from 54 young patients were analysed by an untargeted gas chromatography-mass spectrometry metabolomics-based method. The skeletal maturity was calculated with the cervical vertebrae maturation method, and the dental age was estimated with the Demirjian method. Multivariate analysis and univariate analysis were performed to investigate differences within skeletal, dental and chronological age groups. Metabolomic analysis identified 61 endogenous compounds. Mannose, glucose, glycerol, glyceric acid and pyroglutamic acid levels differentiated significantly with skeletal age (P=.02 to .043), while mannose, lactic acid, glycolic acid, proline, norleucine, 3-aminoisobutyric acid, threonine, cadaverine and hydrocinnamic acid levels differed within the dental age groups (P=.018 to .04); according to the chronological age, only the levels of mannose and 3-hydroxyphenylacetic acid showed variation (P=.029 and .048). The principal component analysis did not manage to highlight differences between the groups of the studied parameters. Differentiated levels of mannose, glucose, glycerol, glyceric acid and pyroglutamic acid related to skeletal maturation were identified. According to dental development, the levels of mannose, lactic acid, glycolic acid, proline, norleucine, 3-aminoisobutyric acid, threonine, cadaverine and hydrocinnamic acid differed within the groups, while regarding chronological age, only the levels of mannose and 3-hydroxyphenylacetic acid showed variations. Further studies are required to prove their relation to skeletal and dental development pathway by applying complementary analytical techniques to wider cover the metabolome.

Prakiraan Usia Gigi Menggunakan Standar Blenkin (Modifikasi Metode Demirjian) pada Anak Penderita Down Syndrome

Age has an important role in the forensic identification process. Age estimation need to be done accurately in determining a person's age. The use of the Blenkin standard as a method of age estimation to the Javanese population produces accurate results. Chronological age estimation can be known through the dental age which is largely controlled by genetic factors. One of the genetic disorders that is associated as one of the causes of delayed development and eruption of teeth is Down Syndrome. The manifestation of Down syndrome in children's teeth is the delay in the timing and sequence of tooth eruption. The purpose of this study was to assess dental age estimates using the Blenkin standard (modified Demirjian method) in children with Down syndrome. This study is a cross-sectional study using children with Down Syndrome as research subjects, aged 10-16 years and willing to sign an informed consent for further panoramic x-rays. The results of the panoramic X-ray are then assessed using the Blenkin Standard for age estimation. The results showed that the dental age was different from the chronological age, which was 2.8 years for the sample of boys with Down Syndrome and 0.72 years for the sample of girls with Down Syndrome.

A comparison of the accuracy of the cervical vertebrae maturation stage method and Demirjian’s method on mandibular length growth

Background: Malocclusion is one of the most familiar dental problems, with a high prevalence among the population. Understanding the patient’s craniofacial growth and development is crucial in diagnosis, as are the planning and subsequent success of the treatment. Malocclusion needs to be treated early to optimise the outcome achieved by the treatment. One of the most common types of malocclusions observed in clinics is crowding. The craniofacial bone relevant to the treatment of crowding is the mandible, defined as the mandibular length from the condylion to gnathion areas. When planning treatment, clinicians may experience difficulties in determining the biological age of patient, particularly when supporting diagnostic tools are not available. The indicators of biological age can be observed by the assessment of bone maturation using the cervical vertebrae maturation (CVM) method and by the analysis of tooth maturation using Demirjian’s method. However, limited studies are available regarding the accuracy of these methods as diagnostic tools. Purpose: This study aims to analyse the accuracy of the CVM method compared with Demirjian’s method concerning mandibular length growth. Methods: An analytic research method and a cross-sectional design are employed. The research sample comprised 50 lateral cephalometric and panoramic photos of children aged 8-16 years. Data were collected by analysing the maturity level of the cervical vertebrae and the teeth, and measuring the mandible length of the children in the photos. The statistical test used was the Wilcoxon test. Results: The results of the Wilcoxon test for the asymptotic sign had a p-value of 0.116 &gt; 0.05, indicating no significant difference between the CVM and Demirjian methods. Conclusion: Both of the methods noted above yielded equally accurate results for determining mandibular length growth.

Correlation of Left Mandibular Third Molar Development and Chronological Age

The aim of this study is to evaluate the development of the left mandibular third-molar development with modified Demirjian method and its relation to chronological age. A total of 1653 digital panoramic radiographs of healthy individuals aged between 7 and 23 years who visited Yonsei University Dental hospital were selected. The developmental status of the left mandibular third molars was assessed using dental maturity scoring proposed by Demirjian et al. The mean age of the first appearance of mineralization, complete crown formation, and complete root formation were around 9, 14, 21 years respectively. Statistically significant differences between males and females in the development stage of D and G were revealed that crown formation and root length completion were attained earlier in males than in females. There was significant positive relationship between age and third molar development in both sexes, and new formula was presented to estimate age of children and adolescents based on their developmental stages of third molars. In this study, the use of left mandibular third molar as a developmental marker is appropriate, and age estimation can be attained with dental maturity stage.

Accuracy of different dental age estimation methods for determining the legal majority of 18years in the Turkish population.

Radiographic evaluation of the third molar maturation is used to estimate dental age, especially in adolescence. This study aimed to assess the application of three age estimation methods (Cameriere's third molar maturity index (I3M), Demirjian's maturation stages, and The London Atlas) to determine whether an individual is 18years or older (adult) or younger than 18years (minor). The dental age was estimated using the I3M, Demirjian's maturation stages, and The London Atlas methods on panoramic radiograms of a total of 500 Turkish individuals aged 14-22years. A logistic model was derived with an individual's adult or minor status as the dependent variable, and each method and sex as predictive variables. The adult status was determined using dental age estimation methods and the performance of these methods in differentiating adults from minors was evaluated. The three methods were compared case-wise for their accuracy in predicting adult status. Logistic regression analysis showed that sex and each estimation method were statistically significant in discriminating adults and minors (p < 0.05). In the case-wise comparison for estimate adulthood, both Demirjian's stages and I3M methods tended to perform better than the London Atlas method, with this trend reaching statistical significance (p < 0.05). Cameriere's I3M and Demirjian's development stages are useful methods for adult age assessment in the tested population. In forensic medicine and legal practices, Cameriere's I3M and Demirjian's maturation stage methods based on the development of the third molar teeth can be used to determine whether an individual is a minor or an adult.

Demirjian and Cameriere methods for age estimation in a Spanish sample of 1386 living subjects

Currently, human identification is a challenge. Migration due to war, economic crisis or other factors is frequent. The wisdom teeth are the last teeth to initiate and complete development therefore, are fundamental for determining the legal age of majority in different countries. The aim of the study is to determine the validity of two methods based on mineralisation of the third molar to predict the ages of majority of individuals in a Spanish population. Orthopantomographies of 636 men and 750 women (mean age, 16.5 years) were analysed. The Demirjian and Cameriere methods were used, and each tooth was assigned a value according to the degree of mineralisation and maturation. The level of significance used in the analyses was 5% (α = 0.05), with a power of 96.2%. The predictive ability of the Demirjian method to determine 18 years of age in the lower wisdom teeth 93%, respectively. The Cameriere method has a predictive capacity of 88%. There are no statistically significant differences between men and women. Stage H and a cut-off point of 0.08 were the guiding values for determining the age of majority of the study population. For other proposed age ranges (14 and 16 years), both methods were useful in determining the actual age of individuals, with the Demirjian method having a sensitivity of 97.5% with and Cameriere having a predictive capacity of 95%. Both methods can be used with high reliability to determine the age of individuals where reliable documentation is unavailable. Stage H with the Demirjian method and a cut-off point of 0.08 with the Cameriere method can determine the age of majority of the Spanish population. The combination of the two methods does not substantially increase predictive ability.

The Applicable Dental Age Estimation Methods for Children and Adolescents in Indonesia.

Indonesia is an archipelagic country bordered by tectonically active zones with intense seismicity and volcanism. This condition is often associated with a high-risk situation of disasters in Indonesia. Forensic identification is a necessary procedure to reveal an individual's identity. An identity, including sex and age, is needed to build a conclusion of human identification. Dental age estimation is a subfield of forensic odontology which focuses on establishing an individual's age. Tooth development, biochemical, and postformation changes are the parameters for estimating dental age. This review discusses the applicable dental age estimation method for children and adolescents in Indonesia. Several articles that have previously studied dental age estimation in Indonesia were reviewed for this manuscript. On reviewing these articles, it was found that the Demirjian method, the Willems method, and the Al Qahtani method are useful in this population with higher accuracy than other methods.

Dental age estimation of Tibetan children and adolescents: Comparison of Demirjian, Willems methods and a newly modified Demirjian method

Tibetan ethnic group is one of the oldest ethnic groups in China and South Asia. This study set out to analyze the dental development and validate Demirjian method and Willems method in estimating dental age of Tibetan children and adolescents, and to modify Demirjian method based on Tibetan population to provide ethnic-specific reference data and a more reliable method for forensic age assessment in Tibetan ethnic group. In this study, 1951 samples aged between 4 and 15 years were retrospectively collected and analyzed. Multiple linear regression was used to establish relationship between chronological age (CA) and developmental stages of left mandibular permanent teeth. The accuracy of the modified method was tested and compared with that of Demirjian and Willems method. Results showed that dental maturity score (DMS) was significantly greater in girls than in boys in all age groups except for the 4-year age group (p < 0.05). Mean absolute error (MAE) was 0.96 years for both boys and girls by Demirjian method, and 1.06 and 1.16 years for boys and girls respectively by Willems method. Adjusted scores table was established and tested. The age of boys was overestimated by 0.13 years and the age of girls was underestimated by 0.06 years by the adjusted scores table. MAE was lower than that of the other two methods. In conclusion, Demirjian method and Willems method was not sufficiently accurate in estimating dental age of Tibetan population. The modified method was more suitable for dental age estimation of Tibetan population than Demirjian and Willems method.

Estimation of dental age using Willems method and comparing it with Demirjian's method in 7-14-year-old children of Uttarakhand.

The aim of this comparative study was to estimate the dental age using Willems method by assessing the developmental stages of left seven permanent mandibular teeth in 7-14 years of age groups with the help of digital orthopantomogram and comparing it with Demirjian's method to conclude which method was more appropriate and better in Indian population of Uttarakhand region. A total of 100 digital orthopantomogram films of patients in the age group of 7-14 years was collected over the study period of 3 years from July 2014 to January 2017 and was equally distributed by convenience sampling. Group I included 50 boys and Group II included 50 girls aging 7-14 years of age (as permanent 7 teeth in the 3rd quadrant were to be assessed and scored according to the Demirjian's table, the 7-14 age group was selected). The date of birth of the subject was documented against their allocated identification number. Dental age according to Willem's method was calculated using Willem's table and Demirjian and Goldstein's table scores were used to calculate dental age by Demirjian's method. Willems method was more accurate and better than Demirjian's method as it showed less mean percentage error, i.e., 0.34% as compared to 15.94% obtained from Demirjian's method in Group II and 2.19% as compared to 8.05% obtained from Demirjian's method in Group I. The results suggested that Willems method of dental age estimation was an effective method of age estimation and was better and more accurate than Demirjian's method.

Accuracy of age estimation using cervical vertebral maturation index and demirjian's method: A comparative study

Dental age estimation is considered to be vital, as tooth development shows less variability than other developmental features. But in case of missing tooth it is not possible to estimate chronological age using dental age estimation methods. So there should be an alternate method for age estimation. The cervical vertebrae maturation index (CVMI) is one of the easiest and most commonly used skeletal maturity indices. Aim of this study is to check the accuracy of age estimation using CVMI and Demirjian's method with chronological age. It is a comparative study to check the accuracy of age estimation using Demirjians method and CVMI method with chronological age among Kannur population, of age range between 10-16 years. 100 panoramic radiographs and 100 lateral cephalograms of same patient were assessed using Demirjians and CVMI method respectively. The results were compared with chronological age and the data were analyzed. p value was less than 0.0001. The mean age difference for total sample using Demirjians method is -0.20+/-0.048 and using CVMI method is 0.63+/-0.08. In the age group of 15-16 years using CVMI method the mean difference is 1.34 +/- 0.09 and the p value is <0.934 which is not statistically significant. Pearson correlation coefficient shows good correlation value for total samples. The correlation between Demirjians and Chronologic age is 0.972 and CVMI with Chronologic age is 0.919. Demirjians method is better & preferred method for estimation of chronological age. But if need arises CVMI can efficiently replace the Demirjians method till the age of 14 years.

Age estimation using panoramic radiography and lateral cephalogram-A comparative study.

Age estimation allows the identification of living individuals, dead victims and estimation of age in children using maxillofacial radiographs. To compare age estimation by mandibular third molar developmental stages using modified Demirjian's method on OPG with age estimation by mandibular linear dimensions on lateral cephalogram. A total of 200 randomly selected subjects (100 males and 100 females), with age range from 9 to 20 years, and 200 Digital Orthopantomograms and 200 Digital Lateral Cephalograms were utilized for the study. Radiographs were taken with Kodak 8000C Digital Panoramic and Cephalometric machine operating at 60-90 kvp, with exposure time of 8-18 s at 2-15 mA, with an inbuilt magnification factor. A flat screen Compaq TFT-LCD monitor was used to view the OPG images. Linear mandibular dimensional measurements were made on each Digital Lateral Cephalogram using Trophy Dicom Software. Regression analysis and regression coefficient for establishing gender-specific equation were observed. Evaluation of results and statistical analysis was carried by using Student's 't' test. For all test, 'P' value of 0.05 or less was utilized for measuring the degree of significance. Intra-observer variability was detected using reliability analysis. The accuracy of age estimation by OPG was 93.8% and by lateral cephalogram was 79.7%. The OPG analysis is more reliable than the cephalometric parameters.