|Year : 2021 | Volume
| Issue : 4 | Page : 468-471
Usefulness of demirjian's comprehensive dental chart for age estimation in dental practice – A pilot radiographic study
MunBhawni Bagga1, Ramandeep S Punia2, Thippeswamy S Halappa3
1 Department of Oral Medicine, Diagnosis and Radiology, MN DAV Dental College and Hospital, Solan, Himachal Pradesh, India
2 Department of Oral Medicine, Diagnosis and Radiology, Dashmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
3 Department of Oral Pathology and Microbiology, Dashmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
|Date of Submission||21-May-2021|
|Date of Decision||18-Nov-2021|
|Date of Acceptance||24-Nov-2021|
|Date of Web Publication||27-Dec-2021|
Dr. MunBhawni Bagga
Department of Oral Medicine, Diagnosis and Radiology, MN DAV Dental College and Hospital, Tatul, Solan, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Demirjian 7-teeth method is a gold standard for dental age estimation (DAE) so it has been simplified to a comprehensive chart (DAEcc) to make it user-friendly. This pilot study aimed to assess applicability and usefulness of DAEcc. 250 OPGs (130 men, 120 women, 5–15 years) were evaluated for DAE in the North Indian population using DAEcc and compared it to chronological age. Results showed a positive correlation between chronological age and estimated age (Correlation = 0.9; P < 0.001). However, like the original Demirjian 7-teeth method here also a slight overestimation of age was there but DAEcc is a more time-efficient method.
Keywords: Demirjian's method, dental age estimation
|How to cite this article:|
Bagga M, Punia RS, Halappa TS. Usefulness of demirjian's comprehensive dental chart for age estimation in dental practice – A pilot radiographic study. J Indian Acad Oral Med Radiol 2021;33:468-71
|How to cite this URL:|
Bagga M, Punia RS, Halappa TS. Usefulness of demirjian's comprehensive dental chart for age estimation in dental practice – A pilot radiographic study. J Indian Acad Oral Med Radiol [serial online] 2021 [cited 2022 Jan 27];33:468-71. Available from: https://www.jiaomr.in/text.asp?2021/33/4/468/333861
| Introduction|| |
In dental practice, radiographic age estimation rely on developmental stages of teeth especially in children as it is a simple, non-destructive and a reliable method. The age estimation can be used for individuals with unknown birth records in legal, forensic or dental practice.
Several methods have been developed to estimate age but fewer studies available in northern India settings about human age estimation using quick radiological methods. Therefore, current study was proposed with an aim to assess the dental age of North Indian children using easy and convenient method, i.e., Demirjian's comprehensive dental chart.
| Materials and Methods|| |
The present pilot study comprise of 250 subjects ranging from 5 to 15 years. The final sample size was calculated with power of the study 87%, expected response rate as 90% and dropout rate of 10%. The study was conducted after obtaining Institutional ethical clearance IRBC/ECC/DCH/72 dated 3.1.2020. The study was in accord with standards as per the Helsinki declaration of 1975. A detailed case history and patient/parent consent was obtained. The inclusion criteria were, patient aged between 5 and 15 years, radiographs already prescribed for any dental diseases, good quality radiograph and no extractions or agenesis in left lower quadrant of teeth. The exclusion criteria were incomplete dental or medical history, previous orthodontic treatment, evident systemic diseases and congenital abnormalities, hypodontia of permanent teeth except third molars, hyperdontia, premature birth and unwilling participant.
Chronological age was estimated by subtracting their birth date from radiography date. The dental age is calculated by a simplified comprehensive dental chart of Demirjian's method. [Figure 1] The digital images were traced and developmental stages were compared to illustrated representation and the analogous scores were marked depending on the gender of the patient., [Figure 2] and [Figure 3] Also, time was noted each and every time while completing the method. The data were analyzed using t test and correlation using Statistical package for the social sciences 20.0.
| Results|| |
In the Demirjian method using DAEcc mean age was 11.2 ± 3.6 and 11.3 ± 2.8 years in comparison to the chronological age of 9.5 ± 3.3 and 9.9 ± 3.0 years respectively for men and women. [Table 1]. The average time taken to complete one interpretation is 7.4 minutes. The correlation and test of significance was calculated to demonstrate the distribution of estimated dental age with chronological age which was strongly significant (P < 0.001) [Table 2]
|Table 1: Mean absolute differences, correlation and standard deviation for age cohort for males and females|
Click here to view
|Table 2: Test of significance for mean age with age calculated by Demirjian DAEcc method|
Click here to view
| Discussion|| |
Identification of age is very important for a variety of reasons, including identifying criminal and legal responsibility, sexual assaults and other social events such as birth certificate, marriage, beginning a job and retirement. The evaluation of mineralization from OPG is the most suitable method for age estimation using teeth in children because the single radiograph gives the complete developmental status of dentition in children. Although various age estimation methods showed high degree of reliability but ethnic differences, growth rate of various population groups were found to affect the accuracy of dental age estimation methods.
The overall mean difference between estimation of dental age and chronological age by simplified comprehensive dental chart of Demirjian's method was 1.4-1.7 years which overestimated the age slightly and was in agreement with previous studies., The studies that have employed Demirjian system refer lot of tables and charts that make whole process time-consuming., Whereas, DAEcc incorporates pictorial representation which are easy to comprehend and requires minimal paperwork to save time. When the comparison between genders was done females mature earlier than males which were in accord with findings of Urzel and Bruzek. A meta-analysis on 26 studies with total of 11,499 children, Demirjian's method overestimated the dental age by 0.35 (4.2 months) and 0.39 (4.68 months) in men and women, respectively.
Limitations and future prospects
As such no published data is available regarding application and convenience of method, thus this study is useful for age estimation in children with unknown chronological age with more sample size and can be compared with other radiographic methods. The validity of the study can be increased by comparing it with another method of age estimation and also by including more observers for intraobserver and interobserver variation.
| Conclusion|| |
The present method nearly estimates the correct dental age in less time.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Balla SB, Venkat Baghirath P, Hari Vinay B, Vijay Kumar J, Babu DB. Accuracy of methods of age estimation in predicting dental age of preadolescent in South Indian Children. J Forensic Leg Med 2016;43:21-5.
Esan TA, Schepartz LA. The timing of permanent tooth development in a Black Southern African population using the Demirjian method. Int J Legal Med 2019;133:257-68.
Kapoor P, Jain V. Comprehensive chart for dental age estimation based on Demirjian 8- teeth method: Simplified for operator ease. J Forensic Leg Med 2018;59:45-9.
Gungor OE, Kale B, Celikoglu M, Gungor AY, Sari Z. Validity of Demirjian method for dental age estimation for Southern Turkish children. Niger J Clin Pract 2015;18:616-9.
] [Full text]
Melo M, Ata-Ali J. Accuracy of the estimation of dental age in comparison with chronological age in a Spanish sample of 2641 living objects using Demirjian and Nolla methods. J Forensic Sci Int 2017;270e-6e.
Jain V, Kapoor P, Miglani R. Demirjian approach of dental age estimation: Abridged for operator ease. J Forensic Dent Sci 2016;8:177-80.
] [Full text]
El Bakary AA, Hammad SM, Ibrahim FM. Comparison between two methods of age estimation among Egyptian children. Mansoura J Forensic Med Clin Toxicology 2009;17:75-86.
Demirjian A, Goldstein H. New system for dental maturity based on seven and four teeth. Ann Hum Biol 1976;3:411-21.
Cameriere R, Ferrante L, Liversidge HM, Prieto JL, Brike H. Accuracy of age estimation in children using radiographs of developing teeth. Forensic Sci Int 2008;176:173-7.
Sinha S, Umapathy D, Shashikant MC, Misra N, Mehra A, Singh AK. Dental age estimation by Demirjian's and Nolla's method: A comparative study among children attending a dental college in Lucknow (UP). J Indian Acad Oral Med Radiol 2014;26:279-86. [Full text]
Hegde S, Patodia A, Dixit U. The applicability of the Demirjian, Willems and chaillet standards to age estimation of 5-15 year old Indian children. J Forensic Odontostomatol 2019;37:40-50.
Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol 1973;45:211-27.
Urzel V, Bruzek J. Dental age assessment in children: A comparison of four methods in a recent French population. J forensic Sci 2013;58:1341-7.
Yan J, Lou X, Xie L, Yu D, Shen G, Wang Y. Assessment of dental age of children aged 3.5 to 16.9 years using Demirjian's method: A meta-analysis based on 26 studies. PLoS One 2013;8:e84672.
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]