Dental age estimation by assessing the pulp volume of five teeth in a peruvian population using cone beam computed tomography images / Estimación de la edad dental evaluando el volumen pulpar de cinco dientes utilizando imágenes de tomografías computarizadas de haz cónico en una población peruana

Abstract Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients (females (134), males (97), age: 12-60 years) were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The Pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.

Resumen La estimación de la edad dental en personas vivas y cadáveres es muy importante para la Odontología Forense, sobre todo en casos de identificación en investigaciones legales y sociales. El objetivo del estudio fue estimación de la edad dental mediante la medición del volumen pulpar de imágenes dentales en tomografía computarizada de haz cónico (TCHC) de pacientes peruanos. Fueron analizadas 231 TCHC de pacientes entre 12 a 60 años a más. (Mujeres (134), hombres (97)) se dividieron en seis grupos de edad (12-19, 20-29, 30-39, 40-49, 50-59, 60 años a más). El análisis volumétrico de la pulpa dental se realizó en un total de 1155 dientes (caninos superiores, incisivos centrales superiores izquierdos, primeros molares superiores izquierdos y primeros premolares inferiores izquierdos), mediante el software Romexis® 5.3.3.5. El análisis de regresión lineal mostró un coeficiente de determinación del 30% que sugiere una correlación débil entre la relación del volumen pulpar de los dientes y la edad. El volumen pulpar de los caninos superiores derecho e izquierdo disminuyó a medida que aumentaba la edad y el volumen pulpar en dientes de personas de 60 años a más fue el más bajo. Sin embargo, se pueden proponer estudios futuros para incluir una gran muestra homogénea de dientes en diferentes categorías y grupos de edad para confirmar la correlación y establecer una ecuación de regresión confiable.

A Importância dos Métodos de Determinação das Idades Esquelética e Dentária na Ortodontia e Odontopediatria ­ uma Revisão de Literatura / The Importance of Methods for Determination of Squeletal and Dental Age in Orthodontics and Pediatric Dentistry ­ a Literature Review

O estágio de desenvolvimento humano é intimamente relacionado à sua maturidade óssea ou dentária, sendo essencial para a escolha do tratamento de alterações dentofaciais em crianças e adolescentes por ortodontistas e odontopediatras. Existem diversos indicadores biológicos para determinar a maturação do indivíduo, como a idade cronológica e as alterações hormonais, porém esses indicadores podem sofrer interferências. Visando uma determinação de desenvolvimento e dos picos de crescimento mais precisa, para um melhor diagnóstico e plano de tratamento, foram desenvolvidos diversos métodos para determinar a idade esquelética e a idade dentária, sendo estes a avaliação da maturação carpal, da morfologia das vértebras cervicais, da fusão óssea da sincondrose esfeno-occipital e da sutura palatina mediana, bem como dos estágios da calcificação dentária. A avaliação das radiografias de mão e punho é o padrão ouro da predição da idade esquelética, e sua correlação com outros métodos já é evidente. Sendo assim, é possível utilizar a avaliação das vértebras cervicais e das idades dentárias de Nolla e Demirjian.

The stage of human development is closely related to bone or dental maturity, being essential for the choice of treatment for dentofacial changes in children and adolescents by orthodontists and pediatric dentists. There are several biological indicators to determine an individual's maturation, such as chronological age and hormonal changes, but these indicators can suffer interference. Aiming at a more accurate determination of development and growth peaks, for a better diagnosis and treatment plan, several methods have been developed to determine skeletal age and dental age, these being the assessment of carpal maturation, the morphology of the cervical vertebrae, bone fusion of the spheno-occipital synchondrosis and the median palatal suture, as well as the stages of dental calcification. The evaluation of hand and wrist radiographs is the gold standard for predicting skeletal age, and its correlation with other methods is already evident. Therefore, it is possible to use the assessment of cervical vertebrae and dental ages by Nolla and Demirjian.

Comparison of Accuracy Between Pulp/Tooth Ratio and Tooth Coronal Index Methods for Dental Age Estimation Using Digital Panoramic Radiographs

ABSTRACT Objective: To evaluate the reliability and the accuracy of Tooth Coronal Index (TCI) and Pulp/Tooth Ratio (PTR) methods in dental age estimation using digital panoramic radiography. Material and Methods: In this cross-sectional study, 237 dental panoramic images were collected. The two methods (TCI and PTR) were applied to all left mandibular first and second molars based on inclusion and exclusion criteria. In order to analyze the acquired data, statistical methods were used. The estimated ages derived by exclusive formula were compared to the chronological age, and the error ranges for each indicator were measured to determine their accuracy. Results: There were negative correlations between PTR in the first molar (r=-0.89) and in the second molar (r=-0.788), as well as TCI in the first molar (r=-0.587) and in the second molar (r=-.242). In this study, we found that the Pulp/Tooth Ratio (PTR) accuracy rate for mandibular first and second molar teeth was 79.21% and 62.09 %, respectively, although the Tooth Coronal Index (TCI) value for these teeth was 34.45% and 5.85%. Conclusion: Pulp/Tooth Ratio and Tooth Coronal Index are potential age estimation indices. Although PTR was the more accurate one in our study. The results also demonstrated that indices related to the first molar tooth could be used to estimate age with greater accuracy and validity.

Use of the Demirjian method to estimate dental age in panoramic radiographs of patients treated at the Buenos Aires University School of Dentistry / Utilización del Método de Demirjian para estimación de la edad dental en radiografías panorámicas de pacientes atendidos en la Facultad de Odontología de la Universidad de Buenos Aires

ABSTRACT 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-class correlation coefficient (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.

RESUMEN El objetivo del presente trabajo fue determinar la diferencia entre la edad real (ER) y la edad dental (ED) en niños y niñas de la Ciudad de Buenos Aires analizando radiografías panorámicas digitales de la base de datos de la Cátedra de Diagnóstico por imágenes FOUBA, utilizando el Método Demirjian (MD). La muestra consistió en 508 radiografías panorámicas (268 del sexo femenino y 240 del sexo masculino) en una población argentina de 6 a 14 años de edad. Se realizó el cálculo de la edad dental en cada una de ellas, conforme el método de Demirjian. Se efectuó un análisis comparativo con la ER proveniente de la base de datos, utilizando la prueba de Wilcoxon. En las 508 panorámicas se estimó la ED. Se pudo establecer que la ER en promedio es 9.36 años con un desviación estándar (DS) de 2,11 y que la edad según el método de Demirjian es 10,45 años con una DS de 2,31. Para el sexo femenino se obtuvo una ER de 9,25 y una DS de 2,12 y según MD es de 10,40 años con una DS de 2,41. Para el sexo masculino se obtuvo una ER de 9,46 y una DS de 2,10 y según MD es de 10,50 años con una DS de 2,22. Se obtuvo un coeficiente de correlación inter-clase (CCI), como medida de correlación entre edad dental y real, de (CCI 1,09%). El CCI para el sexo masculino fue de (CCI 1,04 %) y en el caso del sexo femenino fue de (CCI 1,15%). Se hallaron diferencias significativas entre ED y ER (p<0,01) en general y también para ambos sexos. Se pudo evidenciar que la edad real es menor que la edad dental en la población de la Ciudad de Buenos Aires.

Comparación entre edad cronológica y dental según tres métodos de estimación en una población peruana / Comparison between chronological and dental ages according to three estimation methods in a Peruvian population

Resumen Las técnicas de estimación de edad dental tienen gran importancia en la evaluación odontológica, específicamente en el área de ortodoncia, académica y forense. El objetivo de este estudio fue comparar la edad dental según los métodos de Demirjian, Nolla y Cameriere con la edad cronológica en una población peruana. El diseño del estudio es de tipo observacional, descriptivo, de corte transversal y retrospectivo; tuvo una población total de 578 radiografías panorámicas de sujetos de 6 a 14 años, en las cuales se calculó la diferencia de medias de un estudio previo y, finalmente, fueron seleccionadas 193 de forma aleatoria. Se compararon la edad cronológica (EC) y la edad dental (ED) según los métodos de Nolla, Demirjian y Cameriere, utilizando las Pruebas de Rangos de Wilcoxon y Kruskall Wallis. Las medias de la EC fueron de 8,77±2,34 y 8,90±2,04 años para el género femenino y masculino, respectivamente. Las diferencias de medias de la EC y ED, de acuerdo con los métodos Nolla, Demirjian y Cameriere, fue de -0,38, 0,96 y -0,29 años, respectivamente, para la muestra total de estudio. Se encontró una correlación positiva para los tres métodos estudiados; sin embargo, el método de Demirjian mostró una diferencia estadísticamente significativa con una subestimación de -0,91 años en la muestra total. Asimismo, el método de Cameriere fue el que tuvo más cercanía a la edad cronológica.

Abstract Dental age estimation techniques have great importance in dental evaluation, specifically in the orthodontic, academic, and forensic areas. The aim of this study was to compare the dental age according to the Demirjian, Nolla and Cameriere methods with the chronological age in a Peruvian population. This is an observational, descriptive, retrospective and cross-sectional study, which had a total population of 578 panoramic radiographs of subjects aged 6 to 14 years, where the difference in means from a previous study was calculated, and 193 subjects were finally randomly selected. The chronological ages (CA) and dental ages (DA) were compared using the Wilcoxon and Kruskall Wallis Range Tests. The means were 8.77 ± 2.34 and 8.90 ± 2.04 years of the CA for the female and male genders, respectively. The difference in means of the CA and DA according to the Nolla, Demirjian and Cameriere methods were -0.38, 0.96 and -0.21 years, respectively, for the total study sample. A positive correlation was found for the three methods studied; however, the Demirjian method showed a statistically significant difference with an underestimation of -0.91 years in the total sample. Also, the method of Cameriere was the closest to the chronological age.

Relationship between the Height of Alveolar Bone Resorption and Sex and Age in Adolescents / 法医学杂志

OBJECTIVES@#To explore the relationship between the height of alveolar bone resorption and sex and age in the adolescent dentition.@*METHODS@#Multi-slice computed tomography (MSCT) was used to measure the height of alveolar bone resorption at labial, lingual, mesial and distal sites of teeth in 149 adolescents aged from 10 to 20 years. SPSS 25.0 software was used to analyze the relationship between the height of alveolar bone resorption and sex and age.@*RESULTS@#There was no significant difference in the height of alveolar bone resorption between sex (P>0.05). The height of alveolar bone resorption was positively correlated with age in all types of teeth. The model constructed by combining the alveolar bone resorption height data of four sites (y=2.569x1+3.106x2+4.108x3+1.451x4-0.082, R2max=0.756)had a better ability to infer age than that of combining two sites (y=5.942x1+4.489x2+0.612, R2max=0.706) and a single site (R2max=0.638).@*CONCLUSIONS@#The height of alveolar bone resorption is positively correlated with the age of adolescents. The combination of four sites has a stronger ability to infer the relationship between the height of alveolar bone resorption and age in adolescents and has higher accuracy in practical application.

Avaliação da idade dentária em crianças e adolescentes com epidermólise bolhosa ­ série de casos / Dental age estimation in children and adolescents with epidermolysis bullosa ­ case series

Introdução: a epidermólise bolhosa compreende um grupo de doenças genéticas e raras da pele, onde há uma fragilidade estrutural da pele e das mucosas. A gravidade das manifestações clínicas varia de acordo com o subtipo envolvido, no qual a citada enfermidade distrófica recessiva é a mais severa. Há várias implicações sistêmicas, como a anemia, a desidratação e a desnutrição. O envolvimento bucal acompanha e torna mais severo o comprometimento sistêmico. As alterações em tecidos moles e duros dessa região variam consideravelmente. São relatados atrasos no crescimento e desenvolvimento dentoesquelético. Objetivo: considerando as possíveis alterações de desenvolvimento, este estudo tem o objetivo de mensurar a idade dentária em pacientes com epidermólise bolhosa distrófica recessiva, verificando a acurácia de dois métodos em relação à idade cronológica. Metodologia: foi realizado um estudo descritivo analítico transversal do tipo série de casos, que avaliou a idade dentária de 10 pacientes pelos métodos de Demirjian e Willems. Resultados: não houve divergência significativa entre as idades dentária e cronológica, com superestimação comum aos métodos utilizados. Conclusão: sugere-se que o tempo de maturação dentária pode ser um parâmetro estável frente a fatores adversos ao desenvolvimento, que são comuns a esse grupo. São necessários estudos que avaliem também outras variáveis para melhor compreender a relação da epidermólise bolhosa com o desenvolvimento dentoesquelético.

Introduction: Epidermolysis Bullosa (EB) describes a group of rare genetic skin diseases where there is structural fragility within the skin and mucosa. Severity of clinical manifestations varies according to the specific EB type, and the most severe EB type is recessive dystrophic EB. There are several systemic implications, such as anemia, dehydration and malnutrition. There are also oral manifestations, so systemic manifestations may be more severe. Changes in soft and hard oral tissues vary considerably. Dentofacial growth and development retardation is reported. Aim: considering developmental changes, this study aims to measure the dental age of patients with recessive dystrophic EB by verifying the accuracy of two methods in relation to chronological age. Methods: a descriptive cross-sectional and analytical study of case series was carried out, which assessed the dental age of 10 patients using Demirjian and Willems methods. Results: there was not significant divergence between dental and chronological ages, but there was mutual overestimation related to both methods. Conclusion: it is suggested that dental maturation period may be a stable parameter against adverse developmental factors that are common to this group. Studies that also assess other variables are necessary to better understand the relation between EB and dentofacial growth.

Retraso de la erupción dental en el síndrome de Down: evaluación crítica de la evidencia / Delayed tooth eruption in Down syndrome: critical appraisal of evidence

El síndrome de Down en niños se asocia con múltiples alteraciones orofaciales, dentro de ellas se ha mencionado el retraso en la erupción dental, cuya comprensión no es aún del todo conocida. Se realizó una revisión para analizar los conceptos de erupción dental y acerca de la evidencia disponible respecto al retraso en la erupción dental de los niños con síndrome de Down y su relación con la maduración de los dientes o con otros factores sistémicos y locales. Se observó escasez de estudios sobre el tema, sin embargo, con la literatura encontrada se pudo concluir que el retraso de erupción de las piezas dentales parece no tener relación con la maduración de la pieza dental, sino a otros procesos que tienen lugar durante la erupción dental o que puede ser parte del retraso general del crecimiento y del desarrollo que caracteriza al síndrome de Down.

Down syndrome in children is associated with multiple orofacial alterations, among them delayed tooth eruption has been mentioned, the understanding of which is not yet fully known. A review was carried out to analyze the concepts of tooth eruption and the available evidence regarding delayed tooth eruption in children with Down syndrome, and its relationship with tooth maturation or with other systemic and local factors. Few studies were observed on the subject, however, with the found literature it was possible to conclude that the delay in tooth eruption seems not to be related to the maturation of the tooth, but it is related to other processes that take place during tooth eruption or it may be part of the general delay in growth and development that characterizes Down syndrome.

Age Estimation by Modified Demirjian's Method in a Hospital-Based Population: A Radiographic Study

ABSTRACT Objective: To test the modified Demirjian's method of dental age estimation on the South Indian population and correlate it with the patient's chronological age. Material and Methods: This retrospective radiographic study was performed on digital panoramic radiographs taken during a one-year duration. Radiographs of patients in the age range from 8 to 18 years were included in the study. The radiographs were examined and according to the stage of the crown and root status of the left side mandibular teeth. The stage of calcification was observed for eight teeth in the mandibular arch and was recorded in a specially designed proforma. Each rated tooth with stage was converted into a score using a conversion table specified for girls and boys. Results: 224 digital panoramic radiographs were retrieved from the radiologic database. Out of total study sample, 49.5% (n=111) were boys and 50.5% (n=113). The mean chronological and estimated dental age using dental maturity scores resulted in an overestimation of 3 years and eight months. Also, it was noted that there was a strong positive association between chronological (real) and dental age. Conclusion: It was observed that there was a strong correlation between chronological and dental age. A new formula for determining the chronological age from the estimated dental age was derived. Further studies on a larger population may prove the reliability of this age estimation method.

Research Progress on the Forensic Age Estimation in Living Individuals Using MRI / 法医学杂志

One of the major tasks in the forensic field is age estimation in living individuals, especially in adolescents and young adults. The X-ray examination of left hand, panoramic radiograph and CT scan of the sternal end of clavicles are mature means that are widely used. However, the X-ray technique has great radiation on the human body, and imaging radiation for non-diagnosis and treatment purposes does not conform to the current mainstream medical ethics. MRI is nonradioactive tomographic imaging and is one of the research and development directions in forensic age estimation in living individuals now. This paper summarizes the common indicators and analysis methods of MRI in previous research of age estimation, in order to get better understanding of its trends and provide a clue for future relevant studies.

Research Progress of Adult Age Determination with Imaging Methods / 法医学杂志

Adult age determination plays an important role in individual identification, criminal investigation and social welfare. The most popular adult age determination indicators are pubic symphysis, iliac auricular surface, costal cartilage, cranial sutures, teeth, laryngeal cartilage, etc. In recent years, with the progress of CT imaging and 3D reconstruction technology, the adult age determination study gradually has transferred from a time-consuming general observation of bones with complex pre-processing in the past to the non-destructive, convenient, time-saving and easy to store image analysis technology. To explore more accurate, rapid and convenient adult age determination methods, multiple imaging methods and artificial intelligence have been applied in adult age determination. This paper reviews the common methods and research progress of adult age determination at home and abroad, infers the development direction of adult age determination, in order to provide reference for the improvement and optimization of forensic adult age determination.

The Reliability of Fishman and Nolla Methods in Prediction of Chronological Age of Yemeni Children / A confiabilidade dos métodos Fishman e Nolla na predição da idade cronológica de crianças iemenitas

Objective: This cross-sectional school based study aimed to assess the reliability of Fishman and Nolla methods in predicting the chronological age for Yemeni children. Material and Methods: Orthopantomographs and left handwrist radiographs were taken for 358 Yemeni children (193 boys and 165 girls) 8 - 16 years. Skeletal age estimated by Fishman method and dental age estimated by Nolla method were compared to chronological age using SPSS version 21, statistical significance was predetermined at P < 0.05 , using Intraclass Correlation CoefficientICC and Wilcoxon signed rank test. Results: The mean chronological, skeletal and dental ages were 12.00 ± 2.25 years, 12.39 ± 1.65 years and 11.32 ± 2.65 years, respectively. Intraclass correlation coefficient showed strong correlation between chronological age and skeletal and dental ages. Wilcoxon test showed Fishman method significantly underestimated the chronological age by 0.44 ± 1.26 years in boys and non-significantly underestimated the chronological age by 0.02 ± 1.08 years in girls. Nolla method significantly underestimated the chronological age by 0.59 ± 1.28 years in boys and 0.78 ± 1.21 years in girls. Conclusions: Chronological age of Yemeni children is highly correlated to skeletal age estimated by Fishman method and dental age estimated by Nolla method. However, the two methods underestimate the chronological age of Yemeni children.(AU)

Objetivo: Este estudo transversal de base escolar teve como objetivo avaliar a confiabilidade dos métodos Fishman e Nolla na predição da idade cronológica em crianças iemenitas. Material e Métodos: Foram realizadas ortopantomografias e radiografias do punho esquerdo em 358 crianças iemenitas (193 meninos e 165 meninas) de 8 a 16 anos. A idade esquelética estimada pelo método Fishman e a idade odontológica estimada pelo método Nolla foram comparadas com a idade cronológica pelo, utilizando-se o programa SPSS versão 21; a significância estatística foi predeterminada em P < 0,05, pelo coeficiente de correlação intraclasseICC e pelo teste de Wilcoxon. Resultados: As idades cronológica, esquelética e odontológica média foram de 12,00 ± 2,25 anos, 12,39 ± 1,65 anos e 11,32 ± 2,65 anos, respectivamente. O coeficiente de correlação intraclasse mostrou forte correlação entre idade cronológica e idade esquelética e dentária. O teste de Wilcoxon mostrou que o método Fishman subestimou significativamente a idade cronológica em 0,44 ± 1,26 anos nos meninos e não subestimou significativamente a idade cronológica em 0,02 ± 1,08 anos nas meninas. O método Nolla subestimou significativamente a idade cronológica em 0,59 ± 1,28 anos nos meninos e 0,78 ± 1,21 anos nas meninas. Conclusões: A idade cronológica de crianças iemenitas está altamente correlacionada à idade esquelética estimada pelo método Fishman e à idade dentária estimada pelo método Nolla. No entanto, os dois métodos subestimam a idade cronológica das crianças iemenitas.(AU)

Comparación entre edad cronológica y dental en niños de dos localidades peruanas de diferente altitud / Comparison between chronological and dental age in children from two peruvian locations at different altitude

RESUMEN Introducción: El nivel de maduración dental como indicador del nivel de maduración general de acuerdo con el método de Demirjian, puede ser afectado por la altitud geográfica. Objetivo: Determinar la relación de las edades cronológica y dental según el método Demirjian en niños de dos localidades peruanas con diferente altitud. Métodos: Se realizó un estudio observacional, analítico, retrospectivo de corte transversal, que tuvo como muestra a 179 radiografías panorámicas de niños peruanos entre 6 y 12 años: 109 radiografías de niños de la ciudad de Lima y 70 radiografías de niños de la ciudad de Huancayo. Se determinó la edad dental según el método de Demirjian, luego se relacionó con la edad cronológica en cada paciente de las dos localidades; posteriormente se comparó las diferencias de las edades en las dos ciudades. Resultados: Se encontró correlación estadísticamente significativa entre la edad dental y la cronológica en ambos sexos de pacientes de la ciudad de Lima (p< 0,001); mientras que solo se encontró correlación estadísticamente significativa entre la edad dental y la edad cronológica en el sexo masculino en la ciudad de Huancayo (p< 0,001 para el sexo masculino y p= 0,740 para el femenino). La comparación de las diferencias entre edad cronológica y edad dental de los pacientes de las dos ciudades es no estadísticamente significativa (U de Mann-Whitney, p= 0,057). Conclusiones: No se encontró correlación significativa entre las edades dentales y cronológicas en el sexo femenino de los pacientes habitantes a mayor altitud y al comparar las diferencias, entre la edad cronológica y la edad dental según el método Demirjian, en los habitantes de las localidades peruanas no se encontró diferencia estadísticamente significativa(AU)

ABSTRACT Introduction: The degree of dental maturation as an indicator of the degree of general maturation, according to Demirjian's method, may be affected by geographic altitude. Aim: To determine the relationship between chronological age and dental age according to Demirjian's method in children from two Peruvian locations at different altitudes. Methods: An observational, analytical, retrospective, cross-sectional study was performed on a sample of 179 panoramic radiographs of Peruvian children aged 6 to 12 years. Group A: 109 radiographs of children from Lima City; Group B: 70 radiographs of children from Huancayo City. Dental age was determined according to Demirjian's method and related to chronological age for each patient from each location, and the differences were compared for ages in both cities. Results: A statistically significant correlation was found between dental and chronological age for both sexes in patients from Lima City (p< 0.001), but only for male patients from Huancayo City (p< 0.001 for males and p= 0.740 for females). The differences between chronological age and dental age were not statistically significant in patients from either city (Mann-Whitney U test, p= 0.057). Conclusions: No significant correlation was found between dental age and chronological age in female patients living at higher altitude, and no statistically significant difference was found between chronological age and dental age according to Demirjian's method for children living in either city(AU)

Comparative assessment of chronological, dental, and skeletal age in children

Background: Age of a child can be assessed from various parameters such as chronological age, height, weight, secondary sexual characteristics, skeletal age, or dental age. The present study was planned to assess and compare chronological age with dental age (Demirjian's method and Willem's method) and skeletal age (Fishman's method). Materials and Methods: The present study was done on a sample of 100 children in the age group of 9–14 years. The chronological age was computed through the birth certificates and dental age was calculated from their orthopantomograms (OPGs) using Demirjian's and Willem's methods. Hand-wrist radiograph of the left hand was used to compute skeletal age using Fishman's method. Paired t-test and Pearson's correlation coefficients were calculated as a part of statistical analysis at a significance level of P < 0.01. Results: The mean chronological age among the group was 12.37 ± 1.34 years, the mean dental age by Demirjian's method was 12.36 ± 1.72 years, the mean dental age by Willem's method was 12.36 ± 1.51, and the mean skeletal age by Fishman's method was 13.03 ± 1.34 years. Out of the all methods evaluated in the study, Fishman's method of age estimation showed the least value of correlation coefficient (r = 0.728) with the chronological age, whereas Willem's method showed the maximum correlation with the chronological age (r = 0.885). Conclusion: It can be concluded from the present study that the dental age estimation evaluated by the digital OPG by both the methods, that is, Demirjian's method and Willem's method, has shown high accuracy when applied to the children of Faridabad. Skeletal maturation evaluated by Fishman's method using hand-wrist radiographs was found to overestimate the age when compared to chronological age in both the sexes.

Estimación de la edad cronológica a través de los métodos de Demirjian y Ubelaker en niños peruanos / Estimation of the Chronological Age Through the Methods of Demirjian and Ubelaker in Peruvian Children

RESUMEN Objetivo: Determinar el método de estimación de la edad dental más eficaz, Demirjian y Ubelaker, para estimar la edad cronológica en pacientes de 4 a 13 años del Instituto Nacional de Salud del Niño- Lima Perú. Materiales y métodos: Diseño transversal con una muestra conformada por 465 radiografías panorámicas, 229 de personas de sexo masculino (49.2%) y 236 de femenino (50.8%). La estimación de la edad se realizó mediante el protocolo establecido en cada método. La edad cronológica se estableció a través de la diferencia entre la fecha de toma radiográfica con la fecha de nacimiento. Se estableció la precisión y exactitud de cada método. El análisis inferencial se realizó con un nivel de significancia del 5% a través de las pruebas de correlación de Spearman, test de Wilcoxon. Resultados: Se comprobó que el método Ubelaker tuvo 270 casos errados o no coincidentes y 195 coincidencias mientas que el método Demirjian tuvo 360 casos errados y 105 coincidencias entre la edad cronológica estimada y la edad dental encontrándose diferencias significativas en la estimación en cada uno de los métodos p=0,001 y p<0,001 respectivamente. La exactitud obtenida con Ubelaker fue 0,112 y con Demirjian 1,039. Conclusión: El método Ubelaker es más eficaz con una exactitud mayor en comparación a Demirjian.

ABSTRACT 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 <0.001 respectively. The accuracy obtained with Ubelaker was 0,112 and with Demirjian 1,039.

Aplicabilidade do volume da câmara pulpar para a estimativa de idade em adultos a partir de tomografias computadorizadas de feixe cônico: um estudo piloto / Applicability of the pulp chamber volume for the estimation of age in adults from Cone Beam Computed Tomography: a pilot study

Introdução: A demanda forense de estimativa de idade em indivíduos vivos repercutiu no desenvolvimento de metodologias fundamentadas em recursos imaginológicos, notadamente, a Tomografia Computadorizada de Feixe Cônico (TCFC). Objetivo: Avaliar a aplicabilidade do volume da câmara pulpar para estimar a idade em indivíduos adultos através de imagens de TCFC. Material e Método: Estudo cego e transversal com 26 TCFC, que apresentaram incisivos central e lateral superiores (ICS; ILS), 2º pré-molar superior (2PMS), incisivo lateral (ILI), canino (CI) e 1º pré-molar inferior (1PMI) hígidos. Em cada dente, mediu-se o comprimento dental, pulpar e radicular, e a largura radicular e pulpar em três níveis (junção amelo-cementária (A), meio da raiz (C) e entre as duas anteriores (B)), no plano sagital e coronal. Calculou-se razões entre as medidas pulpares e dentais, procedendo-se à análise de regressão linear (α=5%). Resultados: Das 108 medições, duas demonstraram maior correlação com a idade: comprimento pulpar do ILI, no corte sagital (R2=0,273), e largura pulpar no nível C do 1PMI, no corte coronal (R2=0,289). Obteve-se maior poder de estimativa com a média das razões entre a largura pulpar e dental do ICS e ILS nos três níveis no sentido sagital (R2=0,374), seguido da razão do comprimento polpa/dente do ILI (R2=0,368). Conclusão: As medidas da câmara pulpar em TCFC apresentam aplicabilidade moderada para estimar a idade. O cálculo de razões melhora o poder de estimativa, devendo-se privilegiar os incisivos superiores e o incisivo lateral inferior. Pretende-se aumentar a amostra para realizar validação cruzada das equações geradas

Introduction: The forensic demand of age estimation in living individuals had repercussions on the development of methodologies substantiated on imaging resources, notably, the Cone-beam Computed Tomography (CBCT). Objective: To evaluate the applicability of pulp chamber volume to estimate age in adults individuals through CBCT's images. Material and methods: blind and transverse study with 26 CBCT, that presented maxillary central, lateral incisors and second premolar, and mandibular lateral incisor, canine and first premolar healthy. In each tooth, was measured the dental, pulp and radicular length, and the pulp and radicular width in three levels (enamel-cementum junction (A), middle of the root (C) and between the two previous ones (B)), in the sagittal and coronal plane. Reasons were calculated between pulp and dental measurements, proceeding to linear regression analysis (α=5%). Results: 2 out of 108 measurements demonstrated greater correlation with age: pulp length of mandibular lateral incisor, in sagittal cut (R²=0,273), and pulp width at level C of mandibular first premolar, in coronal cut (R²=0,289). Greater estimative power was obtained with the average between pulp and dental width of maxillary central and lateral incisors in the three levels in sagittal direction (R²=0,374), followed by the reason of dental/pulp length of mandibular lateral incisor (R²=0,368). Conclusion: measurements of pulp chamber in CBCT presented moderate applicability to estimate age. The calculation of the reasons improves the estimation's power, and the maxillary incisors and mandibular lateral incisor should be privileged. It's intended to increase the sample to perform the cross-validation of the equations generated.

Application of Demirjian's and Cameriere's Method in Dental Age Estimation of 8-16 Year Old Adolescents from Hunan Han Nationality / 法医学杂志

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.

Research Progress of Age Estimation Based on the Demirjian's Method / 法医学杂志

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.

Comparações entre as idades cronológica, dentária e óssea de pacientes com e sem cardiopatia congênita / Comparisons between the chronological, dental and bone ages of patients with and without congenital heart disease

Doenças sistêmicas como as cardiopatias, podem interferir no processo de crescimento da criança, podendo levar a uma diminuição da oxigenação dos tecidos e prejudicar o seu desenvolvimento normal. A avaliação da idade e maturação óssea de cardiopatas é de grande utilidade para o planejamento ortodôntico, principalmente para determinação do início do tratamento e emprego de recursos mecânicos ortopédicos. O objetivo deste estudo foi avaliar o grau de correlação entre as idades cronológica, óssea e dentária de pacientes com e sem cardiopatia congênita. A amostra foi composta por 113 crianças e adolescentes, com idades entre 4,6 e 14,6 anos, sendo 74 portadores de cardiopatia congênita e 39 sem qualquer doença sistêmica ou local que pudesse afetar o desenvolvimento sistêmico ou o crescimento craniofacial. Todos foram atendidos no Ambulatório de Pediatria do Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro. A idade óssea foi obtida por meio de radiografias de mão e punho, analisadas de acordo com método de Greulich e Pyle. A idade dentária foi calculadaobservando os estágios de calcificação, em radiografias panorâmicas, pelo método de Demirjian. As idades óssea e dentária foram superiores no grupo de não cardiopatas, porém sem diferença significativa, (p=0,88) e (p=0,6119), respectivamente.A idade óssea foi significativamente menor do que a cronológica, para os cardiopatas (p<0,0001). No grupo de não cardiopatas, a idade óssea foi maior, mas sem diferença significativa (p=0,3471). Em ambos os grupos, cardiopatas e não cardiopatas, a idade dentária foi significativamente maior do que a cronológica (p<0,0001).Houve diferença significativa para os dois grupos, cardiopatas e não cardiopatas, com valor maior para a idade dentária, na comparação com a idade óssea.Quanto à idade dentária, ninguém apresentou atraso, nem do grupo de cardiopatas, nem de não cardiopatas. O mesmo resultado foi observado na estratificação por sexo. Em relação à idade óssea, houve maior atraso no grupo de cardiopatas, sem diferença significativa (p=1). Essa tendência também ocorreu para os meninos e meninas cardiopatas (p=0,680) e (p=0,534), respectivamente.

Systemic diseases such as heart disease can interfere with the child's growth process, which can lead to a decrease in tissue oxygenation and impair normal development. The evaluation of the age and bone maturation of cardiac patients is of great use for orthodontic planning, mainly for determination of the beginning of the treatment and the use of orthopedic mechanical resources. The objective of this study was to evaluate the degree of correlation between the chronological, bone and dental ages of patients with and without congenital heart disease. The sample consisted of 113 children and adolescents, aged between 4.6 and 14.6 years, of whom 74 had congenital heart disease and 39 without any systemic or local disease that could affect systemic development or craniofacial growth. All were attended at the pediatric outpatient clinic of the Pedro Ernesto University Hospital of the State University of Rio de Janeiro. Bone age was obtained by hand and wrist radiographs, analyzed according to the method of Greulich and Pyle. Dental age was calculated by observing the calcification stages on panoramic radiographs by the Demirjian method. Bone and dental ages were higher in the non-cardiopathic group, but with no significant difference (p = 0.88) and (p = 0.6119), respectively. Bone age was significantly shorter than chronological age for cardiac patients (p <0.0001). In the non-cardiopathic group, bone age was higher, but without significant difference (p = 0.3471). In both groups, with and without congenital heart disease patients, dental age was significantly higher than chronological age (p <0.0001). There was a significant difference for the two groups, with and without heart disease, with a higher value for dental age compared to bone age. Regarding the dental age, no one presented delay, neither of the group of cardiac patients nor of non-cardiac patients. The same result was observed in the stratification by sex. In relation to bone age, there was a greater delay in the group of patients with heart disease, without significant difference (p = 1). This trend also occurred for the boys (p = 0.680)and girls (p = 0.534)with heart disease

Applicability of demirjian and chaillet's methods in estimating dental age in children from the state of Zulia, Venezuela / Aplicabilidad de los métodos de demirjian y chaillet en la estimación de la edad dental de niños del estado Zulia, Venezuela

ABSTRACT. Introduction: dental age (DA) is used in clinical disciplines to assess whether an individual is advanced or delayed in his or her dental development, or to determine the age of living or deceased subjects with no valid identification documents; it is also useful in forensic practice. Objective: to study the applicability of the methods of Demirjian et al (revised, 1976) and Chaillet et al in estimating DA in a sample of Venezuelan children and adolescents. Methods: a descriptive, retrospective field study in 516 panoramic X-rays of patients of both sexes with chronological ages ranging from 6 to 18 years. Dental development was assessed in the seven lower left teeth using the maturation stages proposed in the method of Demirjian et al, while DA calculation was carried out according to the reference tables provided by each method. Descriptive statistics were obtained, as well as mean differences between chronological age (CA) and DA estimated by a Student's test. Results: there was age overestimation with Demirjian's method up to the age of 15 years, as well as age underestimation with Chaillet's method. Considering the total sample, both methods underestimated age (Demirjian 0.20 ± 1.46; Chaillet 0.34 ± 1.39), and the difference between CA and DA was significant (Demirjian p = 0.0002; Chaillet p = 0.000). Conclusions: both methods can be used in the sample studied, considering that DA should be assessed in conjunction with other indicators of maturation to evaluate the development of an individual.

RESUMEN Introducción: la edad dental (ED) es empleada en disciplinas clínicas para evaluar si el individuo se encuentra avanzado o atrasado en su desarrollo dentario, o bien para asignar la edad de sujetos vivos o fallecidos sin documentos válidos de identificación, y es de utilidad en la práctica forense. Objetivo: estudiar la aplicabilidad de los métodos de Demirjian et al revisado (1976) y Chaillet et al en la estimación de la ED en una muestra de niños y adolescentes venezolanos. Métodos: se realizó un estudio descriptivo, retrospectivo y de campo; para ello se analizaron 516 radiografías panorámicas de pacientes de ambos sexos con edades cronológicas entre 6 y 18 años. El desarrollo dental fue evaluado en los siete dientes inferiores izquierdos mediante los estadios de maduración propuestos en el método de Demirjian et al, mientras que el cálculo de la ED fue realizado de acuerdo a las tablas de referencia proporcionadas por cada método. Se obtuvieron estadísticas descriptivas, así como diferencias de media entre la edad cronológica (EC) y la ED estimada mediante un test de Student. Resultados: se observó sobreestimación de la edad por el método de Demirjian hasta los 15 años de edad, así como subestimación de la edad con el método de Chaillet. Considerando el total de la muestra, ambos métodos subestimaron la edad (Demirjian 0,20 ± 1,46; Chaillet 0,34 ± 1,39), y la diferencia entre EC y ED fue significativa (Demirjian p = 0,0002; Chaillet p = 0,000). Conclusiones: ambos métodos pueden ser empleados en la muestra estudiada, teniendo en cuenta que la ED debe ser valorada en conjunto con otros indicadores de maduración para la evaluación del desarrollo del individuo.