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Komal Smriti,1,* Murali Venkata Rama Mohan Kodali,2 Mathangi Kumar,1,* Anoushka Saraf,1 Medhini Madi,1 Kalyana Chakravarthy Pentapati,3 Prakashini K,4 Yogesh Chhaparwal,1 Unati Sai Kodali,5 Srikanth Gadicherla6 1Department of Oral Medicine & Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 2Department of Oral and Maxillofacial surgery, College of Dentistry, King Faisal University, Al Hofuf, Eastern Province-Al Ahsa, 31982, Kingdom of Saudi Arabia; 3Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104 India; 4Department of Radio Diagnosis, Kasturba Medical College & Hospital, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 5Dr Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Dr. NTR University of Health Sciences, Vijayawada, India; 6Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India*These authors contributed equally to this workCorrespondence: Medhini Madi; Yogesh Chhaparwal, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India, Email medhini.madi@manipal.edu; yogesh.chhaparwal@manipal.eduIntroduction: Dental age estimation using third molars is a reliable method for estimating the age of individuals. Recently, magnetic resonance imaging (MRI) of the head and neck has been found to be applicable for age estimation of third molar teeth. In the present study, we aimed to apply the Modified Demirjian method of age estimation to magnetic resonance (MR) image sections for dental age estimation by determining the mineralization patterns of the maxillary third molars.Methods: MRI scans of the patients were performed using SIGNA™ 3.0Tesla MRI GE Healthcare (Chicago, USA) with a moving, multifunctional coil. Two expert radiologists with more than three years of experience independently analyzed the image sections using the open-source Digital Imaging and Communications in Medicine (DICOM) viewer software. The age and sex of the patients whose images were included in the study were recorded using a specially designed proforma. The stage of development of the maxillary third molars was determined using the modified Demirjian method. Inter observer agreement was calculated using the intra class correlation coefficient. Simple linear regression analysis was used to predict the actual age at the third molar development stage.Results: There was excellent agreement between observers (ICC =0.99 (95% CI = 0.98– 0.99)). There was also a significant association between the maxillary third molar tooth development stage and chronological age of the individual (P=0.001; B=1.54; 95% CI = 0.71– 2.37).Discussion: The findings from the present study establish that the Modified Demirjian method can also be reliably applied for dental age assessment in MR sections.Keywords: third molars, forensic science, age estimation by teeth, odontogenesis

Background: Age estimation is a preliminary assessment that aids in medico legal assessments and legal proceedings. Teeth development or mineralization is the efficacious for assessment of age and Cone Beam Computed Tomography (CBCT) scans, an advanced imaging modality can be used for the same. Aim: To investigate the association between chronological age and the surface area of the maturing mandibular 3rd molar apices using CBCT scans and in addition, to formulate a regression equation for estimating age. Material and Methods: This study included 120 CBCT scans of different age groups ranging from 13 to 24 years consisting of 66 males and 54 females. MIMICS and 3-MATIC software assist’ were used in calculating root apices surface areas and using the obtained surface area, a regression equation is formulated for age estimation in Andhra Pradesh population. Results: A positive correlation was noted between the surface area of developing molar roots and age where Pearson R value = 0.910 and independent sample “t” test showed significance at

Image processing with artificial intelligence has shown significant promise in various medical imaging applications. The present study aims to evaluate the performance of 16 different convolutional neural networks (CNNs) in predicting age and gender from panoramic radiographs in children and young adults. The networks tested included DarkNet-19, DarkNet-53, Inception-ResNet-v2, VGG-19, DenseNet-201, ResNet-50, GoogLeNet, VGG-16, SqueezeNet, ResNet-101, ResNet-18, ShuffleNet, MobileNet-v2, NasNet-Mobile, AlexNet, and Xception. These networks were trained on a dataset of 7336 radiographs from individuals aged between 5 and 21. Age and gender estimation accuracy and mean absolute age prediction errors were evaluated on 340 radiographs. Statistical analyses were conducted using Shapiro–Wilk, one-way ANOVA, and Tukey tests (p < 0.05). The gender prediction accuracy and the mean absolute age prediction error were, respectively, 87.94% and 0.582 for DarkNet-53, 86.18% and 0.427 for DarkNet-19, 84.71% and 0.703 for GoogLeNet, 81.76% and 0.756 for DenseNet-201, 81.76% and 1.115 for ResNet-18, 80.88% and 0.650 for VGG-19, 79.41% and 0.988 for SqueezeNet, 79.12% and 0.682 for Inception-Resnet-v2, 78.24% and 0.747 for ResNet-50, 77.35% and 1.047 for VGG-16, 76.47% and 1.109 for Xception, 75.88% and 0.977 for ResNet-101, 73.24% and 0.894 for ShuffleNet, 72.35% and 1.206 for AlexNet, 71.18% and 1.094 for NasNet-Mobile, and 62.94% and 1.327 for MobileNet-v2. No statistical difference in age prediction performance was found between DarkNet-19 and DarkNet-53, which demonstrated the most successful age estimation results. Despite these promising results, all tested CNNs performed below 90% accuracy and were not deemed suitable for clinical use. Future studies should continue with more-advanced networks and larger datasets. [ABSTRACT FROM AUTHOR]

Age estimation methods through developmental atlases are simplified by image comparison using radiographs. Atlas‐based methods have been utilized to create population‐specific charts addressing population diversity. To tackle the absence of a dedicated atlas for the Brazilian population, the objective of the present study was to create a new atlas for dental development in Brazil based on the London Atlas chart. The new atlas (RP Atlas) is based on the median of tooth development, eruption, and resorption in individuals aged 5 to 23. The sample (567 individuals) was divided between females (n = 290) and males (n = 277). The RP Atlas was handcrafted, scanned, colored, and clustered in two atlases divided by sex. The development of a specific atlas for the Brazilian population has the potential to enhance the accuracy of age estimation in forensic scenarios, notably in a mixed country like Brazil. Further research is needed to assess the suitability of the newly developed atlas for the Brazilian population. Research Highlights: Atlas development methods provide a more straightforward image comparison using OPGs.Methods for age estimation need to be adaptable to a population‐specific approach.RP Atlas is Brazil's first specific atlas of tooth eruption and development.From 18 years old onwards, dental development has unstable patterns. [ABSTRACT FROM AUTHOR]

Background: The stage of tooth formation is one of the most reliable indicators for predicting a patient's developmental age by radiographs. This study compared the accuracy of three distinct dental age estimation methods (Demirjian, Nolla, and Willems) in children aged 3–17 in the northern Iranian population. Methods: This cross‐sectional study examined panoramic radiographs of 434 children aged 3–17 from Mazandaran Province, Iran, who had teeth 31–37 present on the left mandible. This study employed the Demirjian, Nolla, and Willems methods to estimate the dental age of the sample and compare it with the chronological age. The data were analyzed using SPSS v16. A paired t‐test was used to compare chronological and dental ages. The Pearson correlation was used to correlate the chronological and dental ages. The errors of different methods were compared using the Wilcoxon test. P values < 0.05 were considered significant for all tests except Wilcoxon. For Wilcoxon, a P value < 0.017 was considered significant. Results: The three methods presented differing mean estimated ages. The Demirjian method delivered the highest mean, and all three methods differed significantly when compared in pairs. The results showed that the Demirjian method overestimated chronological age by 0.25 years (P < 0.001) in girls and 0.09 years (P = 0.28) in boys. The Willems method underestimated chronological age by 0.05 years (P = 0.47) in girls and 0.12 years (P = 0.13) in boys. The Nolla method underestimated chronological age by 0.41 years (P < 0.001) in girls and 0.40 years (P < 0.001) in boys. The accuracy of each method varied with the patient's age. Conclusion: According to the findings, the Willems method outperformed the Demirjian method, and the Demirjian method exceeded the Nolla method for estimating dental age in Iranian children aged 3–17. Overall, the Demirjian method overestimated the age of the study population, whereas the other two underestimated it. [ABSTRACT FROM AUTHOR]

Aim: This study aims to determine the accuracy of the Mincer method for estimating dental age (DA) using digital panoramic radiographs (PR) in a Honduran population aged 14–22 years. Materials and Methods: This observational, cross-sectional, retrospective study was applied in a sample of 134 digital PR from a private dental center in Comayagua (72 females and 62 males; mean age 18 ± 3 years). A calibrated observer (kappa ≥0.83) analyzed DA with the Demirjian and Mincer method in all third molars (3M) from stage D (complete crown) to H (apex closure) differentiating by sex. The decimal DA of each individual was calculated from the average of the four 3M. Estimation of chronological age (CA) according to the Mincer method was obtained with linear regression formulas. Results: The results revealed that the mean and standard error of the difference between CA and DA was 0.58 ± 0.13 years (male 0.5 ± 0.19 and female 0.65 ± 0.19). Age groups showed higher overestimation (>1.1) from 14 to 17 years (50%–100%), agreement (±1.1 years) at 18 years (66.7%–70%), and underestimation (<–1.1) from 21 and 22 years (42.9%–100%; P = 0.000). The prediction equations of CA according to DA were statistically significant (P = 0.000) explaining 66.5% of the total sample (error = 1.465), 84.5% in males (error = 1.367), and 79.3% in females (error = 1.548). Conclusion: This study concludes that the Mincer method obtained a reasonable prediction to estimate the age of the majority with improvement in the adjustments with the age estimation formula in a specific population in Comayagua, Honduras. [ABSTRACT FROM AUTHOR]

Abstract Background The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions. Methods The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023. Results One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian’s method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated. Conclusion DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail. Trial registration This study was registered in the PROSPERO database (CRD42023454207).

Adult age estimation is one of the most challenging problems in forensic science and physical anthropology. In this study, we aimed to develop and evaluate machine learning (ML) methods based on the modified Gustafson's criteria for dental age estimation. In this retrospective study, a total of 851 orthopantomograms were collected from patients aged 15 to 40 years old. The secondary dentin formation (SE), periodontal recession (PE), and attrition (AT) of four mandibular premolars were analyzed according to the modified Gustafson's criteria. Ten ML models were generated and compared for age estimation. The partial least squares regressor outperformed other models in males with a mean absolute error (MAE) of 4.151 years. The support vector regressor (MAE = 3.806 years) showed good performance in females. The accuracy of ML models is better than the single-tooth model provided in the previous studies (MAE = 4.747 years in males and MAE = 4.957 years in females). The Shapley additive explanations method was used to reveal the importance of the 12 features in ML models and found that AT and PE are the most influential in age estimation. The findings suggest that the modified Gustafson method can be effectively employed for adult age estimation in the southwest Chinese population. Furthermore, this study highlights the potential of machine learning models to assist experts in achieving accurate and interpretable age estimation. [ABSTRACT FROM AUTHOR]

Background: The utilization of segmentation method using volumetric data in adults dental age estimation (DAE) from cone-beam computed tomography (CBCT) was further expanded by using current 5-Part Tooth Segmentation (SGt5) method. Additionally, supervised machine learning modelling--namely support vector regression (SVR) with linear and polynomial kernel, and regression tree -- was tested and compared with the multiple linear regression model. Material and Methods: CBCT scans from 99 patients aged between 20 to 59.99 was collected. Eighty eligible teeth including maxillary canine, lateral incisor, and central incisor were used in this study. Enamel to dentine volume ratio, pulp to dentine volume ratio, lower tooth volume ratio, and sex was utilized as independent variable to predict chronological age. Results: No multicollinearity was detected in the models. The best performing model comes from maxillary lateral incisor using SVR with polynomial kernel (Radj² = 0.73). The lowest error rate achieved by the model was given also by maxillary lateral incisor, with 4.86 years of mean average error and 6.05 years of root means squared error. However, SGt5 demands a complex approach to segment the enamel volume in the crown section and a lengthier labour time of 45 minutes per tooth. [ABSTRACT FROM AUTHOR]

Background: The evidence in the literature suggests that some skeletal or dental malocclusions are involved with dental development, resulting in advanced or delayed dental age (DA). The purpose of this systematic review was to investigate the association between DA and different types of malocclusions. Methods: The search was carried out on PubMed, Scopus, Web of Science, Virtual Health Library, and in the gray literature. Observational studies that evaluated the association between DA and sagittal, vertical, or transversal malocclusions were included. The quality assessment was performed using the Newcastle–Ottawa Scale (NOS). The data from primary studies were narratively synthesized. The certainty of evidence was evaluated using the GRADE approach. The study was conducted from August 2023 to October 2023. Results: One Thousand Nine Hundred Ninety-One records were identified in the initial search. Twenty (n = 20) studies were included. Most of the studies (n=15) presented a moderate quality according to NOS. Twelve studies evaluated the association between DA and sagittal discrepancies; eight studies evaluated vertical discrepancies, and only one study analyzed a transversal discrepancy. Demirjian's method for DA assessment was the most used among the studies. The primary studies observed that patients of both sexes presenting a vertical growth pattern and males with skeletal Class III malocclusion tend to have advanced DA. The study that investigated transversal malocclusion found that unilateral posterior cross-bite is associated with delayed DA. The certainty of evidence was very low for all outcomes evaluated. Conclusion: DA may be associated with the type of malocclusion. It is suggested that DA can be used as an initial diagnostic tool in orthodontics. Future well-designed studies should be performed in order to investigate the association between DA and different types of malocclusions in more detail. Trial registration: This study was registered in the PROSPERO database (CRD42023454207). [ABSTRACT FROM AUTHOR]

The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the accuracy of three established approaches for legal age threshold estimation in a Croatian sample. Materials and methods: Olze’s third molar eruption stages, Haavikko stages, and Demirjian stages were applied in 583 orthopantomograms of Croatian children and adolescents aged 10.00-20.99 years old. The left mandibular second and third molar were assessed. Tooth formation and eruption chronology were established. Receiver operating characteristic (ROC) curves were performed to assess the classification ability of predictive variables for estimating 16- and 18-year-old thresholds. Results: Havikko stage, Demirjian stage and eruption stages -in tooth 37 performed poorly for 16-year-old and 18-year-old thresholds. Tooth 38 provides valuable information for these two age thresholds estimation. For 16-year-old threshold, Haavikko Stage Rc and Demirjian Stage G both yielded Sp over 98% and Bayes PTP over 95% in both sexes. Eruption stage C yielded Sp over 98%, Bayes PTP over 96% in males, and lower in females (Sp 96.7%, Bayes PTP 88.2%). For 18-year-old threshold, Haavikko stage Ac and Demirjian stage H both yielded 100% Sp and Bayes PTP. Eruption stage D yielded Sp over 96%, Bayes PTP over 90% in both sexes, slightly higehr in females than males. Mean age of tooth 37 at Haavikko stage Ac, Demirjian stage F, H and eruption stage D was statistically lower in females (p

Objective: The aim was to test the Belgrade age formula based on the calculation of open apices of two permanent mandibular teeth on a Bosnian children population and compare its accuracy with European formula. Material and methods: We included 412 panoramic images of children (204 female and 208 male) 7 to 13 years of age. We assessed the performance of both methods (the European formula and the BAF) and compared their results in both sexes. Results: The results showed a high point of average understanding between the age estimated by chronological age and the European formula (ICC=0.927, 95% CI 0.904–0.944, p

Abstract Background Dental age estimation of adults is a challenging procedure in forensic odontology. Radiographic techniques have enabled non-invasive age estimation of adults since the 90’s. Kvaal’s method based on the deposition of secondary dentin has demonstrated broad applicability in several populations. Population-specific studies with this method, however, are scarce in South America. This study tested the validity of Kvaal’s method in a sample of radiographs of Brazilian adults. The sample consisted of 192 periapical radiographs of 106 females (55.2%) and 86 males (44.8%) with ages between 20 and 80 years old. The permanent maxillary right (n = 84, 43.8%) and left (n = 108, 56.2%) central incisors were assessed based on Kvaal’s method. Results Lin’s coefficient of concordance between estimated (EA) and chronological (CA) ages was 0.800 (IC95% = 0.753; 0.847) (p

Background: Dental age estimation of adults is a challenging procedure in forensic odontology. Radiographic techniques have enabled non-invasive age estimation of adults since the 90's. Kvaal's method based on the deposition of secondary dentin has demonstrated broad applicability in several populations. Population-specific studies with this method, however, are scarce in South America. This study tested the validity of Kvaal's method in a sample of radiographs of Brazilian adults. The sample consisted of 192 periapical radiographs of 106 females (55.2%) and 86 males (44.8%) with ages between 20 and 80 years old. The permanent maxillary right (n = 84, 43.8%) and left (n = 108, 56.2%) central incisors were assessed based on Kvaal's method. Results: Lin's coefficient of concordance between estimated (EA) and chronological (CA) ages was 0.800 (IC95% = 0.753; 0.847) (p < 0.001). The mean difference between EA and CA was − 2.84 years (p < 0.001). For females and males, separately, the mean differences between EA and CA were − 3.82 years (CI95% = − 5.38; − 2.25) (p < 0.001) and − 1.86 years (CI95% = − 3.56; − 0.17) (p = 0.031), respectively. Underestimations were predominant and increased with time. Conclusion: After 28 years of the original publication, Kvaal's method remains reliable for non-invasive dental age estimation of adults, especially for the analysis of the permanent maxillary central incisors of Brazilian individuals. [ABSTRACT FROM AUTHOR]

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Objectives Machine learning (ML) algorithms are a portion of artificial intelligence that may be used to create more accurate algorithmic procedures for estimating an individual's dental age or defining an age classification. This study aims to use ML algorithms to evaluate the efficacy of pulp/tooth area ratio (PTR) in cone-beam CT (CBCT) images to predict dental age classification in adults. Methods CBCT images of 236 Turkish individuals (121 males and 115 females) from 18 to 70 years of age were included. PTRs were calculated for six teeth in each individual, and a total of 1416 PTRs encompassed the study dataset. Support vector machine, classification and regression tree, and random forest (RF) models for dental age classification were employed. The accuracy of these techniques was compared. To facilitate this evaluation process, the available data were partitioned into training and test datasets, maintaining a proportion of 70% for training and 30% for testing across the spectrum of ML algorithms employed. The correct classification performances of the trained models were evaluated. Results The models' performances were found to be low. The models' highest accuracy and confidence intervals were found to belong to the RF algorithm. Conclusions According to our results, models were found to be low in performance but were considered as a different approach. We suggest examining the different parameters derived from different measuring techniques in the data obtained from CBCT images in order to develop ML algorithms for age classification in forensic situations. [ABSTRACT FROM AUTHOR]

The dental characteristics created by acquired dental treatments can be used as age estimators. This pilot study aimed to analyze the correlation between the number of teeth observed for dental characteristics and chronological age and to develop new non-invasive age estimation models. Dental features on panoramic radiographs (420 radiographs of subjects aged 20-89 years) were classified and coded. The correlation between the number of teeth for each selected code (codes V, X, T, F, P, and L) and age was observed, and multiple regression was performed to analyze the relationship between them. Eleven regression models with various combinations of dental sextants were presented. The model with the data from both sides of the posterior teeth on both jaws showed the best performance (root mean square error of 14.78 years and an adjusted R2 of 0.461). The model with all teeth was the second-best. Based on these results, we confirmed statistically significant correlations between certain dental features and chronological age. We also observed that some regression models performed sufficiently well to be used as adjunctive methods in forensic practice. These results provide valuable information for the design and performance of future full-scale studies. [ABSTRACT FROM AUTHOR]

Dental age estimation has its application in various subdisciplines of medicine and dentistry. New methods of dental age (DA) estimation are emerging and it is important that we compare different methods to determine which one is more closely related to the chronological age. Demirjian's method is one of the most widely used techniques and has been tested in various ethnic populations globally. In 2016, another approach to DA estimation is the London atlas of human tooth development and eruption. No study has compared Demirjian's comprehensive chart and London atlas method in the Indian population. Hence, in the current study, we estimated DA using Demirjian's comprehensive chart and London atlas method for association with the known chronologic age in children and adolescent population. The study also attempted to determine if sexual dimorphism existed in DA estimated by the two methods. Estimation was performed for both methods on 100 orthopantomogram records (50 males and 50 females, aged 6–16 years) of orthodontic patients. The data were compared and analysed using paired t -tests. There was an overestimation of DA by Demirjian's comprehensive chart on an average of +1.3 years in males and +0.5 years in females, whereas using London atlas, it was +1.4 years in males and +0.5 years in females. The mean of underestimation was −0.6 years in males and −0.8 years in females using Demirjian's comprehensive chart, whereas it was −0.8 years in males and −0.5 years in females. A statistically significant difference (P  < 0.0001) was found when mean chronological age (11.6 ± 2.6) years of the participants was compared with DA estimated using either Demirjian's comprehensive chart (12.3 ± 2.8) years or London atlas (11.8 ± 2.9) years. The trends in this pilot study point towards more accuracy of London atlas over Demirjian's method when done using comprehensive chart for estimating DA. In summary, the results of the current pilot study indicates greater accuracy of London atlas method over Demirjian's comprehensive chart method for estimating DA in Indian population. This finding should be validated by conducting similar studies using larger sample, on diverse Indian ethnic populations, for applicability in pedodontic, orthodontic, and forensic domains. Key points No study has compared Demirjian's comprehensive chart and London atlas method in the Indian population. The dental age estimated by London method was closer to chronological age as compared to Demirjian's method in our study sample. Significant difference was found in chronological age and estimated age using London atlas method in both males and females. [ABSTRACT FROM AUTHOR]

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.

Abstract Background Dental age estimation (DAE) research has grown rapidly and became one of the biggest topics in forensic odontology. This study aimed to evaluate the DAE research trends over the span of 60 years using bibliometric analysis. Methods Sampling was performed in the Scopus database using a search string (“Dental Age Estimation” OR “Age Determination by Teeth”) to detect DAE-related studies. The search was performed from inception to the year 2022. A data-cleaning intervention using a fuzzy-matching technique was done to unify the author and affiliation name variations. Results The initial search returned 1638 articles, years of publication ranging from 1964 to 2022, with an approximate growth rate of 5.9% a year. Source analysis showed that most of the top article sources were Forensic Science International (n = 200). Cameriere R presents the overall highest score (77 articles, Local h-index 30). Authors from Shanghai Jiao Tong University produced the highest number of publications (n = 111). The most locally cited study was “A New System of Dental Age Assessment” by Demirjian et al. (Hum Biol 45:211-227, 1973) (n = 1507). The trending topics analysis shows that earlier DAE studies were focused on dental regressive changes and later changed focus to utilizing technological advancements. Institutions and Author's collaborations were also found to be internationally diverse with 20.82% of the articles being a product of international co-authorships. Conclusions DAE research has grown rapidly helped by multiple advancements in various technological ends. Along with the high demand for DAE analysis, authors and publishers need to continually improve their standards for their respective research and reporting and continue to increase collaboration.

Image processing with artificial intelligence has shown significant promise in various medical imaging applications. The present study aims to evaluate the performance of 16 different convolutional neural networks (CNNs) in predicting age and gender from panoramic radiographs in children and young adults. The networks tested included DarkNet-19, DarkNet-53, Inception-ResNet-v2, VGG-19, DenseNet-201, ResNet-50, GoogLeNet, VGG-16, SqueezeNet, ResNet-101, ResNet-18, ShuffleNet, MobileNet-v2, NasNet-Mobile, AlexNet, and Xception. These networks were trained on a dataset of 7336 radiographs from individuals aged between 5 and 21. Age and gender estimation accuracy and mean absolute age prediction errors were evaluated on 340 radiographs. Statistical analyses were conducted using Shapiro–Wilk, one-way ANOVA, and Tukey tests (p < 0.05). The gender prediction accuracy and the mean absolute age prediction error were, respectively, 87.94% and 0.582 for DarkNet-53, 86.18% and 0.427 for DarkNet-19, 84.71% and 0.703 for GoogLeNet, 81.76% and 0.756 for DenseNet-201, 81.76% and 1.115 for ResNet-18, 80.88% and 0.650 for VGG-19, 79.41% and 0.988 for SqueezeNet, 79.12% and 0.682 for Inception-Resnet-v2, 78.24% and 0.747 for ResNet-50, 77.35% and 1.047 for VGG-16, 76.47% and 1.109 for Xception, 75.88% and 0.977 for ResNet-101, 73.24% and 0.894 for ShuffleNet, 72.35% and 1.206 for AlexNet, 71.18% and 1.094 for NasNet-Mobile, and 62.94% and 1.327 for MobileNet-v2. No statistical difference in age prediction performance was found between DarkNet-19 and DarkNet-53, which demonstrated the most successful age estimation results. Despite these promising results, all tested CNNs performed below 90% accuracy and were not deemed suitable for clinical use. Future studies should continue with more-advanced networks and larger datasets.

Aim: The aim of this study was to investigate tooth development according to chronological age in children with tooth agenesis and to determine whether the severity of tooth agenesis (hypodontia and oligodontia) has an effect on tooth development. Methods: In this retrospective study, the records of children diagnosed with hypodontia and oligodontia referred to the Department of Pediatric Dentistry between January 1, 1999 and January 1, 2018 were examined. The control group was matched with children diagnosed with oligodontia and hypodontia in terms of age and gender. A total of 288 children aged between 6-15 years were included in the study and the control, hypodontic and oligodontic groups were formed as Group I, Group II and Group III, respectively. Chronologic age was calculated and Haavikko’s method was used for dental age. The difference between chronological and dental ages was analyzed by ANOVA test and Tukey test was used for multiple comparisons. Results: There was a difference was determined between groups I and III in dental age determined by Haavikko’s method (p

Background: Dental age estimation (DAE) research has grown rapidly and became one of the biggest topics in forensic odontology. This study aimed to evaluate the DAE research trends over the span of 60 years using bibliometric analysis. Methods: Sampling was performed in the Scopus database using a search string ("Dental Age Estimation" OR "Age Determination by Teeth") to detect DAE-related studies. The search was performed from inception to the year 2022. A data-cleaning intervention using a fuzzy-matching technique was done to unify the author and affiliation name variations. Results: The initial search returned 1638 articles, years of publication ranging from 1964 to 2022, with an approximate growth rate of 5.9% a year. Source analysis showed that most of the top article sources were Forensic Science International (n = 200). Cameriere R presents the overall highest score (77 articles, Local h-index 30). Authors from Shanghai Jiao Tong University produced the highest number of publications (n = 111). The most locally cited study was "A New System of Dental Age Assessment" by Demirjian et al. (Hum Biol 45:211-227, 1973) (n = 1507). The trending topics analysis shows that earlier DAE studies were focused on dental regressive changes and later changed focus to utilizing technological advancements. Institutions and Author's collaborations were also found to be internationally diverse with 20.82% of the articles being a product of international co-authorships. Conclusions: DAE research has grown rapidly helped by multiple advancements in various technological ends. Along with the high demand for DAE analysis, authors and publishers need to continually improve their standards for their respective research and reporting and continue to increase collaboration. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to develop a linear regression model using the pulp-to-tooth volume ratio (PTVR) ratio of the maxillary canine, assessed through cone-beam computed tomography (CBCT) images, to predict chronological age (CA) in Indonesian adults. Materials and Methods: A sample of 99 maxillary canines was collected from patients between 20 and 49.99 years old. These samples were obtained from CBCT scans taken at the Universitas Padjadjaran Dental Hospital in Indonesia between 2018 and 2022. Pulp volume (PV) and tooth volume (TV) were measured using ITK-SNAP, while PTVR was calculated from the PV/TV ratio. Using RStudio, a linear regression was performed to predict CA using PTVR. Additionally, correlation and observer agreement were assessed. Results: The PTVR method demonstrated excellent reproducibility, and a significant correlation was found between the PTVR of the maxillary canine and CA(r= -0.74, P<0.01). The linear regression analysis showed an R2 of 0.58, a root mean square error of 5.85, and a mean absolute error of 4.31. Conclusion: Linear regression using the PTVR can be effectively applied to predict CA in Indonesian adults between 20 and 49.99 years of age. As models of this type can be population-specific, recalibration for each population is encouraged. Additionally, future research should explore the use of other teeth, such as molars. [ABSTRACT FROM AUTHOR]

Background and Aim: Age estimation is an important issue in forensic medicine.Teeth are more resistant to changes than bones, so they are one of the main indicators for age estimation in forensic medicine. To determine the relationship between age and dental changes, the ratio of dental pulp/Tooth volume (PV/ TV) is one of the most appropriate indicators. The aim of this study was to determine the correlation between PV/TV ratio and chronological age in canine teeth using CBCT images. Materials and Methods: In this descriptive-analytical study, a total of 183 CBCT images were selected randomly from archive of images in an oral and maxillofacial radiology center. The images were imported into the 3D Slicer software as DICOM data. Pulp volume, tooth volume and their ratio were calculated. Data were introduced into SPSS 17. We used T-test, ANOVA, Pearson correlation coefficient and linear regression for data analysis. Results: The mean value of PV/TV ratio was not different significantly in relation to gender, teeth location (mandible and maxilla, right and left sides), but there was a significant difference in terms of age. Pearson correlation showed a significant negative relation between the age of the subjects and PV/TV ratio (R = -0.714). The results of regression analysis for all data and also for all of 6 age groups showed significant correlation only in the age groups of 15-19 and 50- 59 years old. Conclusion: The results of this study showed that there was an inverse and significant relationship between PV/TV ratio and chronological age. Also, in the age groups of 15-19 and 50-59 years, it seems that regression model can be considered a reliable method to estimate age in Iranian population.

Abstract Background Age is important in forming the uniqueness of individuals. When chronological age is not available, age estimation is required, particularly in court cases. The mineralization chronology of permanent teeth is a valuable tool for age estimation of subadults. This study aimed to evaluate the mineralization stages of permanent teeth of Brazilian subjects from imaging exams, using the classification by Moorrees et al. modified by the authors, to verify the existence of correlation between the chronology of mineralization stages and sex and to prepare numerical tables of the chronology of dental mineralization stages for Brazilian individuals. Methods Digital panoramic radiographs of 1100 living Brazilian individuals of both sexes, aged between 2 and 25 years, born between 1990 and 2018, from the image bank of a Dental Radiographs and Documentations clinic located in the city of Araraquara, SP, Brazil. The images were evaluated according to the level of crown and root development and classified according to the stages proposed by Moorrees et al. (Am J Phys Anthropol 21: 205–213, 1963) adapted by the authors. All analyses were performed in the R software. Descriptive and exploratory analyses were performed on all data. For intra- and inter-examiner analyses, the rate of agreement and Kappa statistics at a 95% confidence interval were used. Kappa was interpreted according to Landis and Koch. Results Only upper and lower canines showed significant differences between the sexes (p

Purpose: This systematic review aimed to investigate the correlation between chronological age and dental pulp volume in cone-beam computed tomography (CBCT). Materials and Methods: The literature was searched in 4 databases (PubMed, Scopus, Web of Science, and Google Scholar). Within each study, the outcome of interest was the correlation (r) between chronological age and pulp volume. A random-effect meta-analysis was conducted. Subgroup analysis was carried out according to sex and tooth type. Results: Of 5,693 identified studies, 27 fulfilled the inclusion criteria and were selected for meta-analysis. These articles focused on single-rooted teeth (n=21), multi-rooted teeth (n=6), maxillary teeth (n=14), mandibular teeth (n=6), and maxillary and mandibular teeth (n=12). The relationship between chronological age and dental pulp volume was examined in the entire population (r= - 0.67), men (r= - 0.75), and women (r= - 0.77) in single- and multi-rooted teeth. The results of the total population analysis showed a relatively strong negative relationship between age and pulp volume. Conclusion: This study suggested that CBCT is a reliable and repeatable tool for dental age estimation. A strong inverse relationship was observed between pulp chamber volume and age. Further studies on the correlation between chronological age and pulp volume of multi-rooted teeth may be beneficial. [ABSTRACT FROM AUTHOR]

Objectives: Molar crown wear is often used in bioarchaeological research as a proxy for age at death. However, a small number of researchers have used premolars or compared the application of different methods of relative age estimation. Material and methods: Using a sample of 197 previously extracted maxillary first premolars from US dental patients, we considered three protocols for estimating age: the Bang and Ramm/Liversidge and Molleson (BRLM) age estimate method, occlusal topographic analysis, and the Smith system of macrowear scoring. A previous study utilizing the Bang and Ramm method yielded an age estimate range of 9.4 to 10.8 years for the sample. Results: Our analyses showed no associations between occlusal topography parameters (occlusal slope, relief, or faceting) and BRLM age estimates, but some concordance was found between Smith scoring and BRLM ages estimates and between Smith scoring and occlusal topography parameters. Conclusion: The results of the present study suggest that relationships between gross tooth wear, tooth shape, and dental age estimates are complex, and available methods should be considered together to gain a more comprehensive understanding of how teeth change their shape with wear through-out the lifecourse.

Objectives: Estimating age is a crucial determinant of forensic science. Various methods have been used to estimate dental age (DA) and skeletal age (SA).The aim of the current study was to compare the Cameriere’s DA method with the Cameriere’s SA method in estimating CA in children. Materials and methods: A total of 216 radiographs of 130 females and 86 males (between 9 to 14.99 years of age) were evaluated in northwestern Turkey. DA was calculated on the panoramic images using Cameriere’s open apex method. SA was determined on the lateral cephalograms using the fourth cervical vertebrae method by Cameriere. The DA, SA, and CA data were compared using a paired t-test and Wilcoxon test. Results: The mean CA of all groups was calculated as 12.96±0.30, the mean DA of 12.74±0.68 and the mean SA of 12.89±0.89. In males, the DA method presented an underestimation between ages of 14.00 and 14.99 (p

Objectives: This study aimed to determine the sex and estimate the age of individuals by analysing Raman spectra obtained from extracted teeth dentine. Material and methods: A total of 25 male and 26 female extracted teeth were collected, disinfected, and fixed in auto acrylate before being cut near the cervical margin. The inclusion criteria were non endodontically treated teeth with the cervical third of the tooth crown preserved. The exposed dentine was recorded using a Raman spectrometer, with 100 scans per dentine site in the spectral range of 3500 to 200 cm -1 and a resolution of 4 cm -1 . Background-corrected, normalized, and decomposed spectra were subjected to principal component analysis using MATLAB 2010 (The MathWorks, Natick, MA, USA). To assess age differences, prominent vibrational bands were observed and statistically analyzed, while sex differentiation employed the T-test on acquired data, exploring vibrational bands with significant intensity differences. Results: The obtained results revealed a segmentation of spectra in the male sample group based on the age of teeth at extraction, with an accuracy of age estimation at 7.0048 years. A similar segmentation was observed in the female sample group, with an accuracy of 9.3863 years. Conclusion: The recorded spectra were organized into datasets and analyzed with principal component analysis, demonstrating the feasibility of sex determination and age estimation using Raman spectra of teeth. Differences in classification accuracy between sexes may be attributed to hormonally-mediated differences in the biochemical composition of dentine between males and females. The findings of this study can provide valuable insights into methods for forensic and anthropological applications.

Abstract Background Estimating age is essential in both the analysis of human skeletal remains and assessing live persons. The third molar develops over a longer period and is hence used in age estimation for subadults. Since dental age correlates with chronological age better than other growth markers, this study aims to assess the reliability of dental age assessed using the University of Texas (UT) age estimation method and modified Cameriere’s method. Methods It is a retrospective cross-sectional study in which the development and maturation of mandibular third molars were examined in 600 orthopantomograms (264 males and 336 females) of South Indian individuals (16–23 years). Dental age was estimated by using an Indian-specific formula based on maturity index value and the UT-age estimation software program. The results were evaluated using the Student’s t-test for both methods and Pearson’s correlation test to compare chronological age with estimated dental age. Results Positive correlation was noted between chronological age and estimated dental age for males, females, and the total sample with highly statistically significant differences (p = 0.000). Modified Cameriere’s method underestimated dental age in samples ranging from less than 1 year to more than 2 years. UT-age estimation method underestimated age in samples above 20 years and overestimated age in samples below 20 years. The predictive classification of utilizing the maturity index was 79.17% accurate. Conclusions Dental age was negligibly over and underestimated in UT software method whereas it was overestimated in the modified Cameriere's method. To evaluate the reliability of these two methods, studies with larger sample sizes and population-specific data sets should be performed. Graphical Abstract

ObjectiveTo explore the relationship between the height of alveolar bone resorption and sex and age in the adolescent dentition.MethodsMulti-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.ResultsThere 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）.ConclusionThe 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.

Teeth-based age and sex estimation is an important task in mass disasters, criminal scenes, and archeology. Although various methods have been proposed, most of them are subjective and influenced by observers' experiences. In this study, we aimed to develop a deep learning model for automatic dental age and sex estimation from orthopantomograms (OPGs) and compare to manual methods. A large dataset of 15,195 OPGs (age range, 16 ~ 50 years; mean age, 29.65 years ± 9.36 [SD]; 10,218 females) was used to train and test a hybrid deep learning model which is a combination of convolutional neural network and transformer model. The final performance of this model was evaluated on additional independent 100 OPGs and compared to the manual method for external validation. In the test of 1413 OPGs, the mean absolute error (MAE) of age estimation was 2.61 years by this model. The accuracy and the area under the receiver operating characteristic curve (AUC) of sex estimation were 95.54% and 0.984. The heatmap indicated that the crown and pulp chamber of premolars and molars contain the most age-related information. In the additional independent 100 OPGs, this model achieved an MAE of 3.28 years for males and 3.79 years for females. The accuracy of this model was much higher than that of the manual models. Therefore, this model has the potential to assist radiologists in automated age and sex estimation. [ABSTRACT FROM AUTHOR]

Objectives: Age estimation is a crucial aspect of forensic odontology, and the Tooth Coronal Index (TCI) has been widely used for forensic purposes in determining age. The aim of this research was to evaluate the effectiveness of TCI in age estimation. Materials and Methods: A retrospective study was conducted, and TCI was calculated for the mandibular first premolar in 700 digital panoramic radiographs. Age was divided into five groups: 20-30 years, 31-40 years, 41-50 years, 51-60 years, and >61 years. Bivariate correlation was used to establish the relationship between TCI and age. Linear regression was calculated for the different age groups and genders. Inter-observer reliability and agreement were assessed using one-way ANOVA. P-values less than 0.05 were considered statistically significant. Results: Comparison of the mean difference from actual age showed underestimation in males aged 20-30 years and overestimation in males over 60 years of age. The least difference between actual and calculated age was found in females aged 31-40 years. Inter-age comparison using ANOVA for females demonstrated a statistically highly significant difference from actual age in all age groups (P<0.01), with the highest mean in females aged 51-60 years and the lowest in females aged 31-40 years. Inter-group comparison of mean TCI revealed statistically non-significant differences in males and statistically highly significant differences in females (P<0.01). Conclusion: Age estimation using TCI on mandibular first premolars can be recommended as an easy, non-invasive, and less time-consuming method. This study suggests that regression formulas were more accurate for males aged 31-40 years. [ABSTRACT FROM AUTHOR]

Background: Age is important in forming the uniqueness of individuals. When chronological age is not available, age estimation is required, particularly in court cases. The mineralization chronology of permanent teeth is a valuable tool for age estimation of subadults. This study aimed to evaluate the mineralization stages of permanent teeth of Brazilian subjects from imaging exams, using the classification by Moorrees et al. modified by the authors, to verify the existence of correlation between the chronology of mineralization stages and sex and to prepare numerical tables of the chronology of dental mineralization stages for Brazilian individuals. Methods: Digital panoramic radiographs of 1100 living Brazilian individuals of both sexes, aged between 2 and 25 years, born between 1990 and 2018, from the image bank of a Dental Radiographs and Documentations clinic located in the city of Araraquara, SP, Brazil. The images were evaluated according to the level of crown and root development and classified according to the stages proposed by Moorrees et al. (Am J Phys Anthropol 21: 205–213, 1963) adapted by the authors. All analyses were performed in the R software. Descriptive and exploratory analyses were performed on all data. For intra- and inter-examiner analyses, the rate of agreement and Kappa statistics at a 95% confidence interval were used. Kappa was interpreted according to Landis and Koch. Results: Only upper and lower canines showed significant differences between the sexes (p < 0.05), with higher average ages for men. The findings were presented in tables, as well as age estimates with 95% confidence intervals for each mineralization stage and each tooth. Conclusion: In the present study, we evaluated the mineralization stages of permanent teeth of Brazilian subjects from digital panoramic radiographs and found no correlation between the chronology of mineralization stages and sex, except for canines. From the obtained results, numerical tables of the chronology of dental mineralization stages were prepared. [ABSTRACT FROM AUTHOR]

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=-0.242). 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.

Objectives: Age estimation is a crucial aspect of forensic odontology, and the Tooth Coronal Index (TCI) has been widely used for forensic purposes in determining age. The aim of this research was to evaluate the effectiveness of TCI in age estimation. Materials and Methods: A retrospective study was conducted, and TCI was calculated for the mandibular first premolar in 700 digital panoramic radiographs. Age was divided into five groups: 20-30 years, 31-40 years, 41-50 years, 51-60 years, and >61 years. Bivariate correlation was used to establish the relationship between TCI and age. Linear regression was calculated for the different age groups and genders. Inter-observer reliability and agreement were assessed using one-way ANOVA. P-values less than 0.05 were considered statistically significant. Results: Comparison of the mean difference from actual age showed underestimation in males aged 20-30 years and overestimation in males over 60 years of age. The least difference between actual and calculated age was found in females aged 31-40 years. Inter-age comparison using ANOVA for females demonstrated a statistically highly significant difference from actual age in all age groups (P

Background: Estimating age is essential in both the analysis of human skeletal remains and assessing live persons. The third molar develops over a longer period and is hence used in age estimation for subadults. Since dental age correlates with chronological age better than other growth markers, this study aims to assess the reliability of dental age assessed using the University of Texas (UT) age estimation method and modified Cameriere's method. Methods: It is a retrospective cross-sectional study in which the development and maturation of mandibular third molars were examined in 600 orthopantomograms (264 males and 336 females) of South Indian individuals (16–23 years). Dental age was estimated by using an Indian-specific formula based on maturity index value and the UT-age estimation software program. The results were evaluated using the Student's t-test for both methods and Pearson's correlation test to compare chronological age with estimated dental age. Results: Positive correlation was noted between chronological age and estimated dental age for males, females, and the total sample with highly statistically significant differences (p = 0.000). Modified Cameriere's method underestimated dental age in samples ranging from less than 1 year to more than 2 years. UT-age estimation method underestimated age in samples above 20 years and overestimated age in samples below 20 years. The predictive classification of utilizing the maturity index was 79.17% accurate. Conclusions: Dental age was negligibly over and underestimated in UT software method whereas it was overestimated in the modified Cameriere's method. To evaluate the reliability of these two methods, studies with larger sample sizes and population-specific data sets should be performed. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: To determine potential associations between dental and skeletal maturation and palatally displaced canines (PDC) considering gender and chronological age. Material and methods: This study included pretreatment panoramic and lateral cephalometric radiographs of 43 subjects with PDCs and 203 randomly selected orthodontic subjects with normally erupted canines. Both groups were non syndromic patients. Chronological age of subjects was rounded and noted in years with decimal points and compared with chronological age according to Demirjian’s dental age assess-ment. Skeletal maturation was determined by cervical vertebrae changes on cephalometric radiographs. Results: Female subjects with PDC were more affected by left side canine displacement than males (p=0.027) with five times higher odds ratio (OR = 4.9; 95% CIL=1.2-19.7). A comparison of chronologic and skeletal age indicated that PDC subjects were skeletally younger than unaffected groups with statistically significant differences at the age of 10, 12 and 13. (p=0.05). Conclusion: Young subjects with PDCs showed skeletal maturation delay compared to control group, indicating that skeletal maturation assessment could be one of unexplored predicting factors of a PDC, especially at the age between 10 and 13 years in both genders. Subjects with PDC showed intensive growth spurt after the age of 12 years in females, and after the age of 13 in males. Dental maturation delay showed no statistical significance in PDC prediction.

Introduction: Over the last decade, the criminal justice system among the European countries deals with a new group of people, the undocumented people. In the criminal field, most of the suspected claimed to be under the minor legal age according to the type of crime. The government of each European country is committed to protecting the children and vulnerable people. There are serious safety concerns since adults falsely claim to be minors and legal systems oppose to such claims. In this study, we have used different age assessment methods and some of them without accuracy. Objective: To meet the general considerations we developed a study using the current dental age assessment methods. Hence, for the Portuguese population, this study aims to validate the European regression formula between the ages of 6 and 15 years of age; to estimate the cut-off point for the age of 12 years, and to compare the quantitative approach of European regression formula with Demirjian’s qualitative approach for age estimation. Materials and Methods: 483 orthopantomograms were analysed using the European formula and Demirjian scoring stages. A new method, Model 2, was designed to better suit the Portuguese population. Results: The European formula: average age underestimation of 4.88 for the third quadrant and 4.04 months for the fourth quadrant; and a mean absolute error (MAE) of 10.93 and 10.68 months respectively. Demirjian method: average overestimation of 8.70 months, MAE of 12.85 months. In Model 2: MAE of 9.37 months for the third quadrant, and 9.28 months for the fourth quadrant. Both European formula and Demirjian method had an area under ROC curves results above 0.93. Discrepancy of sensitivity between methods for the specific cut-off point: 11.48. The results obtained in this study can be extrapolated to 87.33% of the Portuguese population. Conclusions: The European regression formula can be applied for the Portuguese population, and seems to be more accurate than Demirjian’s methodology in this population. Nevertheless, both European regression formula and Demirjian method present similarly suitable results in the classification of 12 years of age, although there is a noticeable discrepancy favouring the European regression formula. The European Formula when applied for criminal age assessment, independently of population, is mandatory to indicate to the judicial institutions, the sensitivity of the results.

Background: Age estimation is of great importance in many medical fields and dentistry. It is also extensively used in archeology, criminology, and forensic medicine. Considering the importance of dental age estimation, this study was designed. Objectives: This study aimed to evaluate the accuracy of Demirjian and Willems methods for estimating the dental age of 7 - 15-yearolds population of the north of Iran. We also modified the Willems method for this population and compared the results of the modified and original Willems methods. Methods: In this cross-sectional, descriptive, analytical study, a total of 1320 panoramic radiographs in the age range of 7 - 15 years, were examined. Dental age was determined by the Demirjian and Willems methods and compared with the chronological age. Next, a formula based on the Willems method was formulated. Finally, the results of the modified and original Willems methods were compared. Results: The Demirjian method overestimated the chronological age by 0.49 years (0.57 for girls and 0.36 for boys), and the Willems method overestimated this age by 0.07 years (0.03 for girls and 0.14 for boys), too. The mean error of the modified Willems method waszero for the total sample, although formostage subgroups, themodifiedmethodwasmoreerroneous than the original method. Demirjian method had larger overestimations for girls than for boys, whereas the opposite was found for the Willems method. Conclusions: The Demirjian and Willems methods both overestimated the chronological age. However, the overestimations were smaller in the Willems method. Based on the findings, the original Willems method was the preferred choice for age estimation. [ABSTRACT FROM AUTHOR]

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Objective: This study aimed to explore the accuracy of three established approaches for legal age threshold estimation in a Croatian sample., Materials and Methods: Olze's third molar eruption stages, Haavikko stages, and Demirjian stages were applied in 583 orthopantomograms of Croatian children and adolescents aged 10.00-20.99 years old. The left mandibular second and third molar were assessed. Tooth formation and eruption chronology were established. Receiver operating characteristic (ROC) curves were performed to assess the classification ability of predictive variables for estimating 16- and 18-year-old thresholds., Results: Havikko stage, Demirjian stage and eruption stages in tooth 37 performed poorly for 16-year-old and 18-year-old thresholds. Tooth 38 provide value information for these two age thresholds estimation. For 16-year-old threshold, Haavikko Stage Rc and Demirjian Stage G both yielded Sp over 98% and Bayes PTP over 95% in both sexes. yielded Sp over 98% and Bayes PTP over 95% in both sexes. Eruption stage C yielded Sp over 98%, Bayes PTP over 96% in males, and lower in females (Sp 96.7%, Bayes PTP 88.2%). For 18-year-old threshold, Haavikko stage Ac and Demirjian stage H both yielded 100% Sp and Bayes PTP. Eruption stage D yielded Sp over 96%, Bayes PTP over 90% in both sexes, slightly higehr in females than males. Mean age of tooth 37 at Haavikko stage Ac, Demirjian stage F, H and eruption stage D was statistically lower in females (p<0,05)., Conclusion: Croatian population-based data on dental maturity were presented. Haavikko stage Rc, Demirjian stage G, eruption stage C and respective advanced stages in tooth 38 are effective for 16-year-old threshold classification. Haavikko stage Ac, Demirjian stage H and eruption stage D are effective for 18-year-old threshold classification., Competing Interests: Conflict of interest None declared., (University of Zagreb School of Dental Medicine.)

Objective: The aim was to test the Belgrade age formula based on the calculation of open apices of two permanent mandibular teeth on a Bosnian children population and compare its accuracy with European formula., Material and Methods: We included 412 panoramic images of children (204 female and 208 male) 7 to 13 years of age. We assessed the performance of both methods (the European formula and the BAF) and compared their results in both sexes., Results: The results showed a high point of average understanding between the age estimated by chronological age and the European formula (ICC=0.927, 95% CI 0.904-0.944, p<0.001)., BAF also confirmed a high point of agreement with chronological age in boys (ICC=0.941, 95% CI 0.922-0.955, p<0.001) and girls (ICC=0.913, 95% CI 0.886-0.934, p<0.001). BAF was better than the European formula in estimating age in males (0.4448±0.9135 vs. 0.9807±0.9422)., Conclusion: The Belgrade Age Formula (BAF) demonstrates comparable accuracy to the European formula for age determination in Bosnian children, while offering the advantage of being easier and faster to use. This makes the BAF a practical alternative in clinical and research settings where efficiency and reliability are essential., Competing Interests: Conflicts of Interest: The authors declare no conflict of interest., (University of Zagreb School of Dental Medicine.)

Abstract Background Age estimation has been an integral part of forensic science, and age estimation by dental means is by far the most commonly employed method. Dental age estimation in children is more accurate and straightforward as most methods use the chronological stages of odontogenesis that are highly systematic, reducing the chances of dispersed results. In contrast, estimation of age in adults becomes tricky and less accurate with varied approaches since tooth formation is already complete. Main body The methods of adult dental age estimation have come a long way from a calculated guess based on crude visual observation of teeth to radiological methods and to more recent sophisticated methods. Technological advances have opened up molecular and genetic methods by utilizing DNA methylation and telomere length to improve the accuracy of age estimation by reducing error chances. Conclusions Although dental age estimation methods in children and adolescents have been extensively reviewed, various adult age estimation methods are not reviewed as a whole. The aim of this review is to appraise the evolution of dental age estimation methods in adults over the years from mere visualization of dental attrition to employing more sophisticated means such as radioactive carbon dating and genetics. This comprehensive review also attempts to add an account of the accuracy and suitability of various adult dental age estimation methods.

Objective: To assess the evidence on the relationship between dental and cervical vertebrae maturation. Materials and methods: Searches were performed (up to December 2021) in seven databases, as well as in gray literature. Studies that included growing subjects, which evaluated the correlation between the stages of tooth formation and the maturation of cervical vertebrae, were eligible. The methodological quality of the selected reports was assessed using the JBI checklist for cross-sectional studies. Random-effects meta-analyses were implemented to calculate the pooled correlation coefficients between the maturation stages of cervical vertebrae and each tooth type. The GRADE approach was followed to assess the certainty of evidence. Results: Seventy-seven studies were selected. Most of them had limitations related to sampling and reliability of the methods to evaluate maturation. The syntheses evidenced positive correlations between the maturation of cervical vertebrae and the formation/calcification stages of the following lower teeth: canine (n = 7318; r = 0.692; 95% CI: 0.656–0.724), first premolar (n = 6194; r = 0.689; 95% CI: 0.649–0.725), second premolar (n = 6194; r = 0.695; 95% CI: 0.659–0.729), and second molar (n = 7905; r = 0.698; 95% CI: 0.652–0.739). All estimates were affected by the risk of bias and the presence of unexplained statistical heterogeneity. Conclusions: The evidence points to an apparent positive correlation between dental and cervical vertebrae maturation. These results need to be carefully evaluated as the body of evidence is of very low quality. Clinical relevance: Dental maturation might be a potential indicator of skeletal craniofacial growth status. A routine dental x-ray could be sufficient, reducing radiation exposure by requesting additional radiographs. [ABSTRACT FROM AUTHOR]