Application of the London Atlas Software App 2nd edition for the radiographic assessment of dental development

Abstract

Background Assessing the dental development of children and adolescents is an important part of treatment planning. The radiographic visualization of dental developmental stages prior to age estimation is currently feasible by means of digital software apps. Testing the existing software tools is necessary to safeguard application in practice. This study applied the London Atlas Software App 2nd edition™ for dental age estimation in Brazilian children. Material and Methods The software was applied to 1.104 digital panoramic radiographs of females (n = 509) and males (n = 595) with ages between 6 and 15.99 years (mean = 10.88 ± 2.84 years). The sample included at least 100 individuals similarly distributed based on sex within 10 age categories of one year each (6├ 15.99) years. Metrics of errors were quantified between the estimated (EA) and chronological (CA) ages. Results The mean absolute errors among females and males were 0.56 and 0.60 years, respectively (overall = 0.58 years for the combined sample). The lower error values were observed in the age interval of 6 ├ 9.99 years. Error values above one year were detected in older age intervals (10 ├ 15.99 years). Statistically significant differences in dental development were not observed between females and males ( p > 0.05). Conclusions The London Atlas Software App 2nd edition led to specific error rates that can be acceptable for case-specific clinical applications. In the forensic field, caution is advised if the application is planned in the transition between late childhood and early adolescence – when third molars play a major role among the scarce developing teeth. Key words: Brazil, children, dental age estimation, forensic dentistry, radiology.

Accuracy of the London Atlas to estimate the age of legal majority in a sample of the Amazon Regio

“…Contrasting, when The London Atlas was applied based on the developing permanent dentition of Brazilian individuals aged 6-15.99 years ( 7 ), the MAE was only 0.56 and 0.60 years The current results, based solely on third molar formation in the age group 16-22.99 years, showed MAE of 1.76 and 1.52 years for females and males, respectively. These outcomes seem to point out to a potentially acceptable performance of the method since third molar age estimation often leads to MAE rates that could reach over 2.0 years ( 20 , 21 ).…”

“…Out of 2.527 entries detected with a dedicated search string, the London Atlas has not been included amongst the top ranked methods ( 14 ). Regarding the performance of the method, previous studies have found an overall accuracy of 79.9% ( 15 ), while others have demonstrated concern especially when the method is applied solely based on third molars ( 7 , 16 ). Most of the performance tests that have been accomplished with the London Atlas have followed the common methodological structure of dental age estimation studies and quantified the difference between chronological and estimated ages ( 7 , 16 ).…”

“…Regarding the performance of the method, previous studies have found an overall accuracy of 79.9% ( 15 ), while others have demonstrated concern especially when the method is applied solely based on third molars ( 7 , 16 ). Most of the performance tests that have been accomplished with the London Atlas have followed the common methodological structure of dental age estimation studies and quantified the difference between chronological and estimated ages ( 7 , 16 ). Moreover, all the studies performed in the Brazilian population sampled participants from the Southeastern, Central-Western and Northeastern regions of Brazil ( 7 , 13 - 16 ).…”

“…This method is known for the intuitive user-interface and for the robust scientific background. Several studies have tested the performance of the London Atlas worldwide, including in populations from Brazil ( 7 ), China ( 8 ), Korea ( 9 ), Portugal ( 10 ), South Africa ( 11 ) and Thailand ( 12 ). A recent systematic review claimed that the method has an accepTable error rate and proper accuracy for dental age estimation ( 13 ).…”

“…Most of the performance tests that have been accomplished with the London Atlas have followed the common methodological structure of dental age estimation studies and quantified the difference between chronological and estimated ages ( 7 , 16 ). Moreover, all the studies performed in the Brazilian population sampled participants from the Southeastern, Central-Western and Northeastern regions of Brazil ( 7 , 13 - 16 ). Hence, the scientific literature has no study with a population from the Amazon region.…”