The accuracy of estimating chronological age from Demirjian and Nolla methods in a Portuguese and Spanish sample

Abstract

BackgroundAge determination has great importance in many clinical decisions, being commonly used in odontopediatrics, orthodontics, pediatrics, and forensic medicine. The Nolla and Demirjian et al. methods have been used for these purposes. However, estimating chronological age by means of the dental mineralization stage is not a straightforward analysis, and it is fundamental to test the validity of these methods and their applicability to populations. In this article we intend to compare the accuracy of estimating chronological age from dental age measured with the Nolla and Demirjian methods in a Portuguese and Spanish sample, considering the variables of sex and age-group.MethodsThe sample was composed of 821 orthopantomographs of healthy Portuguese (n = 270) and Spanish (n = 551) subjects from 4 to 34 years old. For the Nolla and Demirjian methods, seven mandibular left teeth were examined, staged according to the dental maturity scale of each method. We obtained a good index of inter-rater agreement, a good internal consistency for the teeth assessment, and a good temporal consistency.ResultsDental age was calculated for each method. The Demirjian et al. method tends to overestimate the real age of participants and the Nolla method tends to underestimate it. The accuracy of both methods varied between the sexes and age groups. Both methods were found to be more precise with males. As the age-group increases, the predictive capacities of both methods diminish. The Nolla method was more accurate than the Demirjian method in early and late childhood for both sexes. Neither method could predict chronological age in adults.ConclusionsWe can estimate chronological age for early and late childhood, through the Nolla and Demirjian methods, with the former showing greater predictive capacities than the latter. The Demirjian method tends to overestimate age and the Nolla method tends to underestimate it, leading to the importance of forming regression equations adapted to the population studied. Nolla and Demirjian formulas adapted to our sample were created as a function of sex and age-group.

Accuracy assessment of dental age estimation with the Willems, Demirjian and Nolla methods in Spanish children. Comparative cross-sectional study.

“…For both, our results coincide regarding the tendency of the Demirjian method to overestimate, although we obtained greater precision in boys [17], and our results also agreed regarding underestimation with the Nolla method [16,17].…”

“…However, in the medical-legal environment, the Demirjian method is used based on the stages of the teeth between the left central incisor and the second left molar of the mandible [11]. Its application has been very frequent, and, as in our study, the tendency of the calculation of dental age is towards overestimation [14,16,17,22,28,29]. In the study of Melo et al [16], the precision is very similar to ours, 0.86 and 0.70, respectively.…”

“…The Demirjian method [9,10] is one of the most popular tools for predicting chronological age due to its simplicity, the degree of intraexaminer agreement and the ease of its standardization and reproducibility [3]. In the Spanish population, the Demirjian method is recommended by the Institutes of Legal Medicine of Spain [11] for legal and medical purposes, and it has been used in numerous studies independently [8,[12][13][14][15] or together with the Nolla method [1,16,17].…”

Dental anxiety in schoolchildren with molar incisor hypomineralization—A population‐based cross‐sectional study

“…At 8 years old, with more advanced stages of physiological root resorption, the majority of primary teeth have a less intensive pulp response to stimulus. 42 Moreover, some carious lesions may have been in the chronic phase, which may also not influence on the reports of DA.…”

Northern Chinese dental ages estimated from southern Chinese reference datasets closely correlate with chronological age

“…In line with this, Birchler et al [46] found that dental age was estimated with higher level of precision for younger participants. Tomás et al [47] reported that the predictive capacity of Demirjian decreased with age and the method was unable to predict age in adults. Similarly, Urzel and Bruzek [48] cautioned age estimation for individuals aged over 14 years.…”