Pilot study of a new method for Dental Age Assessment

Introduction: Dental Age Assessment (DAA) of children and young adults is performed using radiographs. Most methods do not include third molars. Objectives: To compare two commonly used methods of DAA with the method of meta-analysis and each of these with the gold standard of Chronological Age (CA). Methods: A total of 50 Dental Panoramic Tomographs (DPT's) were randomly selected for re-use from clinical records of The Eastman Dental Hospital. Ethical approval and consent was obtained. Dental stages for all Tooth Morphology Types (TMTs) were assessed using the methods of: 1. Demirjian 2. Mornstad 3. Meta-analysis. For method 3 the eight Tooth Developmental Stages (TDS) described by Demirjian were assessed for all upper and lower teeth on the left side of the jaw (including third molars). The mean and standard deviation of Dental Age (DA) for each TDS were calculated. Data were analysed using Excel and Stata to produce a weighted mean DA and 95% confidence interval for each subject. The calculated DAs were compared with CA. Results: (i) the mean difference (CA – DA) for the Demirjian method was -0.4 (SD 3.9) years, for the Mornstad method it was -0.43 (SD 3.4) years and using meta-analysis it was -0.2 (SD 1.2) years, with all three methods slightly over-estimating age. Conclusions: Average CA-DA was comparable for the three methods, but meta-analysis improved on previous studies as it was slightly more accurate and resulted in a smaller standard deviation. It must be noted that the sample size of this preliminary investigation was small, and further work is needed to explore the use of meta-analysis in the estimation of DA for gender, ethnicity and factors affecting growth and development.