Applicability of Demirjian, Willems and Haavikko Methods in Croatian Population
Objectives: Age estimation is an essential part of every human identification process. During growth and development it is possible to estimate age based on developmental stages of permanent teeth. The accuracy of age estimation plays an important role in forensic, legal, anthropological, archeological and clinical cases. The aim of this study was to evaluate the applicability of the three most commonly used methods for dental age estimation in Croatian population.
Methods: 1996 digital, standardized orthopantomograms of children (1121 boys and 875 girls) aged 5 to 16 were collected in four major Croatian cities. All the orthopantomograms were taken with the device Cranex (Soredex, Finland). Developmental stages of the permanent teeth were assessed and age was estimated according to the Demirjian, Willems and Haavikko methods by the same investigator (IB). Intra-examiner agreement in assessing developmental stages was validated after two months on a random sample of 100 orthopantomograms.
Results: The Kappa for intra-examiner agreement was 0.83 for Haavikko stages and 0.92 for Demirjian stages. Using Demirjian method, the average overestimation of age was 0.80 years for boys and 0.84 years for girls. Willems method overestimated the mean age by 0.41 years in boys and 0.22 years in girls while Haavikko method underestimated mean age by 0.60 years in boys and 0.80 years in girls, respectively.
Conclusions: Among the tested methods Willems method proved to be the most accurate. Considering the average overestimation in boys and girls, it could be recommended for dental age estimation in Croatian children. Demirjian and Haavikko methods showed greater over- and underestimation respectively and need to be adapted in order to be considered acceptable for dental age estimation in the Croatian population.