Dental Age Estimation by Different Methods in Patients With Amelogenesis Imperfecta

Evaluation of Dental Age of Children With Amelogenesis Imperfecta Using Willems Method, Cameriere European Formula, and London Atlas

The aim of this study is to investigate whether there is a significant difference in dental age between children with amelogenesis imperfecta (AI) and healthy controls using Willems method, Cameriere European formula and London Atlas. If there is a significant difference in dental age between children with AI and healthy controls, it is aimed to create a new formula.

Study Overview

• Status: Recruiting
• Conditions: Amelogenesis Imperfecta; Dental Age Estimation
• Intervention / Treatment: Diagnostic test: Willems method; Diagnostic test: Cameriere method; Diagnostic test: London Atlas method

Detailed Description

One of the developmental enamel defects, amelogenesis imperfecta (AI), is also known as enamel hypoplasia/hypomineralization. It is a rare inherited disease that affects the enamel structure, amount and component in primary and permanent teeth, and it has been reported to be accompanied by some dental anomalies and nephrocalcinosis. Dental anomalies and nephrocalcinosis can affect tooth development, and there are limited studies examining tooth development in these individuals.Dental age is widely evaluated by pedodontists, forensic dentists and orthodontists. While a delay in tooth development may be associated with growth retardation and learning difficulties, dental age determination can also be used for forensic age determination for children whose birth information is uncertain. A clear assessment of maturation in children with continued growth is important in establishing a dental treatment plan.

Dental age is widely evaluated by pedodontists, forensic dentists and orthodontists. While a delay in tooth development may be associated with growth retardation and learning difficulties, dental age determination can also be used for forensic age determination for children whose birth information is uncertain. A clear assessment of maturation in children with continued growth is important in establishing a dental treatment plan.

There are two basic approaches to dental age determination in children:

1. evaluation of eruption of teeth in the oral cavity,
2. evaluation of the development and mineralization of crowns and roots on dental radiographs.

In many methods, the developmental stages of different numbers of permanent teeth are used.

The most commonly used method for determining dental age in children; is the Demirjian method that evaluates the development of seven left permanent mandibular teeth in eight stages (from A to H). Willems et al. In 2001, they modified the Demirjian method by conducting a study on the fact that it showed higher age determination in the Belgian Caucasian population. The adapted method was named the Willems method. It is stated that one of the advantages of this method is that it is a relatively simple system for determining tooth age.

One of the most widely used methods of dental age determination recently is the European formula of Cameriere et al., which is calculated based on open apex. It has been reported that this method has been tested on different population groups, and the results are accurate and reliable.

An atlas method was proposed by a group of London researchers in 2010. The Atlas shows all the teeth array images of certain age groups as a schematic series. Age determination is made by deciding which reference image matches the individual's panoramic radiography image more.

• Study Type: Observational
• Enrollment (Estimated): 240

Contacts and Locations

• Study Contact: Name: Yelda Kasimoglu Eldem, Assoc. Prof.; Phone Number: 00905336233978; Email: yelda.kasimoglu@istanbul.edu.tr

Study Locations

• Turkey
  • Istanbul, Turkey
    • Recruiting
    • Istanbul University, Faculty of Dentistry
    • Contact: Yelda Kasimoglu Eldem, Assoc. Prof.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years to 12 years (Child)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

This study was conducted on gender-age matched healthy control group of children aged 5-14 years, who applied to Istanbul University Faculty of Dentistry, Department of Pedodontics, had an AI record in their anamnesis, had panoramic radiographs in the archive of the Department of Oral and Maxillofacial Radiology, Istanbul University Faculty of Dentistry.

Description

Inclusion Criteria:

• 5-14 years old
• Healthy children
• Children with AI
• Patients without missing left mandibular permanent teeth on panoramic radiography

Exclusion Criteria:

• Children younger than 5 years old and older than 14 years (children that cannot be assessed by the Willems and Cameriere method)
• Poor quality panoramic radiography
• Patients who have received orthodontic treatment
• Patients who received restorative or endodontic treatment

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Children with AI	Diagnostic test: Willems method; Willems method measures the developmental stages of the seven left permanent mandibular teeth and is frequently used for dental age estimation. The score of each stage is allocated, and the sum of the scores provides an evaluation of the subject's dental maturity.; Diagnostic test: Cameriere method; Cameriere et al. designed a quantitative approach through a formula based on sex and the ratio between length and apex opening measurements of each lower left tooth.; Diagnostic test: London Atlas method; The London Atlas requires the user to assess the tooth development and eruption and then match it to one of the 31 pictures of age categories.
Healthy controls with gender-age match	Diagnostic test: Willems method; Willems method measures the developmental stages of the seven left permanent mandibular teeth and is frequently used for dental age estimation. The score of each stage is allocated, and the sum of the scores provides an evaluation of the subject's dental maturity.; Diagnostic test: Cameriere method; Cameriere et al. designed a quantitative approach through a formula based on sex and the ratio between length and apex opening measurements of each lower left tooth.; Diagnostic test: London Atlas method; The London Atlas requires the user to assess the tooth development and eruption and then match it to one of the 31 pictures of age categories.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation coefficient of Willems method.	Dental age of children with AI and healthy controls assessed by the correlation coefficient.	day 1
Correlation coefficient of London Atlas method.	Dental age of children with AI and healthy controls assessed by the correlation coefficient.	day 1
Correlation coefficient of Cameriere European formula.	Dental age of children with AI and healthy controls assessed by the correlation coefficient.	day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dental age estimation in children with AI	Dental age estimation in Turkish children	day 1

Collaborators and Investigators

• Sponsor: Istanbul University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2022
• Primary Completion (Estimated): February 15, 2024
• Study Completion (Estimated): May 15, 2024

Study Registration Dates

• First Submitted: April 18, 2022
• First Submitted That Met QC Criteria: April 18, 2022
• First Posted (Actual): April 25, 2022

Study Record Updates

• Last Update Posted (Actual): November 29, 2023
• Last Update Submitted That Met QC Criteria: November 26, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: children; dental age estimation; amelogenesis imperfecta; chronological age; London Atlas; Cameriere European Formula; Willems method
• Additional Relevant MeSH Terms: Congenital Abnormalities; Stomatognathic Diseases; Tooth Diseases; Stomatognathic System Abnormalities; Tooth Abnormalities; Developmental Defects of Enamel; Amelogenesis Imperfecta
• Other Study ID Numbers: 2021/76

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No