Age estimation of children based on open apex measurement in the developing permanent dentition: an Egyptian formula

Shaimaa S El-Desouky, Ibrahim A Kabbash, Shaimaa S El-Desouky, Ibrahim A Kabbash

Abstract

Background: Cameriere's original formula based on open apex measurements is a reliable, clinically applicable method for dental age estimation in different populations children. Dental development may differ between Egyptian children and other ethnic populations which may affect dental age accuracy using Cameriere's formula.

Aim: Firstly, to verify Cameriere's original formula on large Egyptian children sample, secondly, to develop an Egyptian-specific formula based on Cameriere's method.

Material and methods: A prospective cross-sectional study of 762 good quality Orthopantomograms (OPGs) of 5-15 aged healthy Egyptian children selected from Nile Delta governorates between August 2020 and December 2021. Chronological age (CA) was calculated by subtracting birth date from radiograph date. OPGs were analyzed for N0, S, Xi morphologic variables using Sidexis program after that dental age was calculated using Cameriere's formula then compared to CA. Multiple linear regression model was used to adapt Cameriere's formula to construct an Egyptian formula. The same sample was used to verify the new formula accuracy.

Results: A total of 1093 OPGs were collected; 762 OPGs which met inclusion criteria were analyzed. Cameriere's original formula revealed - 0.59- and - 0.53-year underestimation of females and males dental age (DA) respectively (p < 0.001). Regression analysis using the morphologic variables showed that X4, X7, N0 contributed significantly to CA yielding Egyptian-specific formula. New formula showed - 0.12-year male underestimation and 0.1-year female overestimation (p > 0.05).

Conclusion: Egyptian formula was more accurate than Cameriere's formula in Egyptian children.

Clinical relevance: Egyptian-specific formula decreases the gap between CA and DA, so a relative approximate age is obtained that helps proper diagnosis and treatment planning for orthodontic and pediatric dentistry problems.

Keywords: Cameriere method; Chronological age; Dental age; Forensic dentistry.

Conflict of interest statement

The authors declare no competing interests.

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart of the present study showing sampling process
Fig. 2
Fig. 2
An example from our study group: Sidexis program analyzed a panoramic radiograph of 7.15 years male patient
Fig. 3
Fig. 3
Plots of the chronological against estimated age in males and females for both equations

References

    1. Shamim T. Forensic pediatric dentistry. J Forensic Dent Sci. 2018;10(3):128. doi: 10.4103/jfo.jfds_79_17.
    1. Rajendran R, Sivapathasundharam B. Forensic odontology. Elsevier India: Shafer’s textbook of oral pathology; 2012.
    1. Kanaparthy A, Kanaparthy R. The dental role in forensic medicine. Iosr J Pharm. 2013;3:14–17.
    1. Cruz-Landeira A, Linares-Argote J, Martínez-Rodríguez M, Rodríguez-Calvo M, Otero X, Concheiro L. Dental age estimation in Spanish and Venezuelan children. Comparison of Demirjian and Chaillet’s scores. Int J Legal Med. 2010;124(2):105–112. doi: 10.1007/s00414-009-0380-5.
    1. Abesi F, Haghanifar S, Sajadi P, Valizadeh A, Khafri S. Assessment of dental maturity of children aged 7–15 years using Demirjian method in a selected Iranian population. J Dent. 2013;14(4):165.
    1. Demirjian A, Buschang PH, Tanguay R, Patterson DK. Interrelationships among measures of somatic, skeletal, dental, and sexual maturity. Am J orthod. 1985;88(5):433–8. doi: 10.1016/0002-9416(85)90070-3.
    1. Eid R, Simi R, Friggi M, Fisberg M. Assessment of dental maturity of Brazilian children aged 6 to 14 years using Demirjian’s method. Int J Paediat Dent. 2002;12(6):423–428. doi: 10.1046/j.1365-263X.2002.00403.x.
    1. Bagherian A, Sadeghi M. Assessment of dental maturity of children aged 3.5 to 13.5 years using the Demirjian method in an Iranian population. J Oral Sci. 2011;53(1):37–42. doi: 10.2334/josnusd.53.37.
    1. Panchbhai A. Radiographic evaluation of developmental stages of third molar in relation to chronological age as applicability in forensic age estimation. Dentistry. 2012;1(2):1–7.
    1. Yan J, Lou X, Xie L, Yu D, Shen G, Wang Y. Assessment of dental age of children aged 3.5 to 16.9 years using Demirjian’s method: a meta-analysis based on 26 studies. PloS One. 2013;8(12):e84672. doi: 10.1371/journal.pone.0084672.
    1. Nolla CM (1952) The development of permanent teeth: University of Michigan Ann Arbor
    1. Moorrees C, Fanning E, Hunt E. age variation of formation stages for ten permanent teeth. J Dent Res. 1963;42:1490–1502. doi: 10.1177/00220345630420062701.
    1. Haavikko K. Tooth formation age estimated on a few selected teeth. A simple method for clinical use. Procc Finn Dent Soc. 1974;70(1):15–9.
    1. Anderson D, Thompson G, Popovich F. Age of attainment of mineralization stages of the permanent dentition. J Forensic Sci. 1976;21(1):191–200. doi: 10.1520/JFS10353J.
    1. Willems G, Van Olmen A, Spiessens B, Carels C. Dental age estimation in Belgian children: Demirjian’s technique revisited. J Forensic Sci. 2001;46(4):893–5. doi: 10.1520/JFS15064J.
    1. Chaillet N, Nyström M, Kataja M, Demirjian A. Dental maturity curves in Finnish children: Demirjian’s method revisited and polynomial functions for age estimation. J Forensic Sci. 2004;49(6):JFS2004211–8. doi: 10.1520/JFS2004211.
    1. Demirjian A, Goldstein H, Tanner JM (1973) A new system of dental age assessment. Hum Biol 211–27
    1. Leurs I, Wattel E, Aartman I, Etty E, Prahl-Andersen B. Dental age in Dutch children. Eur J Orthod. 2005;27(3):309–14. doi: 10.1093/ejo/cji010.
    1. Koshy S, Tandon S. Dental age assessment: the applicability of Demirjian’s method in south Indian children. Forensic Sci Int. 1998;94(1-2):73–85. doi: 10.1016/S0379-0738(98)00034-6.
    1. Liversidge H, Speechly T, Hector M. Dental maturation in British children: are Demirjian’s standards applicable? Int J Paediat Dent. 1999;9(4):263–269.
    1. McKenna C, James H, Taylor J, Townsend G. Tooth development standards for South Australia. Aust Dent J. 2002;47(3):223–7. doi: 10.1111/j.1834-7819.2002.tb00333.x.
    1. Prabhakar A, Panda A, Raju O. Applicability of Demirjian’s method of age assessment in children of Davangere. J Indian Soc Pedod Prev Dent. 2002;20(2):54–62.
    1. Mörnstad H, Staaf V, Welander U. Age estimation with the aid of tooth development: a new method based on objective measurements. Eur J Oral Sci. 1994;102(3):137–43. doi: 10.1111/j.1600-0722.1994.tb01169.x.
    1. Kvaal SI, Kolltveit KM, Thomsen IO, Solheim T. Age estimation of adults from dental radiographs. Forensic Sci Int. 1995;74(3):175–85. doi: 10.1016/0379-0738(95)01760-G.
    1. Liversidge H, Lyons F, Hector M. The accuracy of three methods of age estimation using radiographic measurements of developing teeth. Forensic Sci Int. 2003;131(1):22–29. doi: 10.1016/S0379-0738(02)00373-0.
    1. Rai B, Anand S (2008) Age estimation in children from dental radiograph: A regression equation. Internet J Biol Anthropol 1(2)
    1. Cameriere R, Ferrante L, Cingolani M. Age estimation in children by measurement of open apices in teeth. Int J Legal Med. 2006;120(1):49–52. doi: 10.1007/s00414-005-0047-9.
    1. Cameriere R, De Angelis D, Ferrante L, Scarpino F, Cingolani M. Age estimation in children by measurement of open apices in teeth: a European formula. Int J Legal Med. 2007;121(6):449–53. doi: 10.1007/s00414-007-0179-1.
    1. Lan LM, Yang ZD, Sun SL, Wen D, Kureshi A, Zeye MMJ, et al. Application of Demirjian’s and Cameriere’s method in dental age estimation of 8–16 year old adolescents from Hunan Han nationality. Fa yi xue za zhi. 2019;35(4):406–10.
    1. Javadinejad S, Sekhavati H, Ghafari R. A comparison of the accuracy of four age estimation methods based on panoramic radiography of developing teeth. J Dent Res Dent Clin Dent Prospects. 2015;9(2):72–8. doi: 10.15171/joddd.2015.015.
    1. Sharma P, Wadhwan V. Comparison of accuracy of age estimation in Indian children by measurement of open apices in teeth with the London Atlas of tooth development. J Forensic Odontostomatol. 2020;1(38):39–47.
    1. Alsudairi DM, AlQahtani SJ. Testing and comparing the accuracy of two dental age estimation methods on saudi children: measurements of open apices in teeth and the London Atlas of Tooth Development. Forensic Sci Int. 2019;295:226.e1–.e9. doi: 10.1016/j.forsciint.2018.11.011.
    1. AlShahrani I, Yassin SM, Togoo RA, Tikare S, Khader MA, Alkahtani ZM. Age estimation by measurement of open apices in tooth roots: study using Saudi Arabian samples. J Forensic Legal Med. 2019;62:63–68. doi: 10.1016/j.jflm.2019.01.010.
    1. Cugati N, Kumaresan R, Srinivasan B, Karthikeyan P. Dental age estimation of growing children by measurement of open apices: a Malaysian formula. J Forensic Dent Sci. 2015;7(3):227. doi: 10.4103/0975-1475.172445.
    1. Rai B. Accuracy of Cameriere et al regression equation in Haryana population. Rom J Leg Med. 2009;17(2):147–50. doi: 10.4323/rjlm.2009.147.
    1. Rai B, Kaur J, Cingolani M, Ferrante L, Cameriere R. Age estimation in children by measurement of open apices in teeth: an Indian formula. Int J Legal Med. 2010;124(3):237–41. doi: 10.1007/s00414-010-0427-7.
    1. Guo Y-c, Yan C-x, Lin X-w, Zhou H, Li J-p, Pan F, et al. Age estimation in northern Chinese children by measurement of open apices in tooth roots. Int J legal med. 2015;129(1):179–186. doi: 10.1007/s00414-014-1035-8.
    1. Angelakopoulos N, De Luca S, Palacio LAV, Coccia E, Ferrante L, Pinchi V, et al. Age estimation by measuring open apices in teeth: a new formula for two samples of South African black and white children. Int J Legal Med. 2019;133(5):1529–36. doi: 10.1007/s00414-019-02096-z.
    1. Gannepalli A, Balla SB, Pacha VB, Gandhi Babu DB, Vinay BH, Perkari S. Applicability of Cameriere European formula for age estimation of 10–15 years legal threshold in South Indian population. J Forensic Dent Sci. 2019;11(2):78–83. doi: 10.4103/jfo.jfds_72_19.
    1. Mazzilli LEN, Melani RFH, Lascala CA, Palacio LAV, Cameriere R. Age estimation: Cameriere’s open apices methodology accuracy on a southeast Brazilian sample. J Forensic Legal Med. 2018;58:164–168. doi: 10.1016/j.jflm.2018.06.006.
    1. Halilah T, Khdairi N, Jost-Brinkmann PG, Bartzela T. Age estimation in 5–16-year-old children by measurement of open apices: North German formula. Forensic Sci Int. 2018;293:103.e1–.e8. doi: 10.1016/j.forsciint.2018.09.022.
    1. Zelic K, Marinkovic N, Milovanovic P, Cameriere R, Djuric M, Nedeljkovic N. Age estimation in children based on open apices measurement in the Serbian population: Belgrade Age Formula (BAF) Ann Hum Biol. 2020;47(3):229–36. doi: 10.1080/03014460.2020.1764621.
    1. El-Bakary AA, Hammad SM, Mohammed F. Dental age estimation in Egyptian children, comparison between two methods. J Forensic Legal Med. 2010;17(7):363–7. doi: 10.1016/j.jflm.2010.05.008.
    1. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics. 159–74
    1. Liversidge HM. The assessment and interpretation of Demirjian, Goldstein and Tanner’s dental maturity. Ann Hum Biol. 2012;39(5):412–431. doi: 10.3109/03014460.2012.716080.
    1. Pradhan N A, Deshpande, Patel K (2022) Accuracy of Demirjian’s, Willems, Nolla’s and modified Cameriere’s dental age estimation methods in young western Indian children-a cross-sectional study. J Clinic Diagn Res 16(2)
    1. Panchbhai A. Dental radiographic indicators, a key to age estimation. Dento- maxillofacial Radiol. 2011;40(4):199–212. doi: 10.1259/dmfr/19478385.
    1. Priyadarshini C, Puranik MP, Uma S (2015) Dental age estimation methods-a review. : LAP Lambert Academic Publ
    1. Nik-Hussein NN, Kee KM, Gan P. Validity of Demirjian and Willems methods for dental age estimation for Malaysian children aged 5–15 years old. Forensic Sci Int. 2011;204(1–3):208. e1–. e6.
    1. Rai B, Anand S. Tooth developments: an accuracy of age estimation of radiographic methods. World J Med Sci. 2006;1(2):130–2.
    1. Fernandes MM, Tinoco RLR, de Braganca DPP, de Lima SHR, Junior LF, Junior ED. Age estimation by measurements of developing teeth: accuracy of Cameriere’s method on a Brazilian sample. J Forensic Sci. 2011;56(6):1616–9. doi: 10.1111/j.1556-4029.2011.01860.x.
    1. Tunc ES, Koyuturk AE. Dental age assessment using Demirjian’s method on northern Turkish children. Forensic Sci Int. 2008;175(1):23–6. doi: 10.1016/j.forsciint.2007.04.228.
    1. Shrestha A, Yadav R, Shrtestha S, Majarjan I, Camelio S. Measurement of open apices in teeth for estimation of age in children. Health Renaissance. 2014;12(1):33–7. doi: 10.3126/hren.v12i1.11983.
    1. Gulsahi A, Tirali RE, Cehreli SB, De Luca S, Ferrante L, Cameriere R. The reliability of Cameriere’s method in Turkish children: a preliminary report. Forensic Sci Int. 2015;249:319. e1–. e5. doi: 10.1016/j.forsciint.2015.01.031.
    1. De Luca S, De Giorgio S, Butti AC, Biagi R, Cingolani M, Cameriere R. Age estimation in children by measurement of open apices in tooth roots: study of a Mexican sample. Forensic Sci Int. 2012;221(1–3):155. e1–. e7.
    1. Frucht S, Schnegelsberg C, Schulte-Mönting J, Rose E, Jonas I. Dental age in Southwest Germany A radiographic study. J Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 2000;61(5):318–29. doi: 10.1007/PL00001902.
    1. Pahel B, Vann W, Jr, Divaris K, Rozier R. A contemporary examination of first and second permanent molar emergence. J Dent Res. 2017;96(10):1115–21. doi: 10.1177/0022034517716395.
    1. Shafi S, Albeshri A, Mir S. Prevalence of congenitally missing premolars in college of dentistry, King Khaled University, Abha, Kingdom of Saudi Arabia: can early treatment make a difference. Int J Sci Study. 2018;6(1):4–7.
    1. Attiguppe PR, Yavagal C, Maganti R, Mythri P. Age assessment in children: a novel Cameriere’s stratagem. Int J Clinic Pediat Dent. 2016;9(4):330. doi: 10.5005/jp-journals-10005-1387.
    1. Latic-Dautovic M, Nakas E, Jeleskovic A, Cavric J, Galic I. Cameriere’s European formula for age estimation: a study on the children in Bosnia and Herzegovina. South Eur J Orthod Dentofacial Res. 2017;4(2):26–30. doi: 10.5937/sejodr4-15528.

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