Forensic Odontology: testing the accuracy of dental age estimation on a sample of Western Saudi Arabian children and adolescents using three methods

Amin Mohammed A Alshihri

    Research output: ThesisDoctoral Thesis

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    Abstract

    The aim of this study was to determine the accuracy of three methods of age estimation using developing teeth from Orthopantomograms (OPGs) in Western Saudi Arabian children and adolescents between ages 4-23 years old. The design of this study was a retrospective cross-sectional study of dental radiographs. These were good quality OPGs. The radiographs were assessed to establish the developmental stages of the teeth morphology according to the following methods: London Atlas of AlQahtani et al. (2010) from 4–20 years old, [n=241, 104 males and 137 females]; Demirjian et al. (1973) from 4–16 years old, [n=198, 104 males and 137 females]; and Mincer et al. (1993) from 14–23 years old, [n= 130, 48 males, 82 females]. All data analyses, were performed using Excel 2003 software (Microsoft Corporation, Redmond, WA, USA), and SPSS (version 19.0; SPSS Inc., Chicago, IL, USA). Paired t-tests were performed, with statistical significance set to the 95% level (p 0.05). Statistical significance using Wilcoxon Matched Pairs Test for examiner reliability was calculated to be 0.740. This value is not significant and operator calibration considered reliable. In this study population the three methods of age estimation were mostly under-estimating actual age. The London atlas method underestimated chronological age on average by 1.6 (±15.0) months; using the Demirjian’s method, underestimation was only 0.02 (±14.5) months on average, and using Mincer's method, underestimation was 6.7 (±26.5) months on average. Almost two-thirds (65.1%) of the participants had their ages predicted within 12 months of their chronological age using the London Atlas method, almost three-quarters (71.4%) using Demirjian’s, and less than a third (28.5%) using Mincer’s method. Overall, across all ages, estimated age was closest to chronological age using Demirjian's method. This study validates the Demirjian’s method as the most accurate to estimate age, as overall it performed better than both the London Atlas and Mincer's method in this Western Saudi sample population. The latter two methods do not accurately estimate the ages of Western Saudi Arabian children and adolescents. In Summary; the London Atlas method was significantly less accurate than the other two methods when applied to Western Saudi individuals between the ages of 4 - 20 years of age. Demirjian's method was the most accurate when applied to individual’s 16 years of age. The Mincer's method was the most accurate when applied to individual’s 16 years of age. This study found that specific dental age methods are applicable for the different ethnic groups in Western Saudi Arabia, and accuracy varies according to age group. However, one should not restrict, age estimation to the use of only one method, but use different techniques available and perform repetitive measurements and calculation in order to establish maximum reproducibility. The number of population-specific dental age estimation studies are limited, and mostly based on Western populations or specific methods only. It therefore follows that adjusted dental age related tables specifically for the different ethnic groups in Western Saudi Arabia are necessary for age estimation of these children. The adjusted data may provide a valid and more accurate Saudi reference for age estimation and its application in forensic odontology.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2016

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