A comparison of the validity of the Demirjian, Willems, Nolla and Häävikko methods in determination of chronological age of 5–15 year-old Indian children

doi:10.1016/j.jflm.2017.07.007

Journal of Forensic and Legal Medicine

Volume 50, August 2017, Pages 49-57

https://doi.org/10.1016/j.jflm.2017.07.007 Get rights and content

Highlights

•
This paper reports on the applicability of four age estimation methods to an Indian population.
•
The methods were tested on a reasonably large sample of 1200 Indian children.
•
Willems' method most accurately estimated age, followed by Demirjian's, Nolla's and Häävikko's methods.
•
Mean prediction errors were lower than 0.30 years (3.6 months) with all four methods.

Abstract

Background

Demirjian's method has been the most popular and extensively tested radiographic method of age estimation. More recently, Willems' method has been reported to be a better predictor of age. Nolla's and Häävikko's methods have been used to a lesser extent. Very few studies have compared all four methods in non-Indian and Indian populations. Most Indian research is limited by inadequate sample sizes, age structures and grouping and different approaches to statistical analysis.

Aim

The present study aimed to evaluate and compare the validity of the Demirjian, Willems, Nolla and Häävikko methods in determination of chronological age of 5 to 15 year-old Indian children.

Design

In this cross-sectional observational study, four methods were compared for validity in estimating the age of 1200 Indian children aged 5-15 years.

Results

Demirjian's method overestimated age by +0.24 ± 0.80, +0.11 ± 0.81 and +0.19 ± 0.80 years in boys, girls and the total sample, respectively. With Willems' method, overestimations of +0.09 ± 0.80, +0.08 ± 0.80 and +0.09 ± 0.80 years were obtained in boys, girls and the total sample, respectively. Nolla's method underestimated age by -0.13 ± 0.80, -0.30 ± 0.82 and -0.20 ± 0.81 years in boys, girls and the total sample, respectively. Häävikko's method underestimated age by -0.17 ± 0.80, -0.29 ± 0.83 and -0.22 ± 0.82 years in boys, girls and the total sample, respectively. Statistically significant differences were observed between dental and chronological ages with all methods (p < 0.001). Significant gender-based differences were observed with all methods except Willems' (p < 0.05). Gender-specific regression formulae were derived for all methods.

Conclusion

Willems' method most accurately estimated age, followed by Demirjian's, Nolla's and Häävikko's methods. All four methods could be applicable for estimating age in the present population, mean prediction errors being lower than 0.30 years (3.6 months).

Section snippets

1Introduction

The field of age estimation has garnered much interest from investigators for several decades now. However, the increasing need for more accurate methods and the lack of a single method that may be applicable across ages and populations have led to continuous research in this area. Age estimation methods have a wide range of uses, such as providing important information regarding past populations or helping to identify the age at death of a deceased child.¹ Determination of age can be

Methodology

Ethical clearance was obtained from the Ethical Committee, Pacific Dental College and Hospital, Udaipur, India. Parents/guardians had signed an agreement with the dental institution that dental records and radiographs could be used only for research and educational purposes without the possibility of personal identification.

Results

The mean chronological age (±SD) of the entire sample was 10.75 ± 2.72 years, those of females and males being 10.68 ± 2.87 and 10.81 ± 2.60 years, respectively.

In the present study, the mean Demirjian dental ages for girls and boys were 10.79 ± 2.86 years and 11.05 ± 2.71 years, respectively. The mean differences between dental and chronological ages for boys, girls and the total sample (+0.24 ± 0.80, +0.11 ± 0.81 and +0.19 ± 0.80 years, respectively) were statistically significant (p < 0.01).

Discussion

The need for accurate techniques of age estimation has never been greater than in the last two decades owing to the increasing number of unidentified cadavers and human remains, as well as the rise in number of cases requiring age estimation in living individuals with no valid proof of date of birth.¹⁸ Age estimation of juveniles and adolescents is commonly required in most civilized countries, including India, age thresholds of social or legal relevance lying between ages 14 and 20. Since

Conclusions

From the results of the present study, the following conclusions could be drawn.

•
The Willems and Demirjian methods overestimated age, while the Nolla and Häävikko methods underestimated age.
•
Of the methods tested, the Willems method most accurately predicted the age (mean prediction error was 0.09 years or 1.08 months for both genders) of the study sample followed by the Demirjian and Nolla methods. The Häävikko method was the least accurate.
•
The Demirjian method was significantly more accurate in

Conflicts of interest

None.

Acknowledgement

Prof. Prashant Nahar, Dept. of Oral Medicine and Radiology, Pacific Dental College and Hospital, Udaipur, India for providing OPGs.

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A comparison of the validity of the Demirjian, Willems, Nolla and Häävikko methods in determination of chronological age of 5–15 year-old Indian children

Highlights

Abstract

Background

Aim

Design

Results

Conclusion

Section snippets

1Introduction

Methodology

Results

Discussion

Conclusions

Conflicts of interest

Acknowledgement

Forensic Sci Int

Am J Orthod

Singap Dent J

Forensic Sci Int

BMC Oral Health

J Hum Evol

Dental Anthropology

A review of the most commonly used dental age estimation techniques

J Forensic Odontostomatol

The Juvenile Justice (Care and Protection of Children) Act TGoI

The Prohibition of Child Marriage Act of 2006 the Gazette of India MoLaJ

Age variation of formation stages for ten permanent teeth

J Dent Res

The development of the permanent teeth

J Dent Child

Accuracy tests of tooth formation age estimations for human skeletal remains

Am J Phys Anthropol

A new system of dental age assessment

Hum Biol

Dental age estimation in Belgian children: Demirjian's technique revisited

J Forensic Sci

The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study

Suom Hammaslääkäris toimituksia= Fin tandläkarsällskapets förhandlingar

Reliability and validity of five radiographic dental-age estimation methods in a population of Malaysian children

J Investigative Clin Dent