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  • The Internet Journal of Dental Science
  • Volume 6
  • Number 1

Original Article

Accuracy of the Demirjian Method for the Haryana Population

B Rai, J Kaur, S Anand, R Jain, A Sharma, S Mittal

Keywords

age determination, chronological age, demirjian method, dental age, haryana

Citation

B Rai, J Kaur, S Anand, R Jain, A Sharma, S Mittal. Accuracy of the Demirjian Method for the Haryana Population. The Internet Journal of Dental Science. 2007 Volume 6 Number 1.

Abstract

Age estimations of living individuals are increasingly important in medical and dental practice for evaluating developmental progress, for educational purposes, and in legal matters, particularly in the application of criminal law. The study was designed to determine dental age from orthopantomograph using the Demirjian method to investigate applicability of the Demirjian method for estimation of chronological age in north Indian population. The sample for study consisted of 325 subjects between 6 years to 17 years of age with a healthy dentition & without any dental lesions .Demirjian method showed high accuracy when applied in Haryana population.

 

Introduction

Accurate age data are needed in medicine and dentistry, being relevant to the timing of treatment procedures in endocrinology, pediatric dentistry and orthodontics. This information is also important in area of forensic science, when matters of consent or criminal ability arise, or in the identification of deceased persons. In developing countries reliable registration of birth details is often not a priority. Individuals may not have accurate information as their date of birth, or they may choose to suppress such information. In such circumstances age determination technique i.e. estimation of chronological age, may be required.1 The main criteria for forensic age determination in the relevant age group based on odontological examination are tooth eruption and tooth mineralization, both developmental biological features. Tooth mineralization is evaluated based on what is known as an orthopantamogram, a radiograph of the complete dentition. Tooth mineralization begins with the development of the crown at the occlusal surface and continuous to the root. It ends when the root is fully developed and the apex closed, i.e. reduced to the mature pore. For the evaluation of tooth mineralization, various stages of classifications have been put forward.2,3,4,5 The classification of stages proposed by Demirjian appears to be best suited for forensic purpose, since stages are defined by changes in form and independent of possibly speculative length estimates. The degree of mineralization of second molars allows estimates on age approximately until the age of 16 years.6 the continuous patterns of tooth development can be observed on a longitudinal series of radiographs and various mineralization stages have been described.7,8,9,10

The aim of this study was to generate dental maturity scores for a population of Haryana children, using the revised system of Demirijian.2 Ages estimated from these scores were compared with chronological ages of subjects, to determine if the system provides accurate results that could be used for Haryana children; or whether new population specific standards needed to be generated.

Material and Method

The study was conducted at Department of Orthodontics Govt. Dental College, Pt. B.D. Sharma Postgraduate Institute of Medical Sciences (Rohtak), Haryana. The data used in this study were obtained from copies of orthopantomographs required for clinical purposes for a sample of 325 Haryana children, 168 female and 157 males, between 6 years to 17 years of age.

The development of the left quadrant is determined. For any subject with an absent left permanent mandibular tooth, with the exception of third molar, the equivalent tooth on the subject's right was used. Tooth formation is divided into eight stages and criteria for this stages are given for each tooth separately. Each stage of the seven teeth is given score. The sum of score for the seven teeth is transferred to a dental age.

The parent or guardian of each subject was required to submit the copy of birthday certificate for accurate age estimation. Dental age assessment was done by Demirjian methods.

Results

In the present study 325 subject i.e. (168 F : 157 M) were selected from Department of Orthodontics which was divided into 14 groups, in intervals of one years.

Figure 1
Table 1: Mean, Standard Deviation (Mean ± SD) in the Chronological and Dental Age in 6 to 17 years in both gender

(P > .01).

When chronological age was compared with dental age using Demirjian method male and female sample showed statistically significant difference (P < 0.01).

Discussion

Tooth development shows less variability than other developmental features and also low variability in relation to chronological age.12 Hortz observed a greater degree of association between dental age and chronological age than between dental and skeletal age.13A number of methods have been proposed to determine dental age,14,15 but the system developed by Demirjian11 has gained wide acceptance.

In the study chronological and dental age showed significant positive correlation between male and female sample i.e. (P<0.01) as earlier reported.16,17 When Demirjian methods was applied to north Indian population, mean difference between chronological age and dental age was minimal as reported earlier.18,19 The study supports use of Demirijian method for assessment of dental age in Haryana population with few modifications.

Conclusion

The results of our study have concluded that the Demirjian method showed high accuracy when applied to Haryana population. Significant positive correlation was found between chronological and dental age (P<0.01)

Acknowledgement

I am very thankful to Dr. Jasdeep Kaur,Kapurthala,Dr.SimmiKharb,Dr.S.C.Anand,Dr.HelenJames,Dr.Wanker,Prof.Jaipaul Singh, Prof B.K.Behara, Dr.Rajnish K Jain, Prof.S Nath,Dr.K.krishan,Dr.KuldeepLaller,Dr.Porter,Prof.S.david,Prof.B.lenda,Dr.Alen , Dr.J.Pyle and my research team for providing me material and all kind of supports. Finally this study is dedicated to my research team.

Correspondence to

Dr. Balwant Rai (BR formula Founder) Village – Bhangu Distt. Sirsa Post Office – Sahuwala I. E-mail : drbalwantraissct@rediffmail.com Mobile No. : 091-9812185855

References

1. Voor AW, 'Can dental development be used for assessing age in underdeveloped communities?" J Trop Pediatr Environ Child Health 1973; 19: 242.
2. Demirjian A, Goldstein H, Tanner JM : A system of dental age assessment. Hum Biol 1973; 45: 221-227.
3. Greaser, Hunt EE, The permanent mandibular first molar, its calcification, eruption and decay. Am J Phy Anthrop 1955; 13: 253-284.
4. Kullman L, Johanson G, Akesson L, Root development of the lower third molar and its relation to chronological age. Swed Dent J 1992; 16: 161-67.
5. Kohler S, Schmelzle R, Loitz C, Puschel K; Die Entwicklung des weisheitszalmesals Kriterium der lebensalterbestimmung Arm Anat 1994; 176: 339-45.
6. Kahl B, Schwarze CW. Aktualisierung der Dentitionstablle von. I Schour und M Massler Von 1941. Fortschr Kieferorthop 1988; 49: 432-43.
7. Nolla CM. The development of the permanent teeth. J Dent Child 1960; 27: 254-66.
8. Liliequist B, Lundberg M. Skeletal and tooth development. A Methodological investigation. Acta Radiol 1971; 11: 97-111.
9. Gustafson G, Koch G. Age estimation upto 16 years of age based on dental development. Odont Revy 1974; 25: 297-306.
10. Nielson HG, Ravn JJ. A radiographic study of mineralization of permanent teeth in a group of children aged 3-7 years. Scand J Dent Res 1976; 84: 109-118.
11. Demirijian A, Goldstein H. New systems for dental maturity based on seven and four teeth. Ann Hum Biol 1976; 3: 411-21.
12. Demirijian A, Bus chang PH, Tanguay R, Patternson DK. Interrelationships among measures of somatic, skeletal, dental and sexual maturity. Am J Orthod 1985; 88: 433-38.
13. Hotz R. The relation of dental calcification to chronological and skeletal age. Proceedings of the European Orthod Soc Albani. The Hague 1959; 140-49.
14. Hagg U, Matsson L, Dental maturity as an indicator of chronological age. The accuracy and precision of three methods. Eur J Orthod 1985; 7: 25-34.
15. Staaf V, Mornstad H, Welander U. Age estimation based on tooth development: A test of reliability and validity. Scand J Dent Res 1991; 99: 281-286.
16. Jaeger U. Dental age in dependence on the stage of selected physiological development parameters - stomat 1990; 40 (12): 511-14.
17. Carvalho AA, Decarvalho A: Radiographic study of the development of permanent dentition of Brazilian children with chronologic age aof 84 and 131 months. Odontol Revy 1991; 19 (1): 31-39.
18. Nanda R.S. and Chawla T.N. Growth and development of dentition in Indian children and development of permanent teeth. Am J Orthod 1966; 52: 837.
19. Sapoka A and Demirjian A. Dental development of the French Candian child, J. Canda Dent Assoc 1971; 3: 100-104.

Author Information

Balwant Rai
Editor In Chief Internet Journal of Dental Science, P.D.M College Of Dental Sciences

Jasdeep Kaur
B J S Dental College & research Institute

S.C. Anand
Ex –Director, P.D.M College Of Dental Sciences

Rajnish Jain, MDS
G.D.C,PGIMS

Anil Sharma
HOD, Deptt. Of Orthodontic, P.D.M College Of Dental Sciences

Sushil Mittal
Reader, Deptt. of Orthodontics, P.D.M College Of Dental Sciences

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