Comparison of accuracy of age estimation in Indian children by measurement of open apices in teeth with the London Atlas of tooth development

Abstract

Aim: The aim of this study was to evaluate and compare the accuracy of two age estimation methods in Indian children by using the open apex method proposed by Cameriere et al and the London Atlas of Tooth Development.

Materials and method: Three hundred and thirty five archived digitised panoramic radiographs of healthy children (165 males and 170 females) in the age group of 5 to 15.99 years were retrieved and analysed. The observations were entered in the SPSS software (Version 19.0). The paired t-test and independent samples t-test were applied to assess the differences between chronological and estimated age in both genders.

Results and conclusion: Inter-observer reliability was found to be excellent with Cronbach Alpha to be 1.000 and 0.997 for Cameriere's and London Atlas age estimation methods respectively. The difference of 0.59 years (SD ±1.32 years) was highly significant and indicated a consistent underestimation of age using Cameriere's method. While, applying the London Atlas, the difference of -0.03 years (SD± 0.69 years) was not significant and indicated a little overestimation of age. No significant difference was observed for both genders with the methods. Our results revealed that the methods are reliable for age estimation in Indian children, however, the London Atlas is simpler to use and is more accurate than Cameriere's method.

Figure 1

Cameriere’s method of measuring open apices and tooth length (on Adobe Photoshop)

Figure 2

Paired t-test for Cameriere’s method showing the bias for the sample population

Figure 3

Independent samples t-test for Cameriere’s method to express bias for gender

Figure 4

The London Atlas method showing bias for age estimation in different age groups

Figure 5

The London Atlas method showing bias in different age groups in male and female subjects