Accuracy assessment of dental age estimation with the Willems, Demirjian and Nolla methods in Spanish children: Comparative cross-sectional study
- PMID: 32736612
- PMCID: PMC7393889
- DOI: 10.1186/s12887-020-02247-x
Accuracy assessment of dental age estimation with the Willems, Demirjian and Nolla methods in Spanish children: Comparative cross-sectional study
Abstract
Background: The objective of this study was to evaluate and compare the validity and accuracy of the Willems, Demirjian and Nolla methods in predicting chronological age in a Spanish ethnicity population.
Methods: A sample of 604 orthopantomographs of Spanish children aged 4 to 13 years was evaluated by two independent evaluators. Descriptive statistics were applied to calculate the chronological age and dental age, presenting the mean and standard deviation. The difference between dental age and chronological age was calculated for each method. A positive result indicated an overestimation and a negative figure indicated an underestimation. The Wilcoxon test for paired data and Spearman's correlation coefficient were applied by age groups and sex to compare the chronological age and dental age of each method (that of Willems, Demirjian and Nolla). Statistical tests were performed at a 95% confidence level.
Results: The interexaminer agreement was 0.98 (p = 0.00), and the intraexaminer agreement was 0.99 (p = 0.00). The Willems method significantly overestimated the age of boys (0.35 years (0.93)) and girls (0.17 years (0.88)). The Demirjian method significantly overestimated the age of boys (0.68 years (0.95)) and girls (0.73 years (0.94)). The Nolla method significantly underestimated age in boys (0.44 years (0.93)) and girls (0.82 years (0.98)).
Conclusions: In the Spanish population, the use of the Demirjian method for legal and medical purposes is frequent. This study reveals that the Willems method is more appropriate due to its greater precision in estimating dental age.
Keywords: Demirjian method; Dental age estimation; Nolla method; Spanish; Willems method; forensic odontology.
Conflict of interest statement
The authors declare that they have no competing interests.
Figures



Similar articles
-
Comparative Analysis of Dental Age Estimation: A Systematic Review and Meta-analysis Assessing Gender-Specific Accuracy of the Demirjian and Nolla Methods Across Different Age Groups.Cureus. 2024 Dec 3;16(12):e75031. doi: 10.7759/cureus.75031. eCollection 2024 Dec. Cureus. 2024. PMID: 39749055 Free PMC article. Review.
-
Radiological Evaluation of the Accuracy of Demirjian, Nolla, and Willems Methods for Dental Age Estimation in 3-17-Year-Old Iranian Children.Biomed Res Int. 2024 Jul 3;2024:8783660. doi: 10.1155/2024/8783660. eCollection 2024. Biomed Res Int. 2024. PMID: 38988904 Free PMC article.
-
Accuracy of the Demirjian, Willems and Nolla methods for dental age estimation in a northern Chinese population.Arch Oral Biol. 2020 Oct;118:104875. doi: 10.1016/j.archoralbio.2020.104875. Epub 2020 Aug 8. Arch Oral Biol. 2020. PMID: 32795622
-
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.J Forensic Leg Med. 2017 Aug;50:49-57. doi: 10.1016/j.jflm.2017.07.007. Epub 2017 Jul 5. J Forensic Leg Med. 2017. PMID: 28708981
-
Accuracy of the Demirjian's method for assessing the age in children, from 1973 to 2020. A meta-analysis.Leg Med (Tokyo). 2021 Sep;52:101901. doi: 10.1016/j.legalmed.2021.101901. Epub 2021 May 1. Leg Med (Tokyo). 2021. PMID: 33964679
Cited by
-
The Applicable Dental Age Estimation Methods for Children and Adolescents in Indonesia.Int J Dent. 2022 Feb 15;2022:6761476. doi: 10.1155/2022/6761476. eCollection 2022. Int J Dent. 2022. PMID: 35211174 Free PMC article. Review.
-
Influence of sex and timing of mixed dentition on discrepancies between chronological age and dental age in Taiwanese children.J Dent Sci. 2024 Oct;19(4):1942-1950. doi: 10.1016/j.jds.2024.08.003. Epub 2024 Aug 17. J Dent Sci. 2024. PMID: 39347033 Free PMC article.
-
Comparative Analysis of Dental Age Estimation: A Systematic Review and Meta-analysis Assessing Gender-Specific Accuracy of the Demirjian and Nolla Methods Across Different Age Groups.Cureus. 2024 Dec 3;16(12):e75031. doi: 10.7759/cureus.75031. eCollection 2024 Dec. Cureus. 2024. PMID: 39749055 Free PMC article. Review.
-
Global lens of Willems' method for dental age estimation: where we are and where we are going - umbrella review.Int J Legal Med. 2025 May;139(3):1183-1192. doi: 10.1007/s00414-025-03424-2. Epub 2025 Feb 15. Int J Legal Med. 2025. PMID: 39954055
-
Bridging gaps in age estimation: a cross-sectional comparative study of skeletal maturation using Fishman method and dental development using Nolla method among Egyptians.Int J Legal Med. 2025 Mar;139(2):695-714. doi: 10.1007/s00414-024-03394-x. Epub 2025 Jan 6. Int J Legal Med. 2025. PMID: 39760867 Free PMC article.
References
-
- Lopes LJ, Nascimento HAR, Lima GP, Santos LAN, Dos, Queluz D, de P, Freitas. DQ. Dental age assessment: Which is the most applicable method? Forensic Sci Int. 2018;284:97–100. - PubMed
-
- Gunen Yilmaz S, Harorli A, Kilic M, Bayrakdar IS. Evaluation of the relationship between the Demirjian and Nolla methods and the pubertal growth spurt stage predicted by skeletal maturation indicators in Turkish children aged 10–15: investigation study. Acta Odontol Scand. 2019;77:107–13. doi: 10.1080/00016357.2018.1510137. - DOI - PubMed
-
- Hala LA, Moraes MEL, de, Villaça-Carvalho MFL, de Castro Lopes SLP, de Gamba T. Comparison of accuracy between dental and skeletal age in the estimation of chronological age of Down syndrome individuals. Forensic Sci Int. 2016;266:578.e1-578.e10. . - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources