Accuracy of the Demirjian's method for assessing the age in children, from 1973 to 2020. A meta-analysis

Abstract

One of the most common ways to assess the age in subadults using dental records is the Demirjian method. As the number of the studies using this method increased significantly in the recent years, and as their results were often conflicting, we investigated the accuracy of the method. We performed a systematic review and meta-analysis of observational studies obtained from Pubmed, using a random-effects model with the DerSimonian-Laird estimator, and raw mean difference for effect size measure. Prediction intervals (at 95%) were used to assess the presence of significant statistical differences between chronological and dental age. Our meta-analysis showed that Demirijan's method overestimated dental age by 0.48 years in girls and 0.51 in boys. Depending on the location and sex, in girls the smallest average overestimation was found in Asia (except India), with a value of 0.36 years, and the largest overestimation in Turkey/Arabia, with a value of 0.66 years. In boys, the smallest average overestimation was found in India (0.45 years), but Asia (except India), Africa - both with 0.46 years and Oceania - with 0.47 years were close, while the largest overestimation was found in Turkey/Arabia, with an average value of 0.63 years. The Demirjian method overestimated the age by about half a year for both sexes. Even if there are some geographical/ethnic differences, they are rather small, making the method useful irrespective of the ethnic profile of the subjects.

Keywords: Demirijan’s method; Dental age; Dental maturity; Forensic dentistry; Meta-analysis.