Evaluation of third molar development and its relation to chronological age: a panoramic radiographic study

Third molar development, in comparison to other teeth in the dentition, has the greatest variation in morphology, anatomical position, and time of development and eruption, and its reliability for chronological age estimation is controversial. The aim of the present study was to evaluate third molar development and its relation to chronological age using panoramic radiography.

A total of 2536 digital panoramic radiographs of individuals aged between 5 and 26 years were selected. The developmental status of the third molars was assessed using eight-stage developmental scoring proposed by Demirjian et al., with one modification: a stage 0 was added. The collected data were entered into a checklist and subjected to statistical analyses.

The mean ages of the first appearance of third molar bud, complete crown formation, and root apex closure were around 9, 14, and 22 years, respectively. In both jaws, third molar development occurred symmetrically, and sexual dimorphism was observed at some developmental stages. Finally, two formulas were presented to estimate age of the juveniles and adolescents based on their gender and developmental stages of the third molars, and validated on a second sample consisting of 523 individuals aged between 8 and 22.

Assessment of third molar development was found to be a reliable method for age estimation of individuals between 11 and 22 years. Because of possible ethnic and geographic differences in third molar development, population specific researches were recommended.