A novel method of age estimation in children using three-dimensional surface area analyses of maxillary canine apices

The study aimed to develop a novel and reliable age estimation method using three-dimensional surface area analyses of maxillary canine apices among Malaysian children using CBCT data. A validated regression equation for age estimation was derived and correlation between chronological age and the surface areas of the developing maxillary canine's apices were investigated. Variations based on ethnicities, gender and status of root development were also investigated in terms of fit to the age estimation model. CBCT images of the patients ranging in age from 7 to 14 years were included in the study. Training sample of 191 intact permanent maxillary canines was selected from 191 CBCT images belonging to 100 Malays and 91 Chinese. Moreover, an independent validation sample of 96 permanent maxillary canines was selected from 96 CBCT images belonging to 48 Malays and 48 Chinese. Three-dimensional image modeling and surface area analyses of the developing canine's apices were performed using Mimics and 3-Matics software. A strong correlation (r = 0.978) was observed between chronological age and surface area of the developing maxillary canine's apices. 95.6% of the variation in age can be explained by surface area of canine's apices, gender and status of the root development (open/closed apices). However, ethnicity did not contributed to the fit of age estimation model. Female showed advanced development as compared to male. Mean absolute error values indicated that this newly developed 3D surface area analyses of canine apex can be used as a reliable method for age estimation among Malaysian children.