Is chronological age predictable on panoramic images using the Demirjian method on third molars? Insights from a...

Area of Science:

• Forensic Anthropology
• Odontology
• Radiology

Background:

• Third molars (M3) are critical for forensic age estimation in adolescents due to their variable development.
• The modified Demirjian method (stages 0-H) assesses dental maturity.
• Population-specific validation of M3 development is crucial for forensic accuracy.

Purpose of the Study:

• Evaluate the correlation between chronological age and M3 development stages in a Turkish population.
• Assess the influence of gender and anatomical location on M3 development.
• Investigate the impact of impaction classifications (Pell-Gregory, Winter) on M3 development.

Main Methods:

• Digital panoramic radiography of 1656 individuals (mean age 13.9±3.78 years).
• Assessment of 2770 mandibular and 2553 maxillary M3s using the modified Demirjian method.
• Statistical analyses: Spearman correlation, Kruskal-Wallis tests, generalized linear models.

Main Results:

• Strong correlation found between third molar development and chronological age (R²=0.330 mandible; R²=0.337 maxilla).
• Mandibular M3s most frequent in stages C and E; maxillary M3s in C and D.
• Gender and impaction classifications showed no main effects, but significant interactions were observed (Pell-Gregory×Gender, Winter×Pell-Gregory).

Conclusions:

• The modified Demirjian method is reliable for age estimation in Turkish adolescents.
• High correlation between age and M3 developmental stages supports its forensic application.
• Interactions between impaction patterns and gender/location reveal complex growth dynamics, necessitating context-sensitive forensic protocols.