Accuracy of dental age estimation methods in children with chromosomal syndromes: A systematic review and network...

The study aims to systematically examine the accuracy of the application of different dental age estimation (DAE) methods on children with chromosomal syndromes and evaluate its performance based on various populations and regions.

A systematic search of the literature applying the PRISMA-NMA-compliant method was conducted using the databases PubMed, Web of Science, Science Direct, Google Scholar, and Scopus between 1981 and 2020; that estimate dental development of children with chromosomal syndrome based on populations, intervention, comparisons, and outcomes (PICO) search strategy identified. The literature quality was assessed using QUADAS-2. A network meta-analysis was performed to compare the effects of different chromosomal syndromes on the accuracy of estimated dental age (DA). Mean differences were calculated for difference of DA to chronological age (CA) by using the random effects model.

From 60 titles retrieved utilising a standardized search strategy, 45 titles met the qualitative analysis criteria, and 28 titles qualified for the quantitative analysis requirements. Twenty-four comparative studies and twenty-one non-comparative studies suggested five DAE methods within this population used in combination or alone, namely Demirjian, Willems, Nolla, Haavikkoo, and London Atlas. Down's syndrome is the highest contributing literature relating to DAE and chromosomal syndrome.

Underestimations were seen in Amelogenesis Imperfecta and Osteogenesis Imperfecta for Demirjian method. Other methods were lacking primary studies to make a reliable inference. This suggests that no single dental age estimation (DAE) method works consistently across diverse syndromes, emphasizing the importance of personalized approaches in clinical and forensic settings. Publication bias was minor, indicating solid findings.