Exploratory Analysis of Dental Age Differences in Children with Type 1 Diabetes Using the Demirjian Method

Background: Chronological age does not always accurately reflect biological maturation in children, particularly in the presence of systemic conditions. Dental age is widely used as a biological maturity indicator; however, the impact of Type 1 diabetes mellitus on dental development remains unclear and inconsistently reported. Objective: This paper aims to explore differences between dental age (DA) and chronological age (CA) in children with Type 1 diabetes compared to healthy controls, and to assess the association between glycemic control (HbA1c) and dental maturation. Materials and Methods: This observational comparative study included 90 children aged 8-15 years: 45 with Type 1 diabetes and 45 age- and sex-matched healthy controls. Dental age was estimated using the Demirjian method and compared with chronological age. Group comparisons were performed using independent t-tests, while paired t-tests assessed within-group differences. Linear regression analysis evaluated the association between HbA1c and dental age. Effect sizes and 95% confidence intervals were reported. Results: In the diabetes group, dental age was significantly higher than chronological age (mean difference = 1.56 years, p < 0.001), indicating advanced dental maturation. No significant difference between dental and chronological age was observed in the control group. Dental age was also significantly higher in the diabetes group compared to controls (mean difference = 1.61 years, p < 0.001; Cohen's d = 0.93). HbA1c levels were positively associated with dental age (R² = 0.409, p < 0.01), suggesting that metabolic control may contribute to variability in dental maturation. Conclusions: Children with Type 1 diabetes appear to exhibit advanced dental maturation compared to healthy peers. Glycemic control may be associated with this variation, although the findings should be interpreted within the exploratory framework of the study. Dental age assessment should be used cautiously and in conjunction with other maturity indicators, particularly in children with systemic conditions.