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Panoramic radiograph-based dental age estimation in children and adolescents using multi-tooth methods: a scoping
Małgorzata Łysiak-Majchrzak1, Sylwia Jagła2, Natalia Kazimierczak2,3
1Department of Maxillofacial Orthopedics and Orthodontics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland. malgorzata.lysiak-majchrzak@cm.umk.pl.
Background:
Accurate dental age estimation supports treatment planning in pediatric dentistry and orthodontics and forensic assessment when chronological age is uncertain. Because the accuracy of panoramic radiograph-based methods varies across populations, age groups, and method variants, a contemporary synthesis is needed to guide method selection.
Objective:
To map the methods used for panoramic radiograph-based dental age estimation in children and adolescents and to summarize the reported diagnostic accuracy of the most frequently used method families in studies published between 2020 and 2025.
Methods:
This scoping review was conducted using PubMed, Scopus, and Web of Science. Studies published between 1 January 2020 and 31 December 2025 were screened according to predefined eligibility criteria. Data were extracted using a standardized form, including study characteristics, dental age estimation methods, and reported accuracy outcomes (primarily mean absolute error [MAE] and mean difference/bias [DA-CA]). Thirty-four original studies were included.
Results:
The included studies comprised over 35,000 children and adolescents from multiple countries and were predominantly retrospective and clinic-based. Willems-family methods were the most frequently reported, followed by Demirjian-, Cameriere-, and London Atlas-based approaches. Across studies, accuracy reporting was heterogeneous with respect to MAE, bias metrics, sex stratification, and method variants. Cameriere family methods often showed lower MAE values in many cohorts; however, performance varied by population, age range, and method modification.
Conclusion:
Panoramic radiograph-based dental age estimation methods show substantial heterogeneity in use and reported accuracy across populations. Willems-family methods are the most frequently applied, whereas Cameriere-family methods often demonstrate favorable accuracy in many cohorts, but no single method can be considered universally optimal. Population-specific validation and standardized reporting of accuracy metrics are needed.
