|Year : 2020 | Volume
| Issue : 4 | Page : 338-342
Relationship between chronological age, dental age, and body height using Demirjian method among children aged 4–14 years in Pune – A radiographic study
Rahul J Hegde1, Anand Shigli1, Pritesh Gawali1, Geetanjali Jadhav1, Priyanka Garje1, Tejas Kulkarni2
1 Department of Pedodontics and Preventive Dentistry, D Y Patil Dental School, Pune, Maharashtra, India
2 Department of Oral Medicine and Radiology, D Y Patil Dental School, Pune, Maharashtra, India
|Date of Submission||22-Sep-2020|
|Date of Decision||05-Nov-2020|
|Date of Acceptance||30-Nov-2020|
|Date of Web Publication||5-Jan-2021|
Rahul J Hegde
D Y Patil Dental School, Charoli (bk), Lohegaon, Pune, Maharashtra
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Context: The assessment of dental age is useful in the planning of orthodontic treatment, in pediatric dentistry, pediatric endocrinology, and forensic medicine. It is essential for a pediatric dentist to formulate treatment plan and it is a source of complementary information for pediatrician. Changes in the body proportion and composition are the essential elements of growth, especially maturation. Aims: The present study was aimed to correlate the chronological age, dental age, and body height in children from Pune region of Maharashtra, India. Subjects and Methods: Four hundred and thirty-one panoramic radiographs of 177 boys and 254 girls in the age group of 4-14 years were obtained. Chronological age was assessed by recording date of birth. Dental age assessment was done using orthopantamogram following the method described by Demirjian. Body height was recorded using a measuring tape. Results: Chronological age and dental age showed significant positive correlation between male and female sample, i.e., r = 0.905 for males and r = 0.901 for females. Statistically significant correlation was observed between calculated dental age and body height. Conclusions: In the present study, it can be concluded that the Demirjian method of dental age assessment showed high accuracy when applied to pediatric population in Pune.
Keywords: Body height, chronological age, Demirjian method, dental age
|How to cite this article:|
Hegde RJ, Shigli A, Gawali P, Jadhav G, Garje P, Kulkarni T. Relationship between chronological age, dental age, and body height using Demirjian method among children aged 4–14 years in Pune – A radiographic study. J Indian Soc Pedod Prev Dent 2020;38:338-42
|How to cite this URL:|
Hegde RJ, Shigli A, Gawali P, Jadhav G, Garje P, Kulkarni T. Relationship between chronological age, dental age, and body height using Demirjian method among children aged 4–14 years in Pune – A radiographic study. J Indian Soc Pedod Prev Dent [serial online] 2020 [cited 2021 Jan 25];38:338-42. Available from: https://www.jisppd.com/text.asp?2020/38/4/338/306222
| Introduction|| |
The development and eruption of teeth are a part of the child's total development. Dental development schedules are used as indices of growth and maturation during childhood since teeth develop and erupt in characteristic sequences and within predictable age ranges. Dental age assessment has an important role in forensic medicine, pediatric dentistry, and orthodontic treatment planning. Pediatric dentists can use such knowledge in knowing whether the dental maturity of a child with a certain disease has been delayed or advanced. Individuals may not have precise information regarding their date of birth, or they may choose to conceal such information. Owing to a comparatively low variability of tooth formation in relation to chronological age, it seems that methods based on stages of tooth formation are more appropriate in the assessment of chronological age than those based on other indicators of somatic development.
Since human growth shows a considerable variation in the chronological ages at which individual children reach similar developmental events, the developmental status of a child is best estimated relative to specific stages of physiological maturity. Some of the most common measures of physiological age are based on dental and skeletal maturation. Skeletal development is commonly assessed by measuring skeletal maturity and by examining growth in height (skeletal growth). Since skeletal maturation comprises changes in bone size and ossification of the growth plates it implies the completion of skeletal growth and height. Because these two developmental processes are closely related, growth in height can be used as a proxy for linear skeletal growth.
A valuable indicator of dental age is the radiographic evaluation of calcification of dentition as it serves as an index of the overall maturation of the child. Many authors have published techniques in order to assess dental age by tooth formation: Demirjian, Goldstein, Tanner, Glombitza, Nolla, Prahl Andersen, and van der Linden. Of these, the investigation done by Demirjian in 1973 resulted in the creation of a dental maturity scaling system valid for universal use. This method has been found the most easy to use, the most accurate and that is confirmed by the use in so many studies in the whole world.
The aim of the present study is to establish a relationship between the dental age, chronological age, and height using Demirjian's method in children between 4-14 years of age.
| Subjects and Methods|| |
The present study was conducted in the Department of Pedodontics and Preventive Dentistry in DY Patil Dental School, Pune. The sample consisted of 431 panoramic radiographs of the teeth from 177 boys and 254 girls, randomly selected from various schools in Pune from the age group of 4-14 years known chronologic age. The study was approved by Institutional Review Board of DY Patil Dental School, Pune [Table 1].
Inclusion criteria for selection of the participant in the study were as follows:
- Participants aged between 4 and 14 years
- Participants who are Indian by nationality
- Participants with known date of birth
- Participants who showed normal growth and development clinically
- Participants with no history of trauma or injury to the face.
Exclusion criteria for rejection of the participant in the study were as follows:
- Participants with known congenital anomaly, developmental, and/or systemic disorders
- Participants with history of prolonged illness
- Participants with congenitally missing, impacted, or transposition of teeth
- Participants with a history of extraction of any permanent tooth
- Participants having caries, severe malocclusion, and any oral disease that will affect development of teeth
- Participants undergoing orthodontic treatment.
Dental age was calculated from digital OPG using the method described by Demirjian in 1973. Height of the children's in different age groups were recorded by asking the child to stand on a non-carpeted floor and against a wall with legs straight and arms at sides and measured using a measuring tape.
| Results|| |
[Table 1] shows the distribution of a total number of boys and girls in all the age groups from 4 to 14 years. [Table 2], [Table 3], [Table 4] shows mean, standard deviation, mean difference and T value of true and assessed age for 4-14 years. [Table 5] shows the combined relationship of chronological age and dental age in different age groups. [Table 6] shows relationship between chronological age and dental age in boys and girls. [Table 7 ]shows the average body height in boys and girls at different age groups. [Table 8] and [Table 9] shows the relationship between dental age and body height in boys and girls [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9].
|Table 5: Inter relationship between chronological age and dental age of combined male and female sample|
Click here to view
|Table 6: Inter relationship between chronological age and dental age of total male and female sample|
Click here to view
| Discussion|| |
Understanding the relationship between dental age, height, and chronological age in children is fundamental for several disciplines, because it allows the researcher to understand variations in physiological or developmental age of children of the same chronological age. Difference in the development among children of same chronologic age have led to concept of physiological age as a means to define progress toward completeness of development or maturity in the individual child. Thus, physiologic age and development age are measures for describing the status of an individual child, whereas chronologic or calendric age convey only rough estimate of this status of range of development observed for any given age.
The dental growth and development should be studied in parallel with other physiological maturity indicators, such as bone age, menarche, and height. Also, changes in the body proportion and composition are the essential elements of growth, especially maturation. Therefore, the present study is an attempt to establish a correlation between dental age, chronological age and body height in children in the age group of 4-14 years.
Dental age assessments involve the use of radiographs, and different types of radiographs have been used to investigate dental development. Panoramic radiographs were used in this study to determine the dental age using Demirjian's method as this method is most accurate for dental age estimation on Indian population as per the research findings of the Nanda and Chawla, Hegde and Sood, and Hegde and Vadgaonkar
In the present study, true and assessed age of boys and girls at different age groups were calculated [Table 2] and [Table 3]. Chronological age and dental age showed significant positive correlation between male and female sample, i.e., r = 0.905 for males and r = 0.901 for females [Table 5] and [Table 6]. Similar positive correlation was mentioned by Prabhakar et al. who found highly significant correlation between chronological age and estimated dental age (r = 0.5328), which is in accordance with the findings of the present study. This was in agreement and support with Nanda and Chawla and Demirjian who showed that the dental formation of French Canadian children closely correlated with that of Lucknow (Indian) children. The Demirjian method of age assessment was evaluated by Hegde and Sood in Belgaum children and they concluded that this method of age assessment showed high accuracy when applied to Belgaum children. The present study supports the application of Demirjian method for the assessment of dental age in Indian population. The chronological age and dental age showed a significant positive correlation between male and female samples. This is in agreement and support with Cheraskin and Ringdorf, Malagola et al., Jaeger and Carvalho and Decarvalho and Hegde et al.
In this study, the average height of boys and girls at different age groups were recorded and when correlation of calculated dental age and height in boys and girls was made, it was inferred that overall there was a statistically significant correlation between calculated dental age and height [Table 8] and [Table 9], which means as height increases, dental age difference increases significantly. This reflects acceleration of dental development as height increases in boys and girls with boys ahead of girls in somatic growth. Previous studies, have demonstrated a relationship between a child's general somatic growth and dental development. Haddad and Correa concluded that deciduous teeth emergence is highly influenced by the height of the child. Oziegbe et al. suggested that height might be a strong factor in predicting the number of emerged teeth.
The formulation of new scoring measures for Indian population requires more studies to be conducted with the application of Demirjian method.
| Conclusions|| |
A significant positive correlation was found between chronological age, dental age, and height. Careful assessment should be done when applying the Demirjian method as the relationship between the states of maturity of teeth and other parameters of development varies according to racial groups. The limitations of this study are that only limited number of participants were selected from one locality. Further studies are required with large number of samples to compile the full table of dental age conversion from the maturity score.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Mani SA, Naing L, John J, Samsudin AR. Comparison of two methods of dental age estimation in 7-15-year-old Malays. Int J Paediatr Dent 2008;18:380-8.
Lewis AB, Garn SM. The relationship between tooth formation and other maturational factors. Angle Orthod 1960;30:70-7.
Tanner JM. Growth at Adolescence. 2nd
ed. Springfield, Ill: Blackwell; 1962.
Soliman A, De Sanctis V, Elalaily R, Bedair S. Advances in pubertal growth and factors influencing it: Can we increase pubertal growth? Indian J Endocrinol Metab 2014;18:S53-62.
Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol 1973;45:211-27.
Sadia H, Hassan S. Assesment of eruption of permanent teeth according to age and its relation with body mass index in local population. J Pak Dent Assoc 2018;27:127-32.
Beunen GP, Rogol AD, Malina RM. Indicators of biological maturation and secular changes in biological maturation. Food Nutr Bull 2006;27:S244-56.
Nanda RS, Chawla TN. Growth and development of dentitions in Indian children. I. Development of permanent teeth. Am J Orthod 1966;52:837-53.
Hegde RJ, Sood PB. Dental maturity as an indicator of chronological age: Radiographic evaluation of dental age in 6 to 13 years children of Belgaum using Demirjian methods. J Indian Soc Pedod Prev Dent 2002;20:132-8.
Hegde RJ, Vadgaonkar V, Kamath S. A correlative analysis of dental age, chronological age, and body mass index and its impact on dental development in 6-13 year old children of Navi Mumbai, India. J Indian Soc Pedod Prev Dent 2018;36:376-80.
] [Full text]
Prabhakar AR, Panda AK, Raju OS. Applicability of Demirjian′s method of age assessment in children of Davangere. J Indian Soc Pedod Prev Dent 2002;20:54-62.
Cheraskin E, Ringdorf W. Biology of the orthodontic patient: Relationship of chronological and dental age in terms of Vitamin C state. Am J Orthod 1972;42:342-8.
Malagola C, Caigiuri FM, Barrato E. Evaluation of dental age using qualitative radiographic analysis 1. Mondo Ortod 1989;14:375-81.
Jaeger U. Dental age in dependence on the stage of selected physiological developmental parameters. Dtsch Stomatol 1990;40:511-4.
Carvalho AA, Decarvalho A. Radiographic study of the development of permanent dentition in Brazilian children with chronologic age of 84 and 131 months. Odontol Rev 1991;19:31-9.
Hegde RJ, Khare SS, Saraf TA, Trivedi S, Naidu S. Evaluation of the accuracy of Demirjian method for estimation of dental age among 6-12 years of children in Navi Mumbai: A radiographic study. J Indian Soc Pedod Prev Dent 2015;33:319-23.
] [Full text]
Infante PF, Owen GM. Relation of chronology of deciduous tooth emergence to height, weight and head circumference in children. Arch Oral Biol 1973;18:1411-7.
el Lozy M, Reed RB, Kerr GR, Boutourline E, Tesi G, Ghamry MT, et al
. Nutritional correlates of child development in Southern Tunisia. IV. The relation of deciduous dental eruption to somatic development. Growth 1975;39:209-21.
Haddad AE, Correa MS. The relationship between the number of erupted primary teeth and the child's height and weight: A cross-sectional study. J Clin Pediatr Dent 2005;29:357-62.
Oziegbe EO, Adekoya-Sofowora C, Folayan MO, Esan TA, Owotade FJ. Relationship between socio-demographic and anthropometric variables and number of erupted primary teeth in suburban Nigerian children. Matern Child Nutr 2009;5:86-92.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]