Dental age estimation using the London atlas- which tooth and which tooth stage predict age best (excluding 3rd molars)?

objectivesDeveloping teeth are frequently used to assess the developing dentition and to predict age. The London Atlas of Tooth Development estimates age as a single value (midpoint of an age interval). The aim was to determine which tooth stage, tooth, or combination of maxillary/mandibular teeth best estimates age using the Atlas. MATERIALS AND

methodsThe sample was 946 archived panoramic radiographs (491 male, 455 female) of dental patients aged 3-16 years. Crown and root stages of 8323 developing permanent teeth on the left side were assessed. Dental age (DA) was calculated for each tooth using 3rd edition of London Atlas App. Mean difference (MD) and mean absolute difference (MAD) between estimated and chronological age (CA) for each age category and for each tooth was calculated. Student t-test was used to assess MD. A linear regression model assessed predictive strength of individual teeth and combination of teeth with collinearity expressed as variance inflation factor (VIF).

resultsThe second premolar, canine and central incisor showed high collinearity with other teeth; excluding them did not improve age prediction. Individual tooth stages of different teeth could estimate age best for ages 3 to 12. DISCUSSION: No single tooth predicted age best for all individual age categories for this sample because a single tooth stage spans more than one year. Different teeth were accurate for different age categories but the second molars from both jaws showed small MD, MAD and lower VIF values than other teeth.