ArticleInternational journal of legal medicine2026
Improving reliability of permanent tooth staging for dental age estimation using the crown-root ratio method.
Article in International journal of legal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveRoot staging for dental age estimation is subjective when no standard reference is available. This study developed a quantitative approach for Moorrees root stages (R1/4, R1/2, R3/4 and Rc) using crown-root ratio (CRR) measurements and stage-specific bounds. MATERIALS AND
methodsThe development phase included 269 Malaysian subjects (145 males, 124 females) aged 16-25 years. A total of 1,502 mature permanent mandibular left teeth (I1-M3) were measured on panoramic radiographs using ImageJ software to determine mean CRR values for mature roots (Rc), the fraction stages and stage-specific bounds, where [Formula: see text], [Formula: see text], and lower bound=succeeding stage CRR + 0.01. Sex differences were analysed using independent t-tests. Validation used 161 additional radiographs (78 males, 83 females) aged 3-24 years, with 774 developing and mature permanent mandibular left teeth measured and independently staged according to Moorrees' method. Measured CRR values were compared with stage-specific bounds and considered accurate when within the expected range. Accuracy was calculated as: [Formula: see text].
resultsMean CRR values ranged from 0.50 to 0.82, with M3 showing the greatest variability. Significant sex differences were observed for C, P1, M1 and M2 (p < 0.05). Overall staging accuracy was 89.9% (84.6%-95.7%) and declined progressively from R1/4 to Rc. M3 (95.7%) and C (91.3%) showed the highest accuracy, whereas I1 (85.7%) and M1 (88.0%) showed the lowest.
conclusionThe CRR method provides an objective approach for defining Moorrees root stages and improving staging consistency.
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