Adapting Demirjian Standards for Portuguese and Spanish Children and Adolescents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample
2.2. Demirjian Method for Age Estimation
2.3. Ethics, Procedures, and Data Analysis
3. Results
3.1. Inter-Rater Reliability
3.2. Chronological Age Forecast from the Global Score and Tooth by Tooth
3.3. Predictive Capacities According to Age Group
3.4. Chronological Age Forecast from Tooth-by-Tooth Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
B | Unstandardized regression coefficient |
β | Standardized coefficient |
C | Chronological |
D | Demirjian |
F | F-test |
M | Mean |
p | Significance level |
R | Linear regression coefficient |
R2 | R Squared (coefficient of determination) |
SD | Standard-deviation |
SE B | Standard-error for unstandardized coefficient |
SE | Standard-error |
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ICC (1) Consistency | ||||||||
---|---|---|---|---|---|---|---|---|
95% Confidence Interval | 95% Confidence Interval | |||||||
Demirjian score | Single rater | Lower bound | Upper bound | Average of raters | Lower bound | Upper bound | F Value | |
ICC1 | I1 | 0.82 | 0.749 | 0.870 | 0.95 | 0.923 | 0.964 | 18.633 *** |
I2 | 0.84 | 0.785 | 0.891 | 0.96 | 0.936 | 0.970 | 22.483 *** | |
C | 0.77 | 0.694 | 0.838 | 0.93 | 0.901 | 0.954 | 14.512 *** | |
PM1 | 0.78 | 0.707 | 0.845 | 0.94 | 0.906 | 0.956 | 15.315 *** | |
PM2 | 0.82 | 0.758 | 0.875 | 0.95 | 0.926 | 0.966 | 19.438 *** | |
M1 | 0.82 | 0.756 | 0.875 | 0.95 | 0.926 | 0.965 | 19.360 *** | |
M2 | 0.86 | 0.802 | 0.900 | 0.96 | 0.942 | 0.973 | 24.706 *** | |
Global | 0.92 | 0.892 | 0.947 | 0.98 | 0.971 | 0.986 | 48.762 *** |
Predictors: | B | SE B | β | t |
---|---|---|---|---|
(Constant) | −168.01 | 11.80 | −14.24 *** | |
Demirjian global score | 3.45 | 0.13 | 0.69 | 27.22 *** |
R = 0.807, R2 = 0.651, SEE = 1.40, F(1, 572) = 1068.33, p < 0.001 | ||||
B | SE B | β | t | |
(Constant) | −7.10 | 0.52 | −13.67 *** | |
Lateral Incisor | −0.03 | 0.04 | −0.03 | −0.72 |
Central Incisor | −0.04 | 0.06 | −0.03 | −0.65 |
Canine | 0.28 | 0.08 | 0.17 | 3.63 *** |
1st Premolar | 0.46 | 0.05 | 0.35 | 8.84 *** |
2nd Premolar | 0.06 | 0.07 | 0.05 | 0.94 |
1st Molar | 0.22 | 0.03 | 0.22 | 7.25 *** |
2nd Molar | 0.40 | 0.05 | 0.34 | 7.99 *** |
R = 0.847, R2 = 0.717, SEE = 1.27, F(1, 566) = 205.21, p < 0.001 | ||||
Equation forecasting chronological age through the Demirjian global score: | ||||
Predicted chron. age = −168.01 + 3.45 × Demirjian score | ||||
Equations forecasting chronological age through the 4 significant teeth: | ||||
Predicted chron. age = −7.10 + 0.28 × Canine + 0.46 × 1st Premolar + 0.22 × 1st molar + 0.40 × 2nd Molar |
Predictors: | Boys | Girls | ||||||
---|---|---|---|---|---|---|---|---|
B | SE B | β | t | B | SE B | β | t | |
(Constant) | −6.06 | 0.65 | −9.27 *** | −8.24 | 0.80 | −10.29 *** | ||
Global score | 0.19 | 0.01 | 0.83 | 25.38 *** | 0.20 | 0.01 | 0.81 | 23.24 *** |
R = 0.829, R2 = 0.687, SEE = 1.36, F(1, 294) = 644.12, p < 0.001 | R = 0.814, R2 = 0.662, SEE = 1.36 F(1, 276) = 540.18, p < 0.001 | |||||||
B | SE B | β | t | B | SE B | β | t | |
(Constant) | −5.20 | 0.69 | −7.58 *** | −7.86 | 0.76 | −10.39 *** | ||
Lateral Incisor | −0.07 | 0.06 | −0.07 | −1.21 | 0.06 | 0.06 | 0.06 | 1.00 |
Central Incisor | 0.11 | 0.07 | 0.10 | 1.55 | −0.01 | 0.09 | −0.01 | −0.17 |
Canine | 0.24 | 0.10 | 0.14 | 2.32 * | 0.44 | 0.11 | 0.26 | 3.94 *** |
1st Premolar | 0.37 | 0.07 | 0.31 | 5.13 *** | 0.45 | 0.08 | 0.29 | 5.56 *** |
2nd Premolar | 0.18 | 0.09 | 0.13 | 1.90 | 0.13 | 0.10 | 0.09 | 1.38 |
1st Molar | −0.01 | 0.05 | −0.01 | −0.11 | −0.14 | 0.08 | −0.11 | −1.83 |
2nd Molar | 0.50 | 0.06 | 0.42 | 7.73 *** | 0.55 | 0.08 | 0.44 | 6.66 *** |
R = 0.865, R2 = 0.748, SEE = 1.23 F(1, 288) = 122.28, p < 0.001 | R = 0.866, R2 = 0.750, SEE = 1.18 F(1, 270) = 115.93, p < 0.001 | |||||||
Equations forecasting chronological age (estimation in years—global score): | ||||||||
Predicted chronological age (boys) = −6.06 + 0.19 × Demirjian score | Predicted chronological age (girls) = −8.24 + 0.20 × Demirjian score | |||||||
Equations forecasting chronological age (estimation in years) through the 3 significant teeth: | ||||||||
Predicted chronological age (boys) = −5.20 + 0.24 × Canine + 0.37 × 1st Premolar + 0.50 × 2nd Molar | Predicted chronological age (girls) = −7.86 + 0.44 × Canine + 0.45 × 1st Premolar + 0.55 × 2nd Molar |
Chronological Age | Λ Wilks | Age (Estimated Marginal Means—in Months) | ||||||
---|---|---|---|---|---|---|---|---|
Boys | Girls | Boys | Gilrs | |||||
Chronological (C) | Demirjian (D) | Error (D-C) | Chronological (C) | Demirjian (D) | Error (D-C) | |||
6–7 years (72–83 months, n = 41) | 0.03 *** (n = 21) | 0.06 *** (n = 20) | 72.39 | 90.81 | 18.42 | 72.19 | 91.81 | 19.62 |
7–8 years (84–95 months, n = 64) | 0.29 *** (n = 29) | 0.16 *** (n = 35) | 88.83 | 102.31 | 13.48 | 87.86 | 98.86 | 11.00 |
8–9 years (96–107 months, n = 60) | 0.16 *** (n = 36) | 0.23 *** (n = 24) | 98.94 | 107.11 | 8.17 | 102.25 | 114.88 | 12.63 |
9–10 years (108–119 months, n = 92) | 0.19 *** (n = 42) | 0.15 *** (n = 50) | 113.52 | 124.38 | 10.86 | 115.08 | 127.22 | 12.14 |
10–11 years (120–131 months, n = 81) | 0.22 *** (n = 37) | 0.14 *** (n = 44) | 124.46 | 133.11 | 8.65 | 125.36 | 146.23 | 20.87 |
11–12 years (132–143 months, n = 59) | 0.23 *** (n = 29) | 0.10 *** (n = 30) | 137.97 | 137.83 | −0.14 | 138.47 | 155.90 | 17.43 |
12–13 years (144–155 months, n = 49) | 0.40 *** (n = 28) | 0.06 *** (n = 21) | 148.64 | 159.46 | 10.82 | 149.91 | 165.95 | 16.04 |
13–14 years (156–167 months, n = 101) | 0.29 *** (n = 61) | 0.20 *** (n = 40) | 160.90 | 172.39 | 11.49 | 161.45 | 172.75 | 11.30 |
Global (mean) | 118.21 | 128.43 | 10.22 | 117.07 | 134.20 | 15.13 |
Chronological Age | Boys | Girls |
---|---|---|
6–7 years (72–83 months) | R = 0.713, R2 = 0.509, SEE = 0.23 F(7, 16) = 2.37, p = 0 0.073 [n = 24] | R = 0.827, R2 = 0.683, SEE = 0.21 F(7, 12) = 3.70, p = 0.023 [n = 20] |
Chronological age = 5.01 + 0.22 × canine | ||
7–8 years (84–95 months) | R = 0.877, R2 = 0.769, SEE = 0.17 F(7, 21) = 9.97, p < 0.001 [n = 29] | R = 0.759, R2 = 0.577, SEE = 0.22 F(7,27) = 5.25, p = 0.001 [n = 35] |
Chronological age = 7.03 − 0.09 × 1st molar + 0.072nd molar – 0.08 × central incisor + 0.08 × lateral incisor + 0.06 1st premolar | Chronological age = 2.72 − 0.15 × 2nd premolar | |
8–9 years (96–107 months) | R = 0.855, R2 = 0.731, SEE = 0.17 F(7, 28) = 10.85, p < 0.001 [n = 36] | R = 0.800, R2 = 0.641, SEE = 0.23 F(7, 16) = 4.08, p = 0.009 [n = 24] |
Chronological age = 5.37 + 0.13 × 2nd molar + 0.04 × central incisor | Chronological age = 4.65+ 0.22 × 2nd premolar | |
9–10 years (108–119 months) | R = 0.529, R2 = 0.280, SEE = 0.25 F(7, 34) =1.89, p = 0.102 [n = 42] | R = 0.633, R2 = 0.401, SEE = 0.21 F(7, 42) = 4.02, p = 0.002 [n = 50] |
Chronological age = 8.06 + 0.09 × lateral incisor | Chronological age = 7.02 + 0.11 × canine + 0.10 × central incisor − 0.131st premolar | |
10–11 years (120–131 months) | R = 0.455, R2 = 0.207, SEE = 0.33 F(7, 29) = 1.08, p = 0.399 [n = 37] | R = 0.462, R2 = 0.213, SEE = 0.28 F(7, 36) = 1.39, p = 0.238 [n = 44] |
11–12 years (132–143 months) | R = 0.623, R2 = 0.388, SEE = 0.24 F(7, 21) = 1.90, p = 0.121 [n = 29] | R = 0.700, R2 = 0.491, SEE = 0.24 F(7, 22) = 3.03, p = 0.022 [n = 30] |
Chronological age = −0.75 + 0.28 × 2nd molar + 0.17 × lateral incisor | ||
12–13 years (144–155 months) | R = 0.655, R2 = 0.429, SEE = 0.21 F(6, 21) = 2.63, p = 0.047 [n = 28] | R = 0.645, R2 = 0.416, SEE = 0.23 F(5, 15) = 2.14, p = 0.116 [n = 21] |
Chronological age = 21.99 + 0.26 × 2nd molar + 0.60 × 1st molar − 0.42 × 1st premolar | ||
13–14 years (156–167 months) | R = 0.519, R2 = 0.269, SEE = 0.23 F(6, 54) = 3.32, p = 0.007 [n = 61] | R = 0.467, R2 = 0.218, SEE = 0.24 F(5, 34) = 1.90, p = 0.120 [n = 40] |
Chronological age = 11.51 + 0.21 × 2nd molar + 0.37 × central incisor − 0.44 × 1st premolar |
Tooth | Boys | Girls |
---|---|---|
Central incisor | Chronological age = 4.95 + 0.43 × Central incisor | Chronological age = 5.14 + 0.37 × Central incisor |
R = 0.402, R2 = 0.161, SEE = 2.22 F(1, 294) = 56.62, p < 0.001 | R = 0.348, R2 = 0.121, SEE = 2.19 F(1, 276) = 38.04, p < 0.001 | |
Lateral incisor | Chronological age = 0.99 + 0.78 × Lateral incisor | Chronological age = −0.46 + 0.82 × Lateral incisor |
R = 0.668, R2 = 0.446, SEE = 1.80 F(1, 294) = 236.49, p < 0.001 | R = 0.615, R2 = 0.378, SEE = 1.84 F(1, 276) = 167.79, p < 0.001 | |
Canine | Chronological age = −2.79 + 1.27 × canine | Chronological age = −4.81 + 1.34 × canine |
R = 0.767, R2 = 0.588, SEE = 1.56 F(1, 294) = 419.04, p < 0.001 | R = 0.797, R2 = 0.635, SEE = 1.41 F(1, 276) = 480.00, p < 0.001 | |
First pre-molar | Chronological age = 1.13 + 0.70 × first pre-molar | Chronological age = −4.14 + 10.06 × first pre-molar |
R = 0.583, R2 = 0.340, SEE = 1.97 F(1, 294) = 151.35, p < 0.001 | R = 0.687, R2 = 0.472, SEE = 1.70 F(1, 276) = 246.87, p < 0.001 | |
Second pre-molar | Chronological age = −1.73 + 1.03 × second pre-molar | Chronological age = −2.67 + 1.03 × second pre-molar |
R = 0.764, R2 = 0.583, SEE = 1.56 F(1, 294) = 411.12, p < 0.001 | R = 0.711, R2 = 0.506, SEE = 1.64 F(1, 276) = 282.49, p < 0.001 | |
First molar | Chronological age = 1.35 + 0.54 × first molar | Chronological age = −2.72 + 0.87 × first molar |
R = 0.561, R2 = 0.315, SEE = 2.01 F(1, 294) = 134.95, p < 0.001 | R = 0.645, R2 = 0.417, SEE = 1.78 F(1, 276) = 197.10, p < 0.001 | |
Second molar | Chronological age = −0.30 +0.92 × second molar | Chronological age = −1.15 + 0.91 × second molar |
R = 0.774, R2 = 0.599, SEE = 1.53 F(1, 294) = 439.28, p < 0.001 | R = 0.743, R2 = 0.553, SEE = 1.56 F(1, 276) = 340.31, p < 0.001 |
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Mónico, L.S.; Tomás, L.F.; Tomás, I.; Varela-Patiño, P.; Martin-Biedma, B. Adapting Demirjian Standards for Portuguese and Spanish Children and Adolescents. Int. J. Environ. Res. Public Health 2022, 19, 12706. https://doi.org/10.3390/ijerph191912706
Mónico LS, Tomás LF, Tomás I, Varela-Patiño P, Martin-Biedma B. Adapting Demirjian Standards for Portuguese and Spanish Children and Adolescents. International Journal of Environmental Research and Public Health. 2022; 19(19):12706. https://doi.org/10.3390/ijerph191912706
Chicago/Turabian StyleMónico, Lisete S., Luís F. Tomás, Inmaculada Tomás, Purificación Varela-Patiño, and Benjamin Martin-Biedma. 2022. "Adapting Demirjian Standards for Portuguese and Spanish Children and Adolescents" International Journal of Environmental Research and Public Health 19, no. 19: 12706. https://doi.org/10.3390/ijerph191912706