A new model of classification of third molars development and its correlation with chronological age in a Brazilian subpopulation

Int J Legal Med. 2021 Mar;135(2):639-648. doi: 10.1007/s00414-020-02401-1. Epub 2020 Aug 25.

Abstract

The present study correlated the mineralization of third molars to chronological age using a modified classification based on Demirjian's stages in a Brazilian subpopulation and compared with the original classification. A total of 1082 patients with age ranging from 6 to 26 years were included in the sample, with at least one third molar on panoramic radiographs. The third molars were classified according to the original Demirjian classification (8 stages) and a new model based on the Demirjian method, where the original stages were grouped into four stages: AB-enamel mineralization; CD-crown dentin mineralization; EFG-root formation; and H-complete development. Statistical analyses were performed by Kruskal-Wallis/Dunn tests (α = 0.05) and the multinomial logistic regression model. Data were analyzed according to percentiles for the probability of an individual being over 18 years old. The mean ages of the stages in both classifications did not present a significant difference between superior and inferior arches (p < 0.05). The differences in mean ages between all the stages of mineralization were statistically significant (p < 0.001) only for the 4-stage classification. Males attained root formation and complete formation earlier than females (p < 0.05) in the 4-stage classification. The modified classification system showed dependence between chronological age and mineralization stages of third molars, simplifying the age estimation process. At stage H, females present a 95.7% chance of being over 18, while for males, this probability is 89.6%. This modified classification system simplifies the dental age estimation process based on third molars and can be used as a reference for future studies.

Keywords: Age estimation; Demirjian; Panoramic radiograph; Third molars.

MeSH terms

  • Adolescent
  • Adult
  • Age Determination by Teeth / methods*
  • Brazil / epidemiology
  • Child
  • Dental Physiological Phenomena
  • Female
  • Humans
  • Male
  • Molar, Third / growth & development*
  • Radiography, Panoramic
  • Tooth Calcification*
  • Young Adult