Accuracy of the lower third molar radiographic imaging to estimate age among Ugandan young people

Abstract

Objective: Dental development is a useful method for age estimation. Although third molar eruption is commonly used to estimate age in Uganda, it is reported to be unreliable because of external influences. The more reliable radiographic techniques have inter-ethnic differences but data from sub-Saharan Africa are limited regarding estimating age in young adults. This study, therefore, aimed at determining the accuracy of Demirjian’s classification of the lower third molar, a common dental age estimation method, in estimating key ages in a Ugandan population using Ugandan references. Dental records of 1021 Ugandans aged 10-22 years were assigned to two groups; reference and test. The reference data was retrieved from a database of a previous bigger research project. Results: The overall sample population comprised of 514/1021 (50.3%) males. The mean age was 15.8 (3.6) years. No significant sex differences in dental age were established in the reference sample (520 records). Accuracy values (area under the curve) at the 12-, 14-, 16- and 18-year-cut-offs were between 0.83 and 0.90 using the test sample (501 records). The results suggest that Demirjian’s classification of the lower third molars is a useful method for age estimation in the young urban Ugandan population in the 10-22-year age-group.

Determination of age reference standards based on mandibular third molar root development in a Ugandan population aged 10–22 years

“…In the present study, the mean age at apex closure (stages H and A c ) was at 19.8 for females and 20.1 years for males (Tables 4 and 5). These findings are comparable to other studies among Ugandans (Mwesigwa et al, 2019). Similar findings were also reported for males by Moorrees and co-workers (1963) and Nystrom and co-workers (2007).…”

“…The root development at complete length when the apex is half closed (Demirjian et al, 1973, Haavikko, 1970 occurred at 18.8 years for females and 19.0 years for males (Tables 4 and 5). The findings for Ugandan females are in support of other reports among Ugandans (Mwesigwa et al (2019), the Finnish (Haavikko (1970), Brazilians (de Oliveira et al, 2012, and Botswanese (Cavrić et al, 2016). However, the same root development stages in the present study (Tables 4 and 5) occurred slightly earlier when compared with Austrians (Meinl et al, 2007) and Chinese (Zeng, Wu, & Cui, 2010).…”

“…These findings for the Ugandan females are corroborated by earlier studies done among Ugandans (Mwesigwa et al, 2019) and Botswanese (Cavrić et al, 2016) where stage D was found at 12.6 and 12.4 years, respectively. Similarly published tables from Moorrees' original work by Harris and Buck (Harris & Buck, 2002) showed stage R i was within the same age range at 12.9 years for North American White children.…”

“…Despite the relatively similar values at root development stage H, the findings should be taken with caution because of the associated challenges in determining the end point of this stage (Roberts, McDonald, Andiappan, & Lucas, 2015). This is because tooth development is boundless at its upper limit, for instance different studies have enrolled participants with varying upper age limits ranging from 21 years, 22 years (Mwesigwa et al, 2019), 23 years (Cavrić et al, 2016), 24.9 years (Blankenship et al, 2007), and 25 to 26 years (Olze et al, 2004). Inadvertently, this affects the mean age for this stage, and furthermore, some teeth with open apices may be missed depending on the upper age limit set for the study.…”

“…Although the Demirjian, Goldstein, and Tanner (1973) method has previously been used in the Ugandan population (Mwesigwa, Kutesa, Munabi, Kabenge, & Buwembo, 2019), it was based on limited root development stages. The present study considered three additional methods with finer grading of the root development stages in order to establish age estimate standards in relation to the distal root development of the third mandibular molar among Ugandans aged 10-22 years.…”