Dental age estimation in children in Bosnia and Herzegovina: comparison of two Demirjian scores based on four teeth

The aims of this study were to test the applicability of the two Demirjian’s self-weighted scores (1976) based on four teeth from left side of mandible in children in Bosnia and Herzegovina (BH) and to expand age prediction models for observed population. Materials and methods: In cross-sectional, retrospective study, the panoramic radiographs (OPGs) taken from 805 girls and 636 boys in Bosnia and Herzegovina, aged between 4 and 15 years, were scored following the two Demirjian’s scores based on ratings one of eight stages (A-H) of calcification of four different teeth from left side of mandible ; PM1, PM2, M1, M2 ; and I1, PM1, PM2, M2. Dental age was obtained by finding the age at which the 50th percentile value equals the maturity score. Kappa statistic and intraclass correlation coefficient (ICC) were used for testing intra- and inter-observer repeatability of mineralization stages and dental age by assessments of 10% (N=144) of OPGs. Results: Mean Cohen kappa values were 0.82 for intra- and 0.81 for inter-observer agreement of mineralization stages. ICCs were 0.980 for intra- and 0.978 for inter-observer repeatability for PM1, PM2, M1, M2 teeth and 0.982 for intra- and 0.981 for inter-observer repeatability for I1, PM1, PM2, M2 teeth. Both scores overestimates the dental age in the BH sample, the mean overestimations were 0.82(SD 0.97) year in girls and 0.53(SD 0.88) year in boys for PM1, PM2, M1, M2 teeth and 1.07(SD 0.94) year in girls and 0.67(SD 0.88) year for I1, PM1, PM2, M2 teeth. In addition, different regression models were tested for estimation of age as a function of maturity score for both scores and genders, separately.