Construction of Croatian standard for dental age estimation on a sample of digital orthopantomograms

Procjena dobi temeljni je dio svakog identifikacijskog postupka. Preciznost ove procjene važna je kako u forenzičnim, tako i u pravnim postupcima, a svoju primjenu ima i u antropologiji, arheologiji i kliničkom radu. Za vrijeme rasta i razvoja dob je moguće procijeniti na temelju razvojnih stadija zuba pa tako postoje brojne metode za procjenu dentalne dobi. Cilj ovog istraživanja bio je odrediti preciznost najčešće korištenih metoda za procjenu dentalne dobi na reprezentativnom uzorku hrvatske dječje populacije te napraviti prilagodbe za hrvatsku populaciju. U istraživanju je korišteno 1996 digitalnih standardiziranih ortopantomograma djece u dobi od pet do šesnaest godina prikupljenih u Zagrebu, Splitu, Osijeku i Varaždinu. Na temelju očitanih razvojnih stadija procijenjena je dob metodama po Demirjianu, Willemsu i Haavikko. Utvrđeno je da metoda po Demirjianu prosječno precjenjuje dob kod dječaka za 0,80 godina, a kod djevojčica za 0,84 godine. Willemsovom metodom dob se u prosjeku precjenjuje za 0,41 godinu kod dječaka te za 0,22 godine kod djevojčica. Metoda po Haavikko prosječno podcjenjuje dob za 0,61 godinu kod dječaka te za 0,82 godine kod djevojčica. Napravljene su prilagodbe sve tri spomenute metode hrvatskoj populaciji te je njihovim testiranjem utvrđeno statistički značajno povećanje preciznosti u procjeni dobi. Razvijeni su novi modeli za procjenu dentalne dobi koji koriste od dva do šest zuba, a svi su značajno precizniji od originalne Willemsove metode. Korištenjem novih modela moguće je procijeniti dob u slučajevima nedostatka pojedinih zubi u donjoj čeljusti (hipodoncija, fragmentirani ljudski ostatci) što dosad dostupne metode nisu omogućavale. Pri tome preciznost procjene dobi nije kompromitirana, nego čak nadmašuje preciznost dostupnih metoda. Prilagodbe metoda po Demirjianu, Willemsu i Haavikko predstavljaju novi standard za procjenu dentalne dobi u hrvatskoj populaciji. Novi modeli za procjenu dentalne dobi na manjem broju zuba izvoran su i značajan doprinos forenzičnoj i kliničkoj stomatologiji te dentalnoj antropologiji.Age estimation represents a crucial part of every identification process. The accuracy of age estimation plays an essential role in forensic and legal procedures as well as in broader anthropological, archeological and clinical cases. During the time of growth and development it is possible to estimate age based on the developmental stages of permanent teeth, which has resulted in numerous methods intended for dental age estimation. The aim of this study was to test the accuracy of frequently used methods for dental age estimation on a representative sample of Croatian children and to adapt these existing methods for the Croatian population. 1, 996 orthopantomograms of children aged five to sixteen were collected from four Croatian cities: Zagreb, Split, Osijek and Varaždin. Age was estimated based on the developmental stages of permanent teeth using three different methods named after their authors: Demirjian, Willems and Haavikko. All tested methods were adapted with formulas and coeficients specific for the Croatian population. An average age overestimation of 0.80 years in boys and 0.84 years in girls was noted using the Demirjian method. The Willems method overestimated age by 0.41 years in boys and 0.22 years in girls; the Haavikko method underestimated age by 0.61 in boys and 0.82 years in girls. A significant improvement was achieved through adaptation of the cited methods, which was demonstrated by testing new parameters specific for the Croatian population. New models for dental age estimation that use two to six teeth were developed. All the models proved to be significantly more precise than the original Willems method. By utilizing these new models it is possible to estimate age in cases where several mandibular teeth are missing (e.g., hypodontia, incomplete human remains) surpassing the accuracy and extent of existing methods. The adaptation of the Demirjian, Willems and Haavikko methods represents a new standard in dental age estimation for the Croatian population. These newly developed models for dental age estimation based on two to six teeth stand as an important contribution to forensic odontology, clinical dentistry and dental anthropology