Assessment of Dental Age of Children Aged 3.5 to 16.9 Years Using Demirjian’s Method: A Meta-Analysis Based on 26 Studies

BACKGROUND A method for assessing dental maturity in different populations was first developed in 1973 by Demirjian and has been widely used and accepted since then. While the accuracy for evaluating dental age using Demirjian's method compared to children's chronological age has been extensively studied in recent years, the results currently available remain controversial and ambiguous. METHODS A literature search of PubMed, Embase, Web of Science, CNKI and CBM databases was conducted to identify all eligible studies published before July 12th, 2013. Weighted mean difference (WMD) with corresponding 95% confidence interval (95% CI) was used to evaluate the applicability of Demirjian's method for estimating chronological age in children. RESULTS A meta-analysis was conducted on 26 studies with a total of 11,499 children (5,301 boys and 6,198 girls) aged 3.5 to 16.9 years. Overall, we found that Demirjian's method overestimated dental age by 0.35 (4.2 months) and 0.39 (4.68 months) years in males and females, respectively. A subgroup analysis by age revealed that boys and girls between the ages of 5 to 14 were given a dental age estimate that was significantly more advanced than their chronological age. Differences between underestimated dental ages and actual chronological ages were lower for male and female 15- and 16-year-old subgroups, though a significant difference was found in the 16-year-old subgroup. CONCLUSIONS Demirjian's method's overestimation of actual chronological tooth age reveals the need for population-specific standards to better estimate the rate of human dental maturation.