The Demirjian versus the Willems method for dental age estimation in different populations: A meta-analysis of published studies

BackgroundThe accuracy of radiographic methods for dental age estimation is important for biological growth research and forensic applications. Accuracy of the two most commonly used systems (Demirjian and Willems) has been evaluated with conflicting results. This study investigates the accuracies of these methods for dental age estimation in different populations.MethodsA search of PubMed, Scopus, Ovid, Database of Open Access Journals and Google Scholar was undertaken. Eligible studies published before December 28, 2016 were reviewed and analyzed. Meta-analysis was performed on 28 published articles using the Demirjian and/or Willems methods to estimate chronological age in 14,109 children (6,581 males, 7,528 females) age 3–18 years in studies using Demirjian’s method and 10,832 children (5,176 males, 5,656 females) age 4–18 years in studies using Willems’ method. The weighted mean difference at 95% confidence interval was used to assess accuracies of the two methods in predicting the chronological age.ResultsThe Demirjian method significantly overestimated chronological age (pConclusionThe Willems method provides more accurate estimation of chronological age in different populations, while Demirjian’s method has a broad application in terms of determining maturity scores. However, accuracy of Demirjian age estimations is confounded by population variation when converting maturity scores to dental ages. For highest accuracy of age estimation, population-specific standards, rather than a universal standard or methods developed on other populations, need to be employed.

背景：影像学方法用于牙龄评估的准确性，对于生物生长研究及法医学应用均具有重要意义。当前针对两种最常用的牙龄评估系统——德米爾吉安（Demirjian）法与威廉姆斯（Willems）法——的准确性评估结果存在分歧。本研究旨在考察这两种方法在不同人群中开展牙龄评估的准确性。
方法：本研究检索了PubMed、Scopus、Ovid、开放获取期刊数据库（Database of Open Access Journals）及Google Scholar。对2016年12月28日前发表的符合纳入标准的研究进行回顾与分析。针对28篇已发表文献开展荟萃分析，这些文献分别采用德米爾吉安法和/或威廉姆斯法进行实足年龄评估：其中采用德米爾吉安法的研究纳入了14109名年龄3~18岁的儿童（男性6581名，女性7528名），采用威廉姆斯法的研究纳入了10832名年龄4~18岁的儿童（男性5176名，女性5656名）。本研究采用加权均数差及95%置信区间，评估两种方法预测实足年龄的准确性。
结果：德米爾吉安法会显著高估实足年龄（P
结论：威廉姆斯法在不同人群中进行实足年龄评估的准确性更高，而德米爾吉安法在成熟度评分的判定方面应用范围更广。然而，当将成熟度评分转换为牙龄时，德米爾吉安法的年龄评估准确性会受到人群差异的干扰。若要获得最高精度的年龄评估结果，应采用针对特定人群的评估标准，而非通用标准或基于其他人群开发的评估方法。