A Comparison of Two Dental Age Estimation Techniques in Contemporary American Whites: The Moorrees and Demirjian Approaches

Objective: Historically, dental age estimation has used the methods of Moorrees, Fanning and Hunt1 and Demirjian, Goldstein and Tanner5 . The purpose of this study is to apply these two methodologies to a contemporary sample of American whites, ages 9-14 years, and to evaluate the optimal concordance between the Moorrees (14-grade system) and the Demirjian (8-grade system) methods. Materials and Methods: 199 pre-treatment panoramic radiographs of syndrome-free American white children, ages 9-14 years (97 boys, 102 girls), were evaluated by the author. Tooth mineralization stages were scored using seven left mandibular teeth using both techniques. The age of the subjects was predicted using the Demirjian and Moorrees approaches and compared to their actual (chronological) age. Survival analyses was performed, by sex, to include a comparison of the same sample of radiographs using the two methods of Moorrees et al. and Demirjian et al. Results: Both methods, particularly the Moorrees approach, underestimated children's ages. Applying the Demirjian method resulted in a mean overestimation of 0.1 years for girls and a mean underestimation of 1.6 years for boys, while the Moorrees technique resulted in an average underestimation of 2.3 years for girls and 1.9 years for boys. Conclusion: Neither the Demirjian nor the Moorrees techniques accurately estimate chronological age in our sample of contemporary American whites. The reason these methods underestimated chronological age is most likely multifactorial, due to differences in methods and environments.