Dental age assessment among Tunisian children using the Demirjian method

CONTEXT: Since Demirjian system of estimating dental maturity was first described, many researchers from different countries have tested its accuracy among diverse populations. Some of these studies have pointed out a need to determine population-specific standards. AIM: The aim of this study is to evaluate the suitability of the Demirjian's method for dental age assessment in Tunisian children. MATERIALS AND METHODS: This is a prospective study previously approved by the Research Ethics Local Committee of the University Hospital Fattouma Bourguiba of Monastir (Tunisia). Panoramic radiographs of 280 healthy Tunisian children of age 2.8–16.5 years were examined with Demirjian method and scored by three trained observers. STATISTICAL ANALYSIS USED: Dental age was compared to chronological age by using the analysis of variance (ANOVA) test. Cohen's Kappa test was performed to calculate the intra- and inter-examiner agreements. RESULTS: Underestimation was seen in children aged between 9 and 16 years and the range of accuracy varied from −0.02 to 3 years. The advancement in dental age as determined by Demirjian system when compared to chronological age ranged from 0.3 to 1.32 year for young males and from 0.26 to 1.37 year for young females (age ranged from 3 to 8 years). CONCLUSIONS: The standards provided by Demirjian for French-Canadian children may not be suitable for Tunisian children. Each population of children may need their own specific standard for an accurate estimation of chronological age.