Evaluation of four criteria in assessing third molar maturity for age estimation in Koreans

Third molar maturity is one of the major criteria for estimating human age. This study aimed to determine the most suitable third molar maturity criteria for age estimation in Koreans. The correlation between chronological age and the Demirjian, Köhler, Liversidge, and Thevissen criteria was evaluated using 900 panoramic radiographs of patients aged 15–23 years. The four criteria were applied separately to measure third molar maturity on the same radiograph. The concordance rates between third molars within the same jaw and between jaws were calculated and tested using a paired t-test. Regression was performed to observe the relationship between age and the evaluated stages for each tested criterion. The Demirjian standard showed the lowest root mean square error (1.29 years for males, 1.30 years for females) and highest adjusted R(2) (0.753 for males, 0.739 for females) values; however, the differences of the values derived from other criteria were minute. In addition, the symmetry (within the same jaw) and asymmetry (between the upper and lower jaws) of third molar development, which was confirmed in previous Korean studies, was observed only in the Demirjian and Liversidge criteria. Based on the results, we can conclude that all four tested criteria are suitable for age estimation in Koreans. However, the Demirjian and Liversidge criteria can be recommended from the perspective of accurate reflection of the developmental patterns. Further research is necessary to determine whether the results of this study are consistently observed in other populations.