Dental age estimation in children with different methods and examination of relationship with the trabecular structure of mandibula

Aim: In this study, it is aimed to examine dental age by using different dental age (DA) determination methods and to evaluate the relationship between them by examining the trabeculation structure of the mandible with Fractal Dimension Analysis (FD). Material and Method: In the study, dental ages were determined by using Willems (WDA) and London Atlas (LADA) dental age determination methods from Orthopantomographic Radiography (OPTG) of 600 pediatric patients aged 6-12 years who applied to the Department of Pediatric Dentistry, Faculty of Dentistry of Recep Tayyip Erdoğan University. The mean absolute error (MAE) was used for the accuracy of the DA estimation methods. In the second stage of the study, sections of interest [Region of interest (ROI)] containing 25x25 pixel trabecular bone (right and left ANG, KON, KOR) were determined on 426 randomly selected OPTGs and sections were taken from 6 different regions. Bone trabeculation was measured with FD on the sections and its relationship with gender, DA and chronological age (CA) was examined. Paired t, Wilcoxon, Mann Whitney U, independent samples t, one-way analysis of variance and Kruskal Wallis tests were used for statistical evaluation. Significance level was determined as p<0.05. Results: The MAE value obtained by the LADA[MAE(LADA)] method was found to be lower than that obtained by the WDY method [MAE(WDY)] in children aged 11-11.99 years (p=0.047). While it was observed that MAE(WDA) was lower than MAE(LADA) in all other age groups, a statistically significant difference was found in the 7-7.99, 8-8.99 and 6-12 groups (p<0.001). MAE was calculated greater than 1 in LADA at 7-7.99 in both methods in 11-11.99 group, MAE was less than 1 for all other ages. In both methods, women had higher MAE values, but MAE(LADA) was 7-7.99; 9-9.99; A significant difference was found in the 6-12 (p=0.003; p=0.039; p=0.002) MAE(WDA) group in the 10-10.99 group (p=0.021). FD values were not different in terms of gender (p>0.05). While there was an increase in FD values with increasing age, a decrease in FD was detected only at the age of 11 and above.. Conclusion: Within the limits of the study, it can be thought that the WDA method can give more accurate results than the LADA method, but the LADA method may also be among the acceptable methods in certain age groups. The difference in FD values with age is seen as a promising pioneering study in determining DA. Studies with higher participants in different populations are needed. Keywords: Forensic dentistry, Dental age, Chronological age, Fractal analysis