Comparative evaluation of london atlas, haavikko and willems methods for age estimation in Turkish children in Ankara province

Since the accuracy and reliability of dental age estimation methods vary in various populations, it is important that the chosen method is appropriate for a particular population. The aim of this study was to evaluate the agreement between dental ages determined by London Atlas, Haavikko and Willems methods and chronological age in Turkish children in Ankara. In this study, the panoramic radiographs of 510 children between the ages of 5-14 years who applied to the Department of Pediatric Dentistry, Faculty of Dentistry, Yıldırım Beyazıt University, Ankara, between March 2022 and July 2022 were retrospectively analyzed. In the selected panoramic radiographs, a total of 14 teeth in the right mandible and maxilla for the London Atlas method, 4 selected teeth in the right mandible and maxilla for the Haavikko method and 7 teeth in the left mandible for the Willems method were evaluated. The data obtained were analyzed with IBM SPSS V23. A total of 510 children, 241 boys (47.3%) and 269 girls (52.7%), were included in our study. The mean chronological age of the children was 10.02 ± 2.89 years (9.91 ± 2.81 for boys and 10.11 ± 2.96 for girls). While the median value of chronological age was 10, the median value of dental age was 10.12 using the Willems method, 9.71 using the Haavikko method and 10.5 using the London Atlas method. There was a statistically significant difference between the median values of chronologic age and tooth age determined by all methods (p<0.001). The median difference between tooth age and chronological age was +0.37 years for London Atlas method, -0.2 years for Haavikko method and +0.16 years for Willems method. The mean absolute difference values were 0.61 years for Haavikko method, 0.69 years for London Atlas method and 0.73 years for Willems method. When the mean absolute difference was analyzed in age groups, it was determined that the Haavikko method was more compatible with the chronological age in all age groups except the 14-14.99 age group and the London Atlas method was more compatible with the chronological age in the 14-14.99 age group. When the mean acceptable absolute difference was set as 1 year, Haavikko method had the highest accuracy percentage with 80%, followed by London Atlas method with 76.7% and Willems method with 76.5%. When all participants were evaluated in terms of median difference, Willems and London Atlas methods overestimated and Haavikko method underestimated according to chronological age. In the sample we analyzed, the Haavikko method had a higher accuracy rate and has the advantage of being practical due to the smaller number of teeth evaluated compared to other methods. We think that future studies involving different regions and different methods in the Turkish population will be useful.