TY - JOUR

T1 - How old are you? A systematic review investigating the relationship between age and mandibular third molar maturity

AU - Klingberg, Gunilla

AU - Benchimol, Daniel

AU - Berlin, Henrik

AU - Bring, Johan

AU - Gornitzki, Carl

AU - Odeberg, Jenny

AU - Tranæus, Sofia

AU - Twetman, Svante

AU - Wernersson, Emma

AU - Östlund, Pernilla

AU - Domeij, Helena

N1 - Publisher Copyright: © 2023 Klingberg et al.

PY - 2023

Y1 - 2023

N2 - Introduction and objective Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years. Methods The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjiańs method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjiańs tooth stage H). Results A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjiańs tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjiańs tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment. Conclusion The identified literature does not provide scientific evidence for the relationship between Demirjiańs stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.

AB - Introduction and objective Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years. Methods The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjiańs method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjiańs tooth stage H). Results A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjiańs tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjiańs tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment. Conclusion The identified literature does not provide scientific evidence for the relationship between Demirjiańs stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.

U2 - 10.1371/journal.pone.0285252

DO - 10.1371/journal.pone.0285252

M3 - Journal article

C2 - 37200251

AN - SCOPUS:85159764106

VL - 18

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 5

M1 - e0285252

ER -