UNCORRECTED PROOF Accuracy of age estimation in children using radiograph of developing teeth Roberto Cameriere a,b, * , Luigi Ferrante c,b , H.H. Liversidge c,b , J.L. Prieto d,b , H. Brkic e,b a Institute of Forensic Medicine, University of Macerata, Via D. Minzoni, 62100 Macerata, Italy b Institute of Microbiology and Biomedical Sciences, Polytechnic University of Marche, Ancona, Via Ranieri 65, 60100 Ancona, Italy c Dental Institute, Bart’s and The London School of Medicine and Dentistry, Turner Street, London E1 2AD, UK d Laboratory of Forensic Anthropology and Odontology, Instituto Anato ´mico Forense, Ciudad Universitaria s/n, 28040 Madrid, Spain e Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Gunduliceva 5, Zagreb, Croatia Received 1 April 2007; received in revised form 27 August 2007; accepted 1 September 2007 Abstract The aims of this study were: first, to determine the accuracy of the Cameriere method for assessing chronological age in children based on the relationship between age and measurement of open apices in teeth [10] and, second, to compare the accuracy of this method with the widely used Demirjian et al. method [7] and with the method proposed by Willems et al. [8]. Orthopantomographs taken from white Italian, Spain and Croatian children (401 girls, 355 boys) aged between 5 and 15 years were analysed following the Cameriere, Demirjian and Willems methods. The difference between chronological and dental age was calculated for each individual and each method (residual). The accuracy of each method was assessed using the mean of the absolute values of the residuals (mean prediction error). Results showed that the Cameriere method slightly underestimated the real age of children. The median of the residuals was 0.081 years (interquartile range, IQR = 0.668 years) for girls and 0.036 years for boys (interquartile range, IQR = 0.732 years). The Willems method showed an overestimation of the real age of boys, with a median residual error of 0.247 years and an underestimation of the real age of girls (median residual error = 0.073 years). Lastly, the Demirjian method overestimated the real age of both boys and girls, with a median residual error of 0.750 years for girls and 0.611 years for boys. The Cameriere method yielded a mean prediction error of 0.407 years for girls and 0.380 years for boys. Although the accuracy of this method was better for boys than for girls, the difference between the two mean prediction errors was not statistically significant ( p = 0.19). The Demirjian method was found to overestimate age for both boys and girls but the mean prediction error for girls was significantly greater than that for boys ( p = 0.024), and was significantly less accurate than the Cameriere method ( p < 0.001). The Willems method was better than that of Demirjian ( p = 0.0032), but was significantly less accurate than that of Cameriere ( p < 0.001). # 2007 Published by Elsevier Ireland Ltd. Keywords: Age estimation; Teeth; Forensic odontology 1. Introduction Several papers in the field of forensic odontology and archaeology deal with estimating chronological age in humans. Although skeletal radiology is the most widespread method for age estimation in living subjects, modern techniques applied to adults have allowed great improvements in the X-ray processing of teeth, which are better suited for age estimations than bones [1–6]. Various odontological methods have also been applied to estimate age, assessing eruption phases within acceptable error limits [7–11]. Basically these methods define the stages of mineralization of teeth observed in radiographs and code them according to predetermined scores. However, on account of several complications, few papers have been devoted to studying their accuracy and reliability [12–16]. The aims of this study were: first, to determine the accuracy of the Cameriere method for assessing chronological age in children based on the relationship between age and measure- ment of open apices in teeth [10] and, second, to compare the accuracy of this method with the widely used Demirjian method [7] and with the method proposed by Willems et al. [8]. www.elsevier.com/locate/forsciint Forensic Science International xxx (2007) xxx–xxx 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Corresponding author. E-mail address: r.cameriere@unimc.it (R. Cameriere). + Models FSI 5305 1–5 0379-0738/$ – see front matter # 2007 Published by Elsevier Ireland Ltd. doi:10.1016/j.forsciint.2007.09.001 Please cite this article in press as: R. Cameriere, et al., Accuracy of age estimation in children using radiograph of developing teeth, Forensic Sci. Int. (2007), doi:10.1016/j.forsciint.2007.09.001