Dental age estimation using Demirjian and Willems methods: Cross sectional study on children from the Former Yugoslav Republic of Macedonia

To evaluate applicability of Demirjian and Willems methods for calculating dental age of children in the Former Yugoslav Republic of Macedonia we analyzed panoramic radiographs of 966 children (485 female and 481 male, aged 6-13 years) treated at the University and Community Dental Clinics in Skopje using four Demirjian methods and a Willems method for determining dental ages. Intra-rater and inter-rater agreement of mineralization stages were 0.86 and 0.82, respectively. All methods significantly overestimated dental age when compared to the chronological age (p < 0.001). In males, the lowest overestimation was shown using Willems method (0.52 ± 0.87 years), followed by Demirjian methods from 1976 using PM1, PM2, M1, M2 teeth (0.69 ± 0.92 years) and using I2, PM1, PM2, M2 teeth (0.80 ± 0.98 years). The greatest overestimation were shown using Demirjian methods using 7 teeth from 1976 (0.92 ± 0.99 years) and method from 1973 (1.06 ± 1.07 years). In females, the lowest overestimation was shown using Willems method (0.33 ± 0.83 years) than the Demirjian method using PM1, PM2, M1, M2 teeth (1.00 ± 1.01 years), following methods from 1976 using 7 teeth (1.03 ± 1.01 years) and I2, PM1, PM2, M2 teeth (1.12 ± 0.96 years). The greatest overestimation was for method from 1973 using 7 teeth (1.17 ± 0.98 years). Willems method was the most accurate while Demirjian's methods for dental age calculation are not suitable on children from the Former Yugoslav Republic of Macedonia.