Radiographic evaluation of dental age of adults using Kvaal's method

Introduction: It is a well-known fact that the assessment of the dental development can be related to an individual's age, but after the age of 21 years when the wisdom teeth also complete their development, there arises a need for an optimal age estimation procedure. With advancing age, there is a reduction in the size of the pulp due to secondary dentin deposition and a measurement of this reduction can also be used as a parameter to assess the age of the individuals, both in the living and dead.

Aims and objectives: The purpose of the present study was to evaluate the feasibility of this approach in the estimation of age of adults, using Kvaal's method in the set sample.

Materials and methods: The material consisted of the digital long-cone intraoral periapical radiographs from 50 subjects of either sex in the age group of 15-60 years, who were selected after evaluation for the set inclusion and exclusion criteria. The pulp width and length from radiographs of 6 selected teeth, namely, maxillary central incisor, lateral incisor, and second premolar and mandibular lateral incisor, canine, and first premolar of either right or left side were measured using the RVG trophy software [Trophy® Windows is a software program supplied by Trophy Radiologie (Trophy Windows Version 5.03, Copyright 1993-2002,Trophy RVG patented by Trophy, Chicago)]. In order to compensate for the differences in magnification and angulation, various ratios were calculated and the mean of all ratios (M) was taken as the first predictor, while the difference between the mean of 2 width ratios and the mean of 2 length ratios (W - L) was taken as the second predictor. Different regression formulae for all 6 teeth, 3 maxillary teeth, 3 mandibular teeth, and each of the individual teeth were derived and the age was assessed. The assessed age was then co-related with the actual age of the patient using the Student's t test.

Results: The results showed that the coefficient of determination (R(2)) was the strongest (0.198) for the mandibular first premolar indicating that age can be estimated better with this particular tooth. No significant difference was observed between the estimated age and the actual age for all (P>0.05) except in mandibular lateral incisor and maxillary lateral incisor, where a significant difference was observed.

Conclusion: To conclude, the results of the present study suggest the feasibility of Kvaal's method for age estimation in the set sample.