Dental Age Estimation on Digital Panoramic Radiographs: A Comparison among Final Year Students, Graduates, and Postgraduate Trainees

Abstract: Background: Panoramic radiographs aid in holistic treatment planning and dental age estimation based on tooth development stages and eruption sequence. Evaluating dental professionals’ proficiency to precisely estimate patient age using orthopantomograms (OPGs) is crucial for identifying existing skill gaps. Objective: This study aimed to evaluate and compare the knowledge of dental age estimation using digital panoramic radiographs among final-year dental students, recent graduates, and postgraduate trainees. Materials and Methods: This cross-sectional study was conducted at Sindh Institute of Oral Health Sciences (SIOHS), Jinnah Sindh Medical University (JSMU), over a two-month period from 1st October till 30th November 2022, at the Department of Oral Radiology. Ethical approval was obtained bearing number JSMU/IRB/2022/-639. The calculated sample size was 402, and non-probability convenience sampling was used. An online questionnaire was designed with eight digital OPGs (6–16 years), analyzed by dental specialists using the American Dental Association (ADA) eruption sequence guideline. Each OPG was accompanied by options related to the most likely age to be selected by the study participants. The Google Form link was shared with all potential participants via Facebook and WhatsApp Messenger. Frequency of correct responses was calculated, and chi-square test was applied to determine any significant differences between participants based on their responses (p- value ≤ 0.05). Result: The response rate was 78.7%, with 493 completed forms analyzed. Most participants were aged 18-23 years (53.3%), and 71.2% were female. Participants comprised final-year students (32.7%), graduates (41%), and postgraduate trainees (26.4%). Postgraduate trainees had the highest percentage (60.4%) of correct responses, followed by graduates (54.7%) and final-year students (48.4%). Radiographic image 8 had the highest correct responses (74.2%), while image 7 had the lowest (25.6%). No statistically significant relationship was found between participants’ qualifications and their ability to identify the correct age range on OPGs (p > 0.05). Conclusion: The ability to correctly identify the age range of OPGs seems to improve with progression in clinical training, since more postgraduate dental trainees were able to accurately identify the age range of patients compared to other participants. Keywords: Tooth eruption, Age determination by teeth, Panoramic radiography, Orthopantomography, Digital, Forensic dentistry.