Applicability of London atlas of tooth development and eruption for dental age estimation in children of the Malaysian population using maxillofacial imaging

In forensics, dental age estimation is crucial, and literature has many methods for estimating dental age. London Atlas of Human Tooth Development and eruption method was developed on British and Bangladeshi populations in 2010, and there are likely to be differences between other populations. Malaysian children have not yet been extensively tested for the method's applicability despite its universal acceptance and reliability. This research aimed to test the applicability of The London Atlas of human tooth development and eruption in children of the Malaysian population aged 4 to 16.99 years old. The study sample included 523 panoramic radiographs of healthy patients who had attended the Dental Paediatrics Department Hospital Tunku Azizah, Malaysia, between May 2019 and December 2019. The intra- and inter-observer errors were analysed by taking 53 radiographs and evaluating them over 14 days using the interclass correlation and Cohen's Kappa index. A paired t-test was used to compare chronological and estimated age ANOVA F-tests were used to establish if the difference is statistically significant between chronological and estimated age. The range of age estimation fell within a year due to the mean absolute difference of 0.60 years. The mean age for estimated age was 9.31±3.18 for the overall sample, 9.06±3.09 for males, and 9.60±3.27 for females. Paired t-test analysis showed the mean difference between chronological and estimated age of -0.0365 and was not statistically significant (p=0.240). The result also showed no statistically significant difference between the sexes. The difference between the chronological and estimated age was underestimated within minimal range, 0.002 years in males and 0.08 years in females. The London Atlas of human tooth development and eruption showed high accuracy in Malaysian children.