RAJIV GANDHI UNIVERSITY OF

HEALTH SCIENCES

BANGALORE, KARNATAKA.

MASTERS OF DENTAL SURGERY (M.D.S.)

DEPARTMENT OF PEDODONTIA AND

PREVENTIVE DENTISTRY

2009

A.E.C.S. MAARUTI COLLEGE OF DENTAL

SCIENCES & RESEARCH CENTRE,

BANGALORE.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA.

ANNEXURE-II

SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / Dr Shilpa P.H
A.E.C.S. Maaruti College of Dental Sciences & research Centre, Bangalore- 76
2. / NAME OF THE INSTITUTION / A.E.C.S. Maaruti College of Dental Sciences & research Centre, Bangalore- 76
3. / COURSE OF THE STUDY AND SUBJECT / MASTER OF DENTAL SURGERY (MDS)
PEDODONTICS AND PREVENTIVE DENTISTRY
4. / DATE OF ADMISSION TO THE COURSE / 09/04/2009
5. / TITLE OF THE TOPIC / COMPARISON OF DENTAL AND SKELETAL AGE WITH CHRONOLOGICAL AGE USING DEMIRJIAN’S, GREULICH AND PYLE’S METHOD IN BANGALORE SOUTH
SCHOOL GOING CHILDREN

6. BRIEF RESUME OF THE INTENTED WORK

6.1 NEED FOR THE STUDY:

Growth and development of a child has long fascinated poets, parents and paediatricians, but the diversity in its expression has left a lot unsatisfied.

Accurate age estimation is required in the field of health sciences, being relevant to the timing of various treatment procedures.1

Emergence of a tooth into the oral cavity is a fleeting event and its precise time is difficult to determine, however, eruption and calcification of dental tissues has long been used to estimate dental age. Tooth calcification is superior to tooth emergence because calcification is a continuous process that can be assessed by radiography.2

The skeletal maturity is assessed by analysing specific bones of the body whereas dental maturity is estimated by assessing various calcification stages of the developing tooth.

The dental parameters are more suitable for age estimation in children because the variability is low since calcification rates are more controlled by genes than by environmental factors.3

Various methods have been proposed for the dental maturation, but the most widely applied method of dental age estimation was proposed by Demirjian et al4

The most widely used method for skeletal age assessment according to the criteria proposed in the atlas of hand- wrist radiograph by Greulich and Pyle.5

The chronological age is obtained from the birth certificate of the children as per the school records.

Numerous demographic studies have been conducted to test the authenticity of Demirjian standards, this present study aims at determining whether the standards of dental maturation given by Demirjian et al are applicable to the Bangalore south zone school children and to assess the relationship between the obtained dental and skeletal age.

6.2 REVIEW OF LITERATURE:

  1. Greulich and Pyle (1953)5studiedthe white, upper middle class boys and girls enrolled in the Brush Foundation Growth Study from 1931 to 1942. In this study two series of standard plates obtained from left hand -wrist radiographs were used and the levels of maturity within the chronological age groups were assessed and compared with the series of standard plates. It was observed that the age given to the standard plate that fits most closely, is assigned as the skeletal age of the child.
  1. A Demirjian, H Goldstein, JM Tanner(1972)4carried out a study on French Canadians parentage for the estimation of dental age using 1446 boys and 1482 girls. Radiological appearances of all 7 teeth on the left of the mandible wereused. The sum scores on all 7 teeth gave a dentalmaturity score which can beconverted directly into a dental age. In case ofmissing teeth ,the possibility of using combinations of different teeth ishighlighted.
  1. Hegde RJ, Sood PB (2002)2conducted a study to determine dental age from orthopantomographs using Demirjian method to investigate the applicability of Demirjian method for estimation of chronological age in children of Belgaum (Karnataka State). The mean difference between true and assessed age for males showed overestimation of 0.14 years (51 days) and females showed overestimation of 0.04 years (15 days). Demirjian method showed high accuracy when applied to Belgaum children
  1. Tunc ES, Koyuturk AE(2008)6conducted a study to evaluate the applicability of Demirjian’s method for dental age estimation and for description of mandibular permanent tooth formation in north Turkish children aged between 4-12 years of age. The study group comprised of 900 healthy children. It was found out that the northern Turkish children were generally advanced in dental maturity compared with the children in Demirjian’s standard. The mean difference between dental and chronological ages of boys and girls varied from 0.36 to 1.43 years and 0.50 to 1.44 years, respectively. It was concluded that the standards of dental age described by Demirjian et al. in 1973 might not be suitable for northern Turkish children.
  2. Balwant Rai, Jasdeep Kaur (2008)1 carried out astudy to test the applicability of the Demirjian method for estimation of dental age in comparison with the chronological age in North Indian population. The subjects for the study were aged between 6 years to 17 years of age with a healthy dentition and without any dental lesion. In this study the chronological and dental age showed significant positive correlation between male and female sample (P<0.01). it was concluded that Demirjian method showed high accuracy when applied in Haryana population.

6.3 Objectives of the study

  1. To test the applicability of Demirjian’s standards for the maturity score in dental age assessment in Bangalore south zone school children.
  1. To compare and correlate the obtained dental and skeletal age with the respective chronological age.

7.MATERIALS AND METHODS

7.1 SOURCE OF DATA:

The study will be conducted on 250 healthy children who are willing to participate in the investigation, aged between 6 – 15 years, belonging to various schools of Bangalore south zone, are brought to the Department of Pedodontics and Preventive Dentistry, AECS Maaruti Dental College and Research Centre, Bangalore.

INCLUSION CRITERIA

  1. Healthy cooperative caries free children aged between 6 – 15 years known chronological age.
  2. The chronological age of the patient is recorded by their date of birth. (as per school records via birth certificate)
  3. Subject should have complete mandibular permanent dentition (erupted/unerupted, except 3rd molar)
  4. Prior consent is obtained from parents and school authorities.

EXCLUSION CRITERIA

  1. The subject should be clinically free from any developmental, endocrine, nutritional or mental disorders, which might affect development of the subject.
  2. The subject must be clinically free from any medical illness.
  3. The subject should be free from congenital anomalies of teeth.

MATERIALS REQUIRED

  • 6” X 12” film (orthopantomograph)
  • 6½” X 8½” film (hand – wrist radiograph – ALLENGERS X-RAY MACHINE, MODEL – 100CBM/HT)
  • X-ray viewer
  • Orthopantomograph machine –VATECH DIGITAL PANORAMIC X-RAY SYSTEM, PAX-400)
  • Mouth mirror – number 5
  • Non graduated probe or explorer

7.2 METHODOLOGY

An orthopantomograph and hand – wrist radiograph (postero – anterior view) is taken for each subject. The processed radiographs are numbered. Interpretation of the radiographs is carried out with the help of an X-ray viewer. Orthopantomographs are analysed for developmental stages of all the teeth present on the left side of the mandible as per Demirjian’s seven teeth system. The developmental stages of each tooth is assessed and converted into a score using the conversion table given by Demirjian and Goldstein for boys and girls respectively. The score obtained from each tooth of all seven teeth are added together to obtain a total maturity score. After the maturity score is correlated, it is converted into dental age using the table given by Demirjian (1973) as obtained dental age.

The skeletal ages of the hand – wrist radiograph is assessed according to the criteria proposed by the atlas of Greulich and Pyle’s method.

The chronological age of the patient is obtained by using his official birth certificate.

The results will be tabulated and subjected to statistical analysis.

7.3 Does the study require any investigation or interventions to be conducted

on patients or other human or animals? If so, please describe briefly.

Investigation or Interventions required are:

Yes, Orthopantomograph and Hand – wrist Radiographs taken during the

study.

7.4 Has the ethical clearance been obtained from your institution in case of

7.3?

YES

8. LIST OF REFERENCES

  1. Balwant Rai, Jasdeep Kaur, S.C Anand, Rajnish Jain, Anil Sharma, Sushil Mittal. Accuracy of the Demirjian method for the Haryana population. The Internet journal of dental science 2008; 6 (1).
  1. Hegde R.J, Sood P.B. Dental Maturity as an indicator of chronological age: Radiographic evaluation of Dental age in 6 to 13 years children of Belgaum using Demirjian methods. Journal of Indian Society of Pedodontics and Preventive Dentistry 2002; 20 (4): 132-138.
  1. Prabhakar A.R, Panda A.K, Raju S.C. Applicability of Demirjian’s method of age assessment in children of Davangere. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2002 Jun; 20(2): 54-64.
  1. A. Demirjian, H. Goldstein, J.M. Tanner. A New System of Dental Age Assessment (1973). The Canadian Medical Research Council and the Department of National Health and Welfare of Canada Grant No, 604-7-5631972; 25 June.

5. Vicente Gilsanz, Osman. Hand Bone Age; A Digital Atlas of

Skeletal Maturity; eBook-ISBN 3-540-20951-4: 39 –104 Springer-Verlag

Berlin Heidelberg New York, Library of Congress Control Number:

2004114078;1953

6. Tunc ES, Koyuturk AE:Dental age assessment usingDemirjian’s method on

northern Turkish children. Forensic Sci Int.2008 Feb 25;175(1):23-6.

9. SIGNATURE OF THE CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME AND DESIGNATION OF (IN BLOCK LETTERS)
11.1GUIDE
11.2 SIGNATURE / DR. KIRAN ARADHYA M.D.S
PROFESSOR
11.3CO-GUIDE IF ANY:
11.4 SIGNATURE / DR. SAPNA KONDE M.D.S
PROFESSOR & HOD.
11.5 HEAD OF THE DEPARTMENT
11.6 SIGNATURE / DR. SAPNA KONDE, M.D.S
PROFESSOR AND HEAD
DEPARTMENT OF PEDODONTIC AND PREVENTIVE DENTISTRY,
A.E.C.S. MAARUTI COLLEGE OF DENTAL SCIENCES AND RESEARCH CENTRE.
12. REMARKS OF THE CHAIRMAN
AND PRINCIPAL
12.1 SIGNATURE OF THE
CHAIRMAN AND PRINCIPAL