Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder

Deniz Sıla Özdemir Çelik; Elif Demirel Şeker; Elif Tuğçe Nacar

Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder

Abstract

Aims: Autism spectrum disorder (ASD) may be associated with differences in dental development. However, evidence regarding mineralization-based dental age estimation in children with ASD remains limited. This study aimed to evaluate dental age using the Demirjian, Willems, and Nolla methods in children with ASD and compare the findings with healthy controls. Methods: This retrospective study included 117 children aged 5-15 years, comprising 39 children with ASD and 78 age- and gender-matched healthy controls. Dental age was estimated from panoramic radiographs using the Demirjian, Willems, and Nolla methods. The Friedman test was used for related measurements, and the Mann-Whitney U test for between-group comparisons. Bonferroni correction was applied for post-hoc comparisons. Results: In the ASD group, all three methods tended to yield dental age estimates higher than chronological age, while Nolla showed the smallest deviation from chronological age. Differences in dental age-chronological age deviations between groups were not significant for any method (p>0.05). Age-specific analysis revealed significant differences among methods at 7, 9, and 11 years. At 7 years, differences were observed between Demirjian and Willems (p<0.001) and Demirjian and Nolla (p=0.012), while at 9 and 11 years, differences were observed between Demirjian and Nolla (p=0.002 and p=0.024, respectively). Conclusion: Dental age estimates were broadly comparable between children with ASD and healthy controls. All three methods tended to overestimate dental age in children with ASD, while Nolla showed the smallest deviation from chronological age. Method-related differences varied across age groups.

Keywords

Supporting Institution

The authors declared that this study has received no financial support.

Ethical Statement

Written informed consent was obtained from the parents or legal guardians of all participants included in the study.

Thanks

This study was presented as an oral presentation at the 31st International Congress of the Turkish Society of Paediatric Dentistry, Antalya, Türkiye, October 2025.

References

Ostrowski J, Religioni U, Gellert B, Sytnik-Czetwertyński J, Pinkas J. Autism spectrum disorders: etiology, epidemiology, and challenges for public health. Med Sci Monit. 2024;30:e944161. doi:10.12659/MSM.944161
Wang M, Zhang X, Zhong L, Zeng L, Li L, Yao P. Understanding autism: causes, diagnosis, and advancing therapies. Brain Res Bull. 2025;227: 111411. doi:10.1016/j.brainresbull.2025.111411
Zeidan J, Fombonne E, Scorah J, et al. Global prevalence of autism: a systematic review update. Autism Res. 2022;15(5):778-790. doi:10.1002/aur.2696
Tripi G, Roux S, Matranga D, et al. Cranio-facial characteristics in children with autism spectrum disorders (ASD). J Clin Med. 2019;8(5): 641. doi:10.3390/jcm8050641
Gandhi R, Ruxmohan S, Puranik CP. Association between autism spectrum disorder and dental anomalies of the permanent dentition. Pediatr Dent. 2021;43(4):307-312.
Cameriere R, Ferrante L, Cingolani M. Age estimation in children by measurement of open apices in teeth. Int J Legal Med. 2006;120(1):49-52. doi:10.1007/s00414-005-0047-9
Vila-Blanco N, Varas-Quintana P, Tomás I, Carreira MJ. A systematic overview of dental methods for age assessment in living individuals: from traditional to artificial intelligence-based approaches. Int J Legal Med. 2023;137(4):1117-1146. doi:10.1007/s00414-023-02960-z
Jayaraman J, Wong HM, King NM, Roberts GJ. The French-Canadian data set of Demirjian for dental age estimation: a systematic review and meta-analysis. J Forensic Leg Med. 2013;20(5):373-381. doi:10.1016/j.jflm.2013.03.015

Sehrawat JS, Singh M. Willems method of dental age estimation in children: a systematic review and meta-analysis. J Forensic Leg Med. 2017;52:122-129. doi:10.1016/j.jflm.2017.08.017
Nur B, Kusgoz A, Bayram M, et al. Validity of Demirjian and Nolla methods for dental age estimation for northeastern Turkish children aged 5-16 years old. Med Oral Patol Oral Cir Bucal. 2012;17(5):e871-e877. doi:10.4317/medoral.18034
Vasconcelos NPS, Caran EMM, Lee ML, Lopes NNF, Weiler RME. Dental maturity assessment in children with acute lymphoblastic leukemia after cancer therapy. Forensic Sci Int. 2009;184(1-3):10-14. doi:10.1016/j.forsciint.2008.11.009
Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol. 1973;45(2):211-227.
Willems G, Van Olmen A, Spiessens B, Carels C. Dental age estimation in Belgian children: Demirjian’s technique revisited. J Forensic Sci. 2001; 46(4):893-895. doi:10.1520/JFS15064J
Nolla CM. The development of the permanent teeth. J Dent Child. 1960; 27:254-266.
Limeres J, Diz P, Abeleira MT, et al. Brief report: estimating the dental age of children with autism spectrum disorders. J Autism Dev Disord. 2019;49(6):2612-2617. doi:10.1007/s10803-019-04007-y
Ismail AF, Adnan NH, Suhaidi NNS, Mokhtar IW, Yusof MYPM, Mallineni SK. Accuracy of different dental age assessment methods to determine chronological age among children with special needs. J Indian Soc Pedod Prev Dent. 2024;42(1):64-70. doi:10.4103/jisppd.jisppd_47_24
Pereira CP, Russell LM, de Pádua Fernandes M, Alves da Silva RH, Vargas de Sousa Santos RF. Dental age estimation based on development dental atlas assessment in a child/adolescent population with systemic diseases. Acta Stomatol Croat. 2019;53(4):307-317. doi:10.15644/asc53/4/1
Duruk G, Gundogdu Ozdal TP, Duman S. Accuracy of age estimation with Demirjian and Nolla methods in Eastern Turkish children aged 3-17 years old. Eur Oral Res. 2022;56(2):80-87. doi:10.26650/eor.20221057985
Hato E, Coşgun A, Altan H. Comperative evaluation of Nolla, Willems and Cameriere methods for age estimation of Turkish children in the Central Black Sea Region: a preliminary study. J Forensic Leg Med. 2022; 91:102400. doi:10.1016/j.jflm.2022.102400
Kırzıoğlu Z, Ceyhan D. Accuracy of different dental age estimation methods on Turkish children. Forensic Sci Int. 2012;216(1-3):61-67. doi:10.1016/j.forsciint.2011.08.018
Ozveren N, Serindere G. Comparison of the applicability of Demirjian and Willems methods for dental age estimation in children from the Thrace region, Turkey. Forensic Sci Int. 2018;285:38-43. doi:10.1016/j.forsciint.2018.01.017
Türken D, Güler Ç. Assessment of validity of Demirjian and Willems methods for dental age estimation a group of children in the Eastern Black Sea region. Yeditepe Dent J. 2020;16(3):226-230. doi:10.5505/yeditepe.2020.60362
Özdemir Çelik DS, Belevcikli M. Evaluation of dental ages of children with type I diabetes using different dental age estimation methods: a retrospective cohort study. Sci Rep. 2025;15(1):44461. doi:10.1038/s41598-025-28098-z

Details

Primary Language

English

Subjects

Paedodontics, Special Needs Dentistry, Forensic Dentistry

Journal Section

Research Article

Authors

Deniz Sıla Özdemir Çelik ^*
0000-0002-2274-5375
Türkiye

Elif Demirel Şeker
0009-0003-7996-9673
Türkiye

Elif Tuğçe Nacar
0009-0003-0432-749X
Türkiye

Publication Date

October 25, 2026

Submission Date

July 22, 2026

Acceptance Date

September 7, 2026

Published in Issue

Year 2026 Volume: 8 Number: 6

IZ

https://izlik.org/JA59PM69CT

Cite

RIS / Bibtex

APA

Özdemir Çelik, D. S., Demirel Şeker, E., & Nacar, E. T. (2026). Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder. Anatolian Current Medical Journal, 8(6), 1255-1261. https://izlik.org/JA59PM69CT

AMA

1.Özdemir Çelik DS, Demirel Şeker E, Nacar ET. Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder. Anatolian Curr Med J / ACMJ / acmj. 2026;8(6):1255-1261. https://izlik.org/JA59PM69CT

Chicago

Özdemir Çelik, Deniz Sıla, Elif Demirel Şeker, and Elif Tuğçe Nacar. 2026. “Comparative Evaluation of Three Different Radiographic Dental Age Estimation Methods in Children With Autism Spectrum Disorder”. Anatolian Current Medical Journal 8 (6): 1255-61. https://izlik.org/JA59PM69CT.

EndNote

Özdemir Çelik DS, Demirel Şeker E, Nacar ET (October 1, 2026) Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder. Anatolian Current Medical Journal 8 6 1255–1261.

IEEE

[1]D. S. Özdemir Çelik, E. Demirel Şeker, and E. T. Nacar, “Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 6, pp. 1255–1261, Oct. 2026, [Online]. Available: https://izlik.org/JA59PM69CT

ISNAD

Özdemir Çelik, Deniz Sıla - Demirel Şeker, Elif - Nacar, Elif Tuğçe. “Comparative Evaluation of Three Different Radiographic Dental Age Estimation Methods in Children With Autism Spectrum Disorder”. Anatolian Current Medical Journal 8/6 (October 1, 2026): 1255-1261. https://izlik.org/JA59PM69CT.

JAMA

1.Özdemir Çelik DS, Demirel Şeker E, Nacar ET. Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder. Anatolian Curr Med J / ACMJ / acmj. 2026;8:1255–1261.

MLA

Özdemir Çelik, Deniz Sıla, et al. “Comparative Evaluation of Three Different Radiographic Dental Age Estimation Methods in Children With Autism Spectrum Disorder”. Anatolian Current Medical Journal, vol. 8, no. 6, Oct. 2026, pp. 1255-61, https://izlik.org/JA59PM69CT.

Vancouver

1.Deniz Sıla Özdemir Çelik, Elif Demirel Şeker, Elif Tuğçe Nacar. Comparative evaluation of three different radiographic dental age estimation methods in children with autism spectrum disorder. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Oct. 1;8(6):1255-61. Available from: https://izlik.org/JA59PM69CT