Fue un estudio descriptivo, transversal y retrospectivo, donde se determinó la precisión en la estimación de la edad cronológica de los niños atendidos en la clínica de Odontopediatría de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos. El estudio fue realizado con una muestra de 150 historias clínicas de las cuales se registraron en una ficha de recolección de datos el nombre del paciente, fecha de nacimiento, sexo, edad cronológica, estado de mineralización de las 7 piezas dentarias inferiores izquierdas y puntuación dada por el estadío de ineralización de cada una de las piezas según los métodos Nolla y Demirjian. Previo a la ejecución se seleccionaron 15 radiografías panorámicas adicionales para evaluar la fiabilidad intraexaminador para ambos métodos. El coeficiente Kappa para el método Demirjian fue de 0.852 y el de Nolla fue 0.763, ambos resultados obtenidos son válidos y confiables. Las edades cronológicas obtenidas por ambos métodos fueron comparados usado el coeficiente de correlación de Pearson. Para la técnica Demirjian el coeficiente de correlación fue de 0.923 y para la técnica Nolla fue de 0.870, concluyéndose que el método de Demirjian es más preciso que el método de Nolla para la estimación de la edad.

The estimation of age at time of death is often an important step in the identification of human remains. If this age can be accurately estimated, it will significantly narrow the field of possible identities that will have to be compared to the remains in order to establish a positive identification. Some of the more accurate methods of age estimation, in the juvenile and younger adult, have been based on the assessment of the degree of dental development as it relates to chronological age. The purpose of this current study was to test the applicability of one such system, the Demirjian system, to a Sydney sample population, and to develop and test age prediction models using a large sample of Sydney children (1624 girls, 1637 boys). The use of the Demirjian standards resulted in consistent overestimates of chronological age in children under the age of 14 years by as much as a mean of 0.97 years, and underestimates of chronological age in children over 14 years by as much as a mean of 2.18 years in 16 year-old females. Of the alternative predictive models derived from the Sydney sample, those that provided the most accurate age estimates are applicable for the age ranges 2-14 years, with a coefficient of determination value of R-square=0.94 and a 95% confidence interval of �1.8 years. The Sydney based standards provided significantly different and more accurate estimates of age for that sample when compared to the published standards of Demirjian.

The estimation of age at time of death is often an important step in the identification of human remains. If this age can be accurately estimated, it will significantly narrow the field of possible identities that will have to be compared to the remains in order to establish a positive identification. Some of the more accurate methods of age estimation, in the juvenile and younger adult, have been based on the assessment of the degree of dental development as it relates to chronological age. The purpose of this current study was to test the applicability of one such system, the Demirjian system, to a Sydney sample population, and to develop and test age prediction models using a large sample of Sydney children (1624 girls, 1637 boys). The use of the Demirjian standards resulted in consistent overestimates of chronological age in children under the age of 14 years by as much as a mean of 0.97 years, and underestimates of chronological age in children over 14 years by as much as a mean of 2.18 years in 16 year-old females. Of the alternative predictive models derived from the Sydney sample, those that provided the most accurate age estimates are applicable for the age ranges 2-14 years, with a coefficient of determination value of R-square=0.94 and a 95% confidence interval of �1.8 years. The Sydney based standards provided significantly different and more accurate estimates of age for that sample when compared to the published standards of Demirjian.

Objetivo: Comparar los métodos de Demirjian, Nolla y Cameriere para la estimación de la edad según la edad cronológica en una población peruana. Materiales y métodos: El diseño del estudio es de tipo descriptivo, de corte transversal. Se seleccionaron 193 radiografías panorámicas aleatoriamente de niños de 6 a 14 años de edad. Se compararon la edad cronológica (EC) y la edad dental (ED) según los métodos de Nolla, Demirjian y Cameriere, utilizando las Pruebas de Rangos de Wilcoxon y Kruskall Wallis. Resultados: La media de la EC fue de 8.77±2.34 y 8.90±2.04 años para el género femenino y masculino, respectivamente. La diferencia de medias de la EC y ED de acuerdo con los métodos Nolla años, Demirjian y Cameriere años fue de -0.38, 0.96 y -0.29 años, respectivamente, para la muestra total de estudio. Conclusiones: Se encontró una correlación positiva para los tres métodos estudiados, sin embargo, el método de Demirjian mostró una diferencia estadísticamente significativa con una subestimación de -0.91 años en la muestra total. Asimismo, el método de Cameriere fue el que tuvo más cercanía a la edad cronológica. / Aim: The aim of this study is to compare Demirjian, Nolla and Cameriere methods for the estimation of dental age in peruvian population. Materials and Methods: This retrospective and cross-sectional study included 193 panoramic radiographs randomly selected from children aged between 6 and 14 years. Chronological age (CA) and dental age (DA) were compared using the Wilcoxon and Kruskall Wallis Range Tests. Results: The mean was 8.77 ± 2.34 and 8.90 ± 2.04 years of the CA for the female and male gender, respectively. The difference in means of the CA and DA according to the Nolla, Demirjian and Cameriere methods were -0.38, 0.96 and -0.21 years, respectively, for the total study sample. Conclusions: A positive correlation was found for the three methods studied, however, the Demirjian method showed a statistically significant difference with an underestimation of -0.91 years in the total sample. Also, the method of Cameriere was the closest to the chronological age. / Tesis

Sammanfattning Mål: Tidigare studier visar att delar av den fysiska och psykiska tillväxten och utvecklingen hos för tidigt födda barn kan påverkas av den förkortade graviditetsperioden. De odontologiska aspekterna av prematuritet har ännu inte till fullo studerats. Syftet med denna studie är att undersöka om tandmognaden påverkas av för tidig födsel och om enskilda tänder i högre utsträckning är mer påverkade.Material och Metod: I studien deltog 116 barn: 36 extremt för tidigt födda barn (extremely preterm - EPT), 38 mycket för tidigt födda barn (very preterm – VPT) och 42 fullgångna kontroller (controls – C). Panoramaröntgenbilder analyserades av fem kalibrerade observatörer, enligt en metod som utvecklats av Demirjian och Goldstein. Röntgenbilderna avidentifierades och mognadsgraden av de 7 permanenta tänderna i underkäkens vänstra sida (tand 31-37) bedömdes enligt ett 8-stegs system. De 7 bedömningarna adderades sedan till en tandmognadspoäng (maturity score) som motsvarade barnets tandmognadsgrad. Detta möjliggjorde jämförelser på såväl gruppnivå som tandnivå. Observatörernas tillförlitlighet och metodens reproducerbarhet utvärderades genom att 27 slumpvis utvalda röntgenbilder bedömdes ytterligare en gång. Statistiska analyser utfördes av studiens resultat samt av reproducerbarheten.Resultat: Resultatet, med hänsyn till variationer i observatörernas bedömningar, visade att EPT-gruppen hade en genomsnittlig tandmognadspoäng mellan 81.9 och 86.7, VPT 85.2-89.1 och kontrollgruppen 88.1-91.0. Samtliga fem observatörer uppvisade statistiskt signifikanta skillnader mellan EPT-gruppen och kontrollgruppen (p≤0.006). På tandnivå uppvisade alla observatörer en signifikant fördröjning (p≤0.002) av tandmognaden för tand 37 när EPT-gruppen jämfördes mot kontrollgruppen. Signifikanta skillnader mellan ett flertal andra tänder erhölls men konsensus mellan observatörerna saknades. Överensstämmelsen inom varje enskild observatör (intra-observer agreement) beräknades med ett Kappa-test, där resultaten varierade mellan 0.16-1.00. Kappa-beräkningen av reproducerbarheten mellan samtliga observatörer (inter-observer agreement) varierade mellan 0.31-0.71.Slutsats: Resultaten i denna studie tyder på en allmän försening av tandmognaden vid 9 års ålder hos de extremt för tidigt födda barnen (EPT), jämfört med fullgångna barn (C). En förkortad gestationsperiod tycks indikera en fördröjning av tandmognaden jämfört med tandmognaden hos fullgångna barn.

Made available in DSpace on 2014-12-17T14:13:35Z (GMT). No. of bitstreams: 1 MariaCGM_DISSERT.pdf: 783345 bytes, checksum: 2bbd27cd96c8b3b35673be95266c5187 (MD5) Previous issue date: 2010-09-17 / Since Demirjian's system of estimating dental maturity was first described, many researchers from different countries have tested its accuracy among diverse populations. Some of these studies have pointed out a need to determine population-specific standards. In Brazil, the Northeast region is the one that most suffers the negative impact of exodus, specially related to the increase of abandoned children in the cities. The aim of this study was to test the accuracy of Demirjian's system for assessing the dental maturity of northeastern Brazilian children, so as to present a scale for maturity score conversion into dental age developed specifically for this population. This could be used for forensic, anthropological and legal matters, and also as a model for other countries attempting to formulate their own conversion scales. Panoramic radiographs of 1,491 children (821 females and 670 males), aged 7 to 13 years, from Cear? state, northeast Brazil, were assessed by a single observer to determine dental age (DA) according to Demirjian's system. The mean percentage of intra-observer agreement was 86.6%, with a mean Cohen's Kappa coefficient of 0.67 (substantial agreement). The DA was compared by paired t-test to subjects' chronological age (CA). The differences between CA and DA in all age groups were statistically significant (p<0.0001), demonstrating a great advancement in DA among Brazilians. Scatter plots were drawn for both genders, and the data were fitted to a growth curve, y = 100/ (1 + e-a(x b)). Graphs corresponding to the 50th percentile curves were produced. A table with new values for the conversion of maturity score into dental age for northeastern Brazilian children is presented. The great advancement in DA, as obtained by Demirjian's system in this population, justified the determination of specific scores for dental maturity assessment / A estimativa da maturidade dent?ria tem sido descrita na literatura basicamente atrav?s de dois m?todos, a observa??o direta do processo de erup??o do dente na cavidade oral ou por meio de radiografias. A radiografia panor?mica, obtida por t?cnica extra-oral de uso dos raios X, ? um elemento essencial para o diagn?stico por imagens em Radiologia odontol?gica. Este trabalho apresenta dois estudos quantitativos anal?tico-descritivos utilizando o m?todo de determina??o da idade dental atrav?s de radiografia panor?mica em crian?as brasileiras nordestinas. Um estudo piloto realizado com 325 crian?as (191 meninas e 134 meninos) de 7 a 16 anos, da cidade de Fortaleza, objetivando determinar as interrela??es entre as suas idades cronol?gica (data de nascimento), ?ssea (pelo m?todo de Grewlich & Pyle) e dental (segundo Demirjian et al.). Outro estudo, j? publicado, conduzido com 1.491 crian?as (821 meninas e 670 meninos) cearenses, de 7 a 13 anos, visando avaliar a aplicabilidade do m?todo de Demirjian na popula??o estudada. Em ambos os estudos, mostra-se que a estimativa de idade dental utilizando as tabelas de convers?o de maturidade dental propostas por Demirjian et al. n?o se ad?qua ? popula??o pesquisada. Assim, uma escala de valores de convers?o de maturidade dental em idade dental foi desenvolvida especificamente para crian?as nordestinas e ? agora apresentada, visando ? sua aplica??o n?o s? na cl?nica, mas em quest?es forenses, antropol?gicas, legais e/ou criminais. As pesquisas de car?ter interdisciplinar envolveram pesquisadores das ?reas de Odontologia (Odontopediatria, Ortodontia e Radiologia); Medicina (Endocrinologia e Metabologia); e F?sica, preenchendo os requisitos de multidisciplinaridade do Programa de P?s-Gradua??o em Ci?ncias da Sa?de