Evaluation of the accuracy of the Nolla method for the estimation of dental age of children between 4-14 years old in Spain: A radiographic study

Abstract

The aim of this study was to estimate the age of subjects from their dental age by showing the different stages of tooth development using the Nolla method in a Spanish population sample considering the gender, age group, and the development of the two dental arches. The sample consisted of 604 orthopantomographs corresponding to Spanish children (male: 302 and female: 302) aged from 4 to 14 years old. The resulting chronological and dental ages were compared using Student's t-test. We obtained a good index of agreement between the evaluators and good internal consistency in the evaluation of the ages of the teeth. In general, the dental age estimates were lower than the chronological ages, obtaining an underestimation with the application of the Nolla method. In the male group, the average dental age of the maxillary teeth was 8.36 years and that of the mandibular teeth was 8.40 years, compared to the chronological age of 8.84 years in both cases. In the female group, the average dental age of the maxillary teeth was 7.76 years and that of the mandibular teeth was 7.88 years, compared to the chronological age of 8.70 years in both cases. On applying the Nolla method to our sample, a significant overestimation was observed only in children aged between 4 and 6.9 years. The Nolla method can be used as a complementary tool for estimating age in children of Spanish origin. The application of this method is more favourable in the case of individuals evaluated under the law applied to minors. In general, with this method, age is underestimated, but the calculations involved are reliable, and greater precision has been observed in male than in female. The data from this study can be used as a reference to determine the dental maturity of Spanish children and to estimate their ages.