Evaluation of the accuracy of Nolla,Cameriere-European,and Blenkin-Evans methods for dental age estimation of Turkish children

Abstract

Dental age (DA) estimation plays a crucial role in forensic investigations, clinical diagnosis, and treatment planning. It is considered more reliable than skeletal methods due to the predictable nature of dental development. This study aimed to evaluate the accuracy of three DA estimation methods—Nolla method, Cameriere-European formula, and Blenkin-Evans method—in Turkish children aged 6–14 years. A total of 1014 panoramic radiographs were analyzed. DA was estimated using the three methods and compared with chronological age (CA). Accuracy was assessed based on mean absolute error (MAE), mean difference (DA–CA), and correlation coefficients. Statistical analyses were performed to determine significant differences among methods. The Cameriere-European formula demonstrated the lowest MAE (0.44 for boys, 0.48 for girls, and 0.46 for all samples), indicating the highest accuracy, followed by the Blenkin-Evans (0.54 for boys, 0.53 for girls, and 0.54 for all samples) and Nolla (0.57 for boys, 0.65 for girls, and 0.61 for all samples) methods. However, the Cameriere-European formula slightly underestimated CA, particularly in older children. The Blenkin-Evans method showed relatively stable accuracy but overestimated CA in both sexes. The Nolla method generally underestimated CA, except in boys, where it slightly overestimated age. All three methods exhibited strong correlations with CA (Spearman rho correlation coefficients ranging from 0.953 to 0.970, all p < .001). The Cameriere-European formula provided the most accurate DA estimation method, followed by the Blenkin-Evans and Nolla methods for Turkish children from the Northwestern Anatolia. However, the observed biases highlight the need for population-specific calibrations.