Comparison of original and new South African formulae for age estimation in African Black and white children and adolescents using dental and hand-wrist methods

Methods for age estimation in children involve measurements of: (1) the projections of open apices and tooth heights (T), (2) the total area of the carpal bones and the epiphyses of the ulna and radius (HW), and (3) a combination of these parameters (THW). This study aimed to compare the accuracy of the original formulae for T, HW, and THW in Black South African (BSA) and White South African (WSA) samples of children and adolescents.

The sample comprised 556 subjects, 164 BSA (71 males and 93 females) and 392 WSA (171 males and 221 females) aged 6 to 16 years. The main sample comprised 556 subjects and was divided into two parts. The first part was used to develop new formulae specific to the South African population, while the second part, consisting of 183 subjects and referred to as the test sample, was used to evaluate the accuracy of these formulae and to quantify their uncertainty when applied to real cases. Adjusted R² and standard errors of the estimate (SEEs) were calculated for each regression model. The mean absolute difference or error (MAE) between estimated and chronological age and the percentage of individuals within specific age ranges of ± 0.25, ± 0.5, ± 1, and ± 2 years of chronological age was used to compare the accuracy of formulae.

Teeth showed the most significant underestimation in the training sample, -0.49 years in males and − 0.29 years in females, as much as -0.70 years in WSA males, while BSA males were overestimated by + 0.03 years. Combining teeth and hand-wrist, the new formula showed the best performance in age estimation compared to only teeth or hand-wrist, except in WSA males (-0.51 years). New South African-specific formula improved accuracy, especially in males, suggesting their suitability alongside the original Cameriere et al. methods for precise age estimation.

The original regression formulae by Cameriere et al., along with the newly developed formulaespecific to South African populations, shows promise for age estimation, considering potential estimation errors and the accuracy rates demonstrated in this study.