An assessment of dental age in a select South African sample using the Willems scoring systems

Purpose: Age estimation plays a pivotal role in the forensics sciences, medico-legal and clinical dentistry fields. The Willems method has gained significant recognition over the past two decades; however, the accuracy of it varies between population groups and across different regions within a country. Consequently, the present study aimed to investigate the reliability of the Willems scoring systems to a select South African population. Methods: A cross-sectional assessment of 600 digital panoramic radiographs of patients (n = 600: 300 South African Black and 300 South African Indian) between 5.00 and 19.99 years old were employed retrospectively. The dental age was calculated utilizing the Willems et al. (2001) and Willems et al. (2018) scoring systems. Discrepancies between the chronological and dental ages were statistically analyzed. Results: An over-estimation of dental age utilizing the Willems et al. (2001) and Willems et al. (2018) scoring systems was recorded in the selected sample of KwaZulu-Natal. A significant statistical difference between the chronological age and estimated dental age was recorded for both methodologies. Therefore, this study attempted to increase the accuracy of the Willems scoring system in a selected sample of South Africa by generating the following two novel population-specific age predictive models (excluding and including third molars). Conclusion: The population-specific model performed better than the Willems scoring systems for the select sample, with the lowest mean errors and an insignificant statistical discrepancy noted between the chronological and dental ages (p-value >0.05). Therefore, these population-specific models may be used for forensic and medico-legal cases within this region.