Development of A Fully Automated Dental Age Estimation Framework from Panoramic Radiographs Using Tooth-Level Information with an Attention-Weighting Module

Objective This study aimed to develop a fully automated and explainable framework for dental age estimation from panoramic radiographs in young individuals. Methods A dataset of 1,639 radiographs from individuals aged 8 to 23 years was used. The proposed two-stage pipeline involved: (1) oriented tooth detection using the YOLO11-OBB model, and (2) age estimation using deep learning-based regression models with an attention-weighting module to aggregate predictions from individual teeth. Auxiliary features, including the presence of deciduous teeth and sex, were also evaluated for their impact on model performance. Results For the first stage, the tooth detection model achieved an F1-score of 0.981, demonstrating accurate tooth localization and identification. In the later stage, the best-performing model, DenseNet-121 with the deciduous teeth feature, achieved a mean absolute error (MAE) of 1.05 ± 0.95 years. Compared to traditional methods, the proposed framework significantly reduced the MAE. Conclusion This study developed an explainable, high-performing deep learning framework offers a promising solution for real-world age estimation in the forensic domain.