Accuracy and Reliability of Dental Age Estimation Methods in Iranian Children: A Systematic Review and Meta‐Analysis

OBJECTIVES: This study is aimed at systematically evaluating the accuracy and reliability of dental age (DA) estimation methods and conducting a meta-analysis of studies on different DA estimation methods in Iranian children. METHODS: A systematic search of English and Persian literature from database inception to March 2024 was conducted across international and national databases to identify eligible studies on DA estimation using radiographs in Iranian children. Studies that used dental radiographs from healthy individuals aged 3-18 years and reported the mean difference (MD) between DA and chronological age (CA) were included. The meta-analysis calculated the MD between dental and chronological age, with 95% confidence intervals (CIs), to assess the applicability of the DA method for estimating CA in the Iranian population. RESULTS: Twenty-seven eligible published articles were included in this study. Demirjian's method overestimated age (overall MD: males: +0.784 years; females: +0.323 years). Among the alternative methods studied in the systematic review, Moorrees and Nolla's methods tended to underestimate age, whereas Cameriere, Smith, and London Atlas'methods tended to overestimate age. CONCLUSION: Most methods studied consistently overestimated age and should be used cautiously in forensic age estimation, underscoring the importance of tailoring methods such as the Demarjian method for the Iranian population to ensure accuracy and relevance in professional practice. Additional studies employing similar methodologies and focusing on the customization of dental age estimation methods are recommended to improve accuracy and applicability across diverse populations.