Background Accurate dental age estimation is essential in forensic anthropology, particularly for victim identification in mass disasters, assessment of unidentified remains, and age determination in living individuals lacking proper documentation. Nolla and Haavikko methods are widely employed techniques based on tooth development stages, yet their applicability varies across populations, and their direct application without local validation may introduce systematic bias. Therefore, this study aimed to evaluate the accuracy and applicability of Nolla and Haavikko methods for dental age estimation in Egyptian children from dental radiographs and to determine which technique is more suitable for use in this population. Panoramic radiographs from 218 Egyptian children aged 6–16 years (106 males, 112 females) were analyzed. Nolla method was applied to all 218 radiographs, whereas Haavikko method was applied to 169 children aged 6–14 years, consistent with the original developmental parameters of each method. Paired t-tests and Spearman correlation were used to compare dental and chronological ages across sex and age groups. Results Both methods demonstrated strong positive correlations between chronological and dental ages. Nolla method (n = 218, ages 6–16) showed excellent overall agreement with negligible mean difference (0.03 years, p = 0.713) and non-significant differences in both males (-0.10 years, p = 0.275) and females (0.15 years, p = 0.187). In contrast, Haavikko method (n = 169, ages 6–14 years) significantly underestimated chronological age in the total sample (-0.49 years, p < 0.001), with greater bias in females (-0.58 years, p < 0.001) than males (-0.41 years, p < 0.001). At the ± 1.00-year tolerance threshold, Nolla method demonstrated superior accuracy (80.7%) compared to Haavikko method (72.8%), with the most pronounced difference observed in females (75.0% vs. 60.2%). Conclusions Nolla method is more suitable than Haavikko method for forensic age estimation in Egyptian children due to its higher accuracy and minimal bias. Meanwhile, Haavikko method, despite its tendency to underestimate chronological age especially in females, can still provide meaningful age estimates when population-specific adjustments are applied.

Validation and applicability of Nolla and Haavikko methods for dental age estimation in Egyptian children

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2026年7月21日

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Mohamed Nagah,
Sara Madian,
Marwa Ismail Haiba

摘要

Background

Accurate dental age estimation is essential in forensic anthropology, particularly for victim identification in mass disasters, assessment of unidentified remains, and age determination in living individuals lacking proper documentation. Nolla and Haavikko methods are widely employed techniques based on tooth development stages, yet their applicability varies across populations, and their direct application without local validation may introduce systematic bias. Therefore, this study aimed to evaluate the accuracy and applicability of Nolla and Haavikko methods for dental age estimation in Egyptian children from dental radiographs and to determine which technique is more suitable for use in this population. Panoramic radiographs from 218 Egyptian children aged 6–16 years (106 males, 112 females) were analyzed. Nolla method was applied to all 218 radiographs, whereas Haavikko method was applied to 169 children aged 6–14 years, consistent with the original developmental parameters of each method. Paired t-tests and Spearman correlation were used to compare dental and chronological ages across sex and age groups.

Results

Both methods demonstrated strong positive correlations between chronological and dental ages. Nolla method (n = 218, ages 6–16) showed excellent overall agreement with negligible mean difference (0.03 years, p = 0.713) and non-significant differences in both males (-0.10 years, p = 0.275) and females (0.15 years, p = 0.187). In contrast, Haavikko method (n = 169, ages 6–14 years) significantly underestimated chronological age in the total sample (-0.49 years, p < 0.001), with greater bias in females (-0.58 years, p < 0.001) than males (-0.41 years, p < 0.001). At the ± 1.00-year tolerance threshold, Nolla method demonstrated superior accuracy (80.7%) compared to Haavikko method (72.8%), with the most pronounced difference observed in females (75.0% vs. 60.2%).

Conclusions

Nolla method is more suitable than Haavikko method for forensic age estimation in Egyptian children due to its higher accuracy and minimal bias. Meanwhile, Haavikko method, despite its tendency to underestimate chronological age especially in females, can still provide meaningful age estimates when population-specific adjustments are applied.