Assessing the impact of structured teaching on dental age estimation using the Demirjian staging system among undergraduate dental students

Abstract

Background: Training in dental age estimation (DAE) is inconsistent in undergraduate dental curricula. This study aimed to assess the impact of a structured teaching intervention on the inter-rater agreement and accuracy of undergraduate students using the Demirjian staging method.

Material and Methods: Eighteen dental students with no prior training in forensic odontology assessed seven panoramic radiographs using Demirjian’s method during a pre-teaching session. This was followed by a 90-minute lecture led by a qualified forensic odontologist, which included a presentation, interactive discussion, and practical demonstration of the Demirjian staging system. The same radiographs were re-evaluated by the students two weeks later. Inter-observer agreement was assessed using Fleiss’ Kappa, while accuracy was determined by comparing the students' staging results to those of the primary observer.

Results: Initial inter-observer agreement was moderate (κ = 0.45), increasing to substantial agreement (κ = 0.76) after the teaching session. Overall, accuracy improved from 46% to 73% post-teaching. The highest improvement was seen in the incisors, which improved from 48% to 92%.

Conclusion: A brief, structured teaching session substantially improved dental students' reliability and accuracy in DAE. Integrating targeted forensic odontology education into the undergraduate dental curriculum is essential, as even brief instructional interventions can yield notable improvements in both staging consistency and accuracy.

KEYWORDS: Dental age estimation, Dental education, Forensic Odontology, Demirjian Method