Validation of the London Atlas for Dental Age Estimation in an Indian Paediatric Population: A Pilot Study

Abstract

Background: Dental age estimation is important for treatment planning and medico-legal identification in paediatric dentistry, orthodontics, and forensic odontology. The London Atlas of Human Tooth Development and Eruption is a popular non-invasive method, but its accuracy may vary between populations, and data from Indian children remain limited. This pilot study assessed the accuracy and applicability of the London Atlas in Indian children.
Materials and Methods: A retrospective, cross-sectional analysis was performed on 50 anonymised digital orthopantomograms (25 males, 25 females; aged 3–14 years) from departmental archives. Chronological age (CA) was blinded by coding before assessment. A single calibrated, blinded examiner estimated dental age (DA) using the London Atlas online tool. DA was compared with CA using paired t-tests and Pearson’s correlation; significance was set at p < 0.05.
Results: Mean CA was 8.92 ± 2.51 years and mean DA 8.74 ± 2.58 years, a non-significant underestimation of −0.18 ± 1.39 years (p = 0.365). A strong, significant positive correlation was observed (r = 0.851, p < 0.001). Neither sex showed a significant CA–DA difference (females p = 0.849; males p = 0.233). On age-group analysis, the atlas overestimated age in the youngest children (3–6 years, p = 0.038) but agreed closely in older groups.
Conclusion: The London Atlas demonstrated good accuracy and strong correlation with chronological age in this Indian paediatric sample, with no significant systematic bias or sexual dimorphism. As a pilot study, these findings warrant validation in larger, multicentric cohorts.