Dental Age Advancement Among Children with Juvenile Diabetes Mellitus Using the Demirjian Method

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Abstract

Background: Chronological age does not always accurately reflect biological matura-tion in children, particularly in the presence of systemic diseases. Dental age assess-ment is widely used as a biological maturity indicator; however, the effect of juvenile diabetes mellitus on dental maturation remains insufficiently clarified, with incon-sistent findings reported across populations. Objective: This study aimed to compare dental age estimated using the Demirjian method with chronological age in children with juvenile diabetes and in age- and sex-matched healthy controls. Materials and Methods: This observational comparative study included panoramic radiographs from 30 children aged 8–15 years: 15 patients diagnosed with juvenile diabetes mellitus and 15 systemically healthy controls, all presenting Angle Class I malocclusion. Dental age was assessed using the Demirjian method and compared with chronological age. Ap-propriate parametric or non-parametric statistical tests were applied based on data distribution. Results: Children with juvenile diabetes exhibited a statistically signifi-cant advancement in dental age relative to chronological age, with a mean DA–CA difference of 1.36 years (p = 0.0066). No statistically significant differences between dental and chronological age were observed in the control group. Sexual dimorphism was evident from crown completion stages onward, with females demonstrating earli-er dental maturation. Conclusions: Juvenile diabetes mellitus is associated with accel-erated dental maturation. These findings have clinical implications for orthodontic treatment timing and growth assessment and indicate a potential risk of age overesti-mation in forensic contexts. Dental age should therefore be interpreted alongside skel-etal and chronological indicators, particularly in pediatric patients with systemic metabolic conditions.

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