Abstract
Dental age estimation in the living and deceased is a fundamental aspect of forensic
sciences, civil cases, medico-legal proceedings and clinical dentistry. Accordingly, this study aimed
to validate the accuracy and reproducibility of the London Atlas in a select South African sample
of KwaZulu-Natal. In this cross-sectional study, 760 digital panoramic radiographs (n = 760) aged
between 5.00 and 23.99 years were retrospectively reviewed through consecutive sampling. Each
radiograph was assessed and assigned a dental age in accordance with the London Atlas of Human
Tooth Development and Eruption by AlQahtani et al. (2010). The London Atlas overestimated age
with a mean difference of 0.85 to 1.26 years in the selected South African sample of KwaZulu-
Natal. A statistically significant difference between the chronological and estimated dental ages
was recorded. Furthermore, the South African Black and Indian males had a higher overestimation
of age than their female counterparts, with a mean difference of 0.13 and 0.07 years, respectively.
This overestimation was less in the South African Indian population in comparison to the SA Black
population. This outcome resulted in the creation of the KZN population- and sex-specific charts
and atlases for the two selected cohorts of KwaZulu-Natal. The KZN Atlases were found to be
more accurate in the selected sample, with a mean absolute error of 0.57 years and no statistically
significant differences between the chronological and estimated dental ages