Dental age estimation by cementum incremental lines counting: A systematic review and meta-analysis

The estimation of dental age by cementum incremental lines (CIL) is a widely investigated method; how-ever, its reliability remains uncertain. The aim of this article was to assess whether CIL are a reliable bio-logical indicator for estimating dental age. A search was performed in Embase, LILACS, PubMed/MEDLINE, SciELO, Scopus and Web of Science databases using a combination of terms related to the topic. Two in-dependent reviewers used inclusion and exclusion criteria so that relevant articles were selected and evaluated. For the risk of bias analysis, a checklist from The Joanna Briggs Institute was applied. For the meta-analysis, Pearson's Correlation Coefficient between chronological age and estimated age was con-sidered as an effect measure. The heterogeneity of studies was assessed using the Cochran's Q statistical test (p < 0.05), and the publication bias using the asymmetry of the Funnel plot and Egger's linear regression test (p < 0.05). Most selected articles had low risk of bias. Although not all studies were included in the meta-analysis, it demonstrated the presence of high heterogeneity among them. Despite this, the synthe-sized result indicated that the age estimated by CIL count has a high correlation with chronological age. Furthermore, the graphical analysis suggested the absence of publication bias, which was confirmed by the Egger's linear regression test. Therefore, there is scientific evidence that CIL are reliable in estimating dental age, but the method requires a standardized protocol to be followed, as well as the rigorous choice of the root area to be analyzed.(c) 2022 Elsevier B.V. All rights reserved.

Automated summary

The estimation of dental age using cementum incremental lines (CIL) is a widely studied method, but its reliability is still uncertain. This article conducted a literature review and meta-analysis to assess the reliability of CIL as a biological indicator for estimating dental age. The results showed that there is scientific evidence supporting the high correlation between age estimated by CIL count and chronological age, and no publication bias was found. Therefore, CIL can be considered as a reliable method for estimating dental age, but a standardized protocol and rigorous selection of the root area for analysis are necessary.