Accuracy of the London atlas, Willems, and Nolla methods for dental age estimation: a cross-sectional study on Eastern Turkish children



This study aimed to estimate the dental age (DA) using the London Atlas, Willems, and Nolla methods and to compare their accuracies.


The DA was estimated using the aforementioned methods on panoramic radiograms of a total of 919 Eastern Turkish patients aged 6–14 years, of whom 459 were female and 460 were male. The overestimation and underestimation values were determined in relation to the chronological age (CA) values. The paired t test was used to compare the mean DA and CA values. Multiple regression analysis was used to derive gender-specific formulations for the three methods.


The most accurate method for estimating the DA was the Willems method (mean prediction error 0.80), followed by the London Atlas (mean prediction error 0.83) and Nolla (mean prediction error 0.89) methods. Statistically significant differences were found only between the Willems and Nolla methods.


All three methods can be used for DA estimations of Eastern Turkish children.

Clinical relevance

Willems was the most suitable method for this patient sample. However, the London Atlas method may be preferred due to its practicability and comparable accuracy.

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We thank Dr. Cumali Uri, Dr. Sıddık Keskin, Dr. Naci Murat, and Dr. Tamer Tüzüner for the comments and technical assistance in the statistical analysis.

Author information




All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Alaettin Koç, and Ayşe Gül Öner Talmaç. The first draft of the manuscript was written by Alaettin Koç and Esin Özlek, and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alaettin Koç.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Medical University of A (approval number: 2019/02/01-02).

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Informed consent was not needed due to the retrospective design of the study.

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Koç, A., Özlek, E. & Öner Talmaç, A.G. Accuracy of the London atlas, Willems, and Nolla methods for dental age estimation: a cross-sectional study on Eastern Turkish children. Clin Oral Invest (2021).

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  • Forensic dentistry
  • Panoramic radiography
  • Legal medicine
  • Dentistry
  • Quantitative evaluation
  • Forensic sciences