Forensic Dental Age Estimation in Turkish Children Using Panoramic Radiographs: Systematic Review

Dental age estimation is an essential element of forensic investigations when documentary age evidence is missing, incomplete, or unreliable. This systematic review synthesises research on dental age estimation in Turkish children using panoramic radiographs, following PRISMA methodology. Six electronic databases were searched for studies published between January 2010-August 2025. Thirty retrospective studies met inclusion criteria, comprising participants aged 2.2-18 years with sample sizes of 150-1,878. Commonly applied techniques were Willems, Cameriere, Nolla, and Demirjian, alongside regional adaptations including Cameriere, Blenkin-Evans, Bedek, Haavikko, and the London Atlas. Reported accuracy varied by geographic region, sex, and age group. Willems and Cameriere-based approaches frequently achieved closer estimates to chronological age, yet no single method consistently outperformed others across all Turkish subpopulations. Considerable methodological heterogeneity and regional variation underscore the need for population-specific calibration and well-designed, prospective multicentre validation studies. From a forensic standpoint, selecting a validated, population-appropriate method is critical for legal decisions involving age thresholds such as criminal responsibility and immigration status. Combining complementary methods may reduce systematic bias but increases procedural complexity and resource demands. This review provides the first comprehensive synthesis of panoramic radiograph-based forensic dental age estimation in Turkish children, identifies gaps in geographic coverage and study design, and recommends targeted research to develop standardized, population-specific protocols that enhance accuracy, applicability, and judicial defensibility of age assessments. Such consensus-driven standards would also aid training, accreditation, inter-laboratory comparison, and the translation of research into forensic casework and policy.