Many methods exist to estimate age using a variety of body systems, however, teeth are considered to be the most accurate biological indicators of chronological age. This Indian Standard which is identical to ISO 5365 : 2024 ‘Dentistry- Designation system for tooth developmental stages’ issued by the International Organization for Standardization (ISO) was adopted by the Bureau of Indian Standards (BIS) on the reference of the Dentistry Sectional Committee and after approval of the Medical Equipment and Hospital Planning Division Council. This standard offers a standardized system of dental development, stages, terminology and coding, thereby ensuring consistency and accuracy in clinical practice.

Overview of IS 18967:2024

IS 18967:2024, also known as ISO 5365:2024, forms a standardized method of classifying dental developmental stages, promoting global reliability and improving the accuracy of dental age estimation. It presents a clear system of naming and coding the distinct stages of tooth development. The main objective of this standard is to build a cohesive system that eliminates uncertainty in tooth developing assessments. In clinical trial, an accurate predictions are essential in clinical practice, especially in paediatric dentistry, orthodontics and forensic dentistry. The standard offers a simple letter-number code for each developing stage, facilitating data entry, communication and interoperability between diverse dental systems. Determining the different stages of tooth development, including crown, root and crown, allows standard practitioners to systematically assess tooth development.

In addition, the standard also addresses irregularities rising from the several existing numerical systems. With this fresh system, the physician can constantly detect the degree of dental development and use these assessments to more accurately estimate the patient's chronological age.

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Scope of IS 18967:2024

This document specifies a method for designating the coding and nomenclature for tooth developmental stages. It uses a single letter and number to facilitate data entry and enhance interoperability. The first letter in the code represents the part of the tooth (crown, root, or apex), while the number signifies the stage of development of that tooth part.

This standard applies globally to all human teeth, including the teeth's development, crown, root and apex stages. It actually provides a uniform framework for coding the developmental stages of teeth, this ensures that individual methods used in clinical and research settings produce consistent results. This system improves the accuracy of dental age estimations, mainly in forensic investigations, and improves communication among specialists in the field.

Terminology and Definitions

The IS 18967:2024 uses clear descriptions to standardize the understanding of several tooth developmental stages. The terms and definitions defined in the standard are adopted from ISO 1942 and ISO 20888, along with added specific terms required for the appropriate classification of the developmental stages of the tooth. The following terms outlines the several stages of development for different parts of the tooth:

Crown Developmental Stages:

• C0: No appearance of the crown is observed.
• C1: Tooth bud present with no evidence of mineralization is observed.
• C2: Enamel development begins and the developed enamel present is minute.
• C3: Incisal edge visible, with mesial and distal angles can be seen.
• C4: Enamel layer is thick, continuous, but dentin formation is not visible in the radiograph.
• C5: A thin band of dentine visible in radiograph, but the pulp is absent.
• C6: Thick dentine visible, pulp chamber evident, but pulp roof outline is undefined.
• C7: Crown outline complete, pulp roof well-defined, and cervical edges are thin and convergent.

Root Developmental Stages:

• R1: Initial root formation, with divergent spicules extending from the cervical edges.
• R2: Development of root equal up to about half the crown height, with divergent edges.
• R3: Root reaches full crown height, edges remain divergent.
• R4: Root surpasses crown height, and the root edges continue to diverge.
• R5: Complete root development, with parallel root edges.

Apex Developmental Stages:

• A1: The root is complete, but the apex is wide, with an apical periodontal ligament space.
• A2: The apex is more defined with a uniform periodontal ligament space around the root.

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Benefits of IS 18967:2024

There are several benefits of IS 18967: 2024 This exercise has several benefits that contribute to overall well-being, some of its benefits are mentioned below:

• Consistency in clinical practice: IS 18967:2024 introduces a much required standardization in the methods of describing and interpreting stages of tooth development across the world. However, many systems exist, and dentists may use different scoring methods, which can lead to inconsistency. By using this standardized system, the practitioner can ensure that the stages of tooth development are reported consistently, minimizing the possibility for any confusion or error.
• Enhanced Objectivity: An important advantage of this system is that it provides greater objectivity to the assessment process. Clear and standardized terminology, along with relevant diagrams, eliminates individual interpretation, permitting dental professionals to make more precise assessments. This is mainly helpful in forensic contexts, where correct forward prediction can play an important role in legal cases.
• Facilitates Research and Data Sharing: Standardized terminology and coding increases correctness and reliability in research studies and forensic investigations. The researchers use a common language and code to discuss the stages of tooth development, confirming that the findings could be imitated and valid comparisons could be made across studies. In addition, it benefits in sharing dental information globally, as dental specialists in several countries might use the similar system. 
• Improved Dental Education: It helps in facilitating education, dental students and practitioners can get a reliable learning and can be trained more efficiently in tooth developmental stages. It makes sure that all specialists are synced in their understanding related to tooth development, aiming in better clinical decision making and diagnosis. 
• Better Accuracy in Age Assessment: By eliminating uncertainty in the assignment of developmental stages, IS 18967:2024 increases the accuracy of dental age estimation. This is especially significant in forensic dentistry, where it plays an important role in classifying teeth development or estimating the age of an unknown tooth.

Structure of the Code

The standard coding of stages of tooth development actually uses a letter-number system. The letter represents the tooth or its part (C is for Crown, R is for Root and A is for Apex), while the number represents the stage of development of that particular part.

This coding system is intended for human readability and easy use, confirming that the information is reachable and comprehensible through numerous dental practices and methods. For example:

• C3: Refers to the crown at stage 3, where the incisal edge with mesial and distal angles is visible.
• R2: Refers to the root at stage 2, where the root is developed to half the height of the crown.
• A1: Refers to the apex at stage 1, where the root edges are convergent and the apical periodontal ligament space is wide.

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Conclusion

IS 18967:2024 (ISO 5365:2024) plays a critical role in the standardization of tooth developmental stages. By establishing a truly integrated system of coding and nomenclature, this increases the constancy, objectivity, and accuracy of dental age estimation. This consistent approach is particularly valuable for clinical, forensic and research purposes where accurate age estimation is required.

The clear definitions, systematic coding and standardized terminology given by IS 18967:2024 guarantee that dentists across the world can precisely assess and report the developmental stages of teeth. This will eventually lead to improved decision-making in clinical practices, and enhance the accuracy in forensic investigations, and the global organization of dental assessments. The general idea of these standards is an important step toward in the field of dentistry, mainly in the context of age estimation and the use of development as trustworthy indicators of consecutive age. By following to this inclusive framework, dental professionals can confirm the continued precision and reliability of their work in tooth development assessments.