Abstract
Automatic age estimation has garnered significant interest among researchers because of its potential practical uses. The current systematic review was undertaken to critically appraise developments and performance of AI models designed for automated estimation using dento-maxillofacial radiographic images. In order to ensure consistency in their approach, the researchers followed the diagnostic test accuracy guidelines outlined in PRISMA-DTA for this systematic review. They conducted an electronic search across various databases such as PubMed, Scopus, Embase, Cochrane, Web of Science, Google Scholar, and the Saudi Digital Library to identify relevant articles published between the years 2000 and 2024. A total of 26 articles that satisfied the inclusion criteria were subjected to a risk of bias assessment using QUADAS-2, which revealed a flawless risk of bias in both arms for the patient-selection domain. Additionally, the certainty of evidence was evaluated using the GRADE approach. AI technology has primarily been utilized for automated age estimation through tooth development stages, tooth and bone parameters, bone age measurements, and pulp-tooth ratio. The AI models employed in the studies achieved a remarkably high precision of 99.05% and accuracy of 99.98% in the age estimation for models using tooth development stages and bone age measurements, respectively. The application of AI as an additional diagnostic tool within the realm of age estimation demonstrates significant promise.