Nolla staging methods and main findings for estimation of patients dental age radiographically

1. NOLLA STAGING
DR. MUHAMMAD SHARIQ SOHAIL
PGR ORTHODONTICS
FATIMA MEMORIAL HOSPITAL

2. INTRODUCTION
Different skeletal and dental method s are available for age assessment of the child
Different dental age assessment methods are described by Nolla, Demirjian and Willeem where tooth
formation at different age was assessed. Calcification(maturation) of the tooth at different age i.e the
tooth formation is more accurate way to determine dental age
The tooth with developmental stages provides us with a relatively less invasive technique to assess
the age of the child. Dental age helps to Orthodontist and pediatric dentist to plan the treatment.
Abnormality in calcification stages helps to diagnose the deviation in growth pattern.
Different dental age estimation methods by radiographic evaluation of development and calcification of
tooth buds are schour and Masseler method(1941), Nolla’s method(1960), Mooree’s method(1963),
Dermijian’s method (1973). Nolla is most popular gold standard method use for estimation of dental
age.

3. ERUPTION SEQUENCE
The predominant sequence of emergence of primary teeth is as follows:
• Central Incisor
• Lateral Incisor
• First Molar
• Canine
• Second Molar

4. ERUPTION SEQUENCE
The predominant sequence of emergence of permanent teeth is as follows:
MAXILLA:
1st Molar, Central incisor, Lateral incisor, 1st premolar, 2nd Premolar, Canine, 2nd Molar, 3rd
Molar.
MANDIBLE:
1st Molar, Central incisor, Lateral Incisor, Canine, 1st Premolar, 2nd Premolar, 2nd Molar, 3rd
Molar

6. DENTAL AGE
Different stages of eruption of teeth are used to determine the dental age.
Determined from 3 characterstics:
a)The teeth that have erupted
b)Amount of resorption of roots of primary teeth
c)Amount of development of permanent teeth

7. DENTAL AGE
DENTAL AGE 6:
The most common sequence of eruption is the mandibular central incisor, closely
followed by the mandibular first permanent molar and the maxillary first permanenet
molar.
Dental age 6 is characterized by the near simultaneous eruption of the mandibular
central incisors, the mandibular first molars and maxillary first molars.

8. DENTAL AGE
DENTAL AGE 7:
The maxillary centrals and mandibular lateral incisors erupt .
Root formation of max lateral incisor well advanced, but still 1 year to eruption
canines and premolars are in the stages of crown completion or beginning of root
formation

9. DENTAL AGE
DENTAL AGE 8:
Is characted by Eruption of Maxillary lateral incisors
following this there is a delay of 2-3 years before any further teeth erupt.

10. DENTAL AGE
DENTAL AGE 9:
No teeth erupt
Primary canines, first molars and second molars are present
MANDIBLE:
One third of the roots of each Mand. Canine and and mand first premolar is complete
root development is just beginning(if stated) on the mand. Second premolar
MAXILLA:
Root development begun on the first premolar
just beginning(if started) on the canine and second premolar

11. DENTAL AGE
DENTAL AGE 10:
Further resorption of roots of primary canines and molars
half of the root of each mand canines and first premolar completed
half of the root of max first premolar completed
significant root development of:
mand second premolar
max canine
max second premolar
also completion of the roots of all mandibular incisors and near completion of roots of
max lateral incisors

12. DENTAL AGE
DENTAL AGE 11:
Roots of all incisors and first molar complete
Characterized by Eruption of:
mandibular canines
mand first premolar
max first premolars
*The only remaining primary teeth are the maxillary canine and second molar and the
mandibular second molar.

13. DENTAL AGE
DENTAL AGE 12:
The remaining succedanoeous teeth erupt
second permanent molars are nearing eruption
possible to note the early beginnings of the third molars by this stage.

14. DENTAL AGE
DENTAL AGE 13 14 15:
Characterized by extent of root completion of the permanent teeth
By dental age 15, if a third molar is going to form it should be apparent on the radiograph.

15. VARIATIONS
Important variations include:
Eruption of second molars ahead of premolars in the mandibular arch lack of space
Eruption of canines ahead of premolars in the maxillary arch (labially erupted canines)
Asymmetries in eruption between the right & left sides (investigate after a delay of

16. SIGNIFICANCE
Time of start of eruptive movement of tooth is at nolla 6 when 1/3rd root
formed
Time of emergence of tooth in oral cavity is at nolla 8 when 3/4rth root
is formed

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