martes, 19 de agosto de 2025

Nolla Stages: Clinical Guide and Comparative Table

Nolla Stages

Dental age estimation is a key process in pediatric dentistry, orthodontics, and forensic sciences. The Nolla method (1960) established 11 stages of dental maturation, from the absence of calcification to the complete eruption of the tooth in the arch.

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Its clinical value remains relevant due to its simplicity, reliability, and applicability across populations.

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Nolla stages: clinical description

Clinical application in dentistry

➤ Pediatric dentistry
° Evaluates dental maturation to determine the right timing for interceptive treatments.
° Useful in diagnosing delayed or advanced eruption.
➤ Orthodontics
° Guides treatment planning during mixed dentition.
° Helps determine the timing for serial extractions or appliance placement.
➤ Forensic sciences
° Standard tool for estimating chronological age in children and adolescents.

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Comparison with other methods

💬 Discussion
The Nolla method remains one of the most reliable systems in daily clinical practice. Its main strength is the ease of radiographic application, making it a cost-effective and relatively accurate diagnostic tool. However, recent studies indicate variability in accuracy depending on the population being assessed (Cadenas de Llano-Pérula et al., 2020).
Compared to Demirjian, Nolla offers more stages but less validation in multicenter research. In Latin America and the U.S., it continues to be widely used in preventive orthodontics and forensic applications.

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✍️ Conclusion
The Nolla system is a fundamental clinical guide for assessing dental development in children and adolescents. Its usefulness in pediatric dentistry, orthodontics, and forensic sciences keeps it relevant, though combining it with other methods is recommended for higher diagnostic accuracy across populations.

📚 References

✔ Cadenas de Llano-Pérula, M., Alonso-Ezpeleta, O., & Vicente, A. (2020). Dental age estimation using Nolla’s and Demirjian’s methods: A comparative study in a Spanish population. Forensic Science International, 310(110261). https://doi.org/10.1016/j.forsciint.2020.110261
✔ Nolla, C. M. (1960). The development of permanent teeth. Journal of Dentistry for Children, 27(4), 254–266.
✔ Willems, G., Oliveira-Santos, C., Froneman, M., & Thevissen, P. W. (2018). Dental age estimation in children: A widely used method revisited. Forensic Science International, 292, 124–128. https://doi.org/10.1016/j.forsciint.2018.09.002

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