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Purpose: The purpose of present study was to develop a method for assessing the chronological age of Korean adults based on the relationship between age and size of pulp cavity using dental radiographs of mandibular first molars. Methods: A total of 325 dental radiographs of Korean adults with known age and gender were selected for the study (199 males and 126 females) which were taken in the period between January 2009 and June 2014 at the Pusan National University Dental Hospital. The measurements were carried out on both orthopantomographs (OPGs) and intraoral periapical radiographs of mandibular first molar and the following ratios were calculated: pulp chamber floor height ratio (F/L), pulp chamber ceiling height ratio (R/L), and pulp chamber depth ratio (D/L). Results: The ratios of measurements on intraoral periapical images of mandible first molar generally produce more reliable data than the measurements on OPGs. The pulp chamber floor height ratio and pulp chamber thickness ratio showed significant correlation with age, whereas the pulp chamber ceiling height ratios showed weak correlation with age. It was found that the best correlations between the ratios and age were found for pulp chamber thickness ratios (r=-0.731 to -0.751). The multiple regression models were derived using 3 ratios that were significantly correlated with age. The determination coefficients ( $R^2$ ) of the models ranged from 0.556 to 0.596. Conclusions: Our results indicate that the pulp chamber thickness and pulp chamber floor height in mandibular first molar are an age-dependent variable in adults which can be used to estimate age with reasonable accuracy. The higher image quality of dental radiographs will probably narrow the age estimation error and improve dental age estimation.
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