Background: Age estimation in adults is important in forensic odontology, and radiographic approaches such as the Tooth Coronal Index (TCI) and Kvaal's method are commonly applied to panoramic radiographs. This study aimed to compare the agreement of TCI and Kvaal age estimates with chronological age in adults. Methods: This cross-sectional analytic study evaluated 100 panoramic radiographs (50 males, 50 females) of adults aged 23–45 years. Measurements were performed on mandibular first premolars using ImageJ. Accuracy was operationalized as the closeness of the estimated age to the chronological age and assessed using mean differences and Wilcoxon signed-rank tests. Results: TCI differed significantly from chronological age (p = 0.001) and showed a mean difference of −2.64 years, indicating underestimation. Kvaal's method showed no significant difference (p = 0.503) and a mean difference of 0.18 years. In males, Kvaal underestimated age by 0.72 years, whereas in females, it overestimated age by 1.09 years. Conclusions: Within this study sample, Kvaal's method showed closer agreement with chronological age than TCI on panoramic radiographs and may be more useful for adult age estimation in similar forensic settings.
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