New equations for age estimation using four permanent mandibular teeth in Thai children and adolescents

International Journal of Legal Medicine - The purposes of this study were to generate new age estimation equations using two four-teeth methods and to test the accuracy of the resulting equations...     

Chronological age estimation based on third molar development in a Portuguese population

Third molar development was assessed using a sample of 1,131 orthopantomograms from a Portuguese population. The methodology applied was the eight stages (A–H) method described by Demirjian et al. The final sample was made of 739 orthopantomograms, 387 (52.5%) of which belonging to females; age ranged between 6.1 and 22.5 years old (mean age = 14.49, S.D. = 4.37). For each developmental stage, mean age, standard deviation, and minimal and maximal age was assessed; evaluation of the rate formation of each tooth, according to sex, was calculated and data distribution expressed in percentiles for each stage; the probability of an individual being 16 was also evaluated. The relationship between tooth development and chronological age had a statistical significance for all teeth and both sexes (p < 0.0001). The data described may provide reference for forensic application and agree with the thesis that each population need specific data.     

Dental age estimation in Somali children and sub-adults combining permanent teeth and third molar development

Estimation of an individual’s age has important applications in forensics. In young individuals, it often relies on separate evaluations of permanent teeth (PT) and third molars (TM) development. Here, we analysed the age prediction performance of combined information from PT and TM in an unusual sample of healthy Somalis, born and living in Finland. PT development was staged according to Demirjian et al. (Hum Biol, 1973) and TM development according to Köhler et al. (Ann Anat, 1994), using panoramic radiographs from 803 subjects (397 males, 406 females) aged 3–23 years. A sex-specific Bayesian age-estimation model for the multivariate distribution of the stages conditional on age was fitted on PT, TM and PT and TM combined. The age-estimation performances were validated and quantified. The approach combining PT and TM only overestimated age with an ME of − 0.031 years in males and − 0.011 years in females, indicating the best age prediction performance.

     

The chronological age estimation of third molar mineralization of Han population in southwestern China

The purpose of the study was to estimate the chronology of third molar mineralization in Han population of southwestern China and find its unique characteristics so that it would provide a reference in several legal cases like forensic age estimation. The study used Demirjian's staging method to study 2192 orthopantomograms of 984 male and 1208 female subjects aged between 8 and 25 years. The statistical data was analyzed by Student's t test and ANOVA.The conclusions of the study are: (1) The chronological mineralization age of third molars of Han population in Southwestern China is similar to the Turkish and the Japanese, was earlier than the Austrian and Han of South China, but later than the Spanish. (2) The mineralization timing of the third molars between two sides in maxilla or mandible has no significant differences in the same gender group. (3) There is no significant difference in mineralization of third molars between male and female, except for tooth 48 in Demirjian's stage E. (4) The mineralization of third molar in maxilla is earlier than mandible.     

New model for dental age estimation: Willems method applied on fewer than seven mandibular teeth

International Journal of Legal Medicine - Willems method measures the developmental stages of the seven left permanent mandibular teeth and is frequently used for dental age estimation. The aim of...     

Chronological age estimation of third molar mineralization of Han in southern China

In order to study the chronology of age of third molar mineralization of Han in southern China, Demirjian staging method was used to determine the stage of four third molars (18, 28, 38, 48) mineralization in 3,100 Han in southern China aged 4.1–26.9 years based on radiological evidence from digital orthopantomograms. The mean age of the 3,100 patients was 15.96 ± 4.73 years, including 1,200 male (mean age, 15.32 ± 4.62) and 1,900 female (mean age, 16.35 ± 4.76). Results show that there was no significant difference in mineralization between 18 and 28 and 38 and 48 of male or female. However, significant difference was observed between 28 and 38 of female at stage C; 28 was 0.25 years earlier than 38. In male, at stage G, 38 was 0.61 years earlier than 28, and 48 was 0.62 years earlier than 18. At stages D, E, F, G, and H, male 48 was 0.34, 0.66, 0.72, 1.34, and 0.76 years earlier than that of female, respectively. At stages A, D, E, F, G, and H, male 38 was 0.73, 0.26, 0.56, 0.91, 1.29, and 0.70 years earlier than that of female, respectively. At stages B, E, F, G, and H, the mineralization mean age of male 18 was 0.54, 0.50, 0.76, 0.92, and 0.58 years earlier than that of female, respectively. At stages E, F, G, and H, the mineralization mean age of male 28 was 0.51, 0.76, 0.92, and 0.49 years earlier than that of female, respectively. After reviewing the literature, the chronological mineralization age of 48, at stages D to G, of Han in southern China was 1 to 4.6 years earlier than that of Japanese and 1 to 3 years earlier than that of German. The mean age at stage H of 48 of Han in southern China was similar to Turkish, Black African, Japanese, and German, but was later than Spanish. Finally, the conclusions are: (1) in the same gender group of Han in southern China, the mineralization ages between two sides in upper or lower jaw are very similar, and (2) the chronology mean age and complete time of third molar mineralization of male were earlier than that of female.     

Forensic age estimation using the eruption of the second permanent mandibular molar: determining age over 14 years-old

Little is known about the role of the second molar eruption in forensic age estimation; however, in countries where the legal age is 14-years-old, it can provide important information. This study aims to analyse whether the eruption stages of the second mandibular molar can be used for forensic age estimation purposes. The eruption stage of the second left mandibular molar was assessed and correlation between age and stage of eruption was evaluated using Spearman rank order correlation. A Chi-square test was used to assess the correlation between age equal or superior to 14 and stage C or D attainment. The level of significance was defined as p<0.05. Stage C and D attainment and age 14 were significantly related in both sexes (p<0.001). Still, stage 3 was attained by 37% and 44.4% of the males and females younger than 14 years, respectively; stage 4 was attained by 14.8% and 25.6% of the males and females younger than 14 years, respectively. Second molar emergence, particularly stage D, can be used as a dental age indicator. When stage D is attained, particularly in males, there is strong suggestion of age over 14 years. However, other markers should also be used.     

Evaluation of chronological age based on third molar development in the Spanish population

A cross-sectional study was carried out to assess chronological age estimation based on the stages of third lower molar development, following the eight stages (A–H) method of Demirjian et al. The final sample consisted of 1,054 orthopantomograms from Spanish individuals of known chronological age (range 14–21 years) and gender (462 males and 592 females). Results showed a stronger correlation for males (r²=0.54) than for females (r²=0.45). Root formation occurred earlier in males than females, in stages 5, 6 and 7. The mean difference between chronological and estimated age was –0.10 years (±1.23 SD) for left third molar, and –0.07 years (±1.22 SD) for right third molar, with slight variations regarding sex. Comparative tables are provided regarding medicolegal questions concerning age 18 prediction in the Spanish population, showing that legal age is reached in stage 7 (G) by women and in stage 8 (H) by men. No differences have been observed between sides (p<0.0001). Differences were observed between Spaniards and other previously studied populations. Third molar maturity takes place earlier in the Spanish than French-Canadian, Scandinavian, American, German, Japanese and South African populations and is more similar to US Hispanics in root development.     

Reproducibility of mandibular third molar assessment comparing two cone beam CT units in a matched pairs design

The aim of this study was to evaluate the reproducibility of the third molar assessment, comparing five observers and two cone beam CT (CBCT) units. 28 patients, each with two impacted mandibular third molars, were included. Each patient was randomly examined with a Scanora^® 3D (Soredex, Helsinki, Finland) CBCT unit in one mandibular third molar region and with a Cranex^® 3D (Soredex) CBCT unit in the other region. Five observers with varying CBCT experience assessed all third molars and recorded the following variables: number and morphology of the roots, relation to the mandibular canal in two directions, shape of the canal and whether there was a direct contact between the roots of the molar and the mandibular canal. The radiographic assessments were compared pairwise among all observers for all variables. Wilcoxon''s signed-rank test was used to test the differences in observer accordance percentages among the recorded variables in the images from the two units, and kappa statistics expressed interobserver reproducibility. The mean percentages for observer accordance ranged from 65.4 to 92.9 for Scanora 3D and 60.3 to 94.8 for Cranex 3D. There was no significant difference between the observer accordance in the two CBCT units (p > 0.05), except for assessing root flex in the mesiodistal direction, for which the observer accordance was higher for Scanora 3D (p < 0.05). Kappa values ranged from 0.1 to 1.0 for Scanora 3D and from 0.2 to 0.9 for Cranex 3D. For the variable “direct contact”, the interobserver reproducibility was excellent for the two trained radiologists. The two units had almost similar interobserver reproducibility for mandibular third molar assessment. Observer variation existed, and experienced radiologists demonstrated the highest interobserver reproducibility for canal-related variables.     

Application of third molar development and eruption models in estimating dental age in Malay sub-adults

The third molar development (TMD) has been widely utilized as one of the radiographic method for dental age estimation. By using the same radiograph of the same individual, third molar eruption (TME) information can be incorporated to the TMD regression model. This study aims to evaluate the performance of dental age estimation in individual method models and the combined model (TMD and TME) based on the classic regressions of multiple linear and principal component analysis. A sample of 705 digital panoramic radiographs of Malay sub-adults aged between 14.1 and 23.8 years was collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage the TMD and TME, respectively. The data was divided to develop three respective models based on the two regressions of multiple linear and principal component analysis. The trained models were then validated on the test sample and the accuracy of age prediction was compared between each model. The coefficient of determination (R²) and root mean square error (RMSE) were calculated. In both genders, adjusted R² yielded an increment in the linear regressions of combined model as compared to the individual models. The overall decrease in RMSE was detected in combined model as compared to TMD (0.03–0.06) and TME (0.2–0.8). In principal component regression, low value of adjusted R² and high RMSE except in male were exhibited in combined model. Dental age estimation is better predicted using combined model in multiple linear regression models.     

Chronological course of third molar eruption in a Portuguese population

Forensic age determination has become increasingly important over the past few years. Dental age estimation is frequently used as a part of this process due to the technique simplicity and reliability. This process is done taking into account pre-established values that, often, concern the population of the undocumented person. In this manner, population parameters are needed. In this paper, the authors present data concerning the third molar eruption in a Portuguese population: The minimum age for alveolar emergence of third molars ranged from 6.6 to 11.3 in females and 7.4 to 8.3 in males, for gingival emergence was 11.1 to 15.1 for females and 8.3 to 14.4 in males and for complete emergence was 15.9 to 19.4 in females and 13.4 for males. Complete emergence was found to be a useful marker for diagnosing age inferior 16 years, both in males and females, with 99.2% and 99.3% of correct predictions, respectively. These findings point out that it is possible to estimate the age of investigated persons based on alveolar, gingival and complete emergence of the third molars in the occlusal plane.     

Sex estimation using diagonal diameter measurements of molar teeth in African American populations

Teeth are often recovered in forensic cases due to their postmortem longevity. The goal of the present research was to investigate the degree of sexual dimorphism in the permanent molars of African Americans using crown and cervical diagonal diameters. Discriminant functions developed from a modern Greek population were tested for accuracy of sex estimation in an African American population. One hundred and three (53 males and 50 females) individuals ranging in age from 16 years to 66 years old were used from the Robert J. Terry Anatomical Skeletal Collection. Four diagonal diameter measurements were taken for each of the left mandibular and maxillary molars: mesiobuccal-distolingual crown diameter, mesiolingual-distobuccal crown diameter, mesiobuccal-distolingual cervical diameter, and mesiolingual-distobuccal cervical diameter. The overall percentage of accuracy of the modern Greek discriminant functions when applied to the African American sample was between 53.8% and 63.6%. Males were more accurately classified (93.6%–100%) than females (0%–18.2%). The African American population specific direct discriminant functions showed accuracy rates from 72.6% to 100% for the original data and 40%–72.3% for the cross-validated data. The African American stepwise discriminant functions showed accuracy rates from 63.9% to 77.6% for the original and cross-validated data. Comparisons to other populations were made. The results suggest that, in teeth, there is variation in the degree of sexual dimorphism between populations and discriminant functions for sex estimation in dentition are population specific.     

The chronology of second and third molar development in Koreans and its application to forensic age estimation

The accuracy of forensic age estimation based on the chronology of second (M2) and third molar (M3) development was investigated using 2,087 orthopantomograms of Korean men and women aged between 3 and 23 years. The developmental stages of M2s and M3s in these subjects were classified using the criteria of Demirjian. Inter-observer reliability and statistical data on each stage of mineralization of M2s and M3s were evaluated. The left–right symmetries of the maturation degrees in the M2s and M3s were observed in both sexes, between which no arch differences were found, but statistically significant sex-specific differences were observed in some stages of M2 and M3 development. In multiple regression analysis, a strong positive relationship was observed between age and mineralization of M2s and M3s. The regression formulas for estimating the age of Koreans were presented based on sex and combination of teeth. These results suggest that the developments of second and third molars can be considered as valuable age indicators in Korean adolescents and young adults.     

Radiological age estimation: based on third molar mineralization and eruption in Turkish children and young adults

Radiographic evaluation of mineralization and eruption stages of third molars using dental panoramic radiographies can be an efficient tool for chronological age estimation in both forensic sciences and legal medicine. The third molar tooth is utilized for dental age estimation about the age span of 15–23?years because it represents the only tooth still in development. The aim of this study is to obtain and analyze data regarding third molar development and eruption in Turkish population for dental age estimation. A total of 744 dental panoramic radiographies of 394 female and 350 male subjects aged between 8 and 22?years were examined. Third molar development was determined according to the Nolla classification system, and eruption was assessed relative to the alveolar bone level. Mandibular and maxillary third molars were generally found at similar stages of development on both sides. Nolla stage 6 (completed crown calcification) was reached at around the age of 15 in both maxillary and mandibular third molars in both sexes. Alveolar emergence was at around the age of 16 in males and around age of 17 in females. Although third molars’ eruption shows greater variability than development of third molars, data which were obtained from this study about eruption of these teeth can be supportive to development data for age estimation.     

Assessment of the accuracy of the Greulich and Pyle hand-wrist atlas for age estimation in a contemporary Australian population

Age estimation of living individuals is topical, and is particularly important globally, owing to increasing migration of undocumented individuals. Radiographic skeletal analysis of hand-wrist skeletal development is often used to infer chronological age based on direct comparison to standards such as the Greulich and Pyle atlas. However, this atlas has been criticised for being applied to foreign populations without due consideration of accuracy. The aims of the current study are to assess the precision and accuracy of the atlas in a contemporary Western Australian population and to develop population specific standards based on the latter system. The study sample comprised 360 individuals (equal sexes) and aged from birth to 25 years; a hold-out group comprising a further 50 individuals was used for model validation. Age estimation was performed through the visual comparison of the study radiographs against the atlas standards; statistical analyses were performed to assess the relationship between estimated skeletal and actual age. Prediction models were formulated; mean SEE values were ±0.005–0.90 (male) and ±0.25–0.421 years (female). Comparisons with prior research demonstrates the importance of contemporary population standards. The models presented here have forensic utility in a Western Australia jurisdiction, albeit the level of accuracy achieved is not suitable for the specific determination of legal majority.     

Computed tomographic evaluation of the acetabulum for age estimation in an Indian population using principal component analysis and regression models

The acetabulum presents as a well-preserved evidence, resistant to taphonomic degradation changes and can thus aid in the age estimation process. A CT-based examination of the acetabulum can further help simplify the process of age estimation by overcoming the time-consuming process of maceration and by doing away with the interference resulting from tissue remnants. The aim of the present study was to evaluate the role of the acetabulum for age estimation in an Indian population through a CT-based examination, using principal component analysis and regression models. CT images of 400 individuals aged 10 years and above were evaluated according to the features defined in the San-Millán-Rissech method of age estimation. Five of the seven morphological features defined by San-Millán-Rissech were appreciable on CT scans, and, to enable further statistical analysis, a cumulative score was computed using these five features. A significant correlation of 0.835 and 0.830 for the right and left acetabulum, respectively, was obtained between computed cumulative scores and chronological age of individuals. No significant sex differences were observed in the scoring of different age-related morphological changes. Regression models were generated using individual features and cumulative scores. Regression models derived using the cumulative score yielded inaccuracy values of 9.67 years for the right acetabulum and 9.15 years for the left acetabulum. Inaccuracy and bias values were computed for each individual feature, as well as for each decade, using mean point ages established within the original study. Amongst the various features, acetabular rim porosity was seen to have the lowest values of inaccuracy (11.50 years) and bias (2.32 years) and activity on outer edge of acetabular fossa the highest (inaccuracy and bias values of 22.36 years and 21.50 years, respectively). Taking into consideration this differential contribution towards age estimation, weighted coefficients and mean point ages for different morphological features were determined using principal component analysis. Subsequently, summary age models were generated from the obtained weighted coefficients and mean age values. Summary age models derived in the present study yield lower estimates of inaccuracy of 7.60 years for the right acetabulum and 7.82 years for the left acetabulum. While regression models derived in the present study allow for age estimation using even a single appreciable feature, summary age models take into account the contribution of each feature and generate more accurate estimates of age. Both statistical computations yield reduced error rates and thus can render greater applicability to the acetabulum in forensic age estimation.