Measuring the distance of the wisdom teeth from the occlusal plane as forensic-odontological method for chronological age determination

As part of an epidemiological study on tooth eruption it was attempted to define easily accessible criteria for age estimation in living human beings based on the distance of the wisdom teeth from the occlusal plane. 253 cast models of 149 female and 104 male patients were used for evaluation. Due to the great variability observed in the eruption of the wisdom teeth, only a small fraction of the total number of 10,924 cast models was suitable for investigation. Only teeth with the axis being perpendicular to the plane of occlusion during eruption according to radiological and clinical findings were included. After defining these inclusion criteria, the distance of the wisdom teeth from the plane of occlusion was determined and correlated to the age of the subjects. The results confirmed the known large variability concerning wisdom tooth eruption and did not show any reliable relation between age and distance values. Nevertheless, a remarkable finding that may be relevant for forensic odontostomatology was seen in one case where the lower wisdom teeth were taller than the occlusal plane, although the female patient was younger than 14 years. The upper molars were retained and root development was incomplete.     

Studies of the chronological course of wisdom tooth eruption in a Black African population

The importance of forensic age estimation in living subjects has grown over the last few years. In dental age estimation, tooth eruption is a parameter of developmental morphology that can be analyzed by either clinical examination or by evaluation of dental X-rays. In the present study, we determined the stage of wisdom tooth eruption in 410 male and 106 female Black South African subjects of known age (12-26 years) based on radiological evidence from 516 conventional orthopantomograms. Four eruption stages were determined (no emergence, alveolar emergence, gingival emergence, complete emergence). Statistical scores were determined for the individual stages separately for both sexes. The data presented here can be utilized for forensic estimation of the minimum and most probable ages of investigated persons.     

Third molar root development in relation to chronological age: a large sample sized retrospective study

The aim of the present investigation, which is a continuation and extension of a previous published pilot study [Forensic Sci. Int. 129 (2002) 110], was to calculate the chronological age of an individual based on the dental developmental stages of third molars (so-called wisdom teeth). The evaluated material consisted of 2513 orthopantomograms (OPG's) of patients all of Belgian Caucasian origin between 15.7 and 23.3 years. The sample of OPG's was scored by two observers who were calibrated for intra- and interobserver reliability by means of kappa statistics. The kappa statistics revealed a strong agreement between the intra- and interobserver measurements. Further statistical analysis was performed in order to obtain multiple regression formulae for dental age calculation with the chronological age as the independent variable and the third molar developmental stages as dependent variables. Both for males and females a significant Pearson correlation coefficient was noticed for contralateral third molars, a smaller less significant one for the antimeres. For the application of the regression formulae one has to take into consideration the gender, the location and number of wisdom teeth. Probabilities for an individual to be older than 18 years were also calculated in case of fully developed wisdom teeth.     

Age estimation of Korean children based on dental maturity

The aim of this study was to evaluate the relationship between age and dental maturity and to establish the standard database of dental maturity based on the Demirjian's stages, which can be used for the age estimation of Korean children. For this purpose, dental maturity was measured by the Demirjian's stages on a randomly selected sample of panoramic radiographs taken from 2706 patients between 1 and 20 years of age and analyzed by multiple linear regression analysis based on the method of least squares. The results showed that, except for the third molars, the development of permanent teeth in Korean children was more advanced in females. The Demirjian's stage G of the second molar appeared last in both male and female subjects by age 18, showing 95th percentile at age in the male and female subjects between 16.7-17.4 years and 17.1-17.3 years, respectively. Coefficients of determination (r(2)) of the Demirjian's stages relative to age in regression analysis were 0.9721 in male and 0.9740 in female subjects. The standard error was 0.63 years in male and 0.62 years in female subjects. The estimated age according to regression analysis was within +/-1.0 year of the actual age in 92.0% of male and 92.5% of female subjects. Collectively, the data of the present study can be used as a reference for dental maturity and a standard for age estimation of Korean children.     

Accuracy of developing tooth length as an estimate of age in human skeletal remains: the deciduous dentition

Dental age assessments are widely used to estimate age of immature skeletal remains. Most methods have relied on fractional stages of tooth emergence and formation, particularly of the permanent dentition, for predicting the age of infants and very young children. In this study, the accuracy of regression equations of developing deciduous tooth length for age estimation (Liversidge et al.) is tested on a sample of 30 Portuguese subadult skeletons of known age at death. Overall the method shows high accuracy and the average difference between estimated and chronological age is between 0.20 and -0.14 years when using single teeth, and 0.06 years, when using all available teeth. However, there is a tendency for the deciduous molars to provide overestimates of chronological age. Results show that age estimates can be obtained within +/-0.10 years with a 95% confidence interval when several teeth are used. Overall between-tooth agreement in age estimates decreases with increasing age but there is less variability of estimates with more teeth contributing to overall mean age. One seemingly limitation of this method may be the fact that it was developed by combining the maxillary and mandibular teeth. The other is related to the accuracy with which radiographic tooth length can be used as a valid surrogate for actual tooth length. Nevertheless, the advantages of this metric method surpass the limitations of chronologies based on stages of dental development.     

Application of a modified stage classification in evaluating wisdom tooth eruption in a German population

The evaluation of the eruption status of the wisdom teeth constitutes a significant component of the spectrum of dental methods available for purposes of forensic age diagnostics. In the present study, the status of wisdom tooth eruption was identified in 606 conventionally created orthopantomograms of 515 female and 91 male Germans, divided by sex and tooth, using a modified classification comprising four stages. Instead of the original stage C (gingival eruption) which cannot always be reliably identified on X-ray images of suboptimal quality, stage C of the modified classification was considered reached when the erupting wisdom tooth had reached at least half the length of the crown of the adjacent second molar, without however having yet reached the occlusal plane. The new stage classification is especially recommended for age estimation based on X-ray images in which a conclusive delimitation of the gingiva is not possible.     

Studies of the chronological course of wisdom tooth eruption in a Japanese population

The importance of forensic age estimation in living subjects has grown over the last few years. In dental age estimation, tooth eruption is a parameter of developmental morphology that can be analyzed by either clinical examination or by evaluation of dental X-rays. In the present study, we determined the stage of wisdom tooth eruption in 549 male and 751 female Japanese subjects aged 14-26 years based on radiological evidence from 1300 conventional orthopantomograms. The results presented here provide useful data on the age of alveolar, gingival, and complete emergence of the third molars in the occlusal plane that can be utilized for forensic estimation of the minimum and most probable ages of investigated persons.     

Prosthetic restorations, dental root fillings and periodontal bone resorptions as a forensic-odontologic aid for determining the age above 18 years: A radiographic study of orthopantomograms from a group of teenagers and yount adults

The human teeth are a valuable source of information concerning identification and age calculation in forensic sciences. Dental treatment often causes permanent alteration of the teeth, which is visible on radiographs. The correlation of prosthetic restorations, root canal fillings and periodontal bone loss with chronological age has not yet been used for determining the completed 18th year of life in teenagers and young adults, e. g. for legal and anthropological purposes. The aim of this study was to determine whether the evaluation of such findings on radiographs correlates with the chronological age in teenagers and young adults. MATERIAL AND METHODS: The dental X-rays (orthopantomogram, OPG) of 1053 outpatients (age: 14 to 24 years) were avaluated. The values "prosthetically restored", "filled dental root", or "periodontal bone loss" were recorded for each tooth present. The data were then evaluated using statistical tools. RESULTS: The correlation between the number of prosthetically restored teeth and the chronological age is high. The positive predictive value of determining an age of at least 18 years proved to be very high. However, these findings are rarely present in this age group. The number of endodontically treated teeth correlated less exactly with age. On the other hand, the determination of periodontal bone loss gave reasonable positive predictive values for the threshold value "chronological age of 18 years or more". DISCUSSION: This study provides for the first time predictive values for the estimation whether a person is 18 years of age, based on the evaluation of teeth with prosthetic restorations, root canal fillings or periodontal bone loss on OPGs only. Whereas the number of patients with such findings is generally low in this age group, some of the positive findings can be used for age estimation as an adjunct to other sources of age calculation. The sole application of these criteria is not recommended, as sanitary conditions of the teeth depend on both social and individual circumstances. Therefore, the calculated values also reflect the culture of the sample studied. Finally, they are time-dependent and have to be compared to data from other populations. These results have some bearing on the field of forensic odontology.     

Approaches to chronological age assessment based on dental calcification

The aim of the present study was to find an accurate estimation of chronological age using a small number of selected teeth. For this purpose, the method devised by Nolla [C. Nolla, The development of the permanent teeth, J. Dent. Child. 27 (1960) 254-266.] was used: the development of each of the teeth was determined according to this method on 374 radiographs, 195 of boys (mean age 8.59) and 179 of girls (mean age 8.75). The 28 variables representing the calcification stages were analyzed using cluster analysis followed by multivariate analysis (multiple linear regression model). Patient age was considered to be a dependent variable. Our study showed that antimere teeth are the most homogeneous as regards stages of development. The prediction was more accurate for boys and girls below 10 years of age, using teeth 21, 43 and 46 from boys and teeth 21, 46 and 47 from girls. These teeth accounted for 80% total variance of chronological age for dental calcification. Standard error was +/-1.4 years for boys and +/-1.2 years for girls. When the age of the children remained completely unknown, the best estimates were provided by teeth 43, 47, 46 and 44 from boys and teeth 44, 47 and 43 from girls.     

Age estimation and the developing third molar tooth: an analysis of an Australian population using computed tomography

The third molar tooth is one of the few anatomical sites available for age estimation of unknown age individuals in the late adolescent years. Computed tomography (CT) images were assessed in an Australian population aged from 15 to 25 years for development trends, particularly concerning age estimation at the child/adult transition point of 18 years. The CT images were also compared to conventional radiographs to assess the developmental scoring agreement between the two and it was found that agreement of Demirjian scores between the two imaging modalities was excellent. The relatively wide age ranges (mean ± 2SD) indicate that the third molar is not a precise tool for age estimation (age ranges of 3-8 years) but is, however, a useful tool for discriminating the adult/child transition age of 18 years. In the current study 100% of females and 96% of males with completed roots were over 18 years of age.     

Estimating Age of Majority on Third Molars Developmental Stages in Young Adults from Thailand Using a Modified Scoring Technique*

Abstract: The aim of this study was to achieve a referral database for dental age estimation of unaccompanied minors of Thai nationality. A total of 1199 orthopantomograms were collected from original Thai women and men equally divided in age categories between 15 and 24 years. On the radiographs, the developmental stage of the third molars was scored applying a modified scoring technique. Inter- and intra-observer reliabilities were tested using kappa statistics. Correlation between the scores of all four wisdom teeth and left–right symmetry were evaluated with Pearson’s correlation coefficient. Student’s t-test on asymmetry was performed and regression formulas were calculated. The present database was the first to assemble third molar developmental scores on radiographs of Thai individuals and provides more appropriate dental age estimation of unaccompanied Thai minors. Future research on similar databases of different nationalities worldwide may expose ethnical influences on dental development.     

Decayed, filled and missing teeth as a forensic-odontologic aid for determining the age above 18 years: A radiographic study of orthopantomograms from a group of teenagers and young adults

The human teeth are a valuable source of information concerning identification and age calculation in forensic sciences. Dental treatment often causes permanent alteration of the teeth, which is visible on radiographs. The correlation of decayed, missing or filled teeth and chronological age has not yet been used for determining the accomplished 18th year of life in teenagers and young adults, e. g. for legal and anthropological purposes. The aim of this study was to determine whether the evaluation of these findings on radiographs correlates with the chronological age in teenagers and young adults. MATERIAL AND METHODS: The dental X-rays (orthopantomograms, OPG) of 1053 outpatients (age: 14 to 24 years) were evaluated. The values "decayed", "missing", or "filled" were recorded for each tooth present. The data were then calculated using statistical tools. RESULTS: The correlation between the number of missing teeth and the chronological age is low. However, the positive predictive value of determining the age of 18 years for certain types of teeth proved to be very high, even up to 100 %. Further, high numbers of filled teeth gave reasonable positive predictive values for an age of 18 years. The number of decayed teeth did not correlate with age. DISCUSSION: This study provides for the first time predictive values for the estimation whether a person is 18 years of age, based on the evaluation of decayed, missing or filled teeth on OPGs only. Whereas the number of patients with such findings is generally low in this age group, some of the positive findings can be used for age estimation as an adjunct to other sources of age calculation. The sole application of these items is not recommended, as sanitary conditions of the teeth depend on both social and individual circumstances. Therefore, the calculated values also reflect the culture of the sample studied. Finally, they are time-dependent and have to be compared to data from other populations. These results have some bearing on the field of forensic odontology.     

Radiographic survey of third molar development in relation to chronological age among Japanese juveniles

The aim of the present study was to establish Japanese reference material on the third molar development of Japanese juveniles for forensic application. Observations were performed on the orthopantomograms of 1282 Japanese patients between the ages of 14.0 and 24.0 years. Demirjian formation stages of the maxillary and mandibular third molars were recorded for chronological evaluation of wisdom teeth and applied for further statistical analysis. Statistically significant differences were noted between the upper and lower jaws and genders. Accordingly, males achieved root developmental grades earlier than females. We assessed the mean ages for all formation grades and predicted the probability that a Japanese juvenile would be older than the relevant ages of 14, 16, and 20 as defined by Japanese Juvenile Law. We determined the likelihood that a Japanese youth is older than the relevant age of 18 as defined by legislation in the United States.     

Dental age estimation, quality assurance and age estimation of asylum seekers in Norway

The historical development of age estimation and the different techniques are presented. Also it is important to separate individuals below 20 years where tooth development can be used and those above 20 years of age where regressive changes must be used and where the visual assessment may be more important. The recommendations for quality assurance from the International Organization for Forensic Odonto Stomatology (IOFOS) is discussed and also the problems of quality assurance on an international level. Suggestions for changes in these recommendations are presented. Finally the Norwegian dental age estimation project in asylum seekers who claim to be below 18 years of age is described.     

Age estimation of unaccompanied minors. Part II. Dental aspects

Recent years have brought a worldwide increase in cross-border migration due to a globalized economy and ongoing belligerent conflicts. As a result, the percentage of foreigners among the general population has steadily increased not only in Germany, but also in other countries. This trend has triggered a growing demand for forensic medicine to assess the age of adolescents and young adults. The individuals examined here are unaccompanied minors without valid identification documents who do not know their age or else are suspected of not giving their correct age. The mineralization of third molars is the main criterion for dental age estimation of living subjects in the relevant age group. To date insufficient knowledge has been obtained about how ethnic origin can influence tooth mineralization. This, however, constitutes a restraint on the reliability of age estimates and hence on the forensic value of information essential to legal security. A comparative study was conducted to present comparative data on third molar mineralization in a Caucasoid, Mongoloid and African sample. In conclusion, forensic age estimates of living subjects would be more powerful tools if population-specific standards were applied to evaluations of wisdom tooth mineralization. Since the mineralization of third molars is usually completed by the age of 19 or 20 years, this feature cannot be used to ascertain whether a person has attained the forensically relevant age of 21 years. The question was whether determination based on an orthopantomogram of a combination of features relevant to dental age estimation of adults supplies forensically useful information for ascertaining whether a person has attained 21 years of age. The features considered include the DMFT index of all permanent teeth, the DMFT index of all permanent teeth excluding third molars and the DFT index of third molars projecting beyond the occlusal plane. It can be concluded that an evaluation of the variations of the DMFT index does not by itself yield sufficient data to determine with the accuracy required in criminal proceedings whether a person has attained 21 years of age. An additional X-ray examination of the medial clavicular epiphyseal cartilage is, therefore, strongly recommended when assessing whether a person is over 21.     

New forensic approach to age determination in children based on tooth eruption

The present study proposes equations for age determination both in living and dead children, obtained with the help of stepwise ascending multiple linear regression. The equations should be applied, based on the number of erupted teeth and tooth germs, which were detected on radiographs, during clinical examination and in infant skeletal remains. The proposed equations proved to be efficient just like Demirjian's method used as a reference today, and permit age estimation till 20 years of age.     

Objective measurement of dental color for age estimation by spectroradiometry

Age-related changes in tooth color have been described previously, however, the use of dental color for age estimation in forensic odontology has been limited due to the difficulty of measuring color objectively. This study presents an objective method for determining dental color to estimate the age of an individual. Dentine color in 250 teeth from patients ranging in age from 10 to 89 years was determined by spectroradiometry. Color measurements were performed as suggested in the CIE 1931 (International Commission on Illumination). Chromaticity coordinates (x, y, z), luminance (Y), whiteness index (WIC, Z%, WIC) and yellowness index (YI) were obtained. Correlations between these colorimetric variables and aging were established by linear regression analyses. All the variables fit the mathematical model with correlation coefficients ranging from 0.53 to 0.75. This method of color measurement produced an expected associated error of calibration averaging 13.7 years about the mean estimated values, at a 70% level of confidence. Two different multiple regression models for dental age estimation were tested, and variables that made the greatest contributions to age calculation were identified. To determine the effect of postmortem interval on tooth color and its influence in age estimation, 37 teeth obtained from human skeletal remains buried during an interval ranging from 21 to 37 years were also studied. In this material, the correlation between age and dental color measured by spectroradiometry was weaker than in fresh extracted teeth.It is concluded that determination of dentine color by spectroradiometry is a potentially useful objective method to estimate age in forensic studies in combination with other methods.