Reliability and validity of eight dental age estimation methods for adults

This paper evaluates the reliability and validity of eight published dental age estimation methods for adults that may aid in victim identification. Age was calculated on 20 Caucasian teeth of known age according to the methods of Kvaal (for in situ and extracted teeth), Solheim (for in situ and sectioned teeth), Lamendin (for extracted teeth), Johanson (for sectioned teeth) and Bang (for extracted and sectioned teeth) by one independent observer. For each method, mean age error and standard error were assessed as the measures of accuracy and precision. In addition, method simplicity, requirements for tooth preparation and the equipment necessary were assessed and recommendations given for forensic use in various situations. Methods for sectioned teeth gave more reliable results when compared to methods for intact teeth.     

Comparison of four skeletal methods for the estimation of age at death on white and black adults

ABSTRACT: When analyzing human adult skeletal remains, it is often difficult to decide whether a single aging method will give a more reliable age estimation than a combination of methods. This study evaluates four macroscopic indicators for age estimation on 218 American White and Black individuals, ranging in age from 25 to 90 years of age, from the Terry collection. Individuals in the sample were selected to have a balanced race, sex, and age distribution. The following aging methods were applied to each skeleton by one experienced observer: the Suchey–Brooks (SB) pubic symphysis method, the Lovejoy auricular surface method, the monoradicular teeth Lamendin (LM) method, and the I?can (IC) method for fourth ribs. The statistical study involved the evaluation of inaccuracy and bias (based on median age) for each age indicator and the combination of methods using Principal component analysis (PCA). Analysis was performed on the entire sample, then by race, then sex, and then age group (25–40 years, 41–60 years, and >60 years). PCA was the most accurate method for both racial groups when all age groups are analyzed together. When the sample was divided into age groups, SB was the most accurate for young adults (25–40 years) and LM was the most accurate for middle adults (41–60 years). After the age of 60, all methods are highly inaccurate, although IC gives the lowest inaccuracy. As regards bias, the study highlights the tendency of all methods to overestimate the age of young individuals and to underestimate in the older age group. No single skeletal indicator of age at death is ever likely to reflect accurately the many factors that accumulate with chronological age. In fact, one must use as many dental and skeletal indicators as possible. However, in order to maximize the potential of each method, in the final evaluation one should consider mainly the method or methods that have a higher accuracy for a particular age range.     

Accuracy of different dental age estimation methods on Turkish children

Tooth development is widely used to estimate age or maturation. Dental age estimation is so important for various research works. Numerous methods have been described to estimate dental age based on the dental maturation. The aims of this study were to decide the best method to estimate dental age on Turkish children by reviewing several methods and to illustrate the differences among the methods and to assist future studies. The records of Turkish children between the ages of 7 and 13 years who visited the Department of Pediatric Dentistry of the Faculty of Dentistry of the Süleyman Demirel University in Isparta, Turkey were reviewed and a total of 425 healthy children with complete records, satisfactory panoramic radiographs, similar socio-economic background and ethnic origin were included. Panoramic radiographs were examined with Nolla's, Haavikko's and Demirjian's methods. Dental age was calculated for each method, and the differences between the estimated dental age and the chronological age were compared with paired t-test and Wilcoxon signed rank test. The accuracy of three methods was obtained with ICC (intraclass correlation coefficient). An under-estimation of the dental age was observed by using Nolla's and Haavikko's methods (boys -0.53±0.95, girls -0.57±0.91, both -0.54±0.93; boys -0.60±0.80, girls -0.56±0.81, both -0.58±0.80, respectively) and an over-estimation of the dental age was observed by using Demirjian's method (boys 0.52±0.86, girls 0.75±0.90, both 0.64±0.89). Haavikko's method was more accurate in the dental age estimation compared to the other methods. All of the three methods are not completely suitable for Turkish children and establishment of the population-specific standards is essential and crucial.     

Application of three dental methods of adult age estimation from intact single rooted teeth to a Peruvian sample

Methods of estimating adult age at death from such dental features as root translucency, root length, and the extent of periodontosis in intact single rooted teeth have proven useful in studies of modern individuals, especially in estimating age in older adults. Questions remain however, concerning the impact of regional and population variation on accuracy. To examine this issue, three approaches to age estimation were applied to a diverse sample of 100 individuals from Peru. Mean errors of estimation for all three approaches were similar to those originally reported, suggesting minimal impact of population variation of the features measured. A new regression equation, specifically for Peruvian samples, is provided.     

利用牙齿推断年龄的研究进展

牙齿是人体最坚硬的器官之一,其抗腐蚀能力强,多项形态特征具有增龄性变化,因此利用牙齿推断年龄在法医学中得到广泛应用。由于牙齿的生理性变化的复杂性及环境因素的影响,不同牙齿推断年龄的方法各具其应用价值,同时也存在一定的局限性,法医工作者需要依据具体情况选择适合的方法并加以综合运用,以提高年龄推断的准确性。本文对国内外利用牙齿推断年龄的研究现状进行综述,并对各种推断方法进行比较评价,希望能为相关研究和实践提供参考。     

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.     

The accuracy of three methods of age estimation using radiographic measurements of developing teeth

The accuracy of age estimation using three quantitative methods of developing permanent teeth was investigated. These were M?rnstad et al. [Scand. J. Dent. Res. 102 (1994) 137], Liversidge and Molleson [J. For. Sci. 44 (1999) 917] and Carels et al. [J. Biol. Bucc. 19 (1991) 297]. The sample consisted of 145 white Caucasian children (75 girls, 70 boys) aged between 8 and 13 years. Tooth length and apex width of mandibular canine, premolars and first and second molars were measured from orthopantomographs using a digitiser. These data were substituted into equations from the three methods and estimated age was calculated and compared to chronological age. Age was under-estimated in boys and girls using all the three methods; the mean difference between chronological and estimated ages for method I was -0.83 (standard deviation +/-0.96) years for boys and -0.67 (+/-0.76) years for girls; method II -0.79 (+/-0.93) and -0.63 (+/-0.92); method III -1.03 (+/-1.48) and -1.35 (+/-1.11) for boys and girls, respectively. Further analysis of age cohorts, found the most accurate method to be method I for the age group 8.00-8.99 years where age could be predicted to 0.14+/-0.44 years (boys) and 0.10+/-0.32 years (girls). Accuracy was greater for younger children compared to older children and this decreased with age.     

Evaluation of age estimation technique: testing traits of the acetabulum to estimate age at death in adult males

This study evaluates the accuracy and precision of a skeletal age estimation method, using the acetabulum of 100 male ossa coxae from the Grant Collection (GRO) at the University of Toronto, Canada. Age at death was obtained using Bayesian inference and a computational application (IDADE2) that requires a reference population, close in geographic and temporal distribution to the target case, to calibrate age ranges from scores generated by the technique. The inaccuracy of this method is 8 years. The direction of bias indicates the acetabulum technique tends to underestimate age. The categories 46-65 and 76-90 years exhibit the smallest inaccuracy (0.2), suggesting that this method may be appropriate for individuals over 40 years. Eighty-three percent of age estimates were ±12 years of known age; 79% were ±10 years of known age; and 62% were ±5 years of known age. Identifying a suitable reference population is the most significant limitation of this technique for forensic applications.     

三种羟亚胺分析方法的比较

目的建立羟亚胺及氯胺酮定性和定量分析方法。方法分别使用气相色谱质谱联用法(GC/MS)、液相色谱质谱联用法(LC/MS)和液相色谱紫外法(LC/UV)分析羟亚胺,考察各方法的特点及适用范围。结果采用GC/MS法分析时,进样口的高温会导致部分羟亚胺转化为氯胺酮。LC/MS及LC/UV分析则不存在干扰,羟亚胺和氯胺酮的线性范围分别为3.0～300 ng/mL(LC/MS)、0.02～1.00mg/mL(LC/UV);最低检测限分别为1.0ng/mL(LC/MS)、5.0μg/mL(LC/UV)。结论 GC/MS法仅可确定样品中羟亚胺的存在,不能确认是否含有氯胺酮。LC/MS和LC/UV法可分别用于痕量和常量羟亚胺和氯胺酮定性和定量分析。     

运用牙齿影像学方法推断年龄的研究进展

本文对国内外文献在利用牙齿的影像学检查推断幼儿、青少年和成人年龄的方法、特点和优缺点进行了归纳和综述。     

Evaluation of seven methods of estimating age at death from mature human skeletal remains.

Different approaches to the estimation of age at death in mature human skeletal remains were evaluated utilizing samples from 19 recent French autopsy individuals of known age at death. Methods of estimating age at death from single-rooted teeth, the sternal ends of the fourth ribs, the symphyseal face of the pubis and femoral cortical remodeling were evaluated by two independent observers (three observers for the teeth). Comparison included ages estimated from three more comprehensive approaches utilizing data from the application of two or more of the individual methods. The results indicate that the comprehensive approaches are superior to the individual ones and the success of the latter reflects not only the morphological expression of the aging process, but also the technique complexity and the experience of the investigator. Of the individual techniques, the "Lamendin" dental technique was most effective for individuals of ages greater than 25 years.     

A comparison of Demirjian's four dental development methods for forensic age assessment

The aim of this study was to determine the comparative accuracy of Demirjian's four dental development methods for forensic age estimation in the Western Australian population. A sample comprising 143 individuals aged 4.6 to 14.5 years were assessed using Demirjian's four methods for dental development (original 7-tooth: M(2), M(1), PM(2), PM(1), C, I(2), and I(1); revised 7-tooth: M(2), M(1), PM(2), PM(1), C, I(2), and I(1); 4-tooth: M(2), M(1), PM(2), and PM(1); and an alternate 4-tooth: M(2), PM(2), PM(1), and I(1)). When comparing all four methods, the 4-tooth method overestimated age in both males and females by 0.04 and 0.25 years, respectively. The original 7-tooth was least accurate for males, while the original 7-tooth, the revised 7-tooth, and the alternate 4-tooth were unsuitable for females. Therefore, we recommend the 4-tooth method to be used for forensic age estimation in Western Australian males and females, as it has the lowest overall mean deviation and the highest accuracy.     

青少年活体年龄推断的方法比较

目的探讨准确推断青少年活体年龄的方法。方法对233名青少年活体年龄鉴定案所涉及的案件性质、作案距鉴定的间隔时间、自报年龄与鉴定年龄差距等进行归类、分析,并就其中130名骨骺尚未完全愈合的男性青少年的年龄,用多元回归方程法、CHN计分法和本文作者设计的综合法分别进行推断,统计前两个方法与综合法的符合率。结果 归类分析显示:本组资料,刑事案件当事人的涉案性质,抢劫、抢夺的占72.10％;作案距鉴定的间隔时间小于6个月的占75.10％;自报年龄小于鉴定年龄的占60.73％。用多元回归方程法、CHN计分法鉴定年龄与综合法鉴定年龄的符合率分别为90.77％与83.08％。结论活体年龄鉴定应在作案后尽早进行;用多元回归方程法鉴定18岁左右的年龄较CHN计分法准确,采用综合法鉴定年龄可能更好。     

Accuracy of age estimation of radiographic methods using developing teeth

Developing teeth are used to assess maturity and estimate age in a number of disciplines, however the accuracy of different methods has not been systematically investigated. The aim of this study was to determine the accuracy of several methods. Tooth formation was assessed from radiographs of healthy children attending a dental teaching hospital. The sample was 946 children (491 boys, 455 girls, aged 3-16.99 years) with similar number of children from Bangladeshi and British Caucasian ethnic origin. Panoramic radiographs were examined and seven mandibular teeth staged according to Demirjian's dental maturity scale [A. Demirjian, Dental development, CD-ROM, Silver Platter Education, University of Montreal, Montreal, 1993-1994; A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45 (1973) 211-227; A. Demirjian, H. Goldstein, New systems for dental maturity based on seven and four teeth, Ann. Hum. Biol. 3 (1976) 411-421], Nolla [C.M. Nolla, The development of the permanent teeth, J. Dent. Child. 27 (1960) 254-266] and Haavikko [K. Haavikko, The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study. Proc. Finn. Dent. Soc. 66 (1970) 103-170]. Dental age was calculated for each method, including an adaptation of Demirjian's method with updated scoring [G. Willems, A. Van Olmen, B. Spiessens, C. Carels, Dental age estimation in Belgian children: Demirjian's technique revisited, J. Forensic Sci. 46 (2001) 893-895]. The mean difference (+/-S.D. in years) between dental and real age was calculated for each method and in the case of Haavikko, each tooth type; and tested using t-test. Mean difference was also calculated for the age group 3-13.99 years for Haavikko (mean and individual teeth). Results show that the most accurate method was by Willems [G. Willems, A. Van Olmen, B. Spiessens, C. Carels, Dental age estimation in Belgian children: Demirjian's technique revisited, J. Forensic Sci. 46 (2001) 893-895] (boys -0.05+/-0.81, girls -0.20+/-0.89, both -0.12 y+/-0.85), Demirjian [A. Demirjian, Dental development, CD-ROM, Silver Platter Education, University of Montreal, Montreal, 1993-1994] overestimated age (boys 0.25+/-0.84, girls 0.23+/-0.84, both 0.24 y+/-0.86), while Nolla [C.M. Nolla, The development of the permanent teeth, J. Dent. Child. 27 (1960) 254-266] and Haavikko's [K. Haavikko, The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study, Proc. Finn. Dent. Soc. 66 (1970) 103-170] methods under-estimated age (boys -0.87+/-0.87, girls -1.18+/-0.96, both -1.02 y+/-0.93; boys -0.56+/-0.91, girls -0.79+/-1.11, both -0.67 y+/-1.01, respectively). For individual teeth using Haavikko's method, first premolar and second molar were most accurate; and more accurate than the mean value of all developing teeth. The 95% confidence interval of the mean was least for mean of all developing teeth using Haavikko (age 3-13.99 years), followed by identical values for Demirjian and Willems (sexes combined).     

A simple technique for age estimation in adult corpses: the two criteria dental method.

A method for age determination of adults from single rooted teeth is presented. It is based on the measurement of two dental features: periodontosis height times 100/root height (P) and transparency of the root height times 100/root height (T). These measurements are made on the labial surface of the entire tooth without section and do not require special equipment or training. The application of multiple regression analysis to a working sample of 306 teeth of known age, sex and race provided the following equation: Age (years) = 0.18 x P + 0.42 x T + 25.53. The mean error between the actual and estimated age was +/- 10 years on the working sample and +/- 8.4 years on a control sample made of 45 forensic science cases. Upper incisors showed a better precision than the other single rooted teeth and accuracy was not sex related. A comparison of the Gustafson and Lamendin methods on a control sample of 39 teeth resulted in an advantage of the latter considering the mean error on the estimation (14.2 +/- 3.4 years for Gustafson versus 8.9 +/- 2.2 for Lamendin). The Lamendin method can be practical interest for any forensic pathologist or dentist as it is fast, easy to use, and reasonably accurate except for cases of individuals under age 40 where other methods must be preferred.     

Usefulness of combining clinical and radiological dental findings for a more accurate noninvasive age estimation

The aim of this study was to establish correlations of clinical and radiological dental findings, alone or in combination, with chronological age in adults. Dental findings and orthopantomograms of 984 patients (aged 20-60 years; 524 females/460 males) were analyzed. DMF-T index and distance (alveolar bone level, ABL) between cemento-enamel junction and alveolar bone margin were recorded. Additionally, clinical and radiological findings at each tooth crown and root were collected according to the actual status of destruction and restoration, and a total score for each dentition (TSD) was calculated. After univariate correlation analysis, correlation coefficients for ABL and TSD were improved by using square root (sqrt). However, the determination accuracy was still not satisfactory; 90% of the residuals were in the range of about +/-10. The present study showed that clinical and radiological dental findings could not be used, not even in combination, for accurate age estimation as a single method, but that they could support other methods.     

Accuracy of four dental age estimation methodologies in Brazilian and Croatian children

ObjectiveTo compare and analyse the accuracy of four age estimation methods using the mineralisation stages of the permanent teeth (Cameriere et al. [16] [CAM], Liliequist and Lundberg [LLH] and Nolla without third molars [NOL7] or with them [NOL8]) in a mixed population of Brazilians and a homogeneous population of Croatians.MethodsOrthopantomograms of 930 Brazilians (366 males and 564 females) and 924 Croatians (365 males and 556 females) aged between 8 and 14.99 years were analysed using the CAM, LLH, NOL7 and NOL8 age estimation methodologies.ResultsLLH presented the best absolute differences (ADs) among both populations without sex stratification, while CAM presented the worst results. In addition, the mean differences revealed underestimations, except when the LLH and NOL7 methods were used for the Brazilians. When the sample was stratified by sex, the best AD values were found with NOL7 (0.80) for the Brazilians and with LLH (0.98) for the Croatians. When the sample was stratified by sex and age, CAM presented high accuracy at the early ages, and LLH presented high accuracy at the older ages. The results obtained with the Nolla methods (NOL7 and NOL8) were mostly similar, but NOL7 yielded slightly better results.ConclusionsThe values for the Brazilians and the Croatians were relatively similar, and the techniques were properly applied in both population samples. The best method for evaluating both countries was LLH, followed by NOL7, NOL8 and CAM.     

To evaluate the utility of smaller sample sizes when assessing dental maturity curves for forensic age estimation

Dental maturation and chronological age estimation were determined from 144 healthy Western Australian individuals aged 3.6-14.5 years. The results were compared with Farah et al.'s previous study which comprised a larger heterogeneous sample of Western Australian individuals (n = 1450). Orthopantomograms were analyzed with the application of Demirjian and Goldstein's 4-tooth method based on eight stages of dental mineralization. Analysis of variance revealed no significant differences in dental maturity scores in each age group among the males in both studies; similar results were seen in the females. Paired t-tests showed no statistical significance overall between chronological and estimated ages for the males in our sample (p = 0.181), whereas the females showed significant differences (p < 0.001). Our results show that smaller samples may be used when assessing dental maturity curves for forensic age estimation.     

The age at death assessment in a multi-ethnic sample of pelvic bones using nature-inspired data mining methods

Recently published studies showed that age assessment methods are population specific. Authors analyse the senescence changes in pubic symphysis and sacro-pelvic surface of a pelvic bone using data mining methods. The multi-ethnic data set consists of 956 adult individuals ranging from 19 to 100 years of age derived from 9 different populations with known age and sex. The results show that accurate and reliable age assessment is possible to three age classes (less than 30, 30-60, 60 and more). The study confirms that population specificity of the methods exists and the variable "sex" is not important in age classification.