上颌尖牙髓腔体积与牙体积比值在个体性别判定中的应用

目的探讨三维重建的上颌尖牙髓腔体积与牙体体积在个体性别判定中的临床应用价值。方法选取2015年9月-2016年8月山西医科大学口腔医院放射科患者的CBCT影像资料片103例(男51例,女52例),利用Mimics17.0分析软件测量上颌尖牙髓腔体积(PV)、牙体积(TV)及髓腔体积与牙体积比值(PV/TV),使用SPSS16.0统计软件和Fisher判别法对数据处理,得出性别判定函数,并采用Cross-Validated法进行效果评价。结果以牙体积(TV)和髓腔体积与牙体积比值(PV/TV)作为研究指标进行性别推断时,个体性别判别函数为Y=0.009(TV)+28.896(PV/TV)-6.962,采用Cross-validated法进行效果评价,判别符合率为男51例,判断正确率为64.7%;女52例,判断正确率为78.8%。结论上颌尖牙牙体积(TV)和髓腔体积与牙体积比值(PV/TV)能够做为性别推断的研究指标,它为法医个体性别推断提供一种新的方法和途径。     

中国汉族6～18周岁人群牙齿生长发育的地区差异研究

目的探讨中国汉族儿童及青少年下颌恒牙钙化程度不同地区间的差异,为相关研究提供依据。方法根据牙齿钙化的分级标准,对来自广东、河南、陕西、黑龙江、重庆地区11275张(男5499张,女5776张)6～18周岁汉族儿童及青少年全口曲面断层影像片中下颌左侧恒牙钙化程度进行分级评分;评分数据使用SPSS 13.0软件进行统计处理,分性别及年龄段用非参数独立样本检验两两比较上述地区儿童及青少年牙齿生长发育的差异。结果下颌左侧各恒牙钙化分级值存在地区间差异(P0.05),差异最大的为尖牙。结论中国汉族儿童及青少年牙齿发育存在着地区差异;在建立相关利用牙齿钙化程度推断年龄的方程模型时,最好分地区建模。     

应用放射影像技术进行牙龄推断

牙龄是年龄推断的重要方法之一，国外学者常将其与骨龄联合应用以提高年龄推断的准确性，但国内尚未普遍开展。大量研究表明，应用放射影像学这一无创的检查手段，可以准确观察牙齿的增龄性变化，如牙冠与牙根的发育程度、牙髓腔的变化等。目前应用放射影像学进行牙龄推断的主要方法有Gleiser和Hunt法、Demirjian法及牙髓腔测量法等。其中Demirjian法的准确性最高，但在推断法定敏感年龄时尚存在局限性。随着放射影像学的发展，尤其是CT的出现，依赖其高分辨率以及相匹配的测量软件，可提高牙龄推断的准确性与可靠性，有望成为今后推断活体年龄的重要手段。     

中国黑龙江地区汉族未成年人的牙钙化程度及年龄推断

目的探讨未成年人牙齿钙化程度与其年龄的关系,建立根据牙齿钙化程度推断未成年人年龄的方法。方法拍摄黑龙江地区1510名未成年人（男737名,女773名,年龄6～15周岁）牙齿曲面断层影像片,利用计算机观察全口曲面断层影像片中下颌恒牙牙位处钙化程度的影像特征,并建立牙齿钙化分级评分标准,然后根据此标准对下颌牙齿进行分级评分;将其结果输入SPSS13.0软件统计,按α=0.05对牙齿钙化分值分性别分年龄段组进行非参数检验和与年龄的相关性分析,最终建立根据牙齿钙化程度推断年龄的回归方程。结果同名牙左右侧无差异（P〉0.05）,而性别间有差异（P〈0.05）;男女性下颌牙齿的钙化程度均与年龄高度相关（r〉0.7）;所建方程模型合理可靠,盲测结果显示推断年龄与实际年龄间无统计学差异,误差绝对值的平均值男性为（0.367±0.257）岁,女性为（0.367±0.245）岁。结论本研究中未成年人牙齿钙化程度随年龄的增长而呈现增高趋势,直至完全钙化;根据牙齿钙化程度建立的回归方程可用于未成年人活体以及无名尸体的年龄推断。     

上下颌牙齿磨耗推断年龄准确性的比较

目的利用牙齿磨耗不同的分类方法分别推断上、下颌的牙齿年龄,分析各种方法推断上、下颌牙齿年龄的误差,评价上、下颌牙齿用于年龄推断的准确性。方法采用分级法与数量化法分别对164名18~46岁之间的成年人进行牙龄推断,计算出推断牙龄与实际年龄的误差,输入SPSS软件对误差的数据进行统计学分析。结果分别使用不同方法对上、下颌牙齿磨耗程度进行年龄推断的结果差别不大。结论上、下颌牙齿用于牙齿磨耗推断年龄的准确性无明显差异。     

中国汉族6-18周岁男性牙齿生长发育的年龄研究

目的研究牙齿钙化程度与年龄的关系,建立利用牙齿钙化程度推断中国汉族6～18周岁男性年龄的办程。方法通过对6568名6～18周岁汉族男性全口曲面断层影像上牙齿的钙化程度进行评分;将分级值及其对应年龄输入SPSS软件进行分析,建立推断年龄的方程模型;从研究样本外随机抽取已知年龄的样本160例进行卣测,,结果同名牙齿钙化评分值侧别间秩合检验结果P〉0．05;下颌左侧恒牙钙化评分值与年龄相关分析结果r值均存0．7以上,下颌同名牙间相关系数r均在0．9以上;所建回归模型拟合优度R^2=0．828,估计值标准误为1．23岁;阿测平均洪差为0．423±0．269岁。结论本研究所建立的方法准确可靠,可用于中国汉族6～18周岁男性人群的年龄推断。     

陕西省6～15岁汉族未成年人牙龄的研究

目的运用全口曲面断层影像技术,研究陕西省6-15岁汉族未成年人牙齿钙化规律,建立利用牙齿钙化程度推断陕西汉族6-15岁未成年人年龄的方法。方法按照中国汉族儿童及青少年牙齿钙化分级标准,对1997名（男934名,女1063名）陕西省6-15岁汉族未成年人的全口曲面断层影像中下颌恒牙钙化程度进行分级评分;将所得评分值及对应的年龄输入SPSS软件并进行统计分析,最终建立年龄推断的方程。结果下颌同名牙钙化评分值侧别间非参数检验结果 P〉0.05,而性别间非参数独立样本检验结果 P〈0.05;下颌左侧各颗恒牙钙化程度与年龄相关分析结果 r〉0.59;方程拟合优度检验所得校正决定系数均大于0.76,估计值标准误男性在0.85-1.05岁之间、女性在0.83-0.97岁之间。结论本研究建立的方法合理可靠,可用于陕西省汉族6-15岁未成年人年龄的推断。     

河南省安阳市6-15周岁汉族人牙龄的研究

目的建立利用牙齿钙化程度推断未成年人年龄的方法。方法选取河南省安阳市1575名（男性900名,女性675名）6～15周岁人群的全口曲面断层影像片,依照牙齿钙化分级标准对下颌恒牙钙化程度进行评分分级;所得数据经SPSS13．0软件统计分析,建立根据牙齿钙化程度推断年龄的方程;采用拟合优度检验、模型方差分析、回归系数检验和共线性诊断、残差分析对方程的合理性进行检验及盲测。结果下颌同名牙间钙化分级评分值无统计学差异（P〉0．05）,而下颌同名牙性别间钙化评分值在部分年龄组存在差异（P〈0．05）;下颌恒牙的钙化程度与年龄相关系数r均大于0．7;所建方程模型调整决定系数均大于0．8,估计值标准误男性为0．92岁至1．04岁、女性为0．92岁至1．00岁;推测年龄与真实年龄的平均误差男性为0．433±0．288岁、女性为0．502±0．297岁。结论本研究建立的方法在推断相关地区、相关年龄段人群的年龄推断中有较好的应用前景。     

广东省6～15周岁汉族人牙龄的研究

目的研究广东省6～15周岁人群牙齿钙化的规律,建立根据牙齿钙化程度推断未成年人年龄的方法。方法观测2 710例（男性1 363例,女性1 347例）广东省6～15周岁汉族人全口曲面断层影像片,对其下颌牙齿钙化程度进行评分分级,所得数据经SPSS软件统计分析,建立根据牙齿钙化程度推断年龄的方程,并以100例（男60例、女40例）研究外样本进行盲测。结果数据统计显示,两侧同名牙钙化评分分级值的差异无显著性意义（P〉0.05）,而性别间差异有显著性意义（P〈0.05）;下颌单侧8颗牙齿的钙化评分分级值与年龄相关系数（r）女性为0.552～0.759,男性为0.672～0.838;所建回归模型拟合优度（R2）均在0.7以上,估计值标准误男性为0.91～1.11岁,女性为0.92～0.98岁;盲测推测年龄与真实年龄平均误差男性为0.429±0.282岁、女性为0.399±0.252岁。结论本研究所建方法推断结果准确可靠,可用于广东地区6～15周岁人群年龄推断。     

中国汉族6～18周岁女性人群牙齿生长发育的年龄研究

目的研究牙齿钙化程度与年龄的关系,建立利用牙齿推断中国汉族女性人群年龄的方程。方法通过对6923名6～18周岁汉族女性儿童及青少年全口曲面断层影像下颌恒牙的钙化程度进行评分;将分级值及其对应的年龄输入SPSS软件进行分析,最终建立推断年龄的方程模型;从研究样本外随机抽取已知年龄的样本181例进行肓测。结果牙齿钙化评分值与年龄相关分析结果相关系数r均大于0．6,同名牙评分值侧别间统计分析结果P〉0．05且相关系数r均大于0．93,方程拟合优度检验R^2=0．789,估计值标准误为1．28岁,盲测结果与真实年龄的平均误差为0．421±0．272岁。结论本研究所建立的方法在推断中国汉族女性6～18周岁群体年龄方面有良好的应用前景。     

Relationship Between Pulp Tooth Area Ratio and Chronological Age Using Cone‐beam Computed Tomography Images

This study investigated the relationship between chronological age and pulp tooth area ratio (PTR) in maxillary central teeth using cone‐beam computed tomography (CBCT) images in the Turkish population. The sample consisted of CBCT images of 120 male and female subjects between 14 and 75 years old. The PTR of the maxillary central teeth was calculated using inVivo 5 software (Anatomage, San Jose, CA). Data were analyzed with independent t‐test and Pearson's rank correlation test. There was a significant negative correlation between chronological age and PTR (r = ?0.615). The results showed that the PTR of maxillary central teeth is a reliable method for age estimation in the Turkish population.     

Variations in pulp/tooth area ratio as an indicator of age: a preliminary study

This paper details a method for age determination of adults from single rooted teeth. The sample consisted of 100 Italian white Caucasian patients (46 men, 54 women) aged between 18 and 72 years. The single rooted maxillary right canine was utilized in this preliminary study. Pulp/root ration, tooth length, pulp/tooth length ratio, pulp/tooth area and pulp/root width ratios at three different levels were computed. Pearson's correlation coefficients between age and these variables showed that the ratio between pulp and tooth area correlated best with age (r2 = 0.85). Stepwise multiple regression models yielded a linear relationship between pulp/root width at mid-root level and chronological age and a linear relationship when pulp/tooth area was compared to age. Statistical analysis indicated that these two variables explain 84.9% of variations in estimated chronological age. The median of the absolute value of residual errors between actual and estimated ages was less than four years.     

Reliability in age determination by pulp/tooth ratio in upper canines in skeletal remains

Estimation of age of skeletal remains is one of the most complex questions for anthropologists. The most common macroscopic methods are based on dental wear and histological evaluation of bone remodeling. These methods are often qualitative, require great technical expertise, and have proved inexact in the estimation of ages over 50 years. Certain dental methods investigate the apposition of secondary dentine, in the study of tooth cross-sections, and X-rays to study width, height, and pulp area. The primary author previously proposed a method of estimating the age of a living person based on the pulp/tooth ratio (PTR) method in the upper canines. The aim of the present study is to verify whether the PTR method can also be used to estimate the age at death of skeletal remains. This paper investigates the study of historical samples of known age as a means to validate the proposed method.     

Human dental age estimation by calculation of pulp-tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth

Abstract: Secondary dentine is responsible for a decrease in the volume of the dental pulp cavity with aging. The aim of this study is to evaluate a human dental age estimation method based on the ratio between the volume of the pulp and the volume of its corresponding tooth, calculated on clinically taken cone beam computed tomography (CBCT) images from monoradicular teeth. On the 3D images of 111 clinically obtained CBCT images (Scanora^®3D dental cone beam unit) of 57 female and 54 male patients ranging in age between 10 and 65 years, the pulp–tooth volume ratio of 64 incisors, 32 canines, and 15 premolars was calculated with Simplant^® Pro software. A linear regression model was fit with age as dependent variable and ratio as predictor, allowing for interactions of specific gender or tooth type. The obtained pulp–tooth volume ratios were the strongest related to age on incisors.     

Pulp volume quantification methods in cone-beam computed tomography for age estimation: A critical review and meta-analysis

The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone-beam computed tomography (CBCT) with chronological age approximation. A subobjective was to investigate which methodology and CBCT technical parameters would be most appropriate to evaluate this correlation. This critical review followed the PRISMA guidelines, and it was conducted by a search through PubMed, Embase, SciELO, Scopus, Web of Science, Cochrane Library databases, as well as gray literature. Primary studies that used pulp volume, or pulp chamber to tooth volume ratio measured using CBCT were included. Seven hundred and eight indexed and 31 non-indexed records were identified. A qualitative analysis was performed including 25 selected studies with a total of 5100 individuals, age ranging from 8 to 87 years without sex predilection. The most used method was pulp volume/tooth volume. CBCT voxel size ranged between 0.09 and 0.5. Manual segmentation associated with threshold algorithms was used in most of the studies. Correlation between the pulp volume/tooth volume ratio was moderate: −0.66 for the upper central incisors, −0.59 for upper canines and −0.56 for lower canines. High heterogeneity was observed among the studies. It is concluded that pulp volume should be used with caution in age estimation. Evidence supports the preferable use of upper incisors with pulp volume/tooth volume ratio for age estimation. There is not enough evidence that voxel size interferes in age estimation by pulp volume.     

Age estimation by pulp/tooth ratio in canines by peri-apical X-rays

Estimation of age in individuals has received considerable attention in forensic science, in which it is a widely used method for individual identification, together with paleo-demographic analyses to establish mortality patterns in past populations. The present investigation, which is a continuation of a previously published pilot study, was conducted to examine the possible application of the pulp/tooth area ratio by peri-apical images as an indicator of age at death. A total of 200 peri-apical X-rays of upper and lower canines were assembled from 57 male and 43 female skeletons of Caucasian origin, aged between 20 and 79 years. They belong to the Frassetto osteological collection of Sassari (Sardinia) and are housed in the Museum of Anthropology, Department of Experimental and Evolutionistic Biology, University of Bologna. For each skeleton, dental maturity was evaluated by measuring the pulp/tooth area ratio on upper (x(1)) and lower (x(2)) canines. Very good agreement was found between intraobserver measurements. Statistical analysis was performed in order to obtain multiple regression formulae for dental age calculation, with chronological age as dependent variable, and gender, and upper and lower canines as independent variables. Stepwise regression analysis showed that gender did not contribute significantly to the fit (p=0.881) whereas variables x(1) and x(2) and the first-order interaction between them did. These two variables explained 92.5% of variations in estimated chronological age and the residual standard error was 4.06 years. Lastly, two simple linear regression equations were obtained for age estimation using canines from the maxilla and mandible separately. Both models explained 86% of variations in estimated chronological age and allowed an age-at-death estimate with a residual standard error of about 5.4 years.     

Age Estimation Based on Pulp Cavity to Tooth Volume Ratio Using Postmortem Computed Tomography Images

Pulp cavity size is known to decrease with age and can therefore serve as an indicator for age estimation. Here, we evaluated whether reconstructed images of multidetector‐row computed tomography (MDCT) acquired before forensic autopsy are useful for estimating age at death. Images of 136 mandibular first premolars obtained from bodies of known age at death were analyzed, and the volume of the regions corresponding to pulp cavity and that of the whole tooth were determined using a voxel counting function. The pulp cavity was clearly distinguishable from dental hard tissue on the reconstructed images when using a cutoff value of 1400 Hounsfield units. Regression analysis adjusted for sex showed that estimated age correlated significantly with the pulp cavity to tooth volume ratio (r = 0.76). MDCT is gaining more widespread use in forensic medicine, and analyzing dental images to obtain parameters for age prediction is a practical approach for postmortem identification.     

Age estimation by pulp/tooth ratio in canines by mesial and vestibular peri-apical X-rays

Changes in the size of the pulp canal, caused by apposition of secondary dentine, are the best morphometric parameters for estimating age by X-rays. The apposition of secondary dentine is the most frequently used method for age estimation in adult subjects. In two previous papers, we studied the application of the pulp/tooth area ratio by peri-apical X-rays as an indicator of age at death. The aim of the present study was to test the accuracy of age evaluation by combined analysis of labio-lingual and mesial peri-apical X-rays of lower and upper canines. A total of 200 such X-rays were assembled from 57 male and 43 female skeletons of Caucasian origin, aged between 20 and 79 years. For each skeleton, dental maturity was evaluated by measuring the pulp/tooth area ratio according to labio-lingual and mesial X-rays on upper (x(1), x(2)) and lower (x(3), x(4)) canines. Very good agreement was found between intra-observer measurements. Statistical analysis showed that all variables x(1), x(2), x(3), and x(4) and the first-order interaction between x(1) and x(3) contributed significantly to the fit, so that they were included in the regression model, yielding the following regression formula: Age = 120.737 - 337.112x(1) - 79.709x(2) - 364.534x(3) - 65.655x(4) + 1531.918x(1)x(3) . The residual standard error of estimated ages was 3.62 years, with 94 degrees of freedom, and the median of the residuals was -0.155 years, with an interquartile range of 4.96 years. The accuracy of the method was ME = 2.8 years, where ME is the mean prediction error. The model also explained 94% of total variance (R(2) = 0.94).     

Age estimation by pulp/tooth ratio in lower premolars by orthopantomography

Accurate age estimation has always been a problem for forensic scientists, and apposition of secondary dentine is often used as an indicator of age. Since 2004, in order to examine patterns of secondary dentine apposition, Cameriere et al. have been extensively studying the pulp/tooth area ratio of the canines by panoramic and peri-apical X-ray images. The main aim of this paper is to examine the relationship between age and age-related changes in the pulp/tooth area ratio in monoradicular teeth, with the exception of canines, by orthopantomography. A total of 606 orthopantomograms of Spanish white Caucasian patients (289 women and 317 men), aged between 18 and 75 years and coming from Bilbao and Granada (Spain), was analysed. Regression analysis of age of monoradicular teeth indicated that the lower premolars were the most closely correlated with age. An ANCOVA did not show significant differences between men and women. Multiple regression analysis, with age as dependent variable and pulp/tooth area ratio as predictor, yielded several formulae. R(2) ranged from 0.69 to 0.75 for a single lower premolar tooth and from 0.79 to 0.86 for multiple lower premolar teeth. Depending on the available number of premolar teeth, the mean of the absolute values of residual standard error, at 95% confidence interval, ranged between 4.34 and 6.02 years, showing that the pulp/tooth area ratio is a useful variable for assessing age with reasonable accuracy.     

The Effects of Racemization Rate for Age Estimation of Pink Teeth

Pink teeth is thought to result from the seepage of hemoglobin caused by dental pulp decomposition. We investigated whether racemization can be applied for age estimation in cases of pink teeth where the whole tooth is used. The pink teeth used were three cases and the normal teeth for control were five mandibular canines of known age. Age of the pink teeth was calculated on the basis of regression formula obtained from the five control teeth. Only a slight error was noted between the actual and estimated ages of the pink teeth (R² = 0.980, r = 0.990): Cases 1–3 actually aged 23, 53, and 59 years were estimated to be 26, 52, and 60 years. Based on our results of testing pink teeth of known age, we suggest that racemization techniques allow for the age estimation of pink teeth using the same methods for normally colored teeth.