Demirjian法在推断上海汉族青少年生活年龄中的应用

目的研究Demirjian法推断上海汉族青少年生活年龄的适用性。方法收集上海市第九人民医院符合纳入标准的年龄在11～20周岁的汉族青少年口腔曲面全景片501例．其中男性168例．女性333例。按照Demirjian法进行牙龄推断,并对生活年龄与Demirjian法推断的牙龄进行配对t检验：通过单因素数学模型探索两者之间的关系。结果直接应用Demirjian方法推断上海汉族青少年牙龄时．其推断的牙龄与实际生活年龄之间存在差异。通过建立牙龄推断的单因素数学模型。并将其推断的年龄与实际生活年龄进行配对t检验,结果显示男性12～16周岁（不含16周岁）、女性13～14周岁（不含14周岁）和15～17周岁（不合17周岁）年龄段无统计学意义（P〉0．05）,并且有81．04％的样本推断误差小于1岁。结论本研究有望成为推断上海地区汉族青少年生活年龄的有效方法,但不适合17周岁以上青少年人群。     

基于Demirjian法推断年龄的研究进展

近年来,个体年龄推断在法医学实践中逐渐受到关注。常用的年龄推断方法主要是通过骨骼和牙齿发育。与骨骼相比,牙齿更为坚硬且不易受到外部环境影响,因此在年龄推断中具有重要作用。Demirjian法是评估牙龄最常用的方法之一,目前在多个国家得到了广泛应用。本文主要对Demirjian法在不同人群中应用的准确性进行回顾,发现与实际年龄相比,推断年龄大多存在高估现象,结合多位学者的研究结果分析认为,该情况可能与种族、地域、性别等差异具有相关性。     

应用Demirjian法进行法医学年龄推断的评价

目的对应用Demirjian法进行法医学年龄推断的准确度及可靠性进行初步评价。方法应用Demirjian法测定828名上海地区青少年(男279名,女549名,11～19周岁)的牙龄,比较所测牙龄和实际年龄的差异。结果在11～14岁年龄段Demirjian法测定的牙龄比实际年龄高估,在15～16岁年龄段低估,在17岁及17岁以上年龄段具有局限性。结论Demirjian法可以用于测定上海地区11～16岁年龄段青少年的牙龄,使用时需进行适当的修正。     

Demirjian法测定广东地区青少年第三磨牙牙龄

目的评估Demirjian法用于测定广东地区青少年牙龄的可行性。方法收集344例(男性171例,女性173例)广东地区9~25岁汉族青少年全口曲面断层片,应用Demirjian法进行分期评定,并比较测得牙龄与生理年龄的差异,分析男女之间的差异性,并分别比较相应分期与16岁和18岁实际年龄的似然率。结果本文344例样本的统计学分析显示,生理年龄与第三磨牙发育程度呈高度相关,相关系数男性为0.837,女性为0.886;Demirjian法分期为D、E、G期的不同性别之间,第三磨牙的发育程度差异具有统计学意义(P0.05);根据样本分期推断的牙龄与相应个体生理年龄的平均差异,女性为0.98岁,男性为0.88岁,其差异具有统计学意义(P0.05);分期为G期的样本与达到以及大于16岁个体似然率男性为85.7%,女性为94.3%,H期与达到以及大于18岁的似然率男性及女性均为100%。结论根据全口曲面断层片对广东汉族青少年牙龄进行推断不能单独采用Demirjian法,需用其他方法综合校正;而分期中的G及H期可用于对16及18岁年龄的推断。     

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。     

中国北方未成年人群牙龄推断研究

目的运用Cameriere法和Willems法推断中国北方5~14岁人群牙龄,并比较两种方法牙龄推断的准确性。方法收集西安交通大学口腔医院年龄在5~14岁的中国北方未成年人群拍摄的全口曲面断层片2000例,其中男性1000例,女性1000例。分别采用Cameriere法和Willems法进行牙龄推断,利用SPSS 18.0软件对两种方法的推断年龄与生理年龄进行配对t检验,比较推断年龄与生理年龄的差异。结果 Cameriere法的推断年龄比生理年龄平均低估了0.38岁(男性)和0.39岁(女性),而Willems法的推断年龄比生理年龄平均高估了0.61岁(男性)和0.39岁(女性)。对比两种方法的平均绝对误差(mean absolute error, MAE),Cameriere法的MAE为0.87岁,Willems法的MAE为0.91岁。结论 Cameriere法和Willems法均适用于中国北方5~14岁未成年人群的牙龄推断,但Cameriere法比Willems法更准确。     

上、下尖牙髓腔/牙体表面积比值的年龄判定价值研究

目的通过三维重建测量上、下颌尖牙髓腔/牙体表面积比值(Pulp/Tooth area Ratio,PTR)来推断个体年龄,为临床年龄推断的应用提供科学依据。方法收集口腔门诊患者年龄在16~65岁200例锥形束CT(Cone beam computed tomography,CBCT)影像资料,以4个尖牙为测量对象并进行三维重建,测量各尖牙髓腔和牙体表面积,计算PTR值。应用SPSS17.0软件进行统计学分析,推导实际年龄的推断公式。结果Pearson相关分析显示上、下颌尖牙PTR值与实际年龄呈高度负相关(P<0.001,r值为-0.833~-0.891)。4个尖牙间的PTR值无显著差异(P>0.05)。男女性别间尖牙PTR值无显著差异(P>0.05)。尖牙PTR值(x)推断年龄公式为:年龄=84.42-222.22x,R²=0.739。结论检测尖牙的PTR值,可明显提高临床年龄推断的准确性。     

分子生物学在年龄推断中的研究进展

年龄推断是法医学研究与实践的重点和难点内容之一。目前,年龄推断主要依据骨龄、牙龄等形态学方法,但误差较大、影响因素较多。近年来,随着分子生物学理论与技术的发展,研究者发现某些细胞分子水平与年龄密切相关。本文就目前细胞分子水平与年龄关系的研究进展进行综述。     

根据牙齿磨耗度对已知年龄范围的牙龄的推定

根据牙齿推断年龄在法医实践中具有重要的意义。近年来,在统计学的多因素分析中,把某些定性的描述数量化是一项很重要的成就。竹井哲司曾用数量化的方法进行过牙龄研究。作者对牙龄也曾应用数量化和多元逐步回归方法进行过较深入的研究。日前,对无名尸往往可以判定出大致的年龄范围,如20—40岁,30—50岁等。如在此基础上进行年龄推断,可提高其正确性。但迄今为止,对不同年龄阶段进行年龄判定尚无所闻。本文在进一步应用数量     

年龄推断的研究现状

推断年龄目前主要依据人体骨骼、软组织、细胞和生物大分子,以及组织中各类物质的物理和化学特性等随年龄增长的时序性变化。由于生物体各组织器官生长发育的生理性变化及其影响因素极为复杂,不同推断年龄的方法均有其应用价值,但也都存在一定的局限性,在法医学实际检案中如果能综合运用,可提高年龄推断的准确性。本文回顾国内外年龄推断现状,并对各种推断方法进行讨论。     

Dental Age Assessment in Children: A Comparison of Four Methods in a Recent French Population

The aim of this study was to analyze the accuracy and the reliability of four methods of dental age estimation (Demirjian, Willems I, Willems II, and Chaillet standards) in a French population. Orthopantomograms of 743 children aged between 4 and 15 years were used. The Demirjian standards gave a consistent overestimation of dental age compared with chronological age (+0.45 and +0.46 years for girls and boys, respectively). We found that three modified methods were more accurate for both sexes than Demirjian's method: the Willems I method appeared to be more suitable when the sex and ethnicity are both known (?0.09 and +0.14 years for girls and boys, respectively); the Willems II method was more accurate for children of unknown sex (mean difference = 0.00 years), and the Chaillet method was found to be more accurate than the Demirjian method, but less accurate than the Willems I method (?0.59 and ?0.18 years for girls and boys, respectively).     

Applicability of Greulich and Pyle and Demirijan aging methods to a sample of Italian population

Age estimation in forensics is essential in cases involving both living and dead subjects. For living subjects, age estimation may be used to establish an individual's status as a minor in cases involving adoption, criminal responsibility, child pornography, and those seeking asylum. Criteria for age estimation in the living have recently been put forth by The Study Group on Forensic Age Diagnostics. The group has proposed guidelines with a three-step procedure: a physical examination and anthropometrical analysis; dental analysis by orthopantomogram (OPG); and X-ray study of the left hand and wrist. The board of FASE highlighted advantages and limits of each method, and suggested practical solutions concerning the age estimation process for adults and subadults. The aim of this study was to verify the applicability of the Greulich and Pyle, and Demirjian techniques on a sample group of Italians, whose ages were known, in determining the skeletal and dental age, in addition to evaluating the reliability of these techniques. 535 subjects between the ages of 7 and 15years were examined, each one undergoing both an orthopantomography (OPG) and radiography of the left wrist and hand. The data obtained underwent statistical analysis. The analyses have shown that a correlation exists between skeletal and dental age, and real age. Age estimation carried out using the Greulich and Pyle method has shown itself to be especially accurate on the Italian sample, particularly in the age ranges of 7-9years and 10.4-11.5years. The Greulich and Pyle method has shown itself to be reliable for the sample analyzed notwithstanding the ethnic differences between the original sample of reference and those analyzed in this study. Application of the Demirjian technique resulted in an overestimation of dental age. This difference is shown to be more highly significant in the higher age ranges. The combination of the Greulich and Pyle, and Demirjian methods have revealed a difference regarding real age, which turns out to be more modest in the younger age ranges and more significant in older subjects.     

The applications of MicroCT in studying age-related tooth morphological change and dental age estimation: A scoping review

Conventional dental age estimation relies on destructive methods such as sectioning and staining, which are unpreferable when the tooth is required for evidential or archeological preservation. MicroCT is a non-destructive, high-resolution imaging technique that allows for accurate morphometrical measurement. Although microCT technology has been applied in a variety of dental studies, studies focusing on dental age-related change and dental age estimation based on microCT imaging remain lacking. Based on the question: “How has microCT technology been applied in studying human age-related tooth morphological change and dental age estimation studies?”, the authors conducted a scoping review in accordance with the Arksey and O'Malley (2005) and the PRISMA-ScR guidelines. A literature search using five major scientific databases identified 452 articles, with 11 full-text articles being eligible to be included in the scoping review. Furthermore, 6 out of the 11 studies performed dental age estimation modeling. An overview of the parameters used in the selected articles revealed a variety of tooth characteristics, such as pulp cavity to whole tooth volume ratio, secondary dentin, as well as the diameter of root canal orifice. The findings of this scoping review highlight the extent microCT is used in studying dental age-related changes, as well as the effectiveness of microCT in dental age estimation studies. This review serves as a guide for future forensic odontology age estimation studies.     

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).     

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.     

Dental age in Central Poland

Precise evaluation of the developmental stage of a child is an integral part of both diagnosis and treatment of pediatric patients; it is also essential in forensic medicine and dentistry. Among radiological methods for dental age estimation in children the Demirjian's method is widely used, however original standards elaborated for the French-Canadian population are mostly not suitable for other populations. The aim of the study was to compare the dental age of children from the region of Mazovia (Central Poland) with the developmental standards presented by Demirjian, to analyse sexual dimorphism of dental age in the studied group and to estimate validity of the Demirjian's standards for the studied Polish population. The material consisted of clinical files and panoramic X-ray images of 994 children aged from 6 to 16 in good general health, without development impairments. Chronological ages of the patients were established. Next dental ages were estimated by means of the Demirjian method based on developmental maturity of seven left mandibular permanent teeth. It was found that the standards were significantly different from the chronological ages in the studied population, which means that dental development was considerably accelerated. The most significant acceleration was observed in girls aged 11 and 12, as well as in 13-year-old boys; in both groups a considerable acceleration of the dental age was seen in 6-year-olds. No statistically significant differences between dental ages of girls and boys were observed in particular age groups. There were devised gender-specific equations allowing for adaptation of original Demirjian's scores for estimation of dental age in the population of Mazovia (Central Poland). In conclusion, the developmental standards used by Demirjian are not suitable in the case of the population of children of Central Poland. Therefore, it is necessary to establish new tables for this population.     

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.     

Permanent teeth development in a Spanish sample. Application to dental age estimation

The purpose of this study is to clarify the chronology of different stages of dental development, according to Demirjian, in a sample of Spanish children, which will enable us to build a database that will be used as a reference in regard to the dental development of individuals of our socio-geographic environment. In the same studied sample, a calculation of the dental age according to Demirjian was carried out. This study was conducted in a final sample consisting of 1010 orthopantograms, corresponding to Spanish children (485 boys and 525 girls) ages 2-16. Comparing the age of onset of the different stages among the children, evidence was found that girls had an earlier general development than boys. These differences were only statistically significant in teeth and concrete stages. The canine teeth revealed greater gender dimorphism, with significant differences in all stages compared with the upper canines. The method proposed by Demirjian for dental age calculation resulted in a significant overestimation of dental age in relation to the chronological age in boys (average of 0.87 years) and girls (average of 0.55 years). Data from this study may be used as reference for dental maturity, as well as a standard for estimating age in Spanish children.     

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.