Comparison of the validity of three dental methods for the estimation of age at death

The aim of the present study was to compare the accuracy, precision, and bias of two macroscopic and one histological age at death estimation methods on human teeth. The sample was comprised of 67 permanent teeth, obtained from 37 individuals aged 20-91 years. Age was predicted according to the methods proposed by Lamendin et al. (LAM), Bang and Ramm (BR), and the quantification of tooth cementum annulations (TCA). TCA was found to be most accurate in all age groups. Its mean absolute error of the estimated age was about half as high as the mean absolute error for both LAM and BR. BR achieved approximately the same mean absolute error as TCA for old adults only. LAM displayed the highest precision in the young and the old age group whereas TCA was more precise in the middle age group. TCA was found to be the most precise method when the precision was calculated for all ages. Considering the bias, all methods displayed a tendency to overestimate age in young and to underestimate it in old specimens. The exception to this rule was TCA, which provided unbiased estimates for young adults. The higher accuracy and precision recommends favouring TCA over LAM and BR, provided that the required know-how and equipment are available.