Multiple regression models for age estimation by assessment of morphologic dental changes according to teeth source

The aims of this study were twofold: (1). to measure parameters that contribute significantly to estimates of dental age, using a combination of classic methods and a computer-assisted image analysis procedure to avoid the bias inherent in observer subjectivity; and (2). to develop new mathematical regression models for age prediction according to postmortem interval. Two different populations were studied. Forty-three permanent teeth (Group I), extracted for valid clinical reasons, were taken from patients 25-79 years of age. The other population group (Group II) was composed of 37 healthy erupted permanent teeth obtained from human skeletal remains (age 22-82 years) with a postmortem interval ranging from 21 to 37 years. Morphologic age-related changes were investigated by measuring variables on intact and half-sectioned teeth. Multiple regression analyses were performed with age as the dependent variable for each sample source. In fresh extracted teeth, the variables that made the greatest contributions to predictions of age were dental attrition, dentin color, and translucency width, the latter measured with a computer-assisted image analysis method. In teeth from human skeletal remains, the variables that made the greatest contributions to age calculation were cementum apposition, pulp length measured by computer-assisted image analysis, dental attrition, root translucency, and dental color. We conclude by recommending different regression models to calculate age depending on the postmortem interval.     

Age estimation of adults from dental radiographs

Previous studies have shown that with advancing age the size of the dental pulp cavity is reduced as a result of secondary dentine deposit, so that measurements of this reduction can be used as an indicator of age. The aim of the present study was to find a method which could be used to estimate the chronological age of an adult from measurements of the size of the pulp on full mouth dental radiographs. The material consisted of periapical radiographs from 100 dental patients who had attended the clinics of the Dental Faculty in Oslo. The radiographs of six types of teeth from each jaw were measured: maxillary central and lateral incisors and second premolars, and mandibular lateral incisors, canines and first premolars. To compensate for differences in magnification and angulation on the radiographs, the following ratios were calculated: pulp/root length, pulp/tooth length, tooth/root length and pulp/root width at three different levels. Statistical analyses showed that Pearson's correlation coefficient between age and the different ratios for each type of tooth was significant, except for the ratio between tooth and root length, which was, therefore, excluded from further analysis. Principal component analyses were performed on all ratios, followed by regression analyses with age as dependent variable and the principal components as independent variables. The principal component analyses showed that only the two first of them had significant influence on age, and a good and easily calculated approximation to the first component was found to be the mean of all the ratios. A good approximation to the second principal component was found to be the difference between the mean of two width ratios and the mean of two length ratios, and these approximations of the first and second principal components were chosen as predictors in regression analyses with age as the dependent variable. The coefficient of determination (r²) for the estimation was strongest when the ratios of the six teeth were included (r² = 0.76) and weakest when measurements from the mandibular canines alone were included (r² = 0.56). Measurement on dental radiographs may be a non-invasive technique for estimating the age of adults, both living and dead, in forensic work and in archaeological studies, but the method ought to be tested on an independent sample.     

Differences in morphological age-related dental changes depending on postmortem interval.

Morphological methods for age estimation from teeth have been developed and applied to samples without taking the postmortem interval into consideration. We studied differences in morphological age-related changes between fresh extracted teeth and teeth from human skeletal remains in order to develop appropriate dental age estimation methods according to the time after death. Forty-three permanent teeth from dental patients were compared to 37 teeth obtained from human skeletal remains with a postmortem interval from 21 to 37 years. Morphological age-related changes were investigated by measuring variables on intact and half-sectioned teeth. A new computer assisted image analysis procedure to avoid subjectivity was developed to measure variables in sectioned specimens. Dental color, translucency length, attrition, cementum apposition, and secondary dentin showed higher values in teeth from human skeletal remains than in fresh extracted teeth. Variables obtained by morphometric analysis of computer-generated images (tooth length, tooth width, root length, and root area) showed higher values in fresh extracted teeth than in teeth from skeletal remains. The postmortem interval affects age-related morphological changes, and therefore different methods should be used for teeth of unknown postmortem interval.     

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 measurement of open apices of teeth to test chronological age of over 14-year olds in living subjects

Age determination in living subjects is a problem of increasing interest in our community, due to the increasing numbers of individuals without identification papers, who have immigrated illegally or committed crimes, and for whom it is necessary to verify whether they have reached the age of 14 years in order to be charged legally. Although the most widespread methods for age estimation refer to skeletal or dental analysis, these methods do present some drawbacks for identification of the age of 14. The aim of the present study is to discriminate between children who are or are not 14 years of age or older by measuring the open apices of teeth. We evaluated the OPGs of 447 persons aged between 12 and 16 years, of Italian, Croatian and Slovenian nationality. For each individual, dental maturity was estimated using the number of the seven left permanent mandibular teeth with root development complete, and normalized measurement of the open apices of the third molar. The results revealed that an individual is considered to be 14 years of age or older if all seven left permanent mandibular teeth have closed apices and the normalized measurement of open apices of the third molar is lower than 1.1.     

Eruption times of permanent teeth in male children and adolescents of Tehran (Iran)

The eruption times of permanent teeth and the sequence of tooth eruption were investigated in 952 individuals aged 4 to 24 years. Wisdom teeth were excluded from the evaluation. All individuals were inhabitants of Tehran, Iran. The results were compared to results of international studies on tooth eruption of the 20th century and studies published in recent years. The teeth emerged symmetrically in each jaw. However, teeth erupted earlier in the mandible than in the maxilla, excluding the earlier eruption of maxillary premolars. The sequence of emerging teeth in the maxilla is: first molar, central incisor, lateral incisor, first premolar, second premolar, canine, and second molar. The sequence of tooth eruption of the mandible differs from the maxillary sequence: first molar, central incisor, lateral incisor, canine, first premolar, second premolar, second molar. The sequence of all teeth is: lower first molar, lower central incisor, upper first molar, upper central incisor, lower lateral incisor, upper lateral incisor, upper first premolar, lower canine, lower first premolar, upper second premolar, upper canine, lower second premolar, lower second molar, and upper second molar. The results support current theories that the differences in tooth eruption times between humans of different ethnic origin are small.     

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 Reappraisal of Developing Deciduous Tooth Length as an Estimate of Age in Human Immature Skeletal Remains

This study provides an update on a quantitative method for immature age estimation based on postnatal deciduous mandibular tooth length. Two known sex and age skeletal collections from Western Europe were sampled (n = 97). Linear regression models for age estimated were calculated for each individual tooth, each sex, and sex combined sample using classical calibration. Prediction errors, residuals, and percentage of individuals whose real age fell within the 95% prediction interval were calculated. The teeth which develop earlier in life, the incisors and the first molar, showed the greatest precision, while the canine showed the least. This method has greater applicability to archeological skeletons or to children in developing countries than for use in North American or European forensic contexts. The method can be applied to incomplete or poorly preserved remains of unknown sex, particularly when dental radiographs are not an option or when teeth have been removed from the alveolus or crypt.     

中国汉族6～18周岁人群下颌恒牙钙化的性别差异研究

目的通过对中国汉族男女6～18周岁人群全口曲面断层影像上所显示的下颌左侧牙齿钙化程度进行比较研究,探究牙齿生长发育的性别差异,为建立用牙齿推断中国汉族儿童及青少年年龄的线性回归模型提供理论依据。方法通过对13491张(男6568张,女6923张)中国汉族6～18周岁儿童及青少年全口曲面断层影像的牙齿钙化规律进行研究,建立牙齿钙化的分级标准,并对下颌恒牙进行分级评分;数据用SPSS 13.0软件处理。结果非参数检验结果显示大部分年龄组下颌左侧8颗恒牙钙化分级值性别间的差异有统计学意义(P0.05);在8颗恒牙发育程度同等条件下,女性年龄比男性小0.303岁。结论中国汉族6～18周岁人群牙齿发育存在着性别差异;在利用牙齿钙化程度建立推断中国汉族儿童及青少年年龄的方程模型时,应分性别建模。     

Eruption times of permanent teeth in children and adolescents of Paderborn, Westphalia, Germany

The eruption times of permanent teeth and the sequence of tooth eruption were investigated in 1535 individuals aged 3 to 24 years. Wisdom teeth were excluded from the evaluation. All individuals were inhabitants of Paderborn, Westphalia, Germany. The results were compared to results of other German studies on tooth eruption of the 20th century. The teeth emerged symmetrically in each jaw. However, teeth erupted earlier in the mandible than in the maxilla. Teeth erupted earlier in females than in males. The sequence of emerging teeth in the maxilla is identical in both sexes: first molar, central incisor, lateral incisor, first premolar, and canine, second premolar, second molar. The sequence of tooth eruption of the mandible is identical in both sexes but differs from the maxillary sequence: first molar, central incisor, lateral incisor, canine, first premolar, second premolar, second molar. Since the fifties of the last century the acceleration of teeth emergence has not increased in German studies on this subject.     

The application of Kvaal's dental age calculation technique on panoramic dental radiographs

INTRODUCTION: Literature reports on a method for dental age calculation which is based only on radiological measurements on periapical dental radiographs: the relationship between chronological age and the two-dimensional dental pulpal size was analysed by means of multiple regression analyses. The purpose of the present study was to evaluate whether this approach could be feasible and could lead to statistically sound results with adequate repeatability when applied on panoramic radiographs. MATERIALS AND METHODS: One hundred and ninety seven panoramic radiographs were collected at random from patients of whom the age ranged from 19 to 75 years. According to the reported technique, six teeth were selected on the panoramic radiograph: in the maxilla the central and lateral incisor and second bicuspid, and in the mandibula the lateral incisor, cuspid and first bicuspid. The same exclusion criteria as in the original paper were respected. Statistical analysis was carried out in order to spot significant differences between the chronological age and the calculated age. RESULTS: When the age was calculated based on measurements of all six teeth or of all three mandibular teeth, no significant differences were found between the real age and the calculated one. In all other instances using the individual teeth separately or using all three maxillary teeth statistical analysis revealed significant differences. CONCLUSION: There appears to be no significant difference between applying the original technique on standard long-cone periapical radiographs or on orthopantomograms, especially when carrying out measurements on all six selected teeth.     

Age estimation from teeth in children and adolescents

The aim of this cross-sectional study was to evaluate the dental formulas according to age because of possible changes during the last decades. From these dental formulas, the median age of emergence for the permanent teeth was deduced. The study population corresponded to the 1 to 15 year-old children who had consulted either a pediatric dentist or orthodontist in the city of Nice (France). Data were collected from the 5,848 patients' charts that included an orthopantomography. This permitted the observation of emerged teeth and agenesis. Bar charts were used to indicate the dental formula according to age. There was no significant difference in the emergence pattern of both controlateral maxillary and mandibular teeth. Only the anterior tooth emergence significantly differed according to the maxillary. The lower central incisor was the lone tooth with a median age earlier than others; the remaining teeth had an age equivalent to those of previously estimates.     

Measurement of arch widths in a human population: relation of anticipated bite marks

The authors compared arch width measurements of diagnostic dental models obtained from dental school patients. Arch width measurements were taken in the canine area on each dental cast in an effort to assist forensic dental investigators in matching certain classes of subjects to the bites they might possibly inflict. If any canine teeth were absent, the measurements were taken using other specified adjacent teeth which the investigators felt would be interpreted as the arch width determiners in a bite mark injury. The ages of the subjects varied from 14 to 87 years. Statistical comparison of the maxillary arch width, mandibular arch width, and the mean difference between maxillary and mandibular arch width were performed. Significant differences between the arch width measurements were found to exist between several classes of subjects based on race and sex.     

Age of attainment of mineralization stages of the permanent dentition.

The ages at which the maxillary and mandibular teeth of 121 boys and 111 girls reached 14 mineralization stages were determined from serial cephalograms at the Burlington Growth Centre. The present data are more comprehensive than any previously available and can be applied to chronological age determinations in juveniles of indefinite age, and of specimens in anthropological and forensic investigations. The sexes differed in the age at which they attained the stages of mineralization, with the canines demonstrating the greatest difference. In each sex, the ages at identical stages were similar for the corresponding teeth in the maxilla and mandible. Variability in age was greater among the males, especially for the first premolars, and increased with age, except for the third molars. Variability in age of third molar mineralization was greater in females and diminished among both sexes at late stages of root formation.     

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.     

Biomedical image processing for age measurements of intact teeth

With increasing age the roots of teeth undergo sclerosis. The degree of dental root sclerosis can be demonstrated visually if light is transmitted through the specimen. However, this resultant image is only a two-dimensional (2-D) visualization which misrepresents what in truth is a three-dimensional (3-D) characteristic. We have described an image acquisition and computer processing system for imaging intact teeth, with special reference to the root transparency, which tends to progress from the root apex towards the neck of the teeth as a function of age. The components of our system involve: an energy source with light transmission through table-mounted dental specimens; an image processor with a digitizer; a step motor with a holder to rotate the tooth specimen; and a software package to computerize and reconstruct the sectional digital images. After rotating the position of the specimen, while at each rotation obtaining a 2-D image of the sample, we then can reconstruct the true 3-D cross-sectional or longitudinal morphology or both from these 2-D images. With this new approach, the reconstructed dental images represent segments from different angles of the tooth specimen. Picture element values in each image, quantitatively indicate the optical density, expressing the age dependent pattern of the 3-D anatomy in toto.     

Age estimation methods using anthropological parameters on human teeth-(A0736)

The research was conducted on the 160 intact extracted human teeth with one and two roots of the known age and sex. The teeth were disinfected, dried and X-rayed. After that the section of the longitudinal cut through the teeth was performed in order to facilitate monitoring of all tissues and morphological characteristics of the teeth. The age was determined in three ways: Method 1 [G.Bang, E. Ramm, Determination of age in humans from root dentin transparency, Acta Odontol. Scand. 28 (1970) 3-35]--analysis of the translucency of the root dentine, Method 2 [S. Kvaal, T. Solheim, A non-destructive dental method for age estimation, J. Forensic Odonto-stomatol. 12 (1994) 6-11]--analysis of the root and the root canal from the X-ray, Method 3 [G. Johanson, Age determination from human teeth, Odontol. Revy. 22 (1971) 1-126]--analysis of six parameters on each teeth. All data were subject to the correlation and regression analysis which showed the following: all of the three applied methods were in the significant correlation with the real age, and the best of them proved to be Method 3 where the coefficient of correlation was 0.85, p<0.001. The teeth of the maxilla are more convenient for the age determination than the teeth of mandible. They are in the significant strong correlation with the known real age, and in Method 3, the coefficient of correlation is 0.78, p<0.001. Age determination of the teeth with two roots is in significant correlation with the known real age p<0.001 in relation to the determined age on the teeth with one root. The results show that sex too, is in significant correlation with the real age, p<0.001. In practice, the methods used and the results achieved in this research have been enabling the dental age estimation of human remains from mass graves after the 1991 war in Croatia.     

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。     

Dental age assessment: the applicability of Demirjian method in eastern Turkish children

In the literature, little is known about the applicability of this method in Turkish children. The aim of this study was, therefore, to evaluate the reliability of Demirjian method of age estimation when used for eastern Turkish children. A retrospective study was performed on a sample of panoramic radiographs taken from 807 healthy eastern Turkish children. The stages of dental maturity of the mandibular left seven permanent teeth for each subject using the eight radiographic dental maturity stages demonstrated by Demirjian were evaluated. A paired t-test was used for statistical analysis. The mean difference between the chronological and dental ages ranged from 0.2 to 1.9 years in girls and from 0.4 to 1.3 years in boys. The differences between the chronological and dental ages were statistically significant in all age groups. The applicability of Demirjian method is not suitable for eastern Turkish population.     

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。