Dental Cementum in Age Estimation: A Polarized Light and Stereomicroscopic Study

Abstract: Dental hard tissues are good candidates for age estimation as they are less destructive and procedures to determine age can be easily performed. Although cementum annulations and cementum thickness are important parameters in this regard, they are seldom used. This study was undertaken to review the methods, difficulties in execution of techniques, and accuracy of cementum thickness and annulations in estimating the age. Unstained and stained ground sections of tooth were used to measure cemental thickness and count cemental annulations based on which age was estimated and was compared with known age. Although there was positive relation between cemental thickness and annulations with age, only in 1–1.5% of cases, age could be predicted with accuracy.     

Age estimation from the structure of adult human teeth: review of the literature.

The literature on age estimation from the structure of adult human teeth is reviewed. Several anatomic changes of teeth have been shown to be valuable in age determination, but there is still controversy concerning the accuracy of cemental annulation. It is believed that improvements in age estimation can be made using direct measurement rather than scoring systems.     

Individual age determination using growth rings in the cementum of buried human teeth

Incremental lines of the dental cementum were used for individual age determination in 102 teeth. 66 of them come from different historic periods, 15 teeth were cremated. 36 modern teeth of known age were use as controls. The incremental lines were investigated by use of 100 microns thin cross-sections of the root. Age determination by this method was possible in every tooth, independent of incinaration of various burial conditions. The individual age was determined by adding the mean value of the repeatedly counted incremental lines to the sex-specific eruption age of the tooth in question. Since average deviation from known age is +/- 3.23 years only, counting the incremental lines represent a very advantageous, quantitative method for individual age determination.     

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.     

Improving the visibility of tooth cementum annulations by adjustment of the cutting angle of microscopic sections

Age at death assessments by counting tooth cementum annulations (TCAs) in unstained undecalcified microscopic ground sections of (single rooted) teeth is, amongst others, problematic because of the unclear distinction between the bright and darker annulations. Counting is hampered by optical superimposition of the tangentially positioned layers of cementum in the section since 'regular transverse sections' run perpendicular to the axis of a cone-shaped root with its yearly deposited cone-shaped layers of cementum. This study demonstrates that to improve the visibility of the annulations, the cutting angle should be perpendicular to the exterior of a root, not perpendicular to its axis. The site where the cut hits the root perpendicular should show the best possible distinction between the TCAs. Here, superimposition of the now vertical positioned layers within the section will result in increased contrast between bright and darker layers. A procedure for such preparation is given.     

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.     

Correlation of age and incremental lines in the cementum of human teeth

It has been long recognized that cementum thickness increases with age. Much literature has recently been devoted to utilizing incremental lines in cementum as an aging criterion in animals, but only one study has been done suggesting this technique in humans. Thirty-one teeth of known age were histologically stained and sectioned to observe incremental lines. Direct predictions of age based on these lines underestimated the age of older specimens. However, there was a correlation between number of lines and age, and with a large enough specimen size, a computer-generated formula for age prediction may be possible.     

Determination of season at death using dental cementum increment analysis

Dental cementum anchors teeth into their sockets via the periodontal ligament. In mammals, dental cementum is laid down in alternating opaque and translucent bands representing winter (dormant) and summer (growth) seasons. Each pair of bands represents 1 year of life. Estimates of age at death based on counting pairs of bands are highly accurate. If the timing of the transition between winter and summer bands could be identified in humans, dental cementum increment analysis could be used to specify the season at death. This pilot project attempts to determine when these transitions occur and thus provide forensic anthropologists with a technique that would refine our estimates of postmortem interval. Extracted teeth were obtained from a local oral surgeon, embedded, sectioned, ground, polished, and examined under transmitted polarized light. The outermost increment was identified and measured along with other randomly chosen like bands. A transition from translucent to opaque bands was observed in teeth extracted in early October, while teeth extracted in early April exhibited nascent translucent bands. Further, significant correlations were observed between band thickness and number of days into either season, suggesting that band width increases as either season progresses. In this blind study, extracted teeth were effectively sorted into the spring/summer or fall/winter season 99% of the time.     

Approaches to chronological age assessment based on dental calcification

The aim of the present study was to find an accurate estimation of chronological age using a small number of selected teeth. For this purpose, the method devised by Nolla [C. Nolla, The development of the permanent teeth, J. Dent. Child. 27 (1960) 254-266.] was used: the development of each of the teeth was determined according to this method on 374 radiographs, 195 of boys (mean age 8.59) and 179 of girls (mean age 8.75). The 28 variables representing the calcification stages were analyzed using cluster analysis followed by multivariate analysis (multiple linear regression model). Patient age was considered to be a dependent variable. Our study showed that antimere teeth are the most homogeneous as regards stages of development. The prediction was more accurate for boys and girls below 10 years of age, using teeth 21, 43 and 46 from boys and teeth 21, 46 and 47 from girls. These teeth accounted for 80% total variance of chronological age for dental calcification. Standard error was +/-1.4 years for boys and +/-1.2 years for girls. When the age of the children remained completely unknown, the best estimates were provided by teeth 43, 47, 46 and 44 from boys and teeth 44, 47 and 43 from girls.     

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.     

Age estimation in small children: reference values based on counts of deciduous teeth in Finns

The eruption of teeth in the mouth is suitable for age estimations during the period when teeth are actively emerging, in the deciduous dentition phase approximately from the age of 6 months to 2.5 years. Estimations of age can be performed simply by counting the number of teeth in the mouth. Reliability of the estimates depends on the reference data available and each population group should preferably have its own standards. In the present study timing of eruption of successive deciduous teeth was studied longitudinally in 129 Finns. The dates of clinical eruption of deciduous teeth were recorded by mothers and checked by dentists. In 40 of the 129 children emergence ages of at the most the four last teeth were based only on semiannual registrations performed by dentists. The main purpose was to provide normal timetables of tooth eruption in small children in forms that are practical in estimations of dental age. No sexual dimorphism existed in the timing of clinical eruption of successive deciduous teeth. The mean age corresponding to the presence of one tooth in the mouth was 7.1 months (S.D.=1.78) and that corresponding to tooth count 19 was 27.8 months (S.D.=3.99). If the chronological age is known, the presented distributions and means with variations make it possible to estimate the degree of advancement or delay in a child's dental development. If the age of the child is not known, the mean and median ages can be used for estimations of chronological age. However, estimations of age should not be based only on tooth counts because of marked variation also within this homogeneous group.     

Age estimation in small children: reference values based on counts of deciduous teeth in Finns

The eruption of teeth in the mouth is suitable for age estimations during the period when teeth are actively emerging, in the deciduous dentition phase approximately from the age of 6 months to 2.5 years. Estimations of age can be performed simply by counting the number of teeth in the mouth. Reliability of the estimates depends on the reference data available and each population group should preferably have its own standards. In the present study timing of eruption of successive deciduous teeth was studied longitudinally in 129 Finns. The dates of clinical eruption of deciduous teeth were recorded by mothers and checked by dentists. In 40 of the 129 children emergence ages of at the most the four last teeth were based only on semiannual registrations performed by dentists. The main purpose was to provide normal timetables of tooth eruption in small children in forms that are practical in estimations of dental age. No sexual dimorphism existed in the timing of clinical eruption of successive deciduous teeth. The mean age corresponding to the presence of one tooth in the mouth was 7.1 months (S.D.=1.78) and that corresponding to tooth count 19 was 27.8 months (S.D.=3.99). If the chronological age is known, the presented distributions and means with variations make it possible to estimate the degree of advancement or delay in a child’s dental development. If the age of the child is not known, the mean and median ages can be used for estimations of chronological age. However, estimations of age should not be based only on tooth counts because of marked variation also within this homogeneous group.     

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.     

Determination of age based on the skeleton

A skeleton is reported that was found 40-100 cm under the surface of the earth; the light, porous bones had partially fallen to pieces. The most remarkable point was the discrepancy between the age of the bone and that of the teeth: based on the bones, the age of the living human being was about 30-40 years; on the basis of the teeth, however, the person was much older. The matter was cleared up with the help of a neck chain that was a precursor to the torques worn by the Celts; thus the skeleton was about 2500 years old. As the teeth were worn down much more through more use in prehistoric times than they are today, the age of the living person is likely to be the bone age, which was about 35 years.     

Developing permanent tooth length as an estimate of age.

Developing teeth are widely used to predict age in archaeology and forensic science. Regression equations of tooth length for age is a direct method, however, data for permanent teeth is incomplete. The aims of this study were: (a) to calculate regression equations predicting age from tooth length of all permanent teeth from birth to maturity, and (b) to evaluate the difference between radiographic and actual tooth length. The sample studied (N = 76, age range 0 to 19 years) was the Spitalfields juveniles of recorded age-at-death. Tooth length was measured from incisal tip to developing edge of crown or root of 354 dissected teeth. Data for upper and lower teeth were combined except for the lateral incisor. The least squares regression method was used to analyze the data for each tooth type; age being regressed against tooth length for prediction. For most tooth types, growth followed an S-shaped (polynomial) curve with initial fast growth and a further growth spurt around the time of mid root formation. No difference was found between radiographic and true tooth length. These regression equations provide an easy method of predicting age from any developing permanent tooth by measuring tooth length from isolated teeth or from unmagnified, undistorted radiographs.     

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.     

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。     

Some aspects of forensic-medical studies of dog bite injuries

The incidence of dog attacks of humans has increased, but no publications or methodological recommendations on this problem appeared. The history of the problem and statistical data reflecting distribution of injuries with regard to sex and age, location of injuries, and time of the day are presented. Signs which help differentiate injuries inflicted by dog and human teeth or injuries with blunt objects are defined. Further investigation of the problem is needed.     

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.