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Streeter AJ, Schmeling A, Karch A. How certainty is certain enough? Challenges in the statistical methodology for forensic age assessment of living individuals. Med Clin (Barc) 2024:S0025-7753(24)00479-2. [PMID: 39209613 DOI: 10.1016/j.medcli.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 07/18/2024] [Accepted: 07/21/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Adam J Streeter
- Institute of Epidemiology and Social Medicine, University of Münster, Germany.
| | | | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
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2
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Klingberg G, Benchimol D, Berlin H, Bring J, Gornitzki C, Odeberg J, Tranæus S, Twetman S, Wernersson E, Östlund P, Domeij H. How old are you? A systematic review investigating the relationship between age and mandibular third molar maturity. PLoS One 2023; 18:e0285252. [PMID: 37200251 PMCID: PMC10194975 DOI: 10.1371/journal.pone.0285252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/18/2023] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION AND OBJECTIVE Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years. METHODS The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjian´s method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjian´s tooth stage H). RESULTS A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjian´s tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjian´s tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment. CONCLUSION The identified literature does not provide scientific evidence for the relationship between Demirjian´s stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.
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Affiliation(s)
- Gunilla Klingberg
- Faculty of Odontology, Department of Pediatric Dentistry, Malmö University, Malmö, Sweden
| | - Daniel Benchimol
- Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
| | - Henrik Berlin
- Faculty of Odontology, Department of Pediatric Dentistry, Malmö University, Malmö, Sweden
| | | | - Carl Gornitzki
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Jenny Odeberg
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Sofia Tranæus
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
- Faculty of Odontology, Health Technology Assessment–Odontology, Malmö University, Malmö, Sweden
| | - Svante Twetman
- Faculty of Health and Medical Sciences, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Emma Wernersson
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Pernilla Östlund
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
- Faculty of Odontology, Health Technology Assessment–Odontology, Malmö University, Malmö, Sweden
| | - Helena Domeij
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
- Faculty of Odontology, Health Technology Assessment–Odontology, Malmö University, Malmö, Sweden
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Angelakopoulos N, De Luca S, Oliveira-Santos I, Ribeiro ILA, Bianchi I, Balla SB, Kis HC, Jiménez LG, Zolotenkova G, Yusof MYP, Selmanagić AH, Pandey H, Pereira PC, da Nóbrega JBM, Kalani H, Mieke SM, Kumagai A, Gulsahi A, Zelić K, Marinković N, Kelmendi J, Galić I, Vázquez IS, Spinas E, Velezmoro-Montes YW, Moukarzel M, Toledo JP, El-Bakary AAES, Cameriere R. Third molar maturity index (I 3M) assessment according to different geographical zones: a large multi-ethnic study sample. Int J Legal Med 2023; 137:403-425. [PMID: 36520207 DOI: 10.1007/s00414-022-02930-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Abstract
Identification of living undocumented individuals highlights the need for accurate, precise, and reproducible age estimation methods, especially in those cases involving minors. However, when their country of origin is unknown, or it can be only roughly estimated, it is extremely difficult to apply assessment policies, procedures, and practices that are accurate and child-sensitive. The main aim of this research is to optimize the correct classification of adults and minors by establishing new cut-off values for four different continents (Africa, America, Asia, and Europe). For this purpose, a vast sample of 10,701 orthopantomographs (OPTs) from four continents was evaluated. For determination and subsequent validation of the new third molar maturity index (I3M) cut-off values by world regions, a cross-validation by holdout method was used and contingency tables (confusion matrices) were generated. The lower third molar maturity indexes, from both left and right side (I3ML and I3MR) and the combination of both sides (I3ML_I3MR) were calculated. The new cut-off values, that aim to differentiate between a minor and an adult, with more than 74.00% accuracy for all populations were as follows (I3ML; I3MR; I3ML_I3MR, respectively): Africa = (0.10; 0.10; 0.10), America = (0.10; 0.09; 0.09), Asia = (0.15; 0.17; 0.14), and Europe = (0.09; 0.09; 0.09). The higher sensitivity (Se) was detected for the I3ML for male African people (91%) and the higher specificity (Sp) of all the parameters (I3ML; I3MR; I3ML_I3MR) for Europeans both male and female (> 91%). The original cut-off value (0.08) is still useful, especially in discriminating individuals younger than 18 years old which is the goal of the forensic methods used for justice.
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Affiliation(s)
- Nikolaos Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopaedics, University of Bern, Bern, Switzerland.,AgEstimation Project, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Stefano De Luca
- AgEstimation Project, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy. .,Panacea Cooperative Research S. Coop, Ponferrada, Spain.
| | - Inês Oliveira-Santos
- Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Ilenia Bianchi
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | - Sudheer B Balla
- AgEstimation Project, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy.,Department of Forensic Odontology, Panineeya Institute of Dental Sciences and Research Center, Hyderabad, Telangana, India
| | - Hatice Cansu Kis
- Department of Orthodontics, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Lourdes Gómez Jiménez
- Instituto Nacional de Patología "Dr. Sergio Sarita Valdez,", Santo Domingo, Dominican Republic
| | - Galina Zolotenkova
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mohd Yusmiaidil Putera Yusof
- Centre for Oral & Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Aida Hadzić Selmanagić
- Department of Dental Morphology With Dental Anthropology and Forensics, Faculty of Dentistry, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Hemlata Pandey
- Department of Forensic Medicine and Toxicology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Palmela C Pereira
- Facultade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | | | - Hettiarachchi Kalani
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Sylvia M Mieke
- Department of Forensic Odontology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Akiko Kumagai
- Division of Forensic Odontology and Disaster Oral Medicine, Department of Forensic Science, Iwate Medical University, Morioka, Iwate, Japan
| | - Ayse Gulsahi
- AgEstimation Project, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy.,Dentomaxillofacial Radiology Department, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Ksenija Zelić
- Laboratory of Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nemanja Marinković
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jeta Kelmendi
- Department of Orthodontics, Faculty of Medicine Alma Mater Europaea, University of Pristina, Campus Rezonanca, Pristina, Kosovo
| | - Ivan Galić
- AgEstimation Project, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy.,Department of Oral Surgery, School of Medicine, University of Split, Split, Croatia
| | - Israel Soriano Vázquez
- Forensic Odontologist, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Enrico Spinas
- Department of Surgical Sciences, Section of Dentistry, University of Cagliari, Cagliari, Italy
| | | | | | - Jorge Pinares Toledo
- Departamento de Patología Y Medicina Oral, Facultad de Odontología, Universidad de Chile, Santiago, Chile.,Escuela de Odontología, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile
| | | | - Roberto Cameriere
- AgEstimation Project, Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
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Han M, Du S, Ge Y, Zhang D, Chi Y, Long H, Yang J, Yang Y, Xin J, Chen T, Zheng N, Guo YC. With or without human interference for precise age estimation based on machine learning? Int J Legal Med 2022; 136:821-831. [DOI: 10.1007/s00414-022-02796-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
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Heldring N, Larsson A, Rezaie AR, Råsten-Almqvist P, Zilg B. A probability model for assessing age relative to the 18-year old threshold based on magnetic resonance imaging of the knee combined with radiography of third molars in the lower jaw. Forensic Sci Int 2021; 330:111108. [PMID: 34826761 DOI: 10.1016/j.forsciint.2021.111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aims to generate a statistical model based on magnetic resonance imaging of the knee and radiography of third molars in the lower jaw, for assessing age relative to the 18-year old threshold. METHODS In total, 58 studies correlating knee or tooth development to age were assessed, 5 studies for knee and 7 studies for tooth were included in the statistical model. The relation between the development of the anatomical site, based on a binary system, and age were estimated using logistic regression. Separate meta-populations for knee and tooth were generated from the individual based data for men and women. A weighted estimate of probabilities was made by combining the probability densities for knee and tooth. Margin of errors for males and females in different age groups and knee and tooth maturity were calculated within the larger framework of transition analysis using a logit model as a base. Evidentiary values for combinations of knee and tooth maturity were evaluated with likelihood ratios. RESULTS For males, the sensitivity for the method was calculated to 0.78 (probability of correctly classifying adults), the specificity 0.90 (probability of correctly classifying minors), the negative predictive value 0.80 (proportion identified minors are minors) and the positive predictive value 0.89 (proportion identified adults are adults) indicating a model better at identifying minors than adults. The point at which half the female population has reached closed knee lies before the 18-year threshold, adding the knee as an indicator lowers specificity and increases sensitivity. The sensitivity when using tooth as an indicator for females is 0.24 and specificity 0.97, signifying few minors misclassified as adults but also a low probability of identifying adults. The negative predictive value for women when using tooth as the sole indicator is 0.56 and positive predictive value 0.88. Probabilities were calculated for males and females assuming a uniform age distribution between 15 and 21years. The calculated margin of error of minors classified as adults in a population between 15 and 21 years with the model was 11% for males and 12% for females. Further, the evidentiary value as well as margin of error vary for different combinations of knee and tooth maturity. CONCLUSION The statistical model based on the combination of MRI knee and radiography of mandibular third molars is a valid method to assess age relative to the 18-year old threshold when applied on males and of limited value in females.
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Affiliation(s)
- Nina Heldring
- Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden
| | - André Larsson
- Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden
| | - Ali-Reza Rezaie
- Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden
| | - Petra Råsten-Almqvist
- Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden
| | - Brita Zilg
- Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden
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Age assessment in the living using modified Gustafson's criteria in a northern Chinese population. Int J Legal Med 2019; 133:921-930. [PMID: 30790037 DOI: 10.1007/s00414-019-02024-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 02/11/2019] [Indexed: 12/26/2022]
Abstract
Regressive dental changes appear to be suitable for age assessment in living adults. In 2012, Olze et al. showed that several criteria presented by Gustafson for extracted teeth can also be applied to orthopantomograms. The objective of this study was to test the applicability and reliability of this method in a Chinese population. For this purpose, 1300 orthopantomograms of 650 female and 650 male Chinese aged between 15 and 40 years were evaluated. The characteristics of secondary dentin formation, periodontal recession, attrition, and cementum apposition were reviewed in all the mandibular premolars. The sample was split into a training and test dataset. Based on the training set, the correlation of the individual characteristics with chronological age was studied with a stepwise multiple regression analysis, in which individual characteristics formed the independent variable. According to the results, the R values amounted to 0.80 to 0.83; the standard error of estimate was 4.29 to 4.75 years. By analyzing the test dataset, the accuracy of the present study, Olze's and Timme's formulas were determined by the difference between the estimated dental age (DA) and chronological age (CA). Taking both mean differences and mean absolute differences into account, the Chinese age estimation formula did not always perform better compared with Olze's and Timme's formulas for both males and females. It was concluded that this method can be used in Chinese individuals for age assessment. However, the applicability of the method is limited by the quality of the X-ray images, and the method should only be applied by experienced forensic odontologists.
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7
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Rolseth V, Mosdøl A, Dahlberg PS, Ding Y, Bleka Ø, Skjerven-Martinsen M, Straumann GH, Delaveris GJM, Vist GE. Age assessment by Demirjian's development stages of the third molar: a systematic review. Eur Radiol 2018; 29:2311-2321. [PMID: 30506219 DOI: 10.1007/s00330-018-5761-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/21/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Radiographic evaluation of the wisdom teeth (third molar) formation is a widely used age assessment method for adolescents and young adults. This systematic review examines evidence on the agreement between Demirjian's development stages of the third molar and chronological age. METHODS We searched four databases up until May 2016 for studies reporting Demirjian's stages of third molar and confirmed chronological age of healthy individuals aged 10-25 years. Heterogeneity test of the included studies was performed. RESULTS We included 21 studies from all continents except Australia, all published after 2005. The mean chronological age for Demirjian's stages varied considerably between studies. The results from most studies were affected by age mimicry bias. Only a few of the studies based their results on an unbiased age structure, which we argue as important to provide an adequate description of the method's ability to estimate age. CONCLUSION Observed study variation in the timing of Demirjian's development stages for third molars has often been interpreted as differences between populations and ethnicities. However, we consider age mimicry to be a dominant bias in these studies. Hence, the scientific evidence is insufficient to conclude whether such differences exist. KEY POINTS • There is significant heterogeneity between studies evaluating age assessment by Demirjian's third molar development. • Most of the studies were subject to the selection bias age mimicry which can be a source of heterogeneity. • Presence of age mimicry bias makes it impossible to compare and combine results. These biased studies should not be applied as reference studies for age assessment.
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Affiliation(s)
- Veslemøy Rolseth
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway.
| | - Annhild Mosdøl
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål Skage Dahlberg
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | - Yunpeng Ding
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
| | - Øyvind Bleka
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | | | - Gyri Hval Straumann
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Gunn Elisabeth Vist
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
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8
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Third molar maturity index (I3M) for assessing age of majority in northern Chinese population. Int J Legal Med 2018; 132:1759-1768. [DOI: 10.1007/s00414-018-1907-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
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9
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Guo YC, Chu G, Olze A, Schmidt S, Schulz R, Ottow C, Pfeiffer H, Chen T, Schmeling A. Application of age assessment based on the radiographic visibility of the root pulp of lower third molars in a northern Chinese population. Int J Legal Med 2017; 132:825-829. [DOI: 10.1007/s00414-017-1731-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 11/02/2017] [Indexed: 11/30/2022]
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10
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Age estimation of Chinese children based on second molar maturity. Int J Legal Med 2017; 132:807-813. [PMID: 29034417 DOI: 10.1007/s00414-017-1703-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Abstract
In forensic medicine and many other fields, age estimation by the use of teeth is of great importance for the purpose of individual identification. In the past, however, age estimation based on the second molar mineralization was scarcely performed. In this study, a total of 1657 panoramic radiographs taken from 834 males and 823 females of northern Chinese origin in the age bracket 5 to 25 years were assessed. The mineralization status of the second molars was determined using the classification described by Demirjian et al. Results showed that the left and right, as well as maxillary and mandibular second molars were generally at similar stages of mineralization. The maxillary left second molars (27) at stage D, mandibular left second molars (37) at stages C, D, F, and G, and mandibular right second molars (47) at stages D, F, and G showed a significantly lower average age in female subjects than in male subjects. In males, fully developed second molars first appeared with 12 years of age; in females, stage H occurred with 11 years at the earliest. One male individual and one female individual with second molars showing stage G were 23 years old. It was concluded that second molars showing stage H do not exclude an age under 14 years and that second molars showing stage G do not exclude an age above 18 years.
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Guo YC, Li MJ, Olze A, Schmidt S, Schulz R, Zhou H, Pfeiffer H, Chen T, Schmeling A. Studies on the radiographic visibility of the periodontal ligament in lower third molars: can the Olze method be used in the Chinese population? Int J Legal Med 2017; 132:617-622. [PMID: 28812130 DOI: 10.1007/s00414-017-1664-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/04/2017] [Indexed: 10/19/2022]
Abstract
The purpose of the present research is to study the radiographic visibility of the periodontal ligament in third molars from a northern Chinese population to determine if this methodology could be used for the 18-year threshold. A total of 1300 conventional orthopantomograms from 650 males and 650 females of northern Chinese subjects aged between 15 and 40 years were analyzed. The radiographic visibility of the periodontal membrane of fully mineralized third molars was assessed using the stages described by Olze et al. (2010). Stage 0 first appeared at the age of 17.05 years in males and at the age of 18.76 years in females. Stage 1 was first detected at 18.52 years in males and 19.59 years in females. Stage 2 was first achieved by males at the age of 22.33 years and by females at the age of 21.37 years. The earliest appearance of stage 3 was 26.85 years in males and 24.92 years in females. If stage 1 is determined, it is possible to prove that an individual has already attained the age of 18 years. Stages 2 and 3 can be used to determine that a person is over 21 years of age. However, it should also be noted that in 271 cases of tooth 38 and 255 cases of tooth 48, the visibility stage could not be reliably assessed because of fused roots or narrowed furcations. Therefore, this method seems to be of limited value for age estimation in the Chinese population.
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Affiliation(s)
- Yu-Cheng Guo
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China.,Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Mu-Jia Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China
| | - Andreas Olze
- Institute of Legal Medicine, Charité-Universitätsmedizin, Turmstraße 21, 10559, Berlin, Germany
| | - Sven Schmidt
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Ronald Schulz
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Hong Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China.,Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Teng Chen
- College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710004, Shaanxi, People's Republic of China.
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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12
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The role of forensic medicine and forensic dentistry in estimating the chronological age of living individuals in Hamburg, Germany. Int J Legal Med 2016; 131:593-601. [PMID: 28032243 DOI: 10.1007/s00414-016-1517-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 12/07/2016] [Indexed: 10/20/2022]
Abstract
Age estimation represents one of the primary responsibilities of forensic medicine and forensic dentistry. It is an integral procedure aiming to estimate the chronological age of an individual, whose age is either unknown or doubtful, by means of assessing the stage of dental, skeletal, and physical development. The present publication reviews the methods and procedures used in estimating the age of young living individuals as well as the experiences of the Institute of Legal Medicine in Hamburg-Eppendorf, Germany, during the last 25 years. From 1990 to 2015, 4223 age estimations were carried out in Hamburg. During this time, forensic age estimation was requested by different concerned authorities including courts, the foreigners' registration office (Zentrale Ausländerbehörde), and the state office of education and consultation (Landesbetrieb Erziehung und Beratung). In the context of judicial proceedings, orthopantomograms, as well as X-ray examinations of both the left hand and the medial clavicular epiphyses were carried out in accordance with AGFAD recommendations. For investigations not associated with judicial proceedings, orthopantomogram examinations play a key role in the process of age estimation, due to their high diagnostic value and low radiation exposure. Since 2009, mainly unaccompanied young refugees were examined for age estimation. Orthopantomograms and clinical-physical examinations have been used as essential steps in this context to determine whether an individual is 18 years or less. Additional X-ray examinations of the left hand and the medial clavicular epiphyses have been used less frequently.
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13
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Age assessment based on third molar mineralisation : An epidemiological-radiological study on a Central-European population. J Orofac Orthop 2016; 78:97-111. [PMID: 27896417 DOI: 10.1007/s00056-016-0063-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 03/31/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The method published in 1973 by Demirjian et al. to assess age based on the mineralisation stage of permanent teeth is standard practice in forensic and orthodontic diagnostics. From age 14 onwards, however, this method is only applicable to third molars. No current epidemiological data on third molar mineralisation are available for Caucasian Central-Europeans. Thus, a method for assessing age in this population based on third molar mineralisation is presented, taking into account possible topographic and gender-specific differences. METHODS The study included 486 Caucasian Central-European orthodontic patients (9-24 years) with unaffected dental development. In an anonymized, randomized, and blinded manner, one orthopantomogram of each patient at either start, mid or end of treatment was visually analysed regarding the mineralisation stage of the third molars according to the method by Demirjian et al. Corresponding topographic and gender-specific point scores were determined and added to form a dental maturity score. Prediction equations for age assessment were derived by linear regression analysis with chronological age and checked for reliability within the study population. RESULTS Mineralisation of the lower third molars was slower than mineralisation of the upper third molars, whereas no jaw-side-specific differences were detected. Gender-specific differences were relatively small, but girls reached mineralisation stage C earlier than boys, whereas boys showed an accelerated mineralisation between the ages of 15 and 16. CONCLUSIONS The global equation generated by regression analysis (age = -1.103 + 0.268 × dental maturity score 18 + 28 + 38 + 48) is sufficiently accurate and reliable for clinical use. Age assessment only based on either maxilla or mandible also shows good prognostic reliability.
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Guo Y, Olze A, Ottow C, Schmidt S, Schulz R, Heindel W, Pfeiffer H, Vieth V, Schmeling A. Dental age estimation in living individuals using 3.0 T MRI of lower third molars. Int J Legal Med 2015; 129:1265-70. [PMID: 26232290 DOI: 10.1007/s00414-015-1238-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 07/16/2015] [Indexed: 11/26/2022]
Abstract
In order to increase the validity of age estimation in adolescents and young adults when there is no legitimation for X-ray examinations, it seems desirable to be able to assess the mineralization of third molars using X-ray-free imaging procedures. In the present study, the mineralization stages of lower third molars were determined prospectively in 269 male and 248 female individuals aged 12 to 24 years using 3.0 T MRI. The classification system of Demirjian et al. was used to determine the stages. This study presents the minima and maxima, means and standard deviations, median values, and lower and upper quartiles separately for both sexes, for the mineralization stages B-H. Statistically significant sex differences were observed for the mineralization stages C, E, F, and G, and a faster developmental rate was observed for males. It was concluded that magnetic resonance imaging is an X-ray-free alternative to orthopantomography when assessing mineralization of third molars.
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Affiliation(s)
- Yucheng Guo
- College of Medicine and Forensics, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, Shaanxi, People's Republic of China
- College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, Shaanxi, People's Republic of China
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Andreas Olze
- Institute of Legal Medicine, Charité-Universitätsmedizin Berlin, Turmstraße 21, 10559, Berlin, Germany
| | - Christian Ottow
- Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Sven Schmidt
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Ronald Schulz
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Volker Vieth
- Department of Clinical Radiology, Hospital Ibbenbüren, Große Straße 4, 49477, Ibbenbüren, Germany
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
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