Age estimation from pulp/tooth area ratio (PTR) in an Indian sample: A preliminary comparison of three mandibular teeth used alone and in combination

Age estimation in adults by canine teeth: a systematic review of the Cameriere method with meta-analysis on the reliability of the pulp/tooth area ratio

The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults.

Study of secondary dentine deposition in central incisors as an age estimation method for adults

This work aimed to assess the pulp/tooth area ratio's utility in the upper central incisors using orthopantomograms. A convenience sample of 801 adult patient orthopantomograms was studied. Image J® software was used to measure the pulp/tooth area ratio, and a regression model was developed. Our results conclude that the methodology assessing upper incisors' pulp/tooth area ratio using orthopantomograms can lead to age overestimation and statistically significant differences between chronological and estimated age. For those over 50, no correlation between pulp/tooth area ratio and chronological age was found, suggesting that this may be the upper limit of this technique in this population. This methodology may not be suitable for age estimation, particularly in older adults.

Does the crypt: tooth ratio in the developing tooth correlate with chronological age in children?—a novel, radiographic, cross-sectional pilot study using ImageJ tools

Background

The bony cavity known as the crypt encloses the developing tooth, the size of which is influenced by the tooth movements during various phases of tooth eruption. The radiographic observations have revealed that the size of the crypt decreases as the root formation continues. The present study was conducted to assess the relationship between the crypt to tooth ratio (CTR) and the chronological age in children in the age range of 4 to 16 years using their digital panoramic radiographs (OPGs). The ImageJ tools were used to calculate the area of the bony crypt and the area of the developing mandibular second molar from 145 OPGs. The ratio between the area of the crypt and the area of the calcified portion of the tooth was obtained and compared with the calendric age (CA) to develop a regression model for age estimation.

Results

There was a significant negative correlation between the chronological age and the CTR values (r= −0.898, p<0.001) in all the age groups. The derived regression formula was age = 17.192–3.855 (CTR) with an r2 value of 0.807 and a standard error of estimate (SEE) being 1.385. The derived formula was tested using 52 OPGs from a different set of patients in the same age group. The mean chronological age of the test sample was 9.57 years (± 3.42), their mean estimated age (EA) was 8.50 years (± 3.25), and the difference was statistically significant (p<0.001). A difference of more than 1 year was observed in 69% of boys and 54% of girls.

Conclusions

This method is an attempt to correlate the crypt to tooth ratio of developing the second molar tooth with the chronological age. A large sample study is required to validate this novel technique of age estimation in children.

Volumetric Analysis of Teeth using Cone Beam Computed Tomography for Age Estimation among the Indian Residents: A Pilot Study

Background: In forensic odontology, dental age estimation is important. Deposition of secondary dentin is a more significant method in dental age predicton. This secondary dentin decreases the size of the pulp cavity. Thus, pulp size is reduced with advancing age. Therefore, the tooth to pulp size area ratio goes on increasing as age increases. Aim: To assess the ratio of “pulp/tooth volume” in single and multi- rooted teeth by Cone Beam Computed Tomography (CBCT) and correlate with the age. Objective: 1. To analyse ratio of pulp/ tooth volume in single and multi-rooted teeth, 2. To evaluate accuracy of the Yang’s formula available for age estimation, 3. To generate the formula for multi rooted teeth and correlate with the age. Methodology: 150 extracted teeth of which 50 permanent maxillary canines, 50 maxillary first premolars and 50 permanent maxillary first molars were collected and subjected to CBCT scanning for volumetric analysis. ‘Pulp Volume (PV)’, ‘Tooth Volume (TV)’ and ‘Pulp/Tooth Volume Ratio (PTVR)’ were calculated. Result: Linear regression analyses established that the chronological age and PTVR correlated with each other. Pearson correlation coefficient showed TV, PV and PTVR were inversely proportional to age. Conclusion: This study revealed that permanent maxillary canine has the best correlation with age followed by First molar and First premolar.

Age estimation based on 3D post-mortem computed tomography images of mandible and femur using convolutional neural networks

Age assessment has attracted increasing attention in the field of forensics. However, most existing works are laborious and requires domain-specific knowledge. Modern computing power makes it is possible to leverage massive amounts of data to produce more reliable results. Therefore, it is logical to use automated age estimation approaches to handle large datasets. In this study, a fully automated age prediction approach was proposed by assessing 3D mandible and femur scans using deep learning. A total of 814 post-mortem computed tomography scans from 619 men and 195 women, within the age range of 20-70, were collected from the National Forensic Service in South Korea. Multiple preprocessing steps were applied for each scan to normalize the image and perform intensity correction to create 3D voxels that represent these parts accurately. The accuracy of the proposed method was evaluated by 10-fold cross-validation. The initial cross-validation results illustrated the potential of the proposed method as it achieved a mean absolute error of 5.15 years with a concordance correlation coefficient of 0.80. The proposed approach is likely to be faster and potentially more reliable, which could be used for age assessment in the future.

Age estimation in the living: A scoping review of population data for skeletal and dental methods

Age estimation of living individuals has become a crucial part of the forensic practice, especially due to the global increase in cross-border migration. The low rate of birth registration in many countries, hence of identification documents of migrants, especially in Africa and Asia, highlights the importance of reliable methods for age estimation of living individuals. Despite the fact that a number of skeletal and dental methods for age estimation have been developed, their main limitation is that they are based on specific reference samples and there is still no consensus among researchers on whether these methods can be applied to all populations. Though this issue remains still unsolved, population information at a glance could be useful for forensic practitioners dealing with such issues. This study aims at presenting a scoping review and mapping of the current situation concerning population data for skeletal (hand-wrist and clavicle) and dental methods (teeth eruption and third molar formation) for age estimation in the living. Two hundred studies on the rate of skeletal maturation and four hundred thirty-nine on the rate of dental maturation were found, covering the period from 1952 and 2020 for a total of ninety-eight countries. For most of the western and central African countries there are currently no data on the rate of skeletal and dental maturation. The same applies to the countries of the Middle East, as well as the eastern European countries, especially as regard the skeletal development.

Applicability of pulp/tooth ratio method for age estimation

The purpose of this study was to evaluate the reliability of the tooth/pulp ratio method in the process of age estimation at the moment of death in a forensic context and compare it with standard anthropological methods. After the exhumation of mass graves located in sites in Batajnica, Serbia, in 2002 and 2003, skeletal material was thoroughly analyzed by a group of anthropologists and pathologists. As a part of the investigation, orthopantomography (OPG) was performed for each individual. During 2018 these OPGs were reexamined for scientific purposes. Age-at-death was assessed by means of the pulp/tooth ratio method applied to all available lower premolars. Estimated age following standard anthropological methods and chronological age (obtained after DNA identification of victims) was taken from the records. Age estimation using the pulp/tooth ratio and standard methods was compared with chronological age. The pulp/tooth ratio method was accurate in 81.25% of all cases and the standard method was accurate in 56.25% of all cases. The pulp/tooth ratio method of age estimation was found to be applicable and accurate. However, age estimation should be based on all available methods.

Dental health status of skeletal remains excavated from an abandoned well at Ajnala, India: a bioarchaeological study

Present study was conducted to assess dental health status of the mid-19th century skeletal remains excavated from an abandoned ancient well and to scrutinize the demographic affiliations of the remains. Thousands of bones, teeth and contextual items were excavated non-scientifically from an abandoned well situated underneath a religious structure at Ajnala (Amritsar, India). Four thousands four hundred and seventy five teeth of each type were examined for presence of dental pathologies of caries, wear and linear enamel hypoplasia (LEH). The frequency distribution of each pathological state was calculated for each tooth type using international dental standards available in the literature. The overall dental status was characteristic of young individuals having low prevalence of dental caries and enamel hypoplasiac lesions. Very few teeth had seriously exposed dentine and pulp cavity; indicating consumption of some cariogenic food items. The maxillary and posterior teeth were more affected with dental caries than the mandibular and anterior teeth. LEH defects were found more commonly distributed in the lower canines (44.9%) and upper incisors (34.8%) than their corresponding counterparts and statistically significant differences were noticed in LEH prevalence between anterior and, posterior dentition. The overall percentage of LEH has been found as 15.8%; with 15.4% maxillary and 16.2% mandibular teeth being affected with LEH. The paleodontogical examinations, contextual items and the preliminary molecular findings supported the written versions that victims of Ajnala skeletal remains had sound dental health status and probably belonged to adult males who were killed in 1857 as per written versions.

Age estimation by canines' pulp/tooth ratio in an Iranian population using digital panoramic radiography

OBJECTIVE

Age estimation in adults is an important issue in forensic science. This study aimed to estimate the chronological age of Iranians by means of pulp/tooth area ratio (AR) of canines in digital panoramic radiographs.

MATERIALS AND METHODS

The sample consisted of panoramic radiographs of 271 male and female subjects aged 16-64 years. The pulp/tooth area ratio (AR) of upper and lower canines was calculated by AutoCAD software. Data were subjected to correlation and regression analysis.

RESULTS

There was a significant and inverse correlation between age and pulp/tooth area ratio of upper and lower canines (r=-0.794 for upper canine and r=-0.282 for lower canine; p-value<0.001). Linear regression equations were derived separately for upper, lower and both canines. The mean difference between actual and estimated age using upper canine was 6.07±1.7.

CONCLUSION

The results showed that the pulp/tooth area ratios of canines are a reliable method for age estimation in Iranians. The pulp/tooth area ratio of upper canine was better correlated with chronological age than that of lower canine.

Age estimation in adults by dental imaging assessment systematic review

IMPORTANCE

The need to rely on proper, simple, and accurate methods for age estimation in adults is still a world-wide issue. It has been well documented that teeth are more resistant than bones to the taphonomic processes, and that the use of methods for age estimation based on dental imaging assessment are not only less invasive than those based on osseous analysis, but also have shown similar or superior accuracy in adults.

OBJECTIVES

To summarise the results of some of the recently most recently cited methods for dental age estimation in adults, based on odontometric dental imaging analysis, to establish which is more accurate, accessible, and simple.

EVIDENCE REVIEW

A literature search from several databases was conducted from January 1995 to July 2016 with previously defined inclusion criteria.

CONCLUSION

Based on the findings of this review, it could be possible to suggest pulp/tooth area ratio calculation from first, upper canines and other single rooted teeth (lower premolars, upper central incisors), and a specific statistical analysis that considers the non-linear production of secondary dentine with age, as a reliable, easy, faster, and predictable method for dental age estimation in adults. The second recommended method is the pulp/tooth width-length ratio calculation. The use of specific population formulae is recommended, but to include data of individuals from different groups of population in the same analysis is not discouraged. A minimum sample size of at least 120 participants is recommended to obtain more reliable results. Methods based on volume calculation are time consuming and still need improvement.

Age estimation by pulp-to-tooth area ratio using cone-beam computed tomography: A preliminary analysis

Background:

Age estimation of living or deceased individuals is an important aspect of forensic sciences. Conventionally, pulp-to-tooth area ratio (PTR) measured from periapical radiographs have been utilized as a nondestructive method of age estimation. Cone-beam computed tomography (CBCT) is a new method to acquire three-dimensional images of the teeth in living individuals.

Aims:

The present study investigated age estimation based on PTR of the maxillary canines measured in three planes obtained from CBCT image data.

Settings and Design:

Sixty subjects aged 20–85 years were included in the study.

Materials and Methods:

For each tooth, mid-sagittal, mid-coronal, and three axial sections—cementoenamel junction (CEJ), one-fourth root level from CEJ, and mid-root—were assessed. PTR was calculated using AutoCAD software after outlining the pulp and tooth.

Statistical Analysis Used:

All statistical analyses were performed using an SPSS 17.0 software program.

Results and Conclusions:

Linear regression analysis showed that only PTR in axial plane at CEJ had significant age correlation (r = 0.32; P < 0.05). This is probably because of clearer demarcation of pulp and tooth outline at this level.

A Comparison of the Accuracy of Four Age Estimation Methods Based on Panoramic Radiography of Developing Teeth

Background and aims. Tooth development is widely used in determining age and state of maturity. Dental age is of high importance in forensic and pediatric dentistry and also orthodontic treatment planning .The aim of this study was to compare the accuracy of four radiographic age estimation methods. Materials and methods. Orthopantomographic images of 537 healthy children (age: 3.9-14.5 years old) were evaluated. Dental age of the subjects was determined through Demirjian's, Willem's, Cameriere's, and Smith's methods. Differences and correlations between chronological and dental ages were assessed by paired t-tests and Pearson's correlation analysis, respectively. Results. The mean chronological age of the subjects was 8.93 ± 2.04 years. Overestimations of age were observed following the use of Demirjian's method (0.87 ± 1.00 years), Willem's method (0.36 ± 0.87 years), and Smith's method (0.06 ± 0.63 years). However, Cameriere's method underestimated age by 0.19 ± 0.86 years. While paired t-tests revealed significant differences between the mean chronological age and ages determined by Demirjian's, Willem's, and Cameriere's methods (P < 0.001), such a significant difference was absent between chronological age and dental age based on Smith's method (P = 0.079). Pearson's correlation analysis suggested linear correlations between chronological age and dental age determined by all four methods. Conclusion. Our findings indicated Smith's method to have the highest accuracy among the four assessed methods. How-ever, all four methods can be used with acceptable accuracy.

Adult forensic age estimation using mandibular first molar radiographs: A novel technique

Objective:

To develop an independent procedure for estimating age for Indian individuals using radiographs of multi-rooted posterior teeth with accuracy needed in forensic age prediction.

Materials and Methods:

Orthopantomography (OPG) was obtained for 88 subjects. The subjects were divided into two sub sets; study subset (n = 60) which were used to find regression formula to calculate the age from pulp chamber height and test subset (n = 28) which were used to test the accuracy of this formula.

Results:

There was a statistically significant strong correlation between chronological age and pulp chamber crown root trunk height ratio (r = −0.56; P = 0.000). The regression equation for estimating the age, derived from the study subset was estimated age = −100.920 (PCTHR) +55.415. (PCTHR is the pulp chamber crown root trunk height ratio). This equation was applied on the test subset and there was no significant difference between estimated ages and chronological ages (P = 0.639). The mean absolute error (MAE) was 6.96 years, which was within acceptable error limits for forensic age estimation (<±10 years).

Conclusion:

The procedure developed to estimate the age using height reduction in pulp chamber was found to be fairly accurate to perform forensic age prediction in Indian individuals.