Douis N, Martrille L, Trinh JM, Rapp G, Marchand E, Hossu G, Gondim Teixeira PA, Blum A. Prevalence of abnormalities seen on orthopantomograms performed for forensic age estimation in unaccompanied minor asylum seekers.
Eur Radiol 2024;
34:686-691. [PMID:
37566269 DOI:
10.1007/s00330-023-10030-6]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES
Evaluate the prevalence of radiological anomalies on orthopantomograms (OPT) performed as part of forensic age estimation in unaccompanied minors.
METHODS
This is a retrospective study conducted on 208 OPT examinations requested by a magistrate. These OPTs were interpreted independently by two readers to establish the number of missing teeth (MT), presence of dental fillings (DF), and dental anomalies (DA). The presence of radiolucent (RL), radiopaque, and mixed lesions was also assessed.
RESULTS
Most radiologic anomalies were RL, detected on 41% and 39% of the subjects evaluated for R1 and R2, respectively, with a mean of 1.3 ± 2.4 (1-16) and 1.1 ± 2 (1-13) RL lesions per subject. Among the RL identified, the majority were dental (70% for R1 and 65% for R2), all of which had a suspected infectious origin. Among readers, 43% and 41% of the subjects evaluated presented MT, 21% and 15% presented DF, and 22% and 20% presented DA for R1 and R2, respectively. The inter- and intra-observer reproducibility for OPT classification was considered excellent (Kappa = 0.84, 95% CI 0.78-0.90, and Kappa = 0, 95, 95% CI 0.86-0.99).
DISCUSSION
There was a non-negligible prevalence of radiological anomalies in OPT studies performed for forensic age estimation. Most of these lesions were suspected to be infectious in origin, potentially requiring medical care. This constitutes an ethical dilemma inherent in the judicial expertise injunction requiring a limited specific response.
CLINICAL RELEVANCE STATEMENT
This study highlights a non-negligible prevalence of supposedly infectious radiological abnormalities. The restricted possibility for the legal expert to declare these abnormalities raises ethical and medical questions.
KEY POINTS
• Orthopantomograms can be performed as part of forensic age estimation. • Results indicate the majority of radiological anomalies detected on OPTs were of suspected infectious origin. • These findings give rise to ethical and medical questions about the way in which these forensic examinations are carried out.
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