Radiographic evaluation of dental age of adults using Kvaal's method

Dental age estimation using the Kvaal method-an evaluation of length and width ratios: a systematic review

This study aimed to systematically review the correlational accuracy between width ratios and length ratios based on the Kvaal methodology with chronological age. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The search strategy included ProQuest, PubMed, Science Direct, and Taylor and Francis and Willey online without time or language restriction using Kvaal method of age estimation as key words for the search up to December 2021. A team of two researchers independently selected the studies and extracted the data. The Covidence platform was used to systematically organize all titles. The full texts of eligible studies were analyzed. Risk of bias (RoB) was assessed using a modified (to the specific characteristics of this systematic review) checklist based on Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement checklist for observational studies. A total of 658 articles were initially reviewed, but 22 were selected for inclusion. The risk of bias was estimated to be unclear to low overall. Among the length ratios, ratio R showed a strong association with chronological age, followed by ratio P. For the width ratios, ratio B demonstrated a close association with chronological age, followed by ratio C. The results suggest that width ratios correlate better with chronological age than length ratios. This systematic review suggests the width ratios are more strongly associated with chronological age than the length ratios. Using a width ratio could serve as a convenient and rapid way to estimate dental age. Our results apply equally to all types of ethnic groups.

Mandibular Teeth as Predictors in Forensic Age Estimation: A Cone-Beam Computed Tomography-Based Pulp Volume Regression Study

Background

Age estimation is integral to science of forensic odontology and plays an important role in human identification. Pulp volume estimation using cone-beam computed tomography (CBCT) to derive age can be very useful as it is noninvasive and can be applied on individuals of all ages.

Aims and Objectives

The study aimed to estimate the chronological age-based pulp and tooth volume (PTV) ratios in adults from Uttar Pradesh, India, using CBCT and voxel counting dental software.

Materials and Methods

Thirty-six CBCT scans were allocated into three Groups, I, II, and III (12 in each group) randomly to study the pulp volume of lateral incisor, canine, and first premolar, respectively. PTV was calculated by image segmentation method using Xelis Dental software. A correlation between chronological age with PTV was established using derived regression equations.

Statistical Analysis

All the data were subjected to statistical analysis using Statistical Package for Social Sciences version 16.0.

Results

Estimated age and standard error were determined. Standard errors of estimates were 11.24 years (LI), 7.78 years (C), 9.89 years (PM) group, lowest being for canines. The estimated age was compared with the chronological age. The difference between the chronological age and the estimated age by the derived equation for the present study was statistically nonsignificant (P = 1.00).

Conclusions

The results of the study show the feasibility of calculation of PTV ratios on CBCT to estimate the age for the set population with canine as the best predictor of age for the present study population.

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.

Digitilized Radiographic Analysis of Coronal Pulp for Age Estimation in Adults using Tooth Coronal Index Method – A Pilot Study

Background: Teeth have become a valuable index to estimate age of an individual in forensic odontology. Although various methods have been reported in forensic literature for age estimation, radiographic methods are simple and require less expertise. Digitalization of panoramic radiographs and intraoral periapical radiographs helps in obtaining the more precise images and accurate measurements. Secondary dentin continuously gets deposited on pulpal surface throughout the life thus reducing the size of the pulp cavity. The Tooth Coronal Index (TCI) method is the indirect assessment of secondary dentin deposition for age estimation. Aim: This study aims to estimate the Tooth Coronal Index of mandibular first molar and its correlation with chronological age to derive a regression equation. Materials and Methods: A total of 50 adults above 20 years of age were selected from the outpatient department of our college. Digital intraoral periapical radiographs were taken by using Radiovisiography (RVG) for mandibular first molar. The crown height and Coronal Pulp Cavity Height were measured and then TCI was calculated. Further the data were subjected to statistical analysis. Results: Statistically significant difference was observed between age and TCI (p<0.05*) and statistically insignificant difference observed between gender and TCI (p>0.05). Conclusion: The Tooth Coronal Index provides more accurate estimation of age and it is a simple, non invasive and cost-effective method that could be easily applied for both living and dead individuals without any highly specialized equipment.

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.

The coronal pulp cavity index: A forensic tool for age determination in adults

BACKGROUND

Various biochemical and histological methods are available for human age determination which are invasive and may require extraction of teeth. The present study aims to assess the accuracy of age estimation from tooth-coronal index (TCI) of known age and sex individuals and to present a noninvasive method for age estimation.

MATERIALS AND METHODS

This retrospective study comprised 88 patients, which included 54 males and 34 females. An orthopantomogram of these individuals were taken, and premolars and molars in the same were evaluated. The height of the crown (coronal height [CH]) and the height of the coronal pulp cavity (coronal pulp cavity height [CPCH]) was digitally measured on the computer screen. The TCI given by Ikeda et al. in 1985 (TCI = [CPCH × 100]/CH.) was computed on each tooth and regressed on real age of the sample. The mean, median, range, and standard deviation of the computed index were calculated. The correlation between the actual age and the estimated age was calculated using t-test. P < 0.05 was considered significant.

RESULTS

Results revealed that there is a significant correlation between the TCI with age. Increase in TCI observed with age; however, it showed no significant sex difference.

CONCLUSION

TCI is a precise, noninvasive and easily used reliable biomarker for age estimation and is applicable to both living and dead individuals.

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 based on Kvaal's technique using digital panoramic radiographs

INTRODUCTION

Age estimation is important for administrative and ethical reasons and also because of legal consequences. Dental pulp undergoes regression in size with increasing age due to secondary dentin deposition and can be used as a parameter of age estimation even beyond 25 years of age. Kvaal et al. developed a method for chronological age estimation based on the pulp size using periapical dental radiographs. There is a need for testing this method of age estimation in the Indian population using simple tools like digital imaging on living individuals not requiring extraction of teeth.

AIMS AND OBJECTIVES

Estimation of the chronological age of subjects by Kvaal's method using digital panoramic radiographs and also testing the validity of regression equations as given by Kvaal et al.

MATERIALS AND METHODS

The study sample included a total of 152 subjects in the age group of 14-60 years. Measurements were performed on the standardized digital panoramic radiographs based on Kvaal's method. Different regression formulae were derived and the age was assessed. The assessed age was then correlated to the actual age of the patient using Student's t-test.

RESULTS

No significant difference between the mean of the chronological age and the estimated age was observed. However, the values of the mean age estimated by using regression equations as given previously in the study of Kvaal et al. significantly underestimated the chronological age in the present study sample.

CONCLUSION

The results of the study give an inference for the feasibility of this technique by calculation of regression equations on digital panoramic radiographs. However, it negates the applicability of same regression equations as given by Kvaal et al. on the study population.

Age estimation using maxillary central incisors: A radiographic study

BACKGROUND

In the field of forensic dentistry, secondary changes in teeth with advancing age have been used as reliable predictors of age in various studies.

AIM

The purpose of the present study was to present a method for assessing the chronological age based on the relationship between age and morphological parameters of maxillary central incisors.

MATERIALS AND METHODS

Fifty subjects between 20-70 years of age were included in the study. Intraoral periapical radiographs were taken in relation to maxillary central incisors using paralleling technique. The following measurements were recorded: lengths of tooth, pulp, root and width of root and pulp at three different points. Regression formulas were used to calculate the dental age.

RESULTS

The mean estimated age showed no statistically significant difference from the actual mean age (P > 0.05). Also, maximum difference was seen for root length variable (-1.035 ± 1.86 years).