The WITS Atlas: A Black Southern African dental atlas for permanent tooth formation and emergence

Technical note: RP Atlas-an unprecedented proposal for a Brazilian population dental development chart based on the London atlas

Age estimation methods through developmental atlases are simplified by image comparison using radiographs. Atlas-based methods have been utilized to create population-specific charts addressing population diversity. To tackle the absence of a dedicated atlas for the Brazilian population, the objective of the present study was to create a new atlas for dental development in Brazil based on the London Atlas chart. The new atlas (RP Atlas) is based on the median of tooth development, eruption, and resorption in individuals aged 5 to 23. The sample (567 individuals) was divided between females (n = 290) and males (n = 277). The RP Atlas was handcrafted, scanned, colored, and clustered in two atlases divided by sex. The development of a specific atlas for the Brazilian population has the potential to enhance the accuracy of age estimation in forensic scenarios, notably in a mixed country like Brazil. Further research is needed to assess the suitability of the newly developed atlas for the Brazilian population.

Violence against children: A review of cases at a forensic anthropology unit, Johannesburg, South Africa

South Africa is experiencing a scourge of violence against women and children, with alarming levels of violence, and as such, juvenile cases are sometimes encountered in a forensic anthropological setting. The aim of this research was to assess the cases of juveniles (under 20 years) presenting at the Human Variation and Identification Research Unit (HVIRU) for a 6-year period (2016-2022), in order to assess patterns and types of cases referred. A total of 19 cases were assessed, of which 10 were 16-20 years old, 3 between the ages of 5 and 15 years and 6 less than 5 years old at the time of death. Of the 14 children with known sex, 12 were female with features suggesting that they fell prey to sexual violence. Many of the individuals were either known (and referred for trauma analysis) or identified following investigation. Of the 19 juveniles, 11 (58 %) had evidence of perimortem trauma (sharp and/or blunt), attesting to the violent nature of their deaths. Two cases had both sharp and blunt force trauma, of which one is a possible case of dismemberment. The remains of two individuals showed signs of perimortem burning, which may or may not be related to the cause of death. Three individuals had signs of antemortem (healed) trauma, which may suggest a longer period of abuse. Five of the individuals showed signs of disease - two had cribra orbitalia, while two others had various porous lesions indicative of chronic disease or malnutrition. One individual had advanced osteomyelitis, suggesting a natural cause of death. Some of these cases had unusual trauma and pathology, highlighting the contribution of forensic anthropologists.

Osteological, multi-isotope and proteomic analysis of poorly-preserved human remains from a Dutch East India Company burial ground in South Africa

Skeletal remains discovered in Simon's Town, South Africa, were hypothesised as being associated with a former Dutch East India Company (VOC) hospital. We report a novel combined osteological and biochemical approach to these poorly-preserved remains. A combined strontium (87Sr/86Sr), oxygen (δ18OVPDB) and carbon (δ13CVPDB) isotope analysis informed possible childhood origins and diet, while sex-specific amelogenin enamel peptides revealed biological sex. Osteological analyses presented evidence of residual rickets, a healed trauma, dental pathological conditions, and pipe notches. The combined isotope analyses yielded results for 43 individuals which suggested a diverse range of geological origins, including at least 16% of the population being non-local. The inclusion of δ13CVPDB had intriguing implications for three individuals who likely did not have origins in the Cape Town region nor in Europe. Peptide analysis on the dental enamel of 25 tested individuals confirmed they were all biologically male. We suggest that isolated enamel may provide crucial information about individuals' pathological conditions, geographical origins, diet, and biological sex. These data further demonstrated that a combined approach using multiple osteological and biochemical methods is advantageous for human remains which are poorly preserved and can contextualise a site with little direct evidence.

Age estimation using London Atlas methodology: A systematic review and meta-analysis

Age estimation is a fundamental competence of Forensic Anthropologists and Odontologists. The London Atlas is a dental development chart by AlQahtani et al. (2010) that gained recent notoriety due to its applicability in forensic scenarios. This study aimed to answer, by a systematic review of literature and meta-analysis, the following question: "on average, what is the deviation between real and estimated ages, when applying the London Atlas method in sub-adults?". This study was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO). Five electronic databases were screened (PubMed, SciELO, Scopus, Web of Science, and LILACS), and active search was carried out. The quality assessment was performed by means of Joanna Briggs Institute Critical Appraisal Tools for Systematic Reviews. The initial search resulted in 1021 studies, from which 24 filled the inclusion criteria. For the meta-analysis, 17 studies provided sufficient data. Out of these, eleven studies enabled meta-analysis of mean absolute difference values. Standardized mean differences were 0.02 years for MD and 0.78 for MAD. Analysis of subgroups was also accomplished by sex, and did not indicated heterogeneity between males and females. The London Atlas is an accurate age estimation method, presenting acceptable error and bias values worldwide. Despite the high heterogeneity of the studies, majority of studies presented a low risk of bias. Meta-analysis showed a non-significant and slight tendency of overestimating age, in total. Sub-group analysis showed modestly better results for boys than girls.

Employing the London Atlas in the Age Estimation of a Select South African Population

Dental age estimation in the living and deceased is a fundamental aspect of forensic sciences, civil cases, medico-legal proceedings and clinical dentistry. Accordingly, this study aimed to validate the accuracy and reproducibility of the London Atlas in a select South African sample of KwaZulu-Natal. In this cross-sectional study, 760 digital panoramic radiographs (n = 760) aged between 5.00 and 23.99 years were retrospectively reviewed through consecutive sampling. Each radiograph was assessed and assigned a dental age in accordance with the London Atlas of Human Tooth Development and Eruption by AlQahtani et al. (2010). The London Atlas overestimated age with a mean difference of −0.85 to −1.26 years in the selected South African sample of KwaZulu-Natal. A statistically significant difference between the chronological and estimated dental ages was recorded. Furthermore, the South African Black and Indian males had a higher overestimation of age than their female counterparts, with a mean difference of 0.13 and 0.07 years, respectively. This overestimation was less in the South African Indian population in comparison to the SA Black population. This outcome resulted in the creation of the KZN population- and sex-specific charts and atlases for the two selected cohorts of KwaZulu-Natal. The KZN Atlases were found to be more accurate in the selected sample, with a mean absolute error of 0.57 years and no statistically significant differences between the chronological and estimated dental ages.

Forensic human identification: retrospective investigation of anthropological assessments in the Western Cape, South Africa

The identification of unknown persons, particularly those who are decomposed or burnt, is a global challenge. Forensic Anthropology Cape Town (FACT) is a service provider that assists the South African state with the identification of human remains. However, empirical data pertaining to anthropologically analysed forensic cases in the Western Cape Province of South Africa are lacking. Therefore, anthropological data pertaining to the forensic cases submitted to FACT between 2006 and 2018 from Forensic Pathology Services were retrospectively reviewed (n = 172). This study also sought to assess demographic, traumatic and pathological factors that impacted successful identification. Most decedents were male (67%) and older than 35 years (54%). While ante-mortem trauma was observed in 41% of decedents, the lack of medical records on ante-mortem injuries hindered the use of this information for identification. Positive identifications were reached for 37% of decedents, and of these, anthropological estimations were correct in 98% of cases for sex, 84% of cases for age at death and 100% of cases for stature. Considering globally accepted accuracies of 70-80%, these estimations were considered highly accurate, suggesting the anthropological methods used are suited to the population. However, 63% of cases remained unidentified, and this study showed that skeletal completeness and pathological conditions were the main factors that hindered demographic estimations. Lastly, not all unidentified bodies in the province were referred to FACT; given the highly accurate estimations, these data advocate for the routine, if not mandatory, use of forensic anthropology services for skeletonised remains in South Africa, with the overall purpose of positively impacting human identification. To improve identification rates globally, these data highlight the value of retrospective and region-specific studies to identify strengths and weaknesses in the system.

Dental maturation in a Chinese sample using Demirjian method

BACKGROUND

Dental calcification information is relevant for clinical, archaeological, and forensic applications. However, dental maturity measurements in current cohorts of Chinese children are insufficient.

AIM

This study aimed to establish the mandibular dental maturity table and determine the accuracy of dental age estimation using the Demirjian method in a Chinese sample.

SUBJECTS AND METHODS

Permanent mandibular teeth, excluding the third molar, in 2091 panoramic radiographs of 1008 males and 1083 females aged 3-15 were graded, and dental age was estimated according to Demirjian's criteria. Age-of-attainment was calculated with probit regression for each stage by sex, and sex differences were analysed using the Mann-Whitney U test. Dental age was compared with chronological age using paired t-tests.

RESULTS

Although females showed earlier age-of-attainment than males, significant sex differences were only found in stages D-G (p < 0.05). The Demirjian method overestimated the dental age in both males (0.68 ± 1.05 years) and females (0.59 ± 0.97 years).

CONCLUSIONS

The relationship between mineralisation stage and chronological age in this study can be applied as a reference for mandibular dental maturity of Chinese children and adolescents. The Demirjian method overestimated the chronological ages of this sample.

Validation of Roberts' method using root canal width patterns as a mandibular maturity marker in determining the 18-year threshold

The South African Bill of Rights and the Children's Act define a 'child' as a person under the age of 18 years. The age of 18 years is therefore significant for legal purposes in South Africa. The third molar is an important indicator in determining the 18-year threshold. Human biological growth markers are accepted indicators of a subject attaining the age of 18 years. A recent study by Roberts et al. suggested that the relative width of the distal root canals (RCW) of the lower left permanent molars (Fédération Dentaire Internationale notation 36, 37 and 38) as visualised on dental panoramic radiographs can be used as such a growth marker. This study aimed to validate this human biological growth marker in both black and white populations living in South Africa according to Roberts' method. The findings of this validation study were in agreement with this method which showed that individuals with Demirjian stage H left molars and category RCW-C were indeed over the 18-year threshold. Important aspects regarding the rationality and application of Roberts' method are discussed. The authors conclude that this method should not be used in isolation but as an adjunct with other age estimation methods.

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.

Age estimation of Brazilian individuals using the London Atlas

OBJECTIVE

The objective of the present study was to evaluate, for the first time, the applicability of the London Atlas method for age estimation on a sample of Brazilian population.

DESIGN

The study consisted of archived dental panoramic radiographs (n = 288) of individuals aged between 5 and 23 years. Radiographs were assessed using the London Atlas method to determine the developmental and eruption stages of all teeth on each sides of each jaw separately, and also to make an age estimation.

RESULTS

There was no significant differences between the right and left sides of the jaws (p = 0.31 for males and p = 0.65 for females). An overestimation of age occurred more likely in the female sample when compared to the male sample. Three age groups, 20.5, 18.5 and 19.5 years, presented the highest values ​​of mean absolute difference found in the whole sample.

CONCLUSION

The London Atlas of age estimation performed well in general and good viability in an expert context, with most age groups showing age differences lower than two years of age, however it is necessary that it be applied with caution in certain age groups, especially when the third molar is used as a decision tooth for age estimation. Therefore, it is recommended to use more than one method for assessing the age in those age groups.

Dental age estimation in Somali children and sub-adults combining permanent teeth and third molar development

Estimation of an individual’s age has important applications in forensics. In young individuals, it often relies on separate evaluations of permanent teeth (PT) and third molars (TM) development. Here, we analysed the age prediction performance of combined information from PT and TM in an unusual sample of healthy Somalis, born and living in Finland. PT development was staged according to Demirjian et al. (Hum Biol, 1973) and TM development according to Köhler et al. (Ann Anat, 1994), using panoramic radiographs from 803 subjects (397 males, 406 females) aged 3–23 years. A sex-specific Bayesian age-estimation model for the multivariate distribution of the stages conditional on age was fitted on PT, TM and PT and TM combined. The age-estimation performances were validated and quantified. The approach combining PT and TM only overestimated age with an ME of − 0.031 years in males and − 0.011 years in females, indicating the best age prediction performance.