Beurteilung der Weisheitszahneruption

The relevance of taurodontism in forensic dental age estimation

Taurodontism is a dental morphological anomaly characterized by enlarged pulp cavities repositioned towards the apical region of the tooth, coupled with shortened root structures. Molars are commonly affected by this alteration. Certain populations exhibit up to 48% prevalences for this dental alteration, underscoring its significance in dental age estimation (DAE). In the field of DAE, an individual's chronological age is inferred from specific dental features, frequently employed within the forensic context. The effect of taurodontism on the features of DAE is an unanswered issue. The influence of taurodontism on eruption, mineralization, radiographic visibility of root canals, and radiographic visibility of the periodontal ligament space in mandibular third molars- some of the established criteria for DAE as examples-is currently not systematically examined. Some common staging scales for the dental features of DAE cannot technically be applied to taurodontic teeth. Additionally, given the association of taurodontism with syndromes affecting tooth development, caution is warranted in age assessment procedures. Notably, taurodontic teeth may serve as indicators of syndromes influencing skeletal development, further emphasizing the relevance of taurodontism in forensic age assessment. Presumably taurodontic teeth were included in reference data to some extent due to their partially high prevalence in the past, whereby the influence of taurodontism has been statistically absorbed within the overall spread of the features. Future studies should compare the temporal course of these tooth characteristics in affected and unaffected teeth. Subsequent initiatives should focus on raising awareness among forensic dentists regarding taurodontism, necessitating in-depth exploration of the subject.

Studying eruption patterns of mandibular third molars for forensic age assessment: Introducing current reference data from a population of black South Africans

INTRODUCTION

Evaluation of the eruption of mandibular third molars in orthopantomograms (OPGs) is a method of forensic age assessment. The objective of our study was to provide valid reference data for this trait within a population of black South Africans. The study was guided by the criteria for reference studies in age assessment.

MATERIALS AND METHODS

A study population from Pretoria, South Africa comprising 670 OPGs obtained from 338 black females and 332 black males aged between 15.00 and 25.97 years was analysed. All OPGs were performed for medical indication during the period from 2011 to 2022 and were retrospectively evaluated. From the 670 OPGs, a total of 1021 mandibular third molars were evaluated. The assessment of mandibular third molars was conducted using the staging scale presented by Olze et al. in 2012. Two experienced dentists evaluated the OPGs independently of each other. If the two examiners diverged in their assessments, a consensus stage was assigned.

RESULTS

As expected, the mean, median and minimal age increased with higher stages for both teeth and both sexes. The minimum age recorded for stage D, indicating complete tooth eruption, was 15.79 years in females and 16.62 years in males.

CONCLUSION

As it is the case for previous reference studies in other countries, placing exclusive reliance on the evaluation of mandibular third molar eruption is inadequate for ascertaining the age of majority among Black South Africans. Future studies need to examine if our results are transferable to other countries in Sub-Saharan Africa.

Radiological assessment of periodontal ligament space visibility on third molars for forensic age assessment - a comparison study of three different staging scales

Various staging scales have been proposed for the assessment of the visibility of the periodontal ligament space of mandibular third molars on dental panoramic radiographs (PANs) for forensic age assessment in living individuals. However, up to now, there has been no systematic comparison between these staging scales available. We directly compared the 2010 staging scale proposed by Olze et al. with the 2017 staging by Lucas et al. and the 2020 staging by Guo et al. in a German study population. We evaluated 233 PANs from 115 females and 118 males aged 20.0 to 40.9 years using three independent examiners, with one examiner conducting two assessments. We examined the correlation between age and stage, as well as the inter- and intra-rater reliabilities. While the point estimates for the correlation coefficient and the reliability measures were lowest for the Guo scale and highest for the Olze scale, confidence intervals showed a large overlap, particularly for the scales of Olze et al. and Lucas et al. The correlation coefficients between stage and age were consistently lower in females than in males across all methods. In summary, we showed that the staging scales of Olze et al. and Lucas et al. were very similar. The Olze method showed higher point estimates across all analyses, and because there are more reference data available for this method, we argue that it should be preferred as the method of choice for further studies in the field. However, Guo method could be considered for instances, in which the inter-radicular periodontal ligament is not evaluable.

Dental age assessment in the living: a comparison of two common stage classifications for assessing radiographic visibility of the root canals in mandibular third molars

After dentition is complete, degenerative tooth characteristics can be used for dental age assessment. Radiological assessment of the visibility of the root canals of the mandibular third molars in dental panoramic radiographs (DPRs) is known to be one such suitable feature. Essentially, two different stage classifications are available for evaluating the visibility of the root canals of mandibular third molars in the DPR. The aim of this study was to determine if one method outperforms the other. Therefore, the 2010 method of Olze et al. was directly compared to the 2017 method of Lucas et al. in the 2020 modification of Al Qattan et al. To this end, 233 DPRs from 116 females and 117 males aged 20.0 to 40.9 years were evaluated by three independent experienced examiners. In addition, one examiner ran two independent evaluations. Correlation between age and stage was investigated, and the inter- and intra-rater reliability was estimated for both methods. Correlation between age and stage was higher with the Olze method (Spearman rho 0.388 [95% CI 0.309, 0.462], males and 0.283 [95% CI 0.216, 0.357], females) than the Lucas method (0.212 [95% CI 0.141, 0.284], males and 0.265 [95% CI 0.193, 0.340], females). The intra-rater repeatability of the Olze method (Krippendorff's α = 0.576 [95% CI 0.508, 0.644], males and α = 0.592 [95% CI 0.523, 0.661], females) was greater than that for the Lucas method (intra-rater α = 0.422 [95% CI 0.382, 0.502], males and α = 0.516 [95% CI 0.523, 0.661], females). Inter-rater reproducibility was also greater for the Olze method (α = 0.542 [95% CI 0.463, 0.620], males and α = 0.533 [95% CI 0.451, 0.615], females) compared to the Lucas method (α = 0.374 [95% CI 0.304, 0.443], males and α = 0.432 [95% CI 0.359, 0.505], females). The method of Olze et al. was found to present marginal advantages to the Lucas et al. method across all examinations and may be a more appropriate method for application in future studies.

Third Molar Eruption in Dental Panoramic Radiographs as a Feature for Forensic Age Assessment-Presentation of a New Non-Staging Method Based on Measurements

The evaluation of third molar eruption in dental panoramic radiographs (DPRs) constitutes an evidence-based approach for forensic age assessment in living individuals. Existing methodologies involve staging morphological radiographic findings and comparing them to reference populations. Conversely, the existing literature presents an alternative method where the distance between third molars and the occlusal plane is measured on dental plaster models. The aim of this study was to adapt this measurement principle for DPRs and to determine correlation between eruption and chronological age. A total of 423 DPRs, encompassing 220 females and 203 males aged 15 to 25 years, were examined, including teeth 38 [FDI] and 48. Two independent examiners conducted the measurements, with one examiner providing dual assessments. Ultimately, a quotient was derived by comparing orthogonal distances from the mesial cementoenamel junctions of the second and third molars to a simplified radiological occlusal plane. This quotient was subsequently correlated with the individual's age. We estimated correlations between age and quotients, as well as inter- and intra-rater reliability. Correlation coefficients (Spearman's rho) between measurements and individuals' ages ranged from 0.555 to 0.597, conditional on sex and tooth. Intra-rater agreement (Krippendorf's alpha) ranged from 0.932 to 0.991, varying according to the tooth and sex. Inter-rater agreement ranged from 0.984 to 0.992, with distinctions drawn for different teeth and sex. Notably, all observer agreement values fell within the "very good" range. In summary, assessing the distance of third molars from a simplified occlusal plane in DPRs emerges as a new and promising method for evaluating eruption status in forensic age assessment. Subsequent reference studies should validate these findings.

Third molar eruption in orthopantomograms as a feature for forensic age assessment-a comparison study of different classification systems

Evaluation of third molar eruption represents an established method for age assessment of living individuals. Different classification systems are available for the radiological assessment of third molar eruption. The aim of this study was to identify the most accurate and reliable classification system for the mandibular third molar eruption on orthopantomograms (OPG). We compared the method of Olze et al. (2012) with the method of Willmot et al. (2018) and a newly derived classification system using OPGs from 211 individuals aged 15-25 years. The assessments were performed by three experienced examiners. One examiner evaluated all radiographs twice. The correlation between age and stage was investigated and the inter- and intra-rater reliability was estimated for all three methods. Correlation between stage and age was similar between classification systems, although higher in the data from males (Spearman's rho ranging from 0.568 to 0.583) than from females (0.440 to 0.446). Inter- and intra-rater reliability measures were similar across methods and invariant on sex, with overlapping confidence intervals, although the highest point estimates for both intra- and inter-rater reliability were for the method by Olze et al. with Krippendorf's alpha values of 0.904 (95% confidence interval 0.854, 0.954) and 0.797 (95% confidence interval 0.744, 0.850). It was concluded that the method of Olze et al. from 2012 is a reliable method for practical application and future studies.