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Timme M, Viktorov J, Steffens L, Streeter A, Karch A, Schmeling A. 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. Int J Legal Med 2024; 138:499-507. [PMID: 37952073 PMCID: PMC10861756 DOI: 10.1007/s00414-023-03121-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
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.
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Affiliation(s)
- Maximilian Timme
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
| | - Jan Viktorov
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Laurin Steffens
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Adam Streeter
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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Bjørk MB, Kvaal SI, Bleka Ø, Sakinis T, Tuvnes FA, Haugland MA, Lauritzen PM, Eggesbø HB. Age prediction in sub-adults based on MRI segmentation of 3rd molar tissue volumes. Int J Legal Med 2023; 137:753-763. [PMID: 36811675 PMCID: PMC10085921 DOI: 10.1007/s00414-023-02977-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/12/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Our aim was to investigate tissue volumes measured by MRI segmentation of the entire 3rd molar for prediction of a sub-adult being older than 18 years. MATERIAL AND METHOD We used a 1.5-T MR scanner with a customized high-resolution single T2 sequence acquisition with 0.37 mm iso-voxels. Two dental cotton rolls drawn with water stabilized the bite and delineated teeth from oral air. Segmentation of the different tooth tissue volumes was performed using SliceOmatic (Tomovision©). Linear regression was used to analyze the association between mathematical transformation outcomes of the tissue volumes, age, and sex. Performance of different transformation outcomes and tooth combinations were assessed based on the p value of the age variable, combined or separated for each sex depending on the selected model. The predictive probability of being older than 18 years was obtained by a Bayesian approach. RESULTS We included 67 volunteers (F/M: 45/22), range 14-24 years, median age 18 years. The transformation outcome (pulp + predentine)/total volume for upper 3rd molars had the strongest association with age (p = 3.4 × 10-9). CONCLUSION MRI segmentation of tooth tissue volumes might prove useful in the prediction of age older than 18 years in sub-adults.
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Affiliation(s)
- Mai Britt Bjørk
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Postboks 1109, Blindern, N-00317, Oslo, Norway.
| | - Sigrid Ingeborg Kvaal
- Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Postboks 1109, Blindern, N-00317, Oslo, Norway
| | - Øyvind Bleka
- Department of Forensic Sciences, Oslo University Hospital, Postboks 4950 Nydalen, OUS, Rikshospitalet, 0424, Oslo, Norway
| | - Tomas Sakinis
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks 4950 Nydalen, OUS, Ullevål, 0424, Oslo, Norway
| | - Frode Alexander Tuvnes
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks 4950 Nydalen, OUS, Ullevål, 0424, Oslo, Norway
| | - Mari-Ann Haugland
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks 4950 Nydalen, OUS, Ullevål, 0424, Oslo, Norway
| | - Peter Mæhre Lauritzen
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks 4950 Nydalen, OUS, Ullevål, 0424, Oslo, Norway.,Faculty of Health Sciences, Department of Life Sciences and Health, Oslo Metropolitan University, Postboks 4, St. Olavs plass. 0130, Oslo, Norway
| | - Heidi Beate Eggesbø
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Postboks 4950 Nydalen, OUS, Ullevål, 0424, Oslo, Norway.,Department of Radiology and Nuclear Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postboks 4950 Nydalen, OUS, Rikshospitalet, 0424, Oslo, Norway
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Facial biotype classification for orthodontic treatment planning using an alternative learning algorithm for tree augmented Naive Bayes. BMC Med Inform Decis Mak 2022; 22:316. [PMID: 36456974 PMCID: PMC9713997 DOI: 10.1186/s12911-022-02062-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND When designing a treatment in orthodontics, especially for children and teenagers, it is crucial to be aware of the changes that occur throughout facial growth because the rate and direction of growth can greatly affect the necessity of using different treatment mechanics. This paper presents a Bayesian network approach for facial biotype classification to classify patients' biotypes into Dolichofacial (long and narrow face), Brachyfacial (short and wide face), and an intermediate kind called Mesofacial, we develop a novel learning technique for tree augmented Naive Bayes (TAN) for this purpose. RESULTS The proposed method, on average, outperformed all the other models based on accuracy, precision, recall, [Formula: see text], and kappa, for the particular dataset analyzed. Moreover, the proposed method presented the lowest dispersion, making this model more stable and robust against different runs. CONCLUSIONS The proposed method obtained high accuracy values compared to other competitive classifiers. When analyzing a resulting Bayesian network, many of the interactions shown in the network had an orthodontic interpretation. For orthodontists, the Bayesian network classifier can be a helpful decision-making tool.
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Lian X, Dai X, Yan Y, Lei H, Wang G, Li R, Wang Y, Zou H. Application of the ratio of the radiopaque calcified area to the dental follicle (RCA/DF) for dental age assessment on orthopantomograms. Forensic Sci Int 2022; 340:111443. [PMID: 36049248 DOI: 10.1016/j.forsciint.2022.111443] [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: 11/19/2021] [Revised: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study aimed at exploring a new tooth development evaluation method for age assessment and investigating the dynamic alteration and potential trend of tooth development by orthopantomograms (OPGs), in order to provide references for tooth development prediction and forensic purpose. MATERIALS AND METHODS A total of 132 OPGs of children aged 3-8 years were collected. The developmental stages of the permanent mandibular second molar (M2)were evaluated by experienced examiners according to the Nolla method and Mimics software, respectively. Quantitative analysis of the ratio of the radiopaque calcified area to the dental follicle (RCA/DF) in different stages, ages, sexes and quadrants were evaluated and compared via descriptive statistics and Spearman's correlation coefficient analysis. RESULTS There was a strong, positive correlation between the examiners' evaluation and mimics analysis results. With the age increased, the Nolla stage of M2 observed by OPGs increased, and the RCA/DF showed increased trends both in males and females. There were significant differences of the RCA/DF of the M2 at various ages. The tooth calcification development of female was 9.08% earlier than that of male between 3 and 8 years old. However, teeth of male seemed to develop faster than that of female during this period. There was no significant difference between left and right quadrant either according to the Nolla stage or RCA/DF. CONCLUSIONS The RCA/DF value obtained from OPGs of the developmental mandibular second permanent molars could be used as a reliable indicator for tooth maturity and age estimation in children aged 3-8 years. CLINICAL RELEVANCE Age assessment based on radiographs is considered as a reliable and efficient indicator for judging different types of malocclusion, making suitable orthodontic treatment plan, deciding the extraction time of retained deciduous teeth in clinic practice.
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Affiliation(s)
- Xiaoli Lian
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Xiaohua Dai
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Yan Yan
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Han Lei
- Department of Oral & Maxillofacial Radiology, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Guanhua Wang
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Ruixin Li
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Yue Wang
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China; School of Medicine, Nankai University, Tianjin, China
| | - Huiru Zou
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, the Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China.
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Cameriere R, De Luca S, Soriano Vázquez I, Kiş HC, Pigolkin Y, Kumagai A, Ferrante L. A full Bayesian calibration model for assessing age in adults by means of pulp/tooth area ratio in periapical radiography. Int J Legal Med 2020; 135:677-685. [PMID: 33017037 DOI: 10.1007/s00414-020-02438-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/30/2020] [Indexed: 12/01/2022]
Abstract
The Bayesian approach is being a fundamental tool in forensic and legal field where inferences and decisions are made. In this study, a full Bayesian calibration model was developed to make probabilistic inferences about age estimation in a reference sample of 891 periapical X-rays of upper and lower canines. These teeth belonged to both deceased and living adult subjects, aged between 20 and 86 years, coming from five different countries (Turkey, Italy, Portugal, Japan and Mexico). For this purpose, the narrowing of pulp chamber due to the apposition of secondary dentine was analysed by means of the pulp/tooth area ratio. To determine the agreement of the method, intra- and inter-observer differences for measuring process were calculated by means of the intraclass correlation coefficient (ICC) analysis. Observer error tests showed excellent agreement between observers and between repeated assessments. According to the results of the ANCOVA, neither nationality nor sex was associated to the secondary dentine apposition while it is associated with individual's age. The results of the present study indicated that the concept of probability is intrinsically linked to the assessment of age in a forensic context, and the Bayesian approach could be considered a robust tool to overtake the bias generated by traditional regression models, thus helping the decision-making process in a legal framework.
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Affiliation(s)
- R Cameriere
- AgEstimation Project, Macerata, Italy.,Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Stefano De Luca
- Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia. .,Área de Identificación Forense, Unidad de Derechos Humanos, Servicio Médico Legal, Santiago, Chile.
| | | | - H C Kiş
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Y Pigolkin
- Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - A Kumagai
- Division of Forensic Medicine, Department of Forensic Sciences, Iwate Medical University, Morioka, Iwate, Japan
| | - L Ferrante
- Centre of Epidemiology, Biostatistics and Information Technology, Polytechnic University of Marche, Ancona, Italy
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Timme M, Timme WH, Olze A, Schulz R, Pfeiffer H, Dettmeyer R, Schmeling A. Die Beurteilung der Sekundärdentinbildung im Pulpencavum der mandibulären Prämolaren im Orthopantomogramm zur Altersdiagnostik lebender Personen. Rechtsmedizin (Berl) 2019. [DOI: 10.1007/s00194-019-00345-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dental age estimation in Somali children and sub-adults combining permanent teeth and third molar development. Int J Legal Med 2019; 133:1207-1215. [PMID: 30993445 PMCID: PMC6570682 DOI: 10.1007/s00414-019-02053-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022]
Abstract
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.
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State of the art in post-mortem computed tomography: a review of current literature. Virchows Arch 2019; 475:139-150. [PMID: 30937612 DOI: 10.1007/s00428-019-02562-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 02/06/2019] [Accepted: 03/12/2019] [Indexed: 12/14/2022]
Abstract
Computed tomography (CT) and other advanced diagnostic imaging techniques are gaining popularity in forensic pathology. This paper aims to define and offer complete and easily accessible "state of the art" for post-mortem computed tomography (PMCT), by reviewing the latest international literature. The proposed format answers the "five Ws" that follows: (1) What: We report the different kinds of CT scan and settings generally used in post-mortem imaging. The machine most employed is a 8/16-slice spiral CT, usually without contrast enhancement. The introduction of some variables, such as CT-guided biopsies, post-mortem ventilation, and PMCT angiography is becoming increasingly useful. (2) Why: Literature highlights the many advantages of PMCT. Limitations can be partly overcome by modern imaging techniques and combined evaluation with traditional autopsy. (3) Who: Most authors agree that collaboration between different specialists, i.e., radiologists and pathologists, is the best scenario, since radiologic, anatomic, and forensic skills are needed simultaneously. The most important human factor is "teamwork". (4) When: Literature provides no absolute limits for performing PMCT. Some authors have tested PMCT as a replacement for conventional autopsy but found some limitations. Others evaluated PMCT as a guide or screening tool for traditional autopsy. (5) Where: Many research groups around the world have performed studies on the use of PMCT. Although few countries adopt PMCT in routine practice, its use is rapidly spreading.
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Radiation dose in non-dental cone beam CT applications: a systematic review. LA RADIOLOGIA MEDICA 2018; 123:765-777. [DOI: 10.1007/s11547-018-0910-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/24/2018] [Indexed: 10/14/2022]
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