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Timme M, Smit C, Robinson L, Bernitz H, Guo YC, Schmeling A. The relevance of taurodontism in forensic dental age estimation. Leg Med (Tokyo) 2024; 70:102462. [PMID: 38810559 DOI: 10.1016/j.legalmed.2024.102462] [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: 03/13/2024] [Revised: 05/01/2024] [Accepted: 05/26/2024] [Indexed: 05/31/2024]
Abstract
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.
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Affiliation(s)
- Maximilian Timme
- Institute of Legal Medicine, University Hospital Muenster, Röntgenstraße 23, 48149 Münster, Germany.
| | - Chané Smit
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Gauteng, South Africa
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Gauteng, South Africa
| | - Herman Bernitz
- Department of Oral and Maxillofacial Pathology, Faculty of Health Sciences, University of Pretoria, Gauteng, South Africa
| | - Yu-Cheng Guo
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, People's Republic of China
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Muenster, Röntgenstraße 23, 48149 Münster, Germany
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Timme M, Steffens L, Viktorov J, Streeter A, Karch A, Schmeling A. Radiological assessment of periodontal ligament space visibility on third molars for forensic age assessment - a comparison study of three different staging scales. Int J Legal Med 2024; 138:1523-1531. [PMID: 38367027 PMCID: PMC11164763 DOI: 10.1007/s00414-024-03184-5] [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: 12/27/2023] [Accepted: 02/02/2024] [Indexed: 02/19/2024]
Abstract
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.
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Affiliation(s)
- Maximilian Timme
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Munster, Germany.
| | - Laurin Steffens
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Munster, Germany
| | - Jan Viktorov
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Munster, Germany
| | - Adam Streeter
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Munster, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Munster, Germany
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Munster, Germany
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Shen S, Guo Y, Han J, Sui M, Zhou Z, Tao J. Predicting chronological age of 14 or 18 in adolescents: integrating dental assessments with machine learning. BMC Pediatr 2024; 24:248. [PMID: 38600453 PMCID: PMC11005269 DOI: 10.1186/s12887-024-04722-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
AIM Age estimation plays a critical role in personal identification, especially when determining compliance with the age of consent for adolescents. The age of consent refers to the minimum age at which an individual is legally considered capable of providing informed consent for sexual activities. The purpose of this study is to determine whether adolescents meet the age of 14 or 18 by using dental development combined with machine learning. METHODS This study combines dental assessment and machine learning techniques to predict whether adolescents have reached the consent age of 14 or 18. Factors such as the staging of the third molar, the third molar index, and the visibility of the periodontal ligament of the second molar are evaluated. RESULTS Differences in performance metrics indicate that the posterior probabilities achieved by machine learning exceed 93% for the age of 14 and slightly lower for the age of 18. CONCLUSION This study provides valuable insights for forensic identification for adolescents in personal identification, emphasizing the potential to improve the accuracy of age determination within this population by combining traditional methods with machine learning. It underscores the importance of protecting and respecting the dignity of all individuals involved.
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Affiliation(s)
- Shihui Shen
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yibo Guo
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jiaxuan Han
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
| | - Meizhi Sui
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Stomatology, Kashgar Prefecture Second People's Hospital, Kashgar Xinjiang, China
| | - Zhuojun Zhou
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Jiang Tao
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, Shanghai, China.
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Shen S, Zhou Z, Wang J, Fan L, Han J, Tao J. Using machine learning to determine age over 16 based on development of third molar and periodontal ligament of second molar. BMC Oral Health 2023; 23:680. [PMID: 37730591 PMCID: PMC10510268 DOI: 10.1186/s12903-023-03284-5] [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: 04/10/2023] [Accepted: 08/03/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Having a reliable and feasible method to estimate whether an individual has reached 16 years of age would greatly benefit forensic analysis. The study of age using dental information has matured recently. In addition, machine learning (ML) is gradually being applied for dental age estimation. AIM The purpose of this study was to evaluate the development of the third molar using the Demirjian method (Demirjian3M), measure the development index of the third molar (I3M) using the method by Cameriere, and assess the periodontal ligament development of the second molar (PL2M). This study aimed to predict whether Chinese adolescents have reached the age of criminal responsibility (16 years) by combining the above measurements with ML techniques. SUBJECTS & METHODS A total of 665 Chinese adolescents aged between 12 and 20 years were recruited for this study. The development of the second and third molars was evaluated by taking orthopantomographs. ML algorithms, including random forests (RF), decision trees (DT), support vector machines (SVM), K-nearest neighbours (KNN), Bernoulli Naive Bayes (BNB), and logistic regression (LR), were used for training and testing to determine the dental age. This is the first study to combine ML with an evaluation of periodontal ligament and tooth development to predict whether individuals are over 16 years of age. RESULTS AND CONCLUSIONS The study showed that SVM had the highest Bayesian posterior probability at 0.917 and a Youden index of 0.752. This finding provides an important reference for forensic identification, and the combination of traditional methods and ML is expected to improve the accuracy of age determination for this population, which is of substantial significance for criminal litigation.
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Affiliation(s)
- Shihui Shen
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Center for Stomatology, Shanghai, People's Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Zhuojun Zhou
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Center for Stomatology, Shanghai, People's Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Jian Wang
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Center for Stomatology, Shanghai, People's Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
| | - Linfeng Fan
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Center for Stomatology, Shanghai, People's Republic of China
- National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junli Han
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
- National Center for Stomatology, Shanghai, People's Republic of China.
- National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China.
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China.
| | - Jiang Tao
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
- National Center for Stomatology, Shanghai, People's Republic of China.
- National Clinical Research Center for Oral Diseases, Shanghai, People's Republic of China.
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China.
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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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Shah R, Angadi PV. Radiographic assessment of periodontal ligament visibility in mandibular third molars as a tool for defining the 18 year threshold among Indians. AUST J FORENSIC SCI 2021. [DOI: 10.1080/00450618.2019.1711179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rutvi Shah
- Department of Prosthodontics and Crown and Bridge, VK Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belgaum, India
| | - Punnya V. Angadi
- Department of Oral Pathology and Microbiology, VK Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER), Belgaum, India
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Timme M, Karch A, Shay D, Ottow C, Schmeling A. Zur Altersdiagnostik lebender Personen: der Einfluss des sozioökonomischen Status auf die Skelett- und Zahnentwicklung in einer deutschen Studienkohorte. Rechtsmedizin (Berl) 2020. [DOI: 10.1007/s00194-020-00444-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
ZusammenfassungDie forensische Altersdiagnostik kann ein entscheidendes Instrument zur Durchführung rechtstaatlicher Verfahren sein. Bei der Altersdiagnostik wird die Entwicklung von Skelett- und Zahnmerkmalen einer zu begutachtenden Person mit Daten von Referenzpopulationen verglichen. Als möglicher Einflussfaktor auf die Altersdiagnose ist der sozioökonomische Status (SES) der zu begutachtenden Person zu berücksichtigen. Allerdings ist die Studienlage zu diesem Einflussfaktor bislang spärlich. Prospektiv wurde der Zusammenhang zwischen der Skelett- bzw. Zahnentwicklung und dem SES innerhalb einer deutschen Studienpopulation aus freiwilligen Teilnehmern ermittelt. Dazu wurde die Entwicklung der medialen Epiphyse des Schlüsselbeins, der distalen Epiphyse des Radius, der distalen Epiphyse des Femurs, der proximalen Epiphyse der Tibia und des linken unteren dritten Molaren bei 294 Frauen und 287 Männern im Alter von 12 bis 24 Jahren mittels 3‑Tesla-Magnetresonanztomographie (MRT) untersucht. Zusätzlich wurde der SES der Teilnehmer erfasst. Hierzu wurde das Bildungsniveau der Eltern erfragt. Der Einfluss des SES auf die Einzelmerkmale sowie die Gesamtheit der untersuchten Skelettmerkmale wurde mittels linearer Regression ermittelt. Für alle untersuchten Merkmale und Kombinationen konnte keine Evidenz für einen Zusammenhang festgestellt werden. Es wurde geschlussfolgert, dass sich die Lebensumstände der Studienteilnehmer offenbar nicht ausreichend stark unterschieden, um einen Einfluss des SES auf das Skelettalter darzustellen.
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A new model of classification of third molars development and its correlation with chronological age in a Brazilian subpopulation. Int J Legal Med 2020; 135:639-648. [PMID: 32840664 DOI: 10.1007/s00414-020-02401-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
The present study correlated the mineralization of third molars to chronological age using a modified classification based on Demirjian's stages in a Brazilian subpopulation and compared with the original classification. A total of 1082 patients with age ranging from 6 to 26 years were included in the sample, with at least one third molar on panoramic radiographs. The third molars were classified according to the original Demirjian classification (8 stages) and a new model based on the Demirjian method, where the original stages were grouped into four stages: AB-enamel mineralization; CD-crown dentin mineralization; EFG-root formation; and H-complete development. Statistical analyses were performed by Kruskal-Wallis/Dunn tests (α = 0.05) and the multinomial logistic regression model. Data were analyzed according to percentiles for the probability of an individual being over 18 years old. The mean ages of the stages in both classifications did not present a significant difference between superior and inferior arches (p < 0.05). The differences in mean ages between all the stages of mineralization were statistically significant (p < 0.001) only for the 4-stage classification. Males attained root formation and complete formation earlier than females (p < 0.05) in the 4-stage classification. The modified classification system showed dependence between chronological age and mineralization stages of third molars, simplifying the age estimation process. At stage H, females present a 95.7% chance of being over 18, while for males, this probability is 89.6%. This modified classification system simplifies the dental age estimation process based on third molars and can be used as a reference for future studies.
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