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Thevissen P, Waltimo-Sirén J, Saarimaa HM, Lähdesmäki R, Evälahti M, Metsäniitty M. Comparing tooth development timing between ethnic groups, excluding nutritional and environmental influences. Int J Legal Med 2024:10.1007/s00414-024-03279-z. [PMID: 39075151 DOI: 10.1007/s00414-024-03279-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/21/2024] [Indexed: 07/31/2024]
Abstract
The timing of dental development in ethnic Finns and Somalis, who were born and living in Finland, was compared, with efforts to minimize environmental bias. The developmental status of seven lower left permanent teeth were staged according to Demirjian et al., using panoramic radiographs from 2,100 Finnish and 808 Somali females and males, aged 2 to 23 years. For each tooth, a continuation-ratio model was constructed to analyze the allocated stages as a function of sex and ethnic origin. Several statistically significant differences in mean age of certain tooth developmental stage transitions were revealed. While Somalis generally displayed stage transitions at younger age, none of the seven teeth consistently showed earlier stage transitions in Somalis compared to Finns. Within each tooth, the lowest (or highest) mean age of stage transition varied without any discernible pattern between the two ethnic groups. Overall, the observed differences in mean age of stage transition between the groups was minimal, suggesting a low impact on clinical and forensic age assessment practice. In conclusion, the studied ethnic Finn and Somali groups with equal nutritional and /or environmental conditions exhibit similar timing in the development of all lower left permanent teeth.
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Affiliation(s)
- Patrick Thevissen
- Department of Imaging & Pathology, Forensic Odontology, KU Leuven Campus Saint Raphael 7, Block A, Box 7001, Leuven, 3000, Belgium
| | - Janna Waltimo-Sirén
- Department of Pediatric Dentistry and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of South-West Finland, Turku, Finland
| | - Hanna-Maija Saarimaa
- Orthodontics, Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, P.O. Box 63, Haartmaninkatu 8, Helsinki, 00014, Finland
| | - Raija Lähdesmäki
- Orthodontics, Research Unit of Oral Health Sciences, Medical Faculty, University of Oulu, Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University Hospital of Oulu, Oulu, Finland
| | - Marjut Evälahti
- Orthodontics, Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, P.O. Box 63, Haartmaninkatu 8, Helsinki, 00014, Finland
| | - Mari Metsäniitty
- Forensic Medicine, Department of Government Services, Finnish Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, Helsinki, 00271, Finland.
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2
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Liu J, Tang B, Xu X. Concurrency of additional canals in mandibular incisors and second mesiobuccal canal in maxillary first molars: A cone-beam computed tomography investigation. AUST ENDOD J 2023; 49:563-573. [PMID: 37548258 DOI: 10.1111/aej.12787] [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: 04/12/2023] [Revised: 07/08/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
This study investigated the concurrency of additional canals in mandibular incisors and the second mesiobuccal canal in maxillary first molars among the Chinese population. In total, 8644 cone-beam computed tomography images from 8644 patients with bilateral mandibular incisors and maxillary first molars were examined. The data were analysed using Chi-square test, binary logistic regression analysis and receiver operating characteristic curve. Among the patients with additional canals in mandibular central and lateral incisors, 96.2% and 95.5% of them had second mesiobuccal canal in maxillary first molars, respectively. Additional canals of mandibular incisors and second mesiobuccal canal in maxillary first molars exhibited a concurrent relationship. The prevalence of second mesiobuccal canal in maxillary first molars increased with the number of mandibular incisors with additional canals. Moreover, when there was at least one mandibular incisor with additional canals, the presence of the second mesiobuccal canal in maxillary first molars could be highly expected.
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Affiliation(s)
- Jinchi Liu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bei Tang
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Pereira CP, Santos R, Nushi V, Lameiro MV, Antunes P, Carvalho R, Major T, AlQahtani SJ. Dental age assessment: scoring systems and models from the past until the present-how is it presented in the court? Int J Legal Med 2023; 137:1497-1504. [PMID: 37154903 DOI: 10.1007/s00414-023-03011-3] [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: 02/23/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the accuracy of the methods from the past and present, such as Demirjian, Cameriere, and AlQahtani, as well as to determine the most reliable method for human age estimation under the request from the courts according to the effect size from each method in age estimation. DESIGN Four hundred eighty-three orthopantomographic images were selected from 318 patients from Centro Hospitalar Universitário Lisboa Norte aged between 6 and 15 years old. Several measurements of widths and lengths and classification of tooth development stages were performed, according to each age estimation method. The listing of patients and orthopantomographic images were consulted through SECTRA®. All data was entered and analysed using SPSS version 28. Observations' validity was verified through inter- and intraobserver validation. RESULTS The correlation coefficients between age and age estimates by the three methods on both sides were close to 90%. Regarding the estimation error correlation coefficient, Demirjian and AlQahtani values were low, whereas Cameriere's was significantly negative; i.e., underestimation increases as age increases. Between left and right, any significant difference in age estimation in AlQahtani and Cameriere methods was not observed, but there were great variability and large effect for the Demirjian method. Comparing females and males, the statistical analysis showed no significant differences and quite small effects in the precision of the estimates for any of the methods. Finally, although significant differences were detected when comparing estimated values and age, small effects were revealed except for the Demirjian method which attained a medium effect and, therefore, less consistency of estimation. CONCLUSIONS Since it was not possible to determine the most reliable method for age estimation, a combined application of different age estimation methodologies is recommended to be use in the courts with relevant statistical data such as effect size.
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Affiliation(s)
- Cristiana Palmela Pereira
- Faculdade de Medicina Dentária Universidade de Lisboa, Rua Professora Teresa Ambrósio, Cidade Universitária, 1600-277, Lisboa, Portugal.
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Faculdade de Ciências da Universidade de Lisboa, Bloco C6, Piso 4, 1749-016, Lisboa, Portugal.
- Faculdade de Medicina Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.
| | - Rui Santos
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Faculdade de Ciências da Universidade de Lisboa, Bloco C6, Piso 4, 1749-016, Lisboa, Portugal
- Politécnico de Leiria, Escola de Tecnologia e Gestão, 2411-901, Leiria, Portugal
| | - Valon Nushi
- Faculdade de Medicina Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Maria Vitória Lameiro
- Faculdade de Medicina Dentária Universidade de Lisboa, Rua Professora Teresa Ambrósio, Cidade Universitária, 1600-277, Lisboa, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Faculdade de Ciências da Universidade de Lisboa, Bloco C6, Piso 4, 1749-016, Lisboa, Portugal
| | - Patrícia Antunes
- Faculdade de Medicina Dentária Universidade de Lisboa, Rua Professora Teresa Ambrósio, Cidade Universitária, 1600-277, Lisboa, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Faculdade de Ciências da Universidade de Lisboa, Bloco C6, Piso 4, 1749-016, Lisboa, Portugal
| | - Raquel Carvalho
- Faculdade de Medicina Dentária Universidade de Lisboa, Rua Professora Teresa Ambrósio, Cidade Universitária, 1600-277, Lisboa, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Faculdade de Ciências da Universidade de Lisboa, Bloco C6, Piso 4, 1749-016, Lisboa, Portugal
| | - Tatiana Major
- Faculdade de Medicina Dentária Universidade de Lisboa, Rua Professora Teresa Ambrósio, Cidade Universitária, 1600-277, Lisboa, Portugal
- Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Faculdade de Ciências da Universidade de Lisboa, Bloco C6, Piso 4, 1749-016, Lisboa, Portugal
| | - Sakher J AlQahtani
- Department of Paediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia
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Vila-Blanco N, Varas-Quintana P, Tomás I, Carreira MJ. A systematic overview of dental methods for age assessment in living individuals: from traditional to artificial intelligence-based approaches. Int J Legal Med 2023; 137:1117-1146. [PMID: 37055627 PMCID: PMC10247592 DOI: 10.1007/s00414-023-02960-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 04/15/2023]
Abstract
Dental radiographies have been used for many decades for estimating the chronological age, with a view to forensic identification, migration flow control, or assessment of dental development, among others. This study aims to analyse the current application of chronological age estimation methods from dental X-ray images in the last 6 years, involving a search for works in the Scopus and PubMed databases. Exclusion criteria were applied to discard off-topic studies and experiments which are not compliant with a minimum quality standard. The studies were grouped according to the applied methodology, the estimation target, and the age cohort used to evaluate the estimation performance. A set of performance metrics was used to ensure good comparability between the different proposed methodologies. A total of 613 unique studies were retrieved, of which 286 were selected according to the inclusion criteria. Notable tendencies to overestimation and underestimation were observed in some manual approaches for numeric age estimation, being especially notable in the case of Demirjian (overestimation) and Cameriere (underestimation). On the other hand, the automatic approaches based on deep learning techniques are scarcer, with only 17 studies published in this regard, but they showed a more balanced behaviour, with no tendency to overestimation or underestimation. From the analysis of the results, it can be concluded that traditional methods have been evaluated in a wide variety of population samples, ensuring good applicability in different ethnicities. On the other hand, fully automated methods were a turning point in terms of performance, cost, and adaptability to new populations.
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Affiliation(s)
- Nicolás Vila-Blanco
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Departamento de Electrónica e Computación, Escola Técnica Superior de Enxeñaría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Paulina Varas-Quintana
- Oral Sciences Research Group, Special Needs Unit, Department of Surgery and Medical Surgical Specialities, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Inmaculada Tomás
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
- Oral Sciences Research Group, Special Needs Unit, Department of Surgery and Medical Surgical Specialities, School of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
| | - María J Carreira
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Departamento de Electrónica e Computación, Escola Técnica Superior de Enxeñaría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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Genetic, Epigenetic and Environmental Factors Influence the Phenotype of Tooth Number, Size and Shape: Anterior Maxillary Supernumeraries and the Morphology of Mandibular Incisors. Genes (Basel) 2022; 13:genes13122232. [PMID: 36553499 PMCID: PMC9777959 DOI: 10.3390/genes13122232] [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: 07/20/2022] [Revised: 09/05/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to investigate whether the genetic, epigenetic and environmental factors that give rise to supernumeraries in the maxillary incisor region and larger dimensions of the adjacent maxillary incisors are also associated with variations in the morphology of the mandibular incisors. If so, this would contribute to understanding the distribution and interactions of factors during dental development and how these can be modelled. The sample consisted of 34 patients with supernumerary teeth in the maxillary anterior region, matched for gender, age and White Caucasian ethnicity with 34 control subjects. The average ages of the supernumerary and control groups were 12.8 and 12.2 years, respectively. Study models of all subjects were constructed and imaged using a previously validated system. Using custom software, each of the mandibular incisor teeth were measured to obtain 17 parameters from the labial view and 17 from the occlusal view. Principal component analysis (PCA) was used to summarize the measurements into a smaller set representing distinct features of the clinical crowns, followed by a comparison between the supernumerary and control groups using 2-way ANOVA. Seven factors of tooth size of the mandibular central incisors and six factors of the mandibular lateral incisors were identified as major features of the clinical crowns. All parameters of both mandibular incisors were greater in the supernumerary group than in the control, with three of these, located in the incisal and cervical regions of the mandibular lateral incisors, being statistically significantly larger. The findings of this study indicate that the aetiological factors associated with supernumerary teeth in the maxillary anterior region also affect tooth crown dimensions of mandibular incisors. This new evidence enhances several models of the interactions of genetic, epigenetic and environmental components of dental development and supports a multi-model approach to increase understanding of this process and its variations.
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Lee JB, Seo MS. Mandibular incisors with two canals are associated with the presence of the distolingual root in mandibular first molars: a cone-beam computed tomographic study. BMC Oral Health 2022; 22:145. [PMID: 35473630 PMCID: PMC9044624 DOI: 10.1186/s12903-022-02184-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to evaluate the root canal configurations and the association between mandibular first molars and distolingual root (DLR) and mandibular incisors using cone-beam computed tomography (CBCT). Methods Mandibular first molars and incisors were evaluated using CBCT images of 150 patients. Mandibular first molars were classified according to the presence or absence of DLR. The curvature of the DLR was evaluated using Schneider’s method in buccolingual and mesiodistal orientations. The angle of the mesiolingual–distolingual–distobuccal canal orifices (ML–DL–DB) was evaluated at the pulpal floor level. The mandibular central and lateral incisors were classified as either single canal or two canals. The association between the root canal system of the mandibular first molar and mandibular incisors was evaluated. Data were analyzed using the Chi-square test, Student’s t-test, and odds ratios from binary logistic regression. The significance level was set at 5%. Results The frequency of mandibular first molars with DLR was 27.0% and that of mandibular incisors with two canals was 25.8%. The curvature of the DLR was 37.1° in the buccolingual orientation and 10.4° in the mesiodistal orientation. The angle of ML–DL–DB was 79.0°. The presence of two canal systems in mandibular incisors was associated with the presence of DLR in the mandibular first molar (left central incisors: p = 0.001, odds ratio = 4.25; left lateral incisors: p < 0.001, odds ratio = 3.8; right central incisors: p = 0.003, odds ratio = 3.86; right lateral incisors: p = 0.001, odds ratio = 3.44) but not with the curvature of the DLR or angle of the ML–DL–DB orifice (p > 0.05). Conclusions The mandibular first molar showed a high incidence of separate DLRs. It was confirmed that DLR in the mandibular first molar is highly associated with the presence of two-canal system in the mandibular incisors. This association can aid clinicians in successful endodontic treatments.
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Affiliation(s)
- Ju-Bin Lee
- Department of Conservative Dentistry, Dental College, Wonkwang University, Iksan, Korea
| | - Min-Seock Seo
- Department of Conservative Dentistry, Dental College, Wonkwang University, Iksan, Korea. .,Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, 77 Dunsan-Ro, Seo-Gu, Daejeon, 302-120, Republic of Korea.
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Mutebi AK, Kamulegeya A, Nabaggala G, Mwesigwa CL. Determination of age reference standards based on mandibular third molar root development in a Ugandan population aged 10-22 years. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2022; 12:56. [PMID: 36505979 PMCID: PMC9729122 DOI: 10.1186/s41935-022-00308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background This study was aimed at establishing age estimates based on distal root development of the mandibular third molar for Ugandans aged 10-22 years. This was a cross-sectional study using orthopantomograms (OPGs) of 671 patients attending the Mulago Hospital Dental Clinic. The patients' chronological age and sex were obtained from either their national identity cards or birth certificates (females; n = 326, 48.6%). Third molar root development was assessed using Demirjian, Goldstein, and Tanner (DGT), modified Demirjian by Solari, Moorrees, Fanning, and Hunt (MFH), and Haavikko methods. Age was summarized using means/standard deviation (SD), medians, and lower and upper quartiles. Sex differences were assessed using Student's t-test. Results Crown completion (stage D) and root initiation (stage Ri) were observed at 12.6 years for females and 13.5 years for males (P = 0.02), while complete apex closure occurred at 19.8 for females and 20.1 for males (P = 0.3). There were statistically significant differences in Demirjian root stages E, F, and G and MFH and Haavikko stages Ri, R1/4, and R1/2 between the sexes (P < 0.05). The difference in the mean age of root development between females and males ranged between 0.9 year at DGT/MFH root stages D and Ri (13.5-12.6) and 1.4 years at Solari, MFH, and Haavikko root stages F, R1/4, and R1/2 (16.3-14.9, 17.1-15.7). No differences were observed between the right and left mandibular molars. Conclusions This study provides age reference standards based on third molar root development specific to the Ugandan adolescent and young adult population. The findings can be used to formulate contemporary standards and utilized as reference material to assess third molar maturity for forensic purposes.
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Affiliation(s)
- Annet Kutesa Mutebi
- grid.11194.3c0000 0004 0620 0548Department of Dentistry, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Adriane Kamulegeya
- grid.11194.3c0000 0004 0620 0548Department of Dentistry, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Grace Nabaggala
- grid.11194.3c0000 0004 0620 0548Department of Dentistry, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Cathy Lutalo Mwesigwa
- grid.11194.3c0000 0004 0620 0548Department of Dentistry, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
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Fei Y, Yang L, Sheng K, Lai G, Wang J. Dental maturation in a Chinese sample using Demirjian method. Ann Hum Biol 2021; 48:393-399. [PMID: 34605741 DOI: 10.1080/03014460.2021.1988705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Yue Fei
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lianyi Yang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Kai Sheng
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Guangyun Lai
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
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Nelwan SC, Wahluyo S, Khairani FC, Nugraha RA, Utomo H, Tedjosasongko U, Nowwarote N. The relationship between chronological age, dental age, and salivary alkaline phosphatase in Indonesian children aged 8–14 years: A cross-sectional study. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Alqerban A, Alrashed M, Alaskar Z, Alqahtani K. Age estimation based on Willems method versus country specific model in Saudi Arabia children and adolescents. BMC Oral Health 2021; 21:341. [PMID: 34256760 PMCID: PMC8276469 DOI: 10.1186/s12903-021-01707-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aims of this study were to create a method for estimation of dental age in Saudi children and adolescents based on the Willems model developed using the Belgian Caucasian (BC) reference data and to compare the ability of the two models to predict age in Saudi children. METHODS Development of the seven lower left permanent mandibular teeth was staged in 1146 panoramic radiographs from healthy Saudi children (605 male, 541 female) without missing permanent teeth and without all permanent teeth fully developed (except third molars). The data were used to validate the Willems BC model and to construct a Saudi Arabian-specific (Willems SA) model. The mean error, mean absolute error, and root mean square error obtained from both validations were compared to quantify the variance in errors in the sample. RESULTS The overall mean error for the Willems SA method was 0.023 years (standard deviation, ± 0.55), indicating no systematic underestimation or overestimation of age. For girls, the error using the Willems SA method was significantly lower but still negligible at 0.06 years. A small but statistically significant difference in total mean absolute error (11 days) was found between the Willems BC and Willems SA models when the data were compared independent of sex. The overall mean absolute error for girls was slightly lower for the Willems BC method than for the Willems SA method (1.33 years vs. 1.37 years). CONCLUSIONS The difference in ability to predict dental age between the Willems BC and Willems SA methods is very small, indicating that the data from the BC population can be used as a reference in the Saudi population.
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Affiliation(s)
- Ali Alqerban
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Riyadh, Saudi Arabia.,Department of Preventive Dental Science, Dar Al Uloom University, Alkharj, Saudi Arabia
| | - Muath Alrashed
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Riyadh, Saudi Arabia.
| | - Ziyad Alaskar
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Riyadh, Saudi Arabia
| | - Khalid Alqahtani
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
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Age estimation in the living: A scoping review of population data for skeletal and dental methods. Forensic Sci Int 2021; 320:110689. [PMID: 33561788 DOI: 10.1016/j.forsciint.2021.110689] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
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.
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Applicability of newly derived second and third molar maturity indices for indicating the legal age of 16 years in the Southern Chinese population. Leg Med (Tokyo) 2020; 46:101725. [DOI: 10.1016/j.legalmed.2020.101725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 01/10/2023]
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Abstract
The aim of this study is to assess the accuracy of Demirjian and Willems dental age estimation methods on a population of 8- to 15-year-old Taiwanese children. A total of 799 digital panoramic radiographs (404 boys, 395 girls) of children aged from 8.00 to 15.99 years are evaluated. All panoramic films are assessed by 2 examiners using Demirjian and Willems methods. We randomly select 48 panoramic films to evaluate the reproducibility of dental age measurements. The intraobserver and interobserver Cohen's kappa values are 0.733 and 0.762, respectively.The difference between chronological age and dental age is calculated for each individual using both methods. The result shows that Demirjian method slightly overestimates the chronological age of children. The mean age difference is 0.12 years for boys (standard deviation [SD], 0.80) and 0.21 years for girls (SD, 0.95). Willems method slightly underestimates the chronological age of children. The mean age difference is -0.22 years for boys (SD, 0.80) and -0.12 years for girls (SD, 0.92).In conclusion, Demirjian and Willems methods are both accurate for assessing dental age in the Taiwan region of China. The mean age differences of both methods are within ±1 year, which is acceptable at forensic odontology level. However, although the discrepancy between chronological age and dental age is frequently observed between -0.5 and 0.5 years in both methods, there is no guarantee it will be accurate for any particular individual, further modifications to both methods are suggested.
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Complicated Root Canal Morphology of Permanent Mandibular Lateral Incisors is Associated with the Presence of a Second Mesiobuccal Canal in Permanent Maxillary First Molars. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Many studies have been conducted in order to define the root canal morphology based on age, gender, ethnic and racial characteristics of the population. However, relations within morphological variations of certain groups of teeth have rarely been investigated. The aim of this study was to evaluate the root canal morphology of mandibular lateral incisors and to determine the association between their morphologic characteristics and the presence of a second mesiobuccal canal of maxillary first molars. Cone-beam computed tomography images from a pre-existing base were analyzed for the bilateral presence of both permanent mandibular lateral incisors and permanent maxillary first molars. Root canal morphology was analyzed according to the Vertucci classification. Associations of root canal morphologies between incisors and molars were calculated as probabilities using binary logistic regression analysis. In total, 126 mandibular lateral incisors and 126 maxillary first molars were included. 46% of all mandibular lateral incisors showed complicated root canal morphology and Vertucci type III canal configuration as the most frequent. Second mesiobuccal root canal was present in 62.7%. Root canal morphologies showed high level of bilateral symmetry in both tooth groups. The probability of a subject having complicated root canal morphology in lateral incisors was significantly higher when the second mesiobuccal canal was present. Clinicians should consider all available information on patients’ root canal morphology when planning new endodontic treatment. Root canal morphology of permanent mandibular lateral incisors showed high association with the root canal morphology of permanent maxillary first molars.
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Mwesigwa CL, Kutesa AM, Munabi IG, Kabenge CA, Buwembo W. Accuracy of the lower third molar radiographic imaging to estimate age among Ugandan young people. BMC Res Notes 2019; 12:652. [PMID: 31601254 PMCID: PMC6788087 DOI: 10.1186/s13104-019-4686-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/28/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Dental development is a useful method for age estimation. Although third molar eruption is commonly used to estimate age in Uganda, it is reported to be unreliable because of external influences. The more reliable radiographic techniques have inter-ethnic differences but data from sub-Saharan Africa are limited regarding estimating age in young adults. This study, therefore, aimed at determining the accuracy of Demirjian's classification of the lower third molar, a common dental age estimation method, in estimating key ages in a Ugandan population using Ugandan references. Dental records of 1021 Ugandans aged 10-22 years were assigned to two groups; reference and test. The reference data was retrieved from a database of a previous bigger research project. RESULTS The overall sample population comprised of 514/1021 (50.3%) males. The mean age was 15.8 (3.6) years. No significant sex differences in dental age were established in the reference sample (520 records). Accuracy values (area under the curve) at the 12-, 14-, 16- and 18-year cut-offs were between 0.83 and 0.90 using the test sample (501 records). The results suggest that Demirjian's classification of the lower third molars is a useful method for age estimation in the young urban Ugandan population in the 10-22-year age-group.
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Affiliation(s)
- Catherine Lutalo Mwesigwa
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Uganda.
| | - Annet M Kutesa
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, P.O.Box 7072, Kampala, Uganda
| | - Ian G Munabi
- Department of Anatomy, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Catherine A Kabenge
- Department of Oral & Maxillofacial, Mulago National Referral Hospital, Kampala, Uganda
| | - William Buwembo
- Department of Anatomy, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
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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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Rolseth V, Mosdøl A, Dahlberg PS, Ding Y, Bleka Ø, Skjerven-Martinsen M, Straumann GH, Delaveris GJM, Vist GE. Age assessment by Demirjian's development stages of the third molar: a systematic review. Eur Radiol 2018; 29:2311-2321. [PMID: 30506219 DOI: 10.1007/s00330-018-5761-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/21/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Radiographic evaluation of the wisdom teeth (third molar) formation is a widely used age assessment method for adolescents and young adults. This systematic review examines evidence on the agreement between Demirjian's development stages of the third molar and chronological age. METHODS We searched four databases up until May 2016 for studies reporting Demirjian's stages of third molar and confirmed chronological age of healthy individuals aged 10-25 years. Heterogeneity test of the included studies was performed. RESULTS We included 21 studies from all continents except Australia, all published after 2005. The mean chronological age for Demirjian's stages varied considerably between studies. The results from most studies were affected by age mimicry bias. Only a few of the studies based their results on an unbiased age structure, which we argue as important to provide an adequate description of the method's ability to estimate age. CONCLUSION Observed study variation in the timing of Demirjian's development stages for third molars has often been interpreted as differences between populations and ethnicities. However, we consider age mimicry to be a dominant bias in these studies. Hence, the scientific evidence is insufficient to conclude whether such differences exist. KEY POINTS • There is significant heterogeneity between studies evaluating age assessment by Demirjian's third molar development. • Most of the studies were subject to the selection bias age mimicry which can be a source of heterogeneity. • Presence of age mimicry bias makes it impossible to compare and combine results. These biased studies should not be applied as reference studies for age assessment.
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Affiliation(s)
- Veslemøy Rolseth
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway.
| | - Annhild Mosdøl
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål Skage Dahlberg
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | - Yunpeng Ding
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
| | - Øyvind Bleka
- Department of Forensic Sciences, Oslo University Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | | | - Gyri Hval Straumann
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Gunn Elisabeth Vist
- Division for health services, Norwegian Institute of Public Health, Oslo, Norway
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Esan TA, Schepartz LA. The timing of permanent tooth development in a Black Southern African population using the Demirjian method. Int J Legal Med 2018; 133:257-268. [DOI: 10.1007/s00414-018-1968-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 11/08/2018] [Indexed: 11/28/2022]
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Wang J, Bai X, Wang M, Zhou Z, Bian X, Qiu C, Li C, Yang Z, Chen G, Ji F, Tao J. Applicability and accuracy of Demirjian and Willems methods in a population of Eastern Chinese subadults. Forensic Sci Int 2018; 292:90-96. [DOI: 10.1016/j.forsciint.2018.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 09/05/2018] [Indexed: 11/25/2022]
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Bleka Ø, Rolseth V, Dahlberg PS, Saadé A, Saadé M, Bachs L. BioAlder: a tool for assessing chronological age based on two radiological methods. Int J Legal Med 2018; 133:1177-1189. [DOI: 10.1007/s00414-018-1959-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/23/2018] [Indexed: 11/27/2022]
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Dental age estimation in Somali children using the Willems et al. model. Int J Legal Med 2018; 132:1779-1786. [PMID: 30173300 DOI: 10.1007/s00414-018-1926-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
AIM The aim of the current study was to retrospectively collect dental panoramic radiographs from Somali children living in Finland, to use the radiographic data to develop a new age estimation model based on the model established by Willems et al. (J Forensic Sci 46(4):893-895, 2001), and to compare the age prediction performances of the Willems et al. model (WM) and the newly developed model. MATERIAL AND METHODS Dental panoramic radiographs from 808 healthy Somalis born in Finland were selected. The development of the seven left mandibular permanent teeth, from the central incisor to the second molar, was staged according to Demirjian et al. (Hum Biol 45(2):211-227, 1973). Radiographs with all listed permanent teeth completely developed were excluded. The studied sample consisted of 635 subjects (311 females, 324 males) ranging in age from 4 to 18 years. Kappa and weighted Kappa statistics were used to quantify intra- and inter-observer agreement in stage allocation. The collected dataset was used to validate the WM, constructed on a Belgian Caucasian reference sample, and to establish a Somali-specific age estimation model (SM) based on the WM. Both models were validated and their age prediction performances quantified using mean error (ME), mean absolute error (MAE) and root mean squared error (RMSE). RESULTS The SM resulted in a slight underestimation of age when the sex groups were analysed separately or combined, with ME varying between 0.04 (standard deviation (SD) 1.01) and 0.05 (SD 1.04) years, MAE between 0.77 and 0.80 years and RMSE between 1.01 and 1.04 years. The WM statistically significantly underestimated the age of females, with an ME of 0.20 (SD 1.01) years (p = 0.0006). For males, and for females and males combined, no statistically significant ME was observed. CONCLUSION The WM and SM were similar in their age prediction performances, and the use of the WM in dental age assessment in the Somali population is justified.
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Third molar maturity index (I3M) for assessing age of majority in northern Chinese population. Int J Legal Med 2018; 132:1759-1768. [DOI: 10.1007/s00414-018-1907-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
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Antunovic M, Galic I, Zelic K, Nedeljkovic N, Lazic E, Djuric M, Cameriere R. The third molars for indicating legal adult age in Montenegro. Leg Med (Tokyo) 2018; 33:55-61. [PMID: 29859353 DOI: 10.1016/j.legalmed.2018.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 04/23/2018] [Accepted: 05/26/2018] [Indexed: 11/16/2022]
Abstract
AIM From a medico-legal and penalty point of view, it is essential to conclude if an individual is a minor or an adult (18 years of age). Methods based on the third molar development have been used for this purpose. The present article aims to verify the Nolla's stages of mineralization of the third molars and a third molar maturity index (I3M) which is based on the measures of the projections of open apices normalized by their height in the sample of Montenegrins. METHOD AND SAMPLE The sample consisted of 683 panoramic radiographs (324 males and 359 females) between 13 and 24 years of age. The specific mineralization stages of Nolla and the cut-off value of I3M < 0.08 was used to discriminate adults and minors. RESULTS The best performance in discriminating adults and minors was for I3M < 0.08 followed by the Nolla stage 9. For I3M < 0.08 the results demonstrated high sensitivity of 0.92 and 0.82 and specificity of 0.94 and 0.96 in males and females, respectively. The proportions of correctly classified individuals were 0.93 in males and 0.89 in females. The Nolla stage 9 demonstrated the sensitivity of 0.95 and 0.85 and the specificity of 0.84 and 0.90 in males and females, respectively. The proportions of correctly classified individuals were 0.90 in males and 0.87 in females. CONCLUSION The suggested value of I3M < 0.08 followed by Nolla stage 9 can be used to discriminate adults from minors with high specificity.
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Affiliation(s)
- Marija Antunovic
- University of Montenegro, Medical Faculty, Clinical Centre of Montenegro, Ljubljanska bb, 81000 Podgorica, Montenegro
| | - Ivan Galic
- University of Split, School of Medicine, Spinčićeva 2, 21000 Split, Croatia
| | - Ksenija Zelic
- University of Belgrade School of Medicine, Laboratory for Anthropology, Institute of Anatomy, Dr Subotica 4, 11000 Belgrade, Serbia.
| | - Nenad Nedeljkovic
- University of Belgrade School of Dentistry, Clinic for Orthodontics, GastonaGravijea 2, 11000 Belgrade, Serbia
| | - Emira Lazic
- University of Belgrade School of Dentistry, Clinic for Orthodontics, GastonaGravijea 2, 11000 Belgrade, Serbia
| | - Marija Djuric
- University of Belgrade School of Medicine, Laboratory for Anthropology, Institute of Anatomy, Dr Subotica 4, 11000 Belgrade, Serbia
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Kelmendi J, Vodanović M, Koçani F, Bimbashi V, Mehmeti B, Galić I. Dental age estimation using four Demirjian's, Chaillet's and Willems' methods in Kosovar children. Leg Med (Tokyo) 2018; 33:23-31. [PMID: 29709721 DOI: 10.1016/j.legalmed.2018.04.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Tooth formation was recognized as useful body system to assess maturity and predict age. Tooth mineralization is much less affected by the endocrine and different nutritional status than bone mineralization, and teeth formation provides a more reliable indication of chronological age. Demirjian et al. in 1973 presented a scoring system and method for dental age estimation on a sample of French-Canadian children. Chaillet et al. and Willems et al. modified original Demirjian method. This study aimed to evaluate the accuracy of four Demirjian's, Chaillet and Willems methods for age estimation in the children of Kosovo. MATERIALS AND METHODS The cross-sectional study was based on the evaluation of the sample of 1022 orthopantomograms (OPTs) of healthy Kosovar children, aged between 5 and 14 years. OPTs were taken from the Radiology unit of University Dentistry Clinical Center of Kosova, as part of random clinical treatment. We tested the accuracy of four methods based on seven mandibular teeth, Demirjian from 1973 (Dem73) and 1976 (Dem76), Chaillet from 2005 (Chaillet) and Willems from 2001 (Willems) and two Demirjian's methods based on different sets of four teeth (Dem76PM1 and Dem76IN2). RESULTS For most tested methods, we found statistically significant differences between the chronological age (CA) and dental age (DA) (p < 0.05). In males, the most accurate method were those using four teeth, Dem76IN2 (0.03 years) following by Dem76PM1 (-0.05 years), following those using seven teeth, Willems (-0.14 years), Chaillet (-0.24 years) and Dem73 (0.43 years). In females, dental age was the most accurate for the Willems method (-0.24 years) following Chaillet (-0.35 years), Dem76 (0.43 years) and Dem73 (0.55 years), while Dem76PM1 and Dem76IN2 overestimated by 0.45 years and 0.46 years, respectively. The mean absolute difference between DA and CA were between 0.61 years for the Willems, to 0.78 years for the Dem73 in males, and 0.64 years for the Willems to 0.75 years for the Dem76IN2 in females. CONCLUSION The Willems method was the most accurate for estimating a dental age if all seven mandibular teeth are available for analysis, and we found the similar accuracy of Dem76PM1 and Dem76IN2 methods. Therefore, we may encourage their use for age estimation on the Kosovar children.
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Affiliation(s)
- Jeta Kelmendi
- University of Zagreb, School of Dental Medicine, Dental Science, Zagreb, Croatia; Department of Orthodontics, University Dentistry Clinical Center of Kosovo, 10000 Pristina, Kosovo.
| | - Marin Vodanović
- Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Croatia; Department of Dental Medicine, University Hospital Centre Zagreb, Croatia.
| | - Ferit Koçani
- Department of Dental Pathology and Endodontics, University Dentistry Clinical Center of Kosovo, Kosovo.
| | - Venera Bimbashi
- Department of Prosthodontics, Dental School, Faculty of Medicine, University of Prishtina, Kosovo
| | - Blerim Mehmeti
- University of Zagreb, School of Dental Medicine, Dental Science, Zagreb, Croatia; Department of Orthodontics, University Dentistry Clinical Center of Kosovo, 10000 Pristina, Kosovo
| | - Ivan Galić
- School of Medicine at University of Split, Croatia.
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Angelakopoulos N, De Luca S, Velandia Palacio LA, Coccia E, Ferrante L, Cameriere R. Third molar maturity index (I 3M) for assessing age of majority: study of a black South African sample. Int J Legal Med 2018. [PMID: 29520486 DOI: 10.1007/s00414-018-1818-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The evaluation of the cutoff value of I3M = 0.08 for discriminating black South African minors from adults, and its relationship with chronological age. MATERIAL AND METHODS A sample of 833 panoramic radiographs of healthy black South African subjects (500 females and 333 males), in the age range of 14 to 24 years (mean age 17.67 years in females and 17.42 years in males), was retrospectively evaluated. RESULTS ICC values were 99.10% (95% CI 97.70 to 99.70%) and 99.20% (95% CI 98.00 to 99.60%), for the intra- and inter-observer reliability, respectively. I3M decreased as the real age gradually increased in both sexes. According to the logistic regression model, the variable sex was not significant when the probability that an individual is 18 years or older was calculated. The I3M = 0.08 was valuable in discriminating between adults and minors. The overall accuracy (ACC = fraction of accurately classified subjects) is 0.90 (95% CI 0.87-0.91); the proportion of correctly classified subjects (Se = sensitivity) is 0.80 (95% CI 0.76-0.84), and specificity (Sp) is 0.95 (95% CI 0.93-0.97). The PPV (predictive positive value) is 0.96 (95% CI 0.95-0.97), and the negative predictive value is 0.76 (95% CI 0.72-0.80). CONCLUSION The results show that I3M is a valuable method to distinguish subjects who are around legal adult age in South Africa.
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Affiliation(s)
- N Angelakopoulos
- School of Dentistry, Division of Cariology and Endodontics and Pediatric Dentistry, University of Geneva, Geneva, Switzerland
| | - S De Luca
- Unidad Especial de Identificación Forense, Servicio Médico Legal, Santiago de Chile, Chile. .,AgEstimation Project, Institute of Legal Medicine, University of Macerata, Macerata, Italy.
| | - L A Velandia Palacio
- AgEstimation Project, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | - E Coccia
- Department of Odontostomatologic and Specialized Clinical Sciences (DISCO), Polytechnic University of Marche, Ancona, Italy
| | - L Ferrante
- Center of Epidemiology, Biostatistics and Medical Information Technology, Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - R Cameriere
- AgEstimation Project, Institute of Legal Medicine, University of Macerata, Macerata, Italy
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Esan TA, Schepartz LA. Accuracy of the Demirjian and Willems methods of age estimation in a Black Southern African population. Leg Med (Tokyo) 2018; 31:82-89. [DOI: 10.1016/j.legalmed.2018.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 11/16/2022]
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Esan TA, Schepartz LA. The WITS Atlas: A Black Southern African dental atlas for permanent tooth formation and emergence. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:208-218. [PMID: 29446436 DOI: 10.1002/ajpa.23424] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 11/07/2022]
Abstract
Current dental maturity charts, such as the widely applied London atlas, do not take into consideration advanced tooth emergence and formation patterns observed in children of African ancestry. The result is inaccurate age estimation in Southern Africa, a region where there is great forensic and anthropological need for reliable age estimation. OBJECTIVES To develop a population-specific atlas of permanent tooth emergence and formation for age estimation of Black Southern Africans. MATERIALS AND METHODS Using data from a cross-sectional study of 642 school children aged 5-20 years, panoramic radiographs taken during routine dental examination in a mobile treatment van were analyzed using the Demirjian method of eight (A-H) tooth formation stages. Tables of the stages of tooth development for each tooth, including the third molars, were generated separately for age cohorts and by sex. The most frequently occurring (modal) stage of tooth formation was considered the signature developmental stage for the age. The relationship of the third molar occlusal surfaces with occlusal tables on the radiographs were checked and compared with the findings recorded during intra oral examination. RESULTS Comparison with the London atlas shows that at age 9.5 years, the canine and premolar emergence are at least one year ahead and the third molar formation completes four years earlier in the WITS Atlas. DISCUSSION Similarities in advancement in tooth formation and emergence across sub-Saharan Africa suggest that the WITS Atlas can be used for those populations as well.
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Affiliation(s)
- Temitope A Esan
- Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria.,Human Variation and Identification Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Lynne A Schepartz
- Human Variation and Identification Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
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Accuracy of the third molar maturity index in assessing the legal age of 18 years: a systematic review and meta-analysis. Int J Legal Med 2017; 132:1167-1184. [PMID: 29273824 DOI: 10.1007/s00414-017-1766-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/13/2017] [Indexed: 01/21/2023]
Abstract
The age estimation is a complex procedure required in the daily practice of legal medicine. The maturity of third molars stands out by the age of 18 because these teeth are still in development. This systematic review aimed to assess the accuracy of the third molar maturity index (I 3M), proposed by Cameriere et al. (2008), in discriminating whether an individual is under or over 18 years. Seven electronic databases were screened: PubMed, Scopus, ISI Web of Science, Cochrane Library, LILACS, SIGLE, and CAPES. Eligible studies included an assessment of I 3M accuracy at the 0.08 cut-off value. The quality assessment was performed by using QUADAS 2. Three meta-analyses (MA) were accomplished: overall, one for males and another for females. From 2397 articles identified, 16 met the eligibility criteria. Of these, two showed high risk of bias, one in the reference standard domain and the other in the flow and timing domain. The percentage of individuals correctly classified ranged from 72.4 to 96.0%. The overall MA showed pooled sensitivity of 0.86 (0.84 to 0.87; p = 0.0000) and pooled specificity of 0.93 (0.92 to 0.94; p = 0.0000). The AUC (area under the summary receiver operator characteristics curve) and DOR (diagnostic odds ratio) values were, respectively, 0.9652 and 104.68, indicating an overall high discrimination effect. Separately, better results of accuracy were found for males. High heterogeneity was achieved for both sensibility (94.6%) and specificity (88.8%). We conclude that the I 3M is a suitable and useful method for estimating adulthood regarding forensic purposes, regardless of gender.
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Esan TA, Yengopal V, Schepartz LA. The Demirjian versus the Willems method for dental age estimation in different populations: A meta-analysis of published studies. PLoS One 2017; 12:e0186682. [PMID: 29117240 PMCID: PMC5678786 DOI: 10.1371/journal.pone.0186682] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/05/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The accuracy of radiographic methods for dental age estimation is important for biological growth research and forensic applications. Accuracy of the two most commonly used systems (Demirjian and Willems) has been evaluated with conflicting results. This study investigates the accuracies of these methods for dental age estimation in different populations. METHODS A search of PubMed, Scopus, Ovid, Database of Open Access Journals and Google Scholar was undertaken. Eligible studies published before December 28, 2016 were reviewed and analyzed. Meta-analysis was performed on 28 published articles using the Demirjian and/or Willems methods to estimate chronological age in 14,109 children (6,581 males, 7,528 females) age 3-18 years in studies using Demirjian's method and 10,832 children (5,176 males, 5,656 females) age 4-18 years in studies using Willems' method. The weighted mean difference at 95% confidence interval was used to assess accuracies of the two methods in predicting the chronological age. RESULTS The Demirjian method significantly overestimated chronological age (p<0.05) in males age 3-15 and females age 4-16 when studies were pooled by age cohorts and sex. The majority of studies using Willems' method did not report significant overestimation of ages in either sex. Overall, Demirjian's method significantly overestimated chronological age compared to the Willems method (p<0.05). The weighted mean difference for the Demirjian method was 0.62 for males and 0.72 for females, while that of the Willems method was 0.26 for males and 0.29 for females. CONCLUSION The Willems method provides more accurate estimation of chronological age in different populations, while Demirjian's method has a broad application in terms of determining maturity scores. However, accuracy of Demirjian age estimations is confounded by population variation when converting maturity scores to dental ages. For highest accuracy of age estimation, population-specific standards, rather than a universal standard or methods developed on other populations, need to be employed.
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Affiliation(s)
- Temitope Ayodeji Esan
- Human Variation and Identification Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Veerasamy Yengopal
- Department of Community Dentistry, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lynne A. Schepartz
- Human Variation and Identification Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Willems G, Lee SS, Uys A, Bernitz H, Cadenas de Llano-Pérula M, Fieuws S, Thevissen P. Age estimation based on Willems method versus new country-specific method in South African black children. Int J Legal Med 2017; 132:599-607. [PMID: 28921164 DOI: 10.1007/s00414-017-1686-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/04/2017] [Indexed: 11/24/2022]
Abstract
AIM The aims of our study were to develop new maturity scores for dental age estimation in South African black children according to the Willems method, which was developed based on Belgian Caucasian (BC) reference data (Willems et al. J Forensic Sci 46(4):893-895, 2001), and to compare age prediction performance of both methods. SUBJECTS AND METHODS A total of 986 panoramic radiographs of healthy South African black (SAB) children (493 males and 493 females) in the age range of 4.14 to 14.99 years (mean age 10.06 years) were selected for obtaining developmental staging scores (according to Demirjian et al. Hum Biol 45(2):211-227, 1973). Willems BC methodology was applied to develop new country-specific maturity scores (Willems SAB). Age prediction performance of Willems BC and Willems SAB was compared. RESULTS On average, Willems BC renders acceptable results with an overestimation of chronological age of 0.06 years (SD 0.88 years) in SAB children. Compared to Willems SAB, the overall mean absolute error was slightly higher with Willems BC (0.62 and 0.68 years, respectively), but this was not significant in males. Also, the root mean squared error was marginally higher in Willems BC. CONCLUSION The new age prediction method developed in South African black children was found to be better compared to Willems BC, although the difference seems to be small and clinically not relevant, especially in males.
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Affiliation(s)
- Guy Willems
- Department of Oral Health Sciences - Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.
| | - Sang-Seob Lee
- Medical Examiner's Office, National Forensic Service, Wonju, South Korea
| | - Andre Uys
- Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Private bag X20, Hatfield, 0028, South Africa
| | - Herman Bernitz
- Department of Oral Pathology and Oral Biology, School of Dentistry, University of Pretoria, Private bag X20, Hatfield, 0028, South Africa
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences - Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Leuven, Belgium
| | - Patrick Thevissen
- Department of Oral Health Sciences - Forensic Dentistry, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Balla SB, Galic I, P. K, Vanin S, De Luca S, Cameriere R. Validation of third molar maturity index (I 3M ) for discrimination of juvenile/adult status in South Indian population. J Forensic Leg Med 2017; 49:2-7. [DOI: 10.1016/j.jflm.2017.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 03/14/2017] [Accepted: 05/01/2017] [Indexed: 11/26/2022]
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Third molar maturity index (I3M) for assessing age of majority in a black African population in Botswana. Int J Legal Med 2016; 130:1109-1120. [PMID: 26972694 DOI: 10.1007/s00414-016-1344-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 02/17/2016] [Indexed: 10/22/2022]
Abstract
Assessment of legal age, also known as age of majority, is a controversial issue as there are few body biomarkers or evidence during late adolescence differentiating a subject from being a minor or adult. The third molar was recognized as a suitable site for age examination in late adolescence. We analyzed the development of the left mandibular third molar by the third molar maturity index (I3M) and a specific cut-off value of I3M = 0.08, established by Cameriere et al. in 2008 and used it for discriminating between minors and adult black Africans from Gaborone, Botswana. A final sample of panoramic radiographs (OPTs) of 1294 people (582 males and 712 females) aged between 13 and 23 years was evaluated. The real age decreased as I3M gradually increased. There was no statistically significant difference in the third molar development evaluated using I3M between males and females (p > 0.05) across different I3M classes. Results of 2 × 2 contingency tables for different cut-off values indicated that I3M = 0.08 was useful in discriminating between adults and minors. Precisely, for I3M = 0.08, the values of accuracy or overall fraction of correctly classified were 0.91 in males with a 95 % confidence interval (95 % CI) of 0.88 to 0.93 and 0.92 (95 % CI, 0.90 to 0.93) in females. Values of sensitivity of the test or the proportion of participants being 18 years and older were 0.88 (95 % CI, 0.87 to 0.90) in males and 0.88 (95 % CI, 0.90 to 0.93) in females, while values of specificity or proportion of individuals younger than 18 who have I3M <0.08 were 0.94 (95 % CI, 0.91 to 0.96) in males and 0.96 (95 % CI, 0.94 to 0.98) in females. Positive predictive values of the test, where the participants whose I3M <0.08 were adults, were 0.94 (95 % CI 0.91 to 0.96) in males and 0.97 (95 % CI, 0.94 to 0.98) in females, while negative predictive values of the test, where the participants whose I3M was ≥0.08 were minors, were 0.88 (95 % CI 0.85 to 0.90) in males and 0.97 (95 % CI, 0.94 to 0.98) in females. The likelihood ratios of the positive test (LR+) were 13.67 (95 % CI, 9.21 to 21.02) in males and 23.73 (95 % CI, 14.20 to 42.28) in females, while likelihood ratios of the negative test (LR-) were 0.12 (95 % CI 0.10 to 0.16) in males and 0.12 (95 % CI, 0.11 to 0.15) in females. Bayes post-test probabilities, p, were 0.94 (95 % CI 0.90 to 0.98) in males and 0.97 (95 %CI, 0.93 to 1.00) in females. These results indicate with high accuracy that I3M may be a useful alternative method in legal and forensic practice to discriminate individuals of black African origin who are around the legal adult age of 18 years in Botswana. Further studies should address the usefulness of this method and specific cut-off for different adolescent populations.
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