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de Oliveira Santos I, Baptista IP, da Silva RHA, Cunha E. Evaluation of data collection bias of third molar stages of mineralisation for age estimation in the living. Forensic Sci Res 2024; 9:owae004. [PMID: 38765699 PMCID: PMC11099653 DOI: 10.1093/fsr/owae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/18/2023] [Indexed: 05/22/2024] Open
Abstract
Age assessment of the living is a fundamental procedure in the process of human identification, in order to guarantee fair treatment of individuals, which has ethical, civil, legal, and medical repercussions. The careful selection of the appropriate methods requires evaluation of several parameters: accuracy, precision of the method, as well as its reproducibility. The approach proposed by Mincer et al. adapted from Demirjian et al. exploring third molar mineralisation, is one of the most frequently considered for age estimation of the living. Thus, this work aims to assess potential bias in the data collection when applying the classification stages for dental mineralisation adapted by Mincer et al. A total of 102 orthopantomographs, of clinical origin, belonging to individuals aged between 12 and 25 years ([Formula: see text] = 20.12 years, SD = 3.49 years; 65 females, 37 males, all of Portuguese nationality) were included and a retrospective analysis performed by five observers with different levels of experience (high, average, and basic). The performance and agreement between five observers were evaluated using Weighted Cohen's Kappa and the Intraclass Correlation Coefficient. To access the influence of impaction on third molar classification, variables were tested using ordinal logistic regression Generalised Linear Model. It was observed that there were variations in the number of teeth identified among the observers, but the agreement levels ranged from moderate to substantial (0.4-0.8). Upon closer examination of the results, it was observed that although there were discernible differences between highly experienced observers and those with less experience, the gap was not as significant as initially hypothesised, and a greater disparity between the classifications of the upper (0.24-0.49) and lower third molars (>0.55) was observed. When bone superimposition is present, the classification process is not significantly influenced; however, variation in teeth angulation affects the assessment. The results suggest that with an efficient preparation, the level of experience as a factor can be overcome. Mincer and colleague's classification system can be replicated with ease and consistency, even though the classification of upper and lower third molars presents distinct challenges.
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Affiliation(s)
- Inês de Oliveira Santos
- Department of Life Sciences, Laboratory of Forensic Anthropology, Centre for Functional Ecology (CFE), University of Coimbra, Calçada Martim de Freitas, Coimbra 3000-456, Portugal
| | - Isabel Poiares Baptista
- Dentistry Department, Faculty of Medicine, Center for Innovation and Research in Oral Sciences (CIROS), Institute of Periodontology, University of Coimbra, Coimbra 3000-075, Portuga
| | - Ricardo Henrique Alves da Silva
- Department of Stomatology, School of Dentistry of Ribeirão Preto, Forensic Odontology, University of São Paulo, São Paulo, Brazil
| | - Eugénia Cunha
- Department of Life Sciences, Laboratory of Forensic Anthropology, Centre for Functional Ecology (CFE), University of Coimbra, Calçada Martim de Freitas, Coimbra 3000-456, Portugal
- Instituto Nacional de Medicina Legal e Ciências Forenses, Lisboa 1169-201, Portugal
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Matteussi GT, Pereira JGD, Rocha MFN, Maranhão OBV, Janson PG, da Silva PRHA. Age estimation through third molar analysis using the Kullman method among Brazilians. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2022.200492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meghana RV, Mallempalli P, Kondakamalli S, Boringi M, Vaddeswarapu RM, Kairamkonda CR, Gurram A, Balla SB, Angelakopoulos N. A test to study the influence of impaction on mandibular third molar development and forensic age estimation in a sample of south Indian children and young adults. Leg Med (Tokyo) 2021; 54:101998. [PMID: 34896837 DOI: 10.1016/j.legalmed.2021.101998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/10/2021] [Accepted: 11/26/2021] [Indexed: 11/26/2022]
Abstract
It has been argued that the impaction of the third molars could result in delayed maturation, which, in turn, could affect age estimations in criminal proceedings. In view of this, the present study was undertaken to determine whether the impaction status could delay the chronological process of third molar mineralization in a sample of south Indian children and young adults. The orthopantomograms (OPGs) of 915 children and young adults of south Indian origin aged between 15 and 22 years were evaluated. Mineralisation stage and impaction status were determined for all lower third molars. Descriptive statistics were performed at stages D to H of Demirjian staging system. The results of independent t-test show that the impaction resulted in statistically significant slower mineralization in impacted lower third molars at stages D to F in both sexes. It was ascertained that the mean ages with the impacted lower third molars at stage G were 0.98-1.38 years higher in males and 0.50-0.80 years higher in females than those with non-impacted lower third molars. For stage H, the mean ages were 0.14-0.21 years higher in males and 0.25-0.44 years higher in females. The probabilities of being 18 years and above is higher for non-impacted lower third molars at stages G and H than those with impacted ones. It is concluded that the impaction could result in delayed maturation in the lower third molars of the studied sample. Further studies are warranted in a more diverse sample.
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Affiliation(s)
| | | | | | - Mamatha Boringi
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences, India.
| | | | - Charan Raj Kairamkonda
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences, India.
| | | | - Sudheer B Balla
- Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana.
| | - Nikolaos Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopaedics, University of Bern, Bern, Switzerland.
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Saputri RI, De Tobel J, Vranckx M, Ockerman A, Van Vlierberghe M, Fieuws S, Thevissen P. Is third molar development affected by third molar impaction or impaction-related parameters? Clin Oral Investig 2021; 25:6681-6693. [PMID: 33934201 DOI: 10.1007/s00784-021-03955-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the effect of third molar impaction and impaction-related parameters on third molar development. MATERIALS AND METHODS Panoramic radiographs (N=3972) from 473 males and 558 females between 3.2 and 23.5 years old were analysed. Three parameters of impaction were examined: hindering contact between third and adjacent second molar, retromolar space availability (only in lower third molars), and angulation between the third and adjacent second molar. From the separate parameters, a definition for impaction was derived. Third molars' development was staged according to a modified Köhler et al. staging technique. A linear model was used to compare within-stage and overall age, as a function of hindering contact, retromolar space, and impaction. Furthermore, a quadratic function was used to study the correlation between age and angulation. RESULTS Significant differences were found in mean age as a function of hindering contact and retromolar space, depending on third molar location and stage. There was a significant relation between angulation and age, depending on the stage, with all third molars evolving to a more upright position (closer to 0°). Mean ages of subjects with impacted third molars were significantly lower in certain third molar stages, but the differences were clinically small (absolute differences ≤0.65 years). Moreover, after correction for stage differences, no significant differences in age could be demonstrated. CONCLUSIONS The development of impacted and non-impacted third molars can be considered clinically equal in our study population. CLINICAL RELEVANCE There is no distinction required between impacted and non-impacted third molars for dental age estimation.
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Affiliation(s)
- Rosalina Intan Saputri
- Forensic Odontology, Department of Imaging & Pathology, KU Leuven, Kapucijnenvoer 7, blok a - box 7001, 3000, Leuven, Belgium. .,Faculty of Dentistry, Maranatha Christian University, Jalan Surya Sumantri no. 65, Sukawarna, Sukajadi, Kota Bandung, 40164, Indonesia.
| | - Jannick De Tobel
- Forensic Odontology, Department of Imaging & Pathology, KU Leuven, Kapucijnenvoer 7, blok a - box 7001, 3000, Leuven, Belgium
| | - Myrthel Vranckx
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Anna Ockerman
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Martine Van Vlierberghe
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Steffen Fieuws
- KU Leuven - University of Leuven, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, B-3000, Leuven, Belgium
| | - Patrick Thevissen
- Forensic Odontology, Department of Imaging & Pathology, KU Leuven, Kapucijnenvoer 7, blok a - box 7001, 3000, Leuven, Belgium
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Marchiori D, Packota G, Boughner J. Initial third molar development is delayed in jaws with short distal space: An early impaction sign? Arch Oral Biol 2019; 106:104475. [DOI: 10.1016/j.archoralbio.2019.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/05/2019] [Accepted: 06/28/2019] [Indexed: 01/12/2023]
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Arge S, Boldsen JL, Wenzel A, Holmstrup P, Jensen ND, Lynnerup N. Third molar development in a contemporary Danish 13–25 year old population. Forensic Sci Int 2018; 289:12-17. [DOI: 10.1016/j.forsciint.2018.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/27/2018] [Accepted: 05/02/2018] [Indexed: 11/16/2022]
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De Tobel J, Phlypo I, Fieuws S, Politis C, Verstraete KL, Thevissen PW. Forensic age estimation based on development of third molars: a staging technique for magnetic resonance imaging. THE JOURNAL OF FORENSIC ODONTO-STOMATOLOGY 2017; 35:117-140. [PMID: 29384743 PMCID: PMC6100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND The development of third molars can be evaluated with medical imaging to estimate age in subadults. The appearance of third molars on magnetic resonance imaging (MRI) differs greatly from that on radiographs. Therefore a specific staging technique is necessary to classify third molar development on MRI and to apply it for age estimation. AIM To develop a specific staging technique to register third molar development on MRI and to evaluate its performance for age estimation in subadults. MATERIALS AND METHODS Using 3T MRI in three planes, all third molars were evaluated in 309 healthy Caucasian participants from 14 to 26 years old. According to the appearance of the developing third molars on MRI, descriptive criteria and schematic representations were established to define a specific staging technique. Two observers, with different levels of experience, staged all third molars independently with the developed technique. Intra- and inter-observer agreement were calculated. The data were imported in a Bayesian model for age estimation as described by Fieuws et al. (2016). This approach adequately handles correlation between age indicators and missing age indicators. It was used to calculate a point estimate and a prediction interval of the estimated age. Observed age minus predicted age was calculated, reflecting the error of the estimate. RESULTS One-hundred and sixty-six third molars were agenetic. Five percent (51/1096) of upper third molars and 7% (70/1044) of lower third molars were not assessable. Kappa for inter-observer agreement ranged from 0.76 to 0.80. For intra-observer agreement kappa ranged from 0.80 to 0.89. However, two stage differences between observers or between staging sessions occurred in up to 2.2% (20/899) of assessments, probably due to a learning effect. Using the Bayesian model for age estimation, a mean absolute error of 2.0 years in females and 1.7 years in males was obtained. Root mean squared error equalled 2.38 years and 2.06 years respectively. The performance to discern minors from adults was better for males than for females, with specificities of 96% and 73% respectively. CONCLUSION Age estimations based on the proposed staging method for third molars on MRI showed comparable reproducibility and performance as the established methods based on radiographs.
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Affiliation(s)
- Jannick De Tobel
- Department of Radiology and Nuclear Medicine, Ghent University, Belgium
- Department of Oral Health Sciences – Forensic Dentistry, KU Leuven and Department of Dentistry – University Hospitals Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, Leuven University Hospital, Belgium
- Department of Head, Neck and Maxillofacial Surgery, Ghent University Hospital, Belgium
| | - Inès Phlypo
- Department of Dentistry – Special Care in Dentistry, PaeCoMeDiS, Ghent University, Ghent, Belgium
| | - Steffen Fieuws
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, Leuven University Hospital, Belgium
| | | | - Patrick W. Thevissen
- Department of Oral Health Sciences – Forensic Dentistry, KU Leuven and Department of Dentistry – University Hospitals Leuven, Belgium
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Friedrich RE, Schmidt K, Treszl A, Kersten JF. Predictive values derived from lower wisdom teeth developmental stages on orthopantomograms to calculate the chronological age in adolescence and young adults as a prerequisite to obtain age-adjusted informed patient consent prior to elective surgical procedures in young patients with incomplete or mismatched personal data. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2016; 5:Doc23. [PMID: 27975042 PMCID: PMC5141618 DOI: 10.3205/iprs000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: Surgical procedures require informed patient consent, which is mandatory prior to any procedure. These requirements apply in particular to elective surgical procedures. The communication with the patient about the procedure has to be comprehensive and based on mutual understanding. Furthermore, the informed consent has to take into account whether a patient is of legal age. As a result of large-scale migration, there are eventually patients planned for medical procedures, whose chronological age can't be assessed reliably by physical inspection alone. Age determination based on assessing wisdom tooth development stages can be used to help determining whether individuals involved in medical procedures are of legal age, i.e., responsible and accountable. At present, the assessment of wisdom tooth developmental stages barely allows a crude estimate of an individual's age. This study explores possibilities for more precise predictions of the age of individuals with emphasis on the legal age threshold of 18 years. Material and Methods: 1,900 dental orthopantomograms (female 938, male 962, age: 15-24 years), taken between the years 2000 and 2013 for diagnosis and treatment of diseases of the jaws, were evaluated. 1,895 orthopantomograms (female 935, male 960) of 1,804 patients (female 872, male 932) met the inclusion criteria. The archives of the Department of Diagnostic Radiology in Dentistry, University Medical Center Hamburg-Eppendorf, and of an oral and maxillofacial office in Rostock, Germany, were used to collect a sufficient number of radiographs. An effort was made to achieve almost equal distribution of age categories in this study group; 'age' was given on a particular day. The radiological criteria of lower third molar investigation were: presence and extension of periodontal space, alveolar bone loss, emergence of tooth, and stage of tooth mineralization (according to Demirjian). Univariate and multivariate general linear models were calculated. Using hierarchical multivariate analyses a formula was derived quantifying the development of the four parameters of wisdom tooth over time. This model took repeated measurements of the same persons into account and is only applicable when a person is assessed a second time. The second approach investigates a linear regression model in order to predict the age. In a third approach, a classification and regression tree (CART) was developed to derive cut-off values for the four parameters, resulting in a classification with estimates for sensitivity and specificity. Results: No statistically significant differences were found between parameters related to wisdom tooth localization (right or left side). In univariate analyses being of legal age was associated with consecutive stages of wisdom tooth development, the obliteration of the periodontal space, and tooth emergence, as well with alveolar bone loss; no association was found with tooth mineralization. Multivariate models without repeated measurements revealed imprecise estimates because of the unknown individual-related variability. The precision of these models is thus not very good, although it improves with advancing age. When calculating a CART-analysis and a receiver operating characteristics - area under the curve of 78% was achieved; when maximizing both specificity and sensitivity, a Youden's index of 47% was achieved (with 73% specificity and 74% sensitivity). Discussion: This study provides a basis to help determine whether a person is 18 years or older in individuals who are assumed to be between 15 and 24 years old. From repeated measurements, we found a linear effect of age on the four parameters in the individuals. However, this information can't be used for prognosis, because of the large intra-individual variability. Thus, although the development of the four parameters can be estimated over time, a direct conclusion with regard to age can't be drawn from the parameters without previous biographic information about a person. While a single parameter is of limited value for calculating the target age of 18 years, combining several findings, that can be determined on a standard radiography, may potentially be a more reliable diagnostic tool for estimating the target age in both sexes. However, a high degree of precision can't be achieved. The reason for persistent uncertainty lies in the wide chronological range of wisdom tooth development, which stretches from well below to above the 18th life year. The regression approach thus seems not optimal. Although sensitivity and specificity of the CART-model are moderately high, this model is still not reliable as a diagnostic tool. Our findings could have impact, e.g. on elective surgeries for young individuals with unknown biography. However, these results cannot replace social engagement, in particular thorough physical examination of patients and careful registration of their histories. Further studies on the use of this calculation method in different ethnic groups would be desirable.
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Affiliation(s)
- Reinhard E. Friedrich
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Kopf- und Neuro-Zentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Kirsten Schmidt
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Kopf- und Neuro-Zentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - András Treszl
- Institut für Medizinische Biometrie und Epidemiologie, Zentrum für Experimentelle Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Jan F. Kersten
- Institut für Medizinische Biometrie und Epidemiologie, Zentrum für Experimentelle Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Competenzzentrum Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
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De Tobel J, Hillewig E, Verstraete K. Forensic age estimation based on magnetic resonance imaging of third molars: converting 2D staging into 3D staging. Ann Hum Biol 2016; 44:121-129. [DOI: 10.1080/03014460.2016.1223884] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jannick De Tobel
- Department of Radiology and Nuclear Medicine, Ghent University, Gent, Belgium
| | - Elke Hillewig
- Department of Radiology and Nuclear Medicine, Ghent University, Gent, Belgium
| | - Koenraad Verstraete
- Department of Radiology and Nuclear Medicine, Ghent University, Gent, Belgium
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The influence of impaction to the third molar mineralization in northwestern Chinese population. Int J Legal Med 2014; 128:659-65. [PMID: 24532176 DOI: 10.1007/s00414-014-0979-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 02/04/2014] [Indexed: 10/25/2022]
Abstract
Age estimation by third molar mineralization has been developed for a period of time. Recent studies showed that impaction status has an influence on the rate of the third molar mineralization in Europids and male Black African populations. In this regard, the present study was conducted to determine whether the impaction status could delay the chronological process of third molar mineralization in northwestern Chinese population too. A total of 3,512 digital orthopantomograms of 1,255 male and 2,257 female northwestern Chinese subjects aged from 11 to 26 years were assessed based on the formation stages described by Demirjian et al. with two modifications. Mineralization stage and impaction status were determined for all third molars. Statistical measures were calculated at stages C-H in the male and female gender for both impacted and non-impacted third molars. It was ascertained that the mean ages with impacted third molars at stages C-H were 0.02-1.42 years higher in males and 0.04-1.52 years higher in females than those with non-impacted third molars, but statistical differences were only found at stages C, D, and E in males and stages D and E in females. The probabilities of being under 14, 16, or 18 years of age with non-impacted third molars were all higher than those with impacted third molars. The results prove that impacted third molars show significant slower mineralization than non-impacted ones at stages D and E in both males and females of northwestern Chinese population. It is recommended to consider the influence of impaction on the rate of third molar mineralization for dental age estimation.
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Lopez TT, Arruda CP, Rocha M, Rosin ASADO, Michel-Crosato E, Biazevic MGH. Estimating ages by third molars: Stages of development in Brazilian young adults. J Forensic Leg Med 2013; 20:412-8. [DOI: 10.1016/j.jflm.2012.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 11/08/2012] [Accepted: 12/26/2012] [Indexed: 10/27/2022]
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Lauesen SR, Andreasen JO, Gerds TA, Christensen SSA, Borum M, Hillerup S. Association between third mandibular molar impaction and degree of root development in adolescents. Angle Orthod 2012; 83:3-9. [DOI: 10.2319/102911-667.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective:
To compare the root development and the growth rate of the mandibular third molar (M3 inf) in individuals where the M3 inf erupted vs individuals exhibiting M3 inf impaction.
Materials and Methods:
Serial standardized intraoral radiographs (Eggen technique) were taken annually of the mandibular third molar region from 132 subjects (71 male and 61 female) from 15 to 20 years of age. Based on the films, 264 lower third molars were classified into an eruption and an impaction group. Root development was recorded according to a quantitative method described by Haavikko (1970), and the eruption status was analyzed using logistic regression.
Results:
In total, 155 (59%) of the M3 inf erupted, and 109 (41%) were impacted at age 20. In 44 (33%) patients both M3 inf were impacted, in 21 (16%) patients one tooth was erupted and the contralateral tooth impacted, and in 67 (51%) patients both M3 inf were erupted. The more mature a tooth was at age 15, the higher was the probability of eruption (odds ratio: 3.89, P < .001). The growth rate of the root development stage was statistically significantly associated with the probability of eruption (odds ratio: 10.50, P = .041).
Conclusions:
Delayed mandibular third molar root development is associated with impaction. Radiographs taken at age 15 may predict the risk of impaction and thereby guide decision making for the orthodontist or the oral and maxillofacial surgeon.
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Affiliation(s)
- Søren Rødsgaard Lauesen
- Private practitioner, Department of Oral and Maxillofacial Surgery, Faculty of Health and Sciences, Institute of Odontology, University of Copenhagen, Denmark
| | - Jens O. Andreasen
- Associate and Consultant oral maxiofacial surgeon, Senior research, Resource Center for Rare Oral Diseases, University Hospital of Copenhagen, Denmark
| | - Thomas Alexander Gerds
- Associate Professor, Core Biostatistics, Institute of Public Health, Copenhagen, Denmark
| | | | - Mette Borum
- Head, Municipal Dental Service, Hoeje-Taastrup, Denmark
| | - Søren Hillerup
- Professor, Rigshospitalet and Institute of Odontology, Faculty of Health Sciences, University of Copenhagen, Denmark
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Vardimon AD, Shoshani K, Shpack N, Reimann S, Bourauel C, Brosh T. Incremental growth of the maxillary tuberosity from 6 to 20 years-A cross-sectional study. Arch Oral Biol 2010; 55:655-62. [PMID: 20598669 DOI: 10.1016/j.archoralbio.2010.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 03/19/2010] [Accepted: 05/22/2010] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Although the maxillary tuberosity (MT) is a major growth site of the maxilla, its time-related growth was not fully investigated. The objectives of the study were to evaluate the MT growth from 6 to 20 years of age defining the peak growth age and to assess time-related indicators. DESIGN Panoramic radiographs from 189 patients were divided in a cross-sectional study into six age groups. A special panoramic analysis was developed including 18 parameters and 3 time-related indicators, i.e., chronological age, crown/root development stages of the maxillary second (M(2)) and third (M(3)) molars and eruption stages. RESULTS From 6 to 20 years, the MT vertical growth was 5.17-fold greater than the horizontal. The horizontal growth covered 36% of the maxillary growth but was inadequate to secure space for third molar eruption despite a 51% increase in MT area. MT peak growth was between 8 and 9 years and 10-11 year. During these 14 years, the maxillary length increased by pneumatisation of the maxillary sinus (86%), growth of the MT (36%) and decrease of the anterior maxillary region (-22%). Of the 18 examined parameters, 83% showed dependency to the combination chronological age with M(2), M(3) crown/root development stage and 72% to the combination chronological age with M(2), M(3) eruption stage. CONCLUSION MT growth peak occurs with initiation of root development of M(2) and shortly before M(2) eruption (8-9 years to 10-11 years). Dental time-related indicators adjunct with the chronological age provide an effectual system to define MT growth potential.
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Affiliation(s)
- Alexander Dan Vardimon
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
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Van Vlierberghe M, Bołtacz-Rzepkowska E, Van Langenhove L, Laszkiewicz J, Wyns B, Devlaminck D, Boullart L, Thevissen P, Willems G. A comparative study of two different regression methods for radiographs in Polish youngsters estimating chronological age on third molars. Forensic Sci Int 2010; 201:86-94. [PMID: 20452156 DOI: 10.1016/j.forsciint.2010.04.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 04/11/2010] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to establish a third molar developmental database to model dental age of Polish youngsters, to investigate the rating level of the scores when dividing a year interval into a quarter of a year and to examine sex differences, left-right and upper-lower jaw asymmetry. MATERIAL AND METHODS A cross-sectional sample of 1048 orthopantomograms of 644 females and 404 males aged between 12 and 26 years was investigated using the scoring system of Gleiser and Hunt modified by Köhler. Reference tables according to age were split in a whole year and in quarters of a year using descriptive statistics. The various developmental stages between males and females were analyzed with a paired t-test and the cusum method. Differences in mineralization between the quadrants were analyzed with a two-factor ANOVA and the Duncan post hoc test. The single quadratic and support vector regression were performed to describe the relationship between score and age. RESULTS Dividing age classes in quarters of a year discriminated better between individuals provided that there is a sufficient sampling size for all age classes. The mineralization tempo occurred significantly at a faster rate in males. The maturational events in the upper arch developed significantly at earlier ages for both genders. Obtained chronological age had nearly the same standard error of estimate when calculated with both regression methods. DISCUSSION AND CONCLUSION Comparing the results of the present study with those of other population groups suggests that there are differences in the ageing process of the wisdom tooth. This is the first database of Polish youngsters (15-24 years) with their respective regression equations to yield age estimations.
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Affiliation(s)
- M Van Vlierberghe
- School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Department of Forensic Odontology, Katholieke Universiteit Leuven, Kapucijnenvoer 7, B 3000 Leuven, Belgium
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16
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Knell B, Ruhstaller P, Prieels F, Schmeling A. Dental age diagnostics by means of radiographical evaluation of the growth stages of lower wisdom teeth. Int J Legal Med 2009; 123:465-9. [DOI: 10.1007/s00414-009-0330-2] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 02/05/2009] [Indexed: 10/21/2022]
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17
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Abstract
BACKGROUND Population differences in tooth formation using radiographs can be determined if the entire developmental sequence of a single tooth is studied. The only developing tooth visible radiographically from initiation to root completion is the third molar or wisdom tooth. AIM The timing of mandibular third molar formation was documented for two groups of children in England and two in South Africa. SUBJECTS AND METHODS Panoramic radiographs of White and Bangladeshi children from London and Black African and Cape Coloured children from South Africa were examined (age 5-24). Mean age of entering third molar stages (crypt appearance to root completion) was calculated using logistic regression and compared between sex and group using a t-test. RESULTS Average age of third molar stages was significantly (p < 0.001) later in three groups for almost all stages of the third molar compared to Black children. The average age of entering initial mineralization ranged from 7.97 to 9.74 years while average age of apex closed was 19.27-20.88. CONCLUSION These results show for the first time a significant difference in the timing of maturation of the mandibular third molar between groups with South African Black children being earlier than other groups.
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Affiliation(s)
- H M Liversidge
- Dental Institute, Barts and The London School of Medicine and Dentistry, London, UK.
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Meinl A, Tangl S, Huber C, Maurer B, Watzek G. The chronology of third molar mineralization in the Austrian population—a contribution to forensic age estimation. Forensic Sci Int 2007; 169:161-7. [PMID: 17029860 DOI: 10.1016/j.forsciint.2006.08.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 07/21/2006] [Accepted: 08/21/2006] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to determine the chronology of third molar mineralization and to establish Austrian reference data. Therefore, a cross-sectional study was undertaken by evaluating 610 panoramic radiographs in order to assess the mineralization status of the mandibular third molars of Austrian male and female individuals (275 males and 335 females) between the ages of 12 and 24. The evaluation was carried out using the eight grade scheme of Demirjian et al. (1973). Mean ages, standard deviations, standard errors and percentile distributions are presented for each stage of development. Significant differences between the left and right mandibular third molars were not found. Males reach the developmental stages earlier than females, statistically significant differences were noted in stages E and F. Both mandibular third molars were observed in the majority of the individuals of the Austrian sample (477 individuals, 78.2%). For medicolegal purposes the likelihood of whether an Austrian individual is older than 18 years or not was determined.
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Affiliation(s)
- A Meinl
- Department of Anthropology, University of Vienna, Althanstrasse 14, A-1090 Vienna, Austria.
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