On the applicability of secondary dentin formation to radiological age estimation in young adults

Evaluation of radiographic visibility of root pulp in mandibular second molars using cone beam computed tomography images for age estimation

The purpose of this study is to estimate chronological age and determine whether individuals were aged under or over 18 years using root pulp visibility (RPV) in cone-beam computed tomography (CBCT) images. The study included CBCT images of 699 individuals aged between 15 and 75 years. One thousand twenty-three mandibular second molar (2M) teeth were evaluated using Olze's RPV method in four stages. Descriptive statistics of the stages and the relationship between the stages and the chronological age were assessed. The distribution of the stages was analyzed according to the 18-year age threshold. There was a positive correlation between RPV stages and chronological ages in both sexes. For females and males, the mean ages of stage 0, stage 1, and stage 2, for females and males, were found as 27.21, 28.93, and 33.68 years, and 37.69, 40.9, and 44.88 years, respectively. Stage 0 and stage 1 were found both in individuals aged under and over 18 years, and stage 2 and stage 3 were not observed in individuals aged under 18 years. The presence of stage 2 and stage 3 may be an indication that an individual is aged over 18 years according to Olze's RPV age estimation method. For more reliable results, 2M teeth should be examined bilaterally in forensic science.

Introspection of the Etiopathological Mechanisms Underlying Noncarious Cervical Lesions: Analysis of the Different Theories and Their Impact on the Mineralized Structures of the Tooth

The noncarious cervical lesions (NCCLs) recognize an etiological framework of onset very different from the carious processes with etiology whose bacteria aggregated in a biofilm play a predominant role, leading in this way to the loss of the mineralized structure of the tooth. The pathological picture of the NCCLs, which manifests itself with a clinical picture of dental wear, differs from caries because it mainly recognizes a series of pathological processes, such as erosion, through the action of generally acidic chemical agents and abrasion, which is basically expressed through repeated mechanical trauma characteristic of tooth brushing. However, in the literature, there is no unanimous agreement in identifying only these two mechanisms, but there are some who propose a more marked role of anomalous occlusal loads, which would be unloaded on some teeth which, in addition to both erosive and abrasive mechanisms, would give rise to abfraction. Therefore, the aim of this review was to collect literature etio-pathological information and discuss the mechanisms underlying NCCLs.

Combining the third molar mineralization to further improve the accuracy of the Kvaal's method in dental age estimation of subadults in northern China

The morphological changes based on deposition of secondary dentin and mineralization of the third molar have been proven to be related to chronological age. However, Kvaal's method on the theory of deposition of secondary dentin was controversial with respect to dental age estimation in the recent research. The aim of this study was to combine the parameters of Kvaal's method with relatively high correlation coefficients and mineralization stages of the third molar to improve the accuracy of predicting the dental age of subadults in northern China. A total of 340 digital orthopantomograms of subadults aged from 15 to 21 years were analysed. A training group was used to test the accuracy of the original Kvaal's method and to establish novel methods for subadults in northern China. A testing group was used to compare the accuracy of the newly established methods with the Kvaal's original method and with published method specifically used in northern China. To increase the feasibility of our estimation model, we combined the mineralization of the third molar to build a combined specific formula. The results showed that the combined specific model increased the coefficient of determination to 0.513, and the standard error of the estimate was reduced to 1.482 years. We concluded that the combined specific model based on the deposition of secondary dentin and mineralization of the third molar could improve the accuracy of dental age assessment of subadults in northern China.

KEY POINTS

The decrease in the dental pulp cavity based on deposition of secondary dentin is a useful variable for assessing age.A total of 340 orthopantomographs were used in this research, including 278 in training groups and 62 in testing groups.Original Kvaal's method underestimated the dental age for subadults in northern China.The equation of combined specific method constructed in our study was proved more suitable to calculate dental age for subadults in northern China.

Application of the Kvaal Method in Age Estimation of the Serbian Population Based on Dental Radiographs

This study aimed to evaluate the applicability of the Kvaal method in determining the age of a Serbian population. In this retrospective descriptive study, 170 dental patients (age range 16–77 years) were included. The measurements of six types of teeth were performed on digital orthopantomography radiographs according to the Kvaal method. Statistical inter-observer and intra-observer reliabilities were calculated to evaluate the reproducibility of the measurements, as well as to examine the correlation between chronological age and measured values. The evaluation revealed a substantial difference (over 12 years) between chronological and estimated age. The P ratio had the strongest correlation with chronological age for the maxillary central (r = ±0.293) and lateral incisors (r = ±0.240), whereas the pulp/root width ratio at level A had the strongest correlation for the mandibular first premolars (r = ±0.270). The lowest SD values, for measurements on teeth 15/25 (SD = 125,787), had the most accurate correlation with age. Thus, we can conclude that the original Kvaal method is not applicable in the age estimation of the Serbian population. For future research, we suggest using cone beam computer tomography as a precise technology to evaluate the applicability of Kvaal and other methods for age estimation.

Age estimation in young dogs by radiographic assessment of the canine pulp cavity/tooth width ratio

Age estimation in adult dogs can be performed by the radiographic measurement of the tooth pulp cavity, but the technique has hardly been described. In this study, the application of measuring pulp/tooth width ratios (P/T ratios) of the maxillary canine teeth was investigated. Pulp and tooth widths were measured at two locations on 166 maxillary canine teeth of the heads of 84 dog cadavers, using digital extraoral lateral oblique open mouth radiographs. The dogs belonged to different breeds and sexes and had a known age between 194 and 1907 days (approximately 6 months - 5 years). Both at the cemento-enamel junction (CE) and the half-height of the tooth, a comparable non-linear regression with age was demonstrated. Measuring at the CE location was less hindered by wear or superimposition. No statistically significant difference according to sex and breed size and no clinically significant difference according to skull type was found. The highest predictable capacity was found in the youngest dogs until the age of 448 days, of which 84.4% of the canine teeth had a P/T ratio above 0.39. Our results demonstrate that measuring P/T ratios of canine teeth can be used in practice to assign dogs to age categories, with the highest accuracy in young adult dogs.

The impact of age mimicry bias on the accuracy of methods for age estimation based on Kvaal's pulp/tooth ratios: a bootstrap study

INTRODUCTION

Methods based on pulp/tooth ratios proposed by Kvaal et al. (1995) have been widely used for age estimation in adults. The tendency of age estimates to mimic the age structure of the reference population, i.e. age mimicry bias, is a possible source of controversy in the results of studies. The primary objective of the present study was to evaluate the effect of age mimicry bias on the accuracy of the original Kvaal's method and its recent modification proposed by Roh et al. (2018).

METHOD AND MATERIAL

The study sample comprised 240 cone-beam computed tomography scans of an Iranian population. The bootstrap procedure was used to study the impact of age mimicry bias on age estimates by constructing reference populations with different age structures. The accuracy of Kvaal's and Roh's variables for age estimation was assessed using a twofold cross-validation technique and principal component analysis.

RESULTS

The application of original equations resulted in SEE values highly greater than the acceptable threshold for forensic purposes (10 years). The population-specific equations obtained SEE values of 9.18, 11.03, and 9.22 years using Kvaal's variables and 9.19, 11.13, and 9.14 years using Roh's variable for the maxillary, mandibular, and all teeth, respectively. The bootstrap procedure revealed that using uneven reference populations to formulate the equation resulted in significantly greater SEEs (almost all >10 years) that were not acceptable for forensic purposes. Moreover, using an older (a younger) reference population contributed to a sharp rise in the amount of over- (under-) estimation for younger (older) age groups.

CONCLUSION

Age mimicry bias had an undesirable impact on the accuracy of dental age estimation based on Kvaal's and Roh's methods. The accuracy of the original equations was low for age estimation in the Iranian sample. However, the performance of the population-specific equations was reasonably acceptable for the maxillary and all six teeth.

Age-dependent decrease in dental pulp cavity volume as a feature for age assessment: a comparative in vitro study using 9.4-T UTE-MRI and CBCT 3D imaging

Evaluation of secondary dentin formation is generally suitable for age assessment. We investigated the potential of modern magnetic resonance imaging (MRI) technology to visualize the dental pulp in direct comparison with cone beam computed tomography (CBCT). To this end, we examined 32 extracted human teeth (teeth 11–48 [FDI]) using 9.4-T ultrashort echo time (UTE)-MRI and CBCT (methods). 3D reconstruction was performed via both manual and semi-automatic segmentation (settings) for both methods in two runs by one examiner. Nine teeth were also examined by a second examiner. We evaluated the agreement between examiners, scan methods, and settings. CBCT was able to determine the pulp volume for all teeth. This was not possible for two teeth on MRI due to MRI artifacts. The mean pulp volume estimated by CBCT was consistently higher (~ 43%) with greater variability. With lower variability in its measurements, evaluation of pulp volume using the MRI method exhibited greater sensitivity to differences between settings (p = 0.016) and between examiners (p = 0.009). The interactions of single-rooted teeth and multi-rooted teeth and method or setting were not found to be significant. For examiner agreement, the mean pulp volumes were similar with overlapping measurements (ICC > 0.995). Suitable for use in age assessment is 9.4-T UTE-MRI with good reliability and lower variation than CBCT. For MRI, manual segmentation is necessary due to a more detailed representation of the interior of the pulp cavity. Since determination of pulp volume is expected to be systematically larger using CBCT, method-specific reference values are indispensable for practical age assessment procedures. The results should be verified under in vivo conditions in the future.

Age estimation in the living: A scoping review of population data for skeletal and dental methods

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.

Can canines alone be used for age estimation in Chinese individuals when applying the Kvaal method?

Due to the secondary dentin formation, the dental pulp undergoes changes in shape throughout life. Based on this phenomenon, the Kvaal method has been applied to various populations for age estimation, and its usefulness has been verified. When applying the Kvaal method to Chinese subjects, we observed a relatively strong correlation between mandibular canines and age. This study notes the correlation between canines and chronological age and is the first to identify which canine is most closely related to chronological age. In addition, a new, simpler formula is determined based on canines according to Kvaal's methodology. The radiographs of 360 individuals from northern China were selected, from which the widths and lengths of the pulp from four canines were measured according to the Kvaal method. Next, inter- and intra-observer reliabilities were analyzed in order to assess the repeatability of these measurements. The correlation between measurements and age was examined, and Chinese-specific age estimation formulae were derived. The results revealed that the ratios from the left maxillary canine exhibited the strongest correlation with age compared to the other canines, whereas the left mandibular canine showed the weakest correlation, which may contribute to the overall poor correlation of mandibular canines with age. What's more, the formula derived from the left maxillary canine in this study displayed the highest coefficients of determination, and the formula derived from all canines showed the lowest residuals. Both of these formulae performed better than the Chinese-specific formula derived from six different types of teeth in our previous study, which had formerly possessed the highest coefficients of determination and the lowest residuals. Thus, we concluded that canines do play an important role in age estimation in the Chinese population, and the correlation between maxillary canines and chronological age is stronger than that of mandibular canines, although no distinct trend as to which side is better correlated with age was established. Going forward, we recommend the analysis of additional samples from different geographical regions and populations to further verify the importance of canines in age estimation.

Usability of dental pulp visibility and tooth coronal index in digital panoramic radiography in age estimation in the forensic medicine

Age estimation has a great importance due to legal requirements. The aim of our study was to determine the applicability of two different methods in age estimation; one of them based on the calculation of the visibility of the root pulp of mandibular third molar teeth and the other based on the calculation of the tooth coronal index (TCI) in the mandibular first and second molar teeth in the 9059 digital orthopantomogram of people aged between 15 and 40 in Bursa. In the first method in which the visibility of the fully mineralized root pulp of the mandibular third molar teeth was evaluated in 4 stages; the stages 0, 1, 2, and 3 were observed regardless of sex at the earliest 17.2; 19.1; 20.1, and 25.1 years, respectively. In the second method in which TCI was regressed on chronological age using measuring crown and coronal pulp cavity heights, the most accurate age estimation model based on simple linear regression for all cases without any sex difference was found to be with right first molar tooth (SEE ±7304 years) and the most accurate age model based on multiple regression model was found to be with bilateral first molar teeth (SEE ±7413 years). In conclusion, we believe that the root pulp visibility of the third molar teeth can be applied safely for stages 1, 2, and 3 at 16, 17, and 21 years of ages, respectively. A correlation was also found between TCI and age, and our findings have shown that both methods are available for forensic purposes.

Examination of regressive features of third molars for the purpose of age assessment in the living by means of rescaled regression analyses

The main criterion of dental age assessment in living adolescents and young adults is the evaluation of third molars' mineralization. Concerning forensic age assessment after the completion of third molars' mineralization, apposition of secondary dentine and narrowing of the periodontal membrane as seen as decreasing radiolucent areas in the radiographs for mandibular third molars have already been described as regressive features. The present study examines the combination of both these features for the purpose of age assessment in regression analyses after rescaling the data to make it on the interval scale. To this end, a total of 1245 orthopantomograms was evaluated, taken from 606 females and 639 males in the age group of 15-40 years. The apposition of secondary dentine and narrowing of the periodontal membrane as seen as decreasing radiolucent areas in the radiographs were determined for the lower third molars. The correlation of the features with the chronological age was assessed by means of rescaled regression analyses. Furthermore, regression formulas for age assessment were established. The values of the standard error of estimate ranged between 3.55 and 4.52 years. In general, the rescaled regression of the examined features appears to be suited for forensic age assessment. A limitation of the present study is the comparatively low number of evaluable teeth in the examined age group. Due to an incomplete development or a lack of the mandibular third molars, only a mere half of the respective teeth could be included in the statistical analysis.

Age estimation using pulp/enamel volume ratio of impacted mandibular third molars measured on CBCT images in a northern Chinese population

The present study aims to evaluate the relation between chronological age and the ratio of pulp volume (PV) to enamel volume (EV) of impacted mandibular third molars (IMTMs) by using cone-beam computed tomography (CBCT) images and an improved 3D image segmentation technique. A sample of CBCT images of IMTM was collected from 414 northern Chinese subjects (214 male and 200 female clinical patients) ranging in age from 20 to 65 years. The GrowCut effect image segmentation (GCEIS) module algorithm was used to calculate the PV and EV from CBCT images. The total sample was divided into a training group and validation group in a ratio of 7 to 3. The PV/EV ratio (PEr) in the training sample was used to develop a mathematical formula for age estimation as follows: age = - 5.817-21.726 × Ln PEr (p < 0.0001) (Ln, natural logarithm). The mean absolute error (MAE) and root mean square error (RMSE) were used to determine the precision and accuracy of the mathematical formula in the validation group and all samples. The MAEs in the male, female, and pooled gender samples were 9.223, 7.722, and 8.41, respectively, and the RMSEs in the male, female, and pooled gender samples were 10.76, 9.58, and 9.986, respectively. The precise and accurate results indicate that the PEr of IMTM in CBCT images is a potential index for dental age estimation and is possible to be used in forensic medicine.

Age assessment by Demirjian's development stages of the third molar: a systematic review

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.

Dental age estimation in Malaysian adults based on volumetric analysis of pulp/tooth ratio using CBCT data

Forensic odontology plays an important role in human identification and dental age estimation is an integral part of this process. The aim of the study was to investigate the association between chronological age and pulp/tooth volume ratio in a Malaysian population (Malays and Chinese) from cone-beam computed tomography (CBCT) scans, enhanced with Mimics software. Three hundred CBCT scans of 153 males and 147 females, aged between 16 and 65 years were divided into 5 age groups. Volumetric analysis of the pulp/tooth ratio was performed in maxillary left canines, maxillary right canines and maxillary right central incisors. Simple linear regression and Pearson correlation analysis indicated the strongest coefficient of correlation (R) values for maxillary right central incisors (0.83) followed by maxillary right canines (0.74) and maxillary left canines (0.73). Fisher's Z test indicated that dental age estimation is gender independent. The derived regression equations were further validated on an independent group of 126 teeth. The results indicated mean absolute error (MAE) values of 6.48 and 8.58 years for maxillary right central incisors and maxillary canines respectively. It was also noticed that MAE values were higher among the age groups ranging from 46 to 65 years. This study showed that a volumetric change in the pulp cavity with age is a valuable assessment method for dental age estimation among Malaysian population.

Age estimation by assessment of pulp chamber volume: a Bayesian network for the evaluation of dental evidence

PURPOSE

The present study aimed to investigate the performance of a Bayesian method in the evaluation of dental age-related evidence collected by means of a geometrical approximation procedure of the pulp chamber volume. Measurement of this volume was based on three-dimensional cone beam computed tomography images.

METHODS

The Bayesian method was applied by means of a probabilistic graphical model, namely a Bayesian network. Performance of that method was investigated in terms of accuracy and bias of the decisional outcomes. Influence of an informed elicitation of the prior belief of chronological age was also studied by means of a sensitivity analysis.

RESULTS

Outcomes in terms of accuracy were adequate with standard requirements for forensic adult age estimation. Findings also indicated that the Bayesian method does not show a particular tendency towards under- or overestimation of the age variable. Outcomes of the sensitivity analysis showed that results on estimation are improved with a ration elicitation of the prior probabilities of age.

Orthodontic Treatment: Real Risk for Dental Age Estimation in Adults?

Dental age estimation becomes a challenge once the root formation is concluded. In living adults, one dental age indicator is the formation of secondary dentine, also associated with orthodontic treatment as well as root shortening. The aim of this study was to establish whether these secondary effects of orthodontic treatment could generate a statistically significant difference in dental age estimations when using Kvaal's method. The study sample included 34 pairs of pre- and postorthodontic panoramic radiographs, from different individuals with exactly the same age and sex distribution. Females 65%, median age 17.5 years, and males 35%, median age 22.5 years, were included. After data collection, dental age was estimated per tooth using formulae previously published. The risk of obtaining over-estimation of age was calculated. (RR = 1.007). The changes caused by orthodontic treatment do not have any significant effect on age estimation when Kvaal et al.'s method is applied on panoramic radiographs.

Age estimation in adults by dental imaging assessment systematic review

IMPORTANCE

The need to rely on proper, simple, and accurate methods for age estimation in adults is still a world-wide issue. It has been well documented that teeth are more resistant than bones to the taphonomic processes, and that the use of methods for age estimation based on dental imaging assessment are not only less invasive than those based on osseous analysis, but also have shown similar or superior accuracy in adults.

OBJECTIVES

To summarise the results of some of the recently most recently cited methods for dental age estimation in adults, based on odontometric dental imaging analysis, to establish which is more accurate, accessible, and simple.

EVIDENCE REVIEW

A literature search from several databases was conducted from January 1995 to July 2016 with previously defined inclusion criteria.

CONCLUSION

Based on the findings of this review, it could be possible to suggest pulp/tooth area ratio calculation from first, upper canines and other single rooted teeth (lower premolars, upper central incisors), and a specific statistical analysis that considers the non-linear production of secondary dentine with age, as a reliable, easy, faster, and predictable method for dental age estimation in adults. The second recommended method is the pulp/tooth width-length ratio calculation. The use of specific population formulae is recommended, but to include data of individuals from different groups of population in the same analysis is not discouraged. A minimum sample size of at least 120 participants is recommended to obtain more reliable results. Methods based on volume calculation are time consuming and still need improvement.

Pulp/tooth ratio of mandibular first and second molars on panoramic radiographs: An aid for forensic age estimation

Objective:

To determine and compare the accuracy of pulp/tooth ratio method in mandibular first and second molar teeth in forensic age estimation.

Materials and Methods:

A total 300 panoramic radiographs of the Gujarati population (187 males and 113 females) were studied. The measurements of Pulp Chamber Height (PCH) and Crown Root Trunk Height (CRTH) were performed on the mandibular first and second molar teeth. The acquired data was subjected to correlation and regression.

Results:

The pulp chamber crown root trunk height ratios (PCTHR) of both the first (r = −0.609) and second molars (r = −0.422) were significantly correlated with the age of the individual. Individual regression formulae were derived for both the teeth which were then used separately to calculate the age. The standard errors estimate (SEE) for the first and second molars were 8.84 years and 10.11 years, respectively. There was no statistically significant difference between chronological and calculated age by both the teeth (P = 1.000).

Conclusion:

The mandibular first and second molar is a potential tool for age estimation in forensic dentistry. The pulp/tooth ratio of both the teeth is a useful method for forensic age prediction with reasonable accuracy in the Gujarati population.

Age estimation based on Kvaal's technique using digital panoramic radiographs

INTRODUCTION

Age estimation is important for administrative and ethical reasons and also because of legal consequences. Dental pulp undergoes regression in size with increasing age due to secondary dentin deposition and can be used as a parameter of age estimation even beyond 25 years of age. Kvaal et al. developed a method for chronological age estimation based on the pulp size using periapical dental radiographs. There is a need for testing this method of age estimation in the Indian population using simple tools like digital imaging on living individuals not requiring extraction of teeth.

AIMS AND OBJECTIVES

Estimation of the chronological age of subjects by Kvaal's method using digital panoramic radiographs and also testing the validity of regression equations as given by Kvaal et al.

MATERIALS AND METHODS

The study sample included a total of 152 subjects in the age group of 14-60 years. Measurements were performed on the standardized digital panoramic radiographs based on Kvaal's method. Different regression formulae were derived and the age was assessed. The assessed age was then correlated to the actual age of the patient using Student's t-test.

RESULTS

No significant difference between the mean of the chronological age and the estimated age was observed. However, the values of the mean age estimated by using regression equations as given previously in the study of Kvaal et al. significantly underestimated the chronological age in the present study sample.

CONCLUSION

The results of the study give an inference for the feasibility of this technique by calculation of regression equations on digital panoramic radiographs. However, it negates the applicability of same regression equations as given by Kvaal et al. on the study population.

Maximum likelihood estimate of life expectancy in the prehistoric Jomon: Canine pulp volume reduction suggests a longer life expectancy than previously thought

Recent theoretical progress potentially refutes past claims that paleodemographic estimations are flawed by statistical problems, including age mimicry and sample bias due to differential preservation. The life expectancy at age 15 of the Jomon period prehistoric populace in Japan was initially estimated to have been ∼16 years while a more recent analysis suggested 31.5 years. In this study, we provide alternative results based on a new methodology. The material comprises 234 mandibular canines from Jomon period skeletal remains and a reference sample of 363 mandibular canines of recent-modern Japanese. Dental pulp reduction is used as the age-indicator, which because of tooth durability is presumed to minimize the effect of differential preservation. Maximum likelihood estimation, which theoretically avoids age mimicry, was applied. Our methods also adjusted for the known pulp volume reduction rate among recent-modern Japanese to provide a better fit for observations in the Jomon period sample. Without adjustment for the known rate in pulp volume reduction, estimates of Jomon life expectancy at age 15 were dubiously long. However, when the rate was adjusted, the estimate results in a value that falls within the range of modern hunter-gatherers, with significantly better fit to the observations. The rate-adjusted result of 32.2 years more likely represents the true life expectancy of the Jomon people at age 15, than the result without adjustment. Considering ∼7% rate of antemortem loss of the mandibular canine observed in our Jomon period sample, actual life expectancy at age 15 may have been as high as ∼35.3 years.

Age estimation using intraoral periapical radiographs

Context:

Changes in the size of dental pulp caused by the apposition of secondary dentin and occlusal wear are morphometric parameters for estimating age.

Aim:

To estimate the accuracy of age evaluation by Kvaal's method and the effect of occlusal wear on age using digital intraoral periapical radiographs in a subset of the Indian population.

Materials and Methods:

A total of 300 teeth were radiographically evaluated using intraoral periapical digital radiographs from 50 adult patients. A few modifications were made in the design of the study compared to the original Kvaal's method. The radiographs of three teeth from each jaw were taken and morphometric measurements in ratios were analyzed, which included the pulp length to tooth length (X₁), pulp length to root length (X₂), pulp width to root widths at three defined levels (X₃), and tooth length to root length (X₄).

Statistical Analysis:

The Pearson product-moment correlation coefficient (PCC) between age and the morphological variables showed that among them X₁, X₂, and X₃ were statistically significant but not the tooth root length ratio (X₄).

Conclusions:

The ratios X₁, X₂, and X₃ were good indicators of age and hence a multiple linear regression model for age estimation was derived using these three variables. However, it was found that X₄ was not a good indicator of age estimation in said population.

A new age estimation procedure based on the 3D CBCT study of the pulp cavity and hard tissues of the teeth for forensic purposes: A pilot study

BACKGROUND

Dental age of adults can be estimated by the analysis of the progressive physiological and degenerative phenomena which affect dental tissues. The pulp-dentinal complex is one of the dental structures that show modifications related to age, mainly resulting in the reduction of the pulp chamber volume due to the continual deposition of secondary dentin. The study aims to evaluate the accuracy of a simple and conservative method for estimating the age of adults based on CBCT (Cone Beam Computed Tomography) analysis of the narrowing of the pulp chamber caused by secondary dentin deposition.

MATERIALS AND METHODS

Two operators have randomly analyzed 148 CBCT (Scanora 3D - Soredex) and considered the upper left central incisor. The sample consists of 57 male individuals and 91 females aged between 10 and 80 years. This research was designed to simplify dental volume measurement through geometric approximation of the different parts of the tooth. The root and the pulp were assimilated to elliptical based cones and the crown to an elliptical based truncated cone and these volumes were calculated through measurements using Osirix(®) software (OnDemand 3D software CyberMed Inc.). The ratio between the pulp volume and the hard tissues volume (PHr) was assumed as a variable according to the following formula: PHr = V pulp/V ht. The proposed method based on geometric approximation of dental volumes was validated comparing volumes calculated using CBCT with physical measurements of real volumes of 3 teeth.

RESULTS

The physical measurements revealed that the measurement procedures using CBCT produce a regular underestimation of real volumes, that ranges from 53% to 70%. Since the error occurs quite regularly both for pulp and for hard tissue volume, it tends to be eliminated when their ratio is considered. The PHr was statistically significant (p-value < 0.001) as a predictor for age estimation. The gender variable was not significantly correlated with age (p = 0.7694) and it was, therefore, excluded from the linear regression formula for age estimation: Age = -64.14 - 32.00*Ln PHr. The age cohorts between 30 to 59 years showed the highest accuracy in age prediction (residual errors 0.71, 2.88, and -5.86 years), whilst for other age cohorts the estimation error is similarly reported by applying other dental methods.

CONCLUSION

The outcomes of this pilot study show that the narrowing of the pulp chamber is a reliable parameter for estimating the age of adults, and that CBCT is an easy and conservative approach that allows accurate calculation of tooth volumes. The proposed approach based on geometric approximation of upper central incisor volumes measured by CBCT remarkably reduced the operating time in comparison to other more complex and expensive techniques. The validation procedure in which real volumes are compared with those calculated using CBCT supports the accuracy of the experimented approach and the good inter-examiner agreement (ICC 0.99) demonstrates that the method is highly reproducible.

Infant mortality and isotopic complexity: New approaches to stress, maternal health, and weaning

OBJECTIVES

Studies of the carbon and nitrogen stable isotope ratios (δ(13) C and δ(15) N) of modern tissues with a fast turnover, such as hair and fingernails, have established the relationship between these values in mothers and their infants during breastfeeding and weaning. Using collagen from high-resolution dentine sections of teeth, which form in the perinatal period we investigate the relationship between diet and physiology in this pivotal stage of life.

MATERIALS AND METHODS

Childhood dentine collagen δ(13) C and δ(15) N profiles were produced from horizontal sections of permanent and deciduous teeth following the direction of development. These were from two 19th-century sites (n = 24) and a small number (n = 5) of prehistoric samples from Great Britain and Ireland.

RESULTS

These high-resolution data exhibit marked differences between those who survived childhood and those who did not, the former varying little and the latter fluctuating widely.

DISCUSSION

Breastfeeding and weaning behavior have a significant impact on the morbidity and mortality of infants and the adults they become. In the absence of documentary evidence, archaeological studies of bone collagen of adults and juveniles have been used to infer the prevalence and duration of breastfeeding. These interpretations rely on certain assumptions about the relationship between isotope ratios in the bone collagen of the adult females and the infants who have died. The data from this study suggest a more complex situation than previously proposed and the potential for a new approach to the study of maternal and infant health in past populations.

Adult forensic age estimation using mandibular first molar radiographs: A novel technique

Objective:

To develop an independent procedure for estimating age for Indian individuals using radiographs of multi-rooted posterior teeth with accuracy needed in forensic age prediction.

Materials and Methods:

Orthopantomography (OPG) was obtained for 88 subjects. The subjects were divided into two sub sets; study subset (n = 60) which were used to find regression formula to calculate the age from pulp chamber height and test subset (n = 28) which were used to test the accuracy of this formula.

Results:

There was a statistically significant strong correlation between chronological age and pulp chamber crown root trunk height ratio (r = −0.56; P = 0.000). The regression equation for estimating the age, derived from the study subset was estimated age = −100.920 (PCTHR) +55.415. (PCTHR is the pulp chamber crown root trunk height ratio). This equation was applied on the test subset and there was no significant difference between estimated ages and chronological ages (P = 0.639). The mean absolute error (MAE) was 6.96 years, which was within acceptable error limits for forensic age estimation (<±10 years).

Conclusion:

The procedure developed to estimate the age using height reduction in pulp chamber was found to be fairly accurate to perform forensic age prediction in Indian individuals.

Analysis of radiocarbon, stable isotopes and DNA in teeth to facilitate identification of unknown decedents

The characterization of unidentified bodies or suspected human remains is a frequent and important task for forensic investigators. However, any identification method requires clues to the person’s identity to allow for comparisons with missing persons. If such clues are lacking, information about the year of birth, sex and geographic origin of the victim, is particularly helpful to aid in the identification casework and limit the search for possible matches. We present here results of stable isotope analysis of ¹³C and ¹⁸O, and bomb-pulse ¹⁴C analyses that can help in the casework. The ¹⁴C analysis of enamel provided information of the year of birth with an average absolute error of 1.8±1.3 years. We also found that analysis of enamel and root from the same tooth can be used to determine if the ¹⁴C values match the rising or falling part of the bomb-curve. Enamel laydown times can be used to estimate the date of birth of individuals, but here we show that this detour is unnecessary when using a large set of crude ¹⁴C data of tooth enamel as a reference. The levels of ¹³C in tooth enamel were higher in North America than in teeth from Europe and Asia, and Mexican teeth showed even higher levels than those from USA. DNA analysis was performed on 28 teeth, and provided individual-specific profiles in most cases and sex determination in all cases. In conclusion, these analyses can dramatically limit the number of possible matches and hence facilitate person identification work.

Three-dimensional modeling of the various volumes of canines to determine age and sex: a preliminary study

Canines are usually used in anthropological and forensic sciences for sex and age determination. The best methods to estimate age are based on secondary dentine apposition, evaluated from periapical X-rays. The aim of this study was to propose a new method of sex and age estimation using 3D models to obtain more precise predictions using tooth volumes. Fifty-eight dental CT scans of patients aged 14-74 with a well-balanced sex ratio composed the sample. One hundred and thirty-three healthy canines were modeled (Mimics 12.0). The sample was divided into a training sample and a validation sample. An age formula was determined using the "pulp volume/tooth volume" ratio. Sex prediction was adjusted with total volumes. Applying the equations to the validation sample, no significant difference was found between the real and predicted ages, and 100% of the sex predictions were correct. This preliminary study gives interesting results, and this method is worth being tested on a larger data sample.

Cone-Beam Computed Tomography: a useful tool for dental age estimation?

Assessment of oral hard tissues can be of great help in determining the age of an individual. The development and physiological aging of teeth provide many clues for estimating age, in methods that are mainly based on conventional radiography. Although these conventional techniques reveal information on the anatomical and pathological characteristics, they only show two-dimensional images of a system that originally exists in three dimensions. With the growth and development of three-dimensional imaging, it has become possible to include measurements such as volumetric data, which give a better grasp of the continuous process of tooth mineralization. Up to now, these measurements have been obtained in vitro using micro-computed tomography (micro-CT) but three-dimensional imaging has recently been enriched by a new technique: Cone-Beam Computed Tomography (CBCT), which is devoted to the maxillo-facial sphere. These acquisitions may offer real potential for exploiting and analyzing volumetric measurements of teeth. We hypothesize that, using CBCT acquisitions, multiple regression analysis including quantitative volumetric measurement of various parts of each tooth can be useful to determine significant variables for dental age estimation in living subjects. Currently, CBCT examinations are being performed and contain important information for the quantitative study of dental tissue. Although CBCT examinations are conducted in the first intention of making a clinical diagnosis or prognostic evaluation, they could be used as an initial database for the measurement of dental volumes and their ratios, thus furnishing preliminary evaluations and information. Multiple regression analysis requires the constitution of a larger sample sizes which may demonstrate that CBCT data can be helpful to study other aspects of dental morphology in greater depth, especially dental growth. In this hypothesis, integration with a larger network system would be necessary. CBCT data could be helpful in defining new parameters for the rating of dental development, for a quantitative description of the fractions of crown and root and could offer new research oriented towards various aspects of teeth and jaws, thanks to its broad sampling possibilities.