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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: 1] [Impact Index Per Article: 1.0] [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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Kakumanu NR, Ch G, G KA, Rathore K, Badam R, Erukala DS, Tadakamadla J, Tadakamadla SK, Balla SB. Premolar maturity index (IPM) for indicating legal age 12 years in a sample of south Indian children - A digital pantomographic study. Leg Med (Tokyo) 2022; 59:102145. [PMID: 36103783 DOI: 10.1016/j.legalmed.2022.102145] [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: 02/28/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022]
Abstract
Legal age of 12 years has been set as the minimum age of criminal responsibility in many countries. This paper concerned a method for predicting the legal age 12 years based on the maturation of lower first and second premolars. The sample consisted of 900 digital pantomographs of south Indian children (450 males, 450 females) aged between 8 and 16 years. Among them, 580 DPTs were used as test sample and 320 DPTs as validation sample. New cut-offs at the age threshold 12 years were determined by using the measurement of open apices in first premolars (IPM1 < 0.10), second premolars (IPM2 < 0.14) and the combined method (IPM1 + IPM2 < 0.12). The sensitivity (Se), specificity (Sp) and posttest probability (PTP) were established. For IPM1 < 0.10, the Se, Sp and PTP were 92.4 %, 91.3 % and 91.1 % for males and 90.8 %, 87 % and 86.5 % for females. For IPM2 < 0.14, they were 92.6 %, 93.6 % and 93.4 % for males and 91.5 %, 83.1 % and 83.4 % for females. And, for the combined predictor (IPM1 + IPM2 < 0.12), these values were 92.6 %, 94.8 % and 94.6 % and 90.5 %, 84.9 % and 84.7 % in males and females respectively. The best score of positive predictive value and specificity was obtained for males with the combined predictor (IPM1 + IPM2 < 0.12) and with single predictor (IPM1 < 0.10) for females. To conclude, the combined predictor has resulted in better discrimination in males, while in females the single predictor (IMP1 < 0.10) did slightly better. Further studies are warranted to test the combination of dental and skeletal indicators for the prediction of 12 years in the studied population.
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Affiliation(s)
| | - Gayathri Ch
- Department of Oral Pathology and Microbiology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India.
| | | | - Kiran Rathore
- Department of Prosthodontics, Army College of Dental Sciences, Secunderabad, India.
| | - Rajkumar Badam
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India.
| | | | | | - Santosh Kumar Tadakamadla
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Flora Hill, Australia.
| | - Sudheer B Balla
- Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India.
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Yılancı HÖ, Akkaya N, Bulut G, Göksülük D, Bulut H, Cameriere R. Assessment of second (I 2M) and third (I 3M) molar maturity indices individually and in combination (I 2M+3M) and the sum of the seven mandibular teeth indices (S) for the legal age thresholds of 12 and 15 years in a Turkish sample. AUST J FORENSIC SCI 2022. [DOI: 10.1080/00450618.2020.1865454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hümeyra Özge Yılancı
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, İzmir Demokrasi University, Konak, İzmir, Turkey
| | - Nursel Akkaya
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Gülçin Bulut
- Clinic of Pediatric Dentistry, İzmir Training Dental Hospital, İzmir, Turkey
| | - Dinçer Göksülük
- Department of Biostatistics, Faculty of Medicine, Erciyes University, Talas, Kayseri, Turkey
| | - Hakan Bulut
- Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Roberto Cameriere
- AgEstimation Project, Department of Forensic Medicine, University of Sechenov, Moscow, Russia
- For. Med. Lab., Forensic Medicine and Laboratory, S.R.L. University of Macerata, Macerata, Italy
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Age group prediction with panoramic radiomorphometric parameters using machine learning algorithms. Sci Rep 2022; 12:11703. [PMID: 35810213 PMCID: PMC9271070 DOI: 10.1038/s41598-022-15691-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/28/2022] [Indexed: 11/09/2022] Open
Abstract
The aim of this study is to investigate the relationship of 18 radiomorphometric parameters of panoramic radiographs based on age, and to estimate the age group of people with permanent dentition in a non-invasive, comprehensive, and accurate manner using five machine learning algorithms. For the study population (209 men and 262 women; mean age, 32.12 ± 18.71 years), 471 digital panoramic radiographs of Korean individuals were applied. The participants were divided into three groups (with a 20-year age gap) and six groups (with a 10-year age gap), and each age group was estimated using the following five machine learning models: a linear discriminant analysis, logistic regression, kernelized support vector machines, multilayer perceptron, and extreme gradient boosting. Finally, a Fisher discriminant analysis was used to visualize the data configuration. In the prediction of the three age-group classification, the areas under the curve (AUCs) obtained for classifying young ages (10-19 years) ranged from 0.85 to 0.88 for five different machine learning models. The AUC values of the older age group (50-69 years) ranged from 0.82 to 0.88, and those of adults (20-49 years) were approximately 0.73. In the six age-group classification, the best scores were also found in age groups 1 (10-19 years) and 6 (60-69 years), with mean AUCs ranging from 0.85 to 0.87 and 80 to 0.90, respectively. A feature analysis based on LDA weights showed that the L-Pulp Area was important for discriminating young ages (10-49 years), and L-Crown, U-Crown, L-Implant, U-Implant, and Periodontitis were used as predictors for discriminating older ages (50-69 years). We established acceptable linear and nonlinear machine learning models for a dental age group estimation using multiple maxillary and mandibular radiomorphometric parameters. Since certain radiomorphological characteristics of young and the elderly were linearly related to age, young and old groups could be easily distinguished from other age groups with automated machine learning models.
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Balla SB, Kollata VRS, Bathala V, Ganapathy SK, Ch G, Vedula P, B ST, Palla A. Evaluation of the effect of impaction on the mineralization of mandibular third molars and forensic age estimation in a sample of south Indian children. Int J Legal Med 2021; 136:861-869. [PMID: 34652487 DOI: 10.1007/s00414-021-02713-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022]
Abstract
Assessment of third molar mineralization is a basic forensic odontological method available for age estimation in children and adolescents. Due to their protracted development into the late adolescence, their development has become the subject of interest and acquired great forensic importance. It is clearly evident in the literature that impaction factor has an influence on the rate of maturation of the third molars. In this regard, the present study was undertaken to test the relationship between impaction and its concomitant effect on the mineralization of the third molar and forensic age estimation. A total of 520 digital orthopantomograms (OPG) of 260 males and 260 females of south Indian origin were assessed retrospectively. Maturation of the third molars (I3M) was assessed using the method of Cameriere et al. (Int J Leg Med 122 (6):493-497, 2008). Impaction status was determined according to the position of lower right and left third molars in relation to the long axis of the second molars. Out of the total sample, 68.1% of lower left third molars and 71.2% of lower right molars were impacted. Statistical measures for I3M were calculated in the males and females for both impacted and non-impacted third molars. It was ascertained that the mean age and I3M values were higher in impacted third molars, indicating the slower rate of maturation than non-impacted ones. The sensitivity and specificity of the test (I3M < 0.08) was 96.2% and 72.4% for non-impacted third molars and 46.2% and 87% for impacted third molars, respectively. Our findings indicate that the cut-off value of I3M < 0.08 resulted in greater number of age misclassifications (false negatives) for impacted molars, highlighting the need for new cut-off value of I3M to meet the legal standards. It was concluded that the mineralization of impacted third molars was slower compared to non-impacted ones in south Indian males and females. Further studies are warranted to validate these findings among a larger and more diverse sample.
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Affiliation(s)
- Sudheer Babu Balla
- Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India.
| | | | | | | | - Gayathri Ch
- Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India
| | | | - Sai Tejaswi B
- Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India
| | - Alekya Palla
- Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India
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Legal age determined by a new threshold value of third molar maturity index in subjects with impacted mandibular third molars: An orthopantomographic study in south Indian adolescents. Int J Legal Med 2021; 136:251-259. [PMID: 34633500 DOI: 10.1007/s00414-021-02715-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
Third molars are one of the few biological markers available for age estimation in juveniles, especially for the estimation of the 18-year-age threshold. Literature has indicated that impaction has an influence on the development of third molars, which could possibly result in age misclassifications. The present study is intended to identify an alternative cut-off value of the third molar maturity index (I3M) in impacted mandibular third molars and also to evaluate its applicability in estimating the major (≥ 18 years)/minor (< 18 years) status. A total of 1330 digital orthopantomograms (OPGs) of 665 male and 665 female south Indian adolescents aged from 15 to 22 years were collected and assessed. Eight hundred forty OPGs (63.1%) represented test sample, and 490 OPGs (36.9%) represented validation sample. I3M was measured for the total sample. Logistic regression, receiver operating characteristic (ROC) curve analysis, and Youden's index were used to test the performance of the method in the test sample. An alternative cut-off value of I3M < 0.17 was established for the highest value of the Youden's index of 0.598 for both sexes. When tested in validation sample, it has resulted in sensitivity and specificity values of 0.91 (95% CI; 0.86-0.95) and 0.90 (95% CI; 0.78-0.91) in males and 0.86 (95% CI; 0.80-0.92) and 0.90 (95% CI; 0.83-0.95) in females. In conclusion, cut-off value of I3M < 0.17 could accurately discriminate adults from minors with impacted mandibular third molars. However, more work is needed to be done among a more diverse sample to confirm these findings.
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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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Suvarna M, Lingam S, Balla SB, Lakshmi Prasanna N, Gayathri C, Sai Tejaswi B, Sivaraj LD, Galic I, Cameriere R. Measurement of the open apices of mandibular first and second premolars to test the chronological age over 14 years: Study on a sample of south Indian children. Leg Med (Tokyo) 2020; 49:101835. [PMID: 33418270 DOI: 10.1016/j.legalmed.2020.101835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/19/2020] [Accepted: 12/27/2020] [Indexed: 11/26/2022]
Abstract
Age estimation is an integral part of forensic medical and dental practice. In many countries, the age threshold of 14 years is set to determine the minimum age for criminal responsibility. In the present study, the authors studied the final maturation of the first (IPM1) and second mandibular premolars (IPM2) by Cameriere maturity index and determined cut-offs at the age threshold of 14 years, and validate on the test sample. Orthopantomograms of 960 healthy south Indian children and sub-adults (480 boys and 480 girls) aged between 10 and 18 were analysed, 640 as training sample and 320 as a test sample. The results of logistic regression analysis with age (</≥14 years) as a dependent variable and IPM1, IPM2, and sex as predictor variables on training sample showed that both IPM1 and IPM2 significantly related to the legal age of 14 years but not the sex (p = 0.052). A receiver operating characteristic (ROC) curve analysis was performed to evaluate the specific cut-off values of IPM1 and IPM2 for predicting 14 years. A cut- off value of IPM1 < 0.01 and IPM2 < 0.02 were obtained using the highest Youden index value. Our results on test sample showed that the combined predictor, IPM1 + IPM2 < 0.02, showed the highest specificity (97.5% in boys and 92.5% for girls), better post-test probability, 97.2% in boys and 91.9% for girls, and a smaller number of false positives (6.8%). In conclusion, the combination of IPM1 and IPM2 could be useful in determining the age of over 14 years in south Indian children.
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Affiliation(s)
- M Suvarna
- Department of Dentistry, Government Medical College, Nalgonda, India
| | | | - Sudheer B Balla
- Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India.
| | - N Lakshmi Prasanna
- Department of Oral Pathology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram, India
| | - Ch Gayathri
- Department of Oral Pathology & Microbiology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India
| | - B Sai Tejaswi
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India
| | | | - Ivan Galic
- Departments of Research in Biomedicine and Health, University of Split School of Medicine & University Hospital of Split, Croatia
| | - Roberto Cameriere
- Department of Forensic Medicine University of Sechenov, Moscow, Russian Federation AgEstimation Project, FOR.MED.LAB, University of Macerata, Macerata, Italy
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Thomas LA, Thomas LR, Balla SB, Gopalaiah H, Kanaparthi A, Sai Sravanthi G, Palla A, Galic I. Above or below 14 years? An orthopantomographic study based on chronological course of eruption of mandibular premolars and second molars in a sample of south Indian children. Leg Med (Tokyo) 2020; 48:101814. [PMID: 33246253 DOI: 10.1016/j.legalmed.2020.101814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 11/17/2022]
Abstract
In the context of dental age assessment, two significant factors can be studied; tooth mineralisation and tooth emergence. Little is known about the role of a second molar eruption in forensic age estimation. This paper aims to contribute to forensic age estimation using an age threshold of 14 years, studying the eruption stages of permanent mandibular premolars and second molars. Totally 640 orthopantomograms (OPGs) of south Indian children, aged between 10 and 18 years, were evaluated using Olze et al. staging of tooth eruption stages (A-D). Spearman's rho correlation showed a strong, positive, and statistically significant correlation between the chronological age and the eruption stages of both sexes' teeth. Accuracy, sensitivity, specificity, likelihood ratios, and post-test probability values were calculated for all tested teeth. The best performance to discriminate individuals above or below 14 years showed stage D in second molars. The sensitivity varied between 89% and 94% and specificity between 75% and 84%, respectively. Receiver operating characteristic curve analysis revealed high diagnostic performance for stage D, with area under the ROC curve (AUC) values of 84% and 85% for tooth 37 and 85% and 83% for tooth 47 in males and females, respectively. In conclusion, it is possible to predict age over 14 years in south Indian children using tooth emergence stages from OPGs with a relatively high interobserver agreement and good diagnostic accuracy. However, there are some limitations and, therefore, must be used in conjunction with other methods.
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Affiliation(s)
| | | | - Sudheer B Balla
- Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, Telangana, India.
| | - Hema Gopalaiah
- Department of Oral Medicine & Radiology, MNR Dental College & Hospital, India
| | - Alekhya Kanaparthi
- Department of Oral Medicine & Radiology, MNR Dental College & Hospital, India
| | - G Sai Sravanthi
- Department of Oral Medicine & Radiology, Sri Balaji Dental College, India
| | - Alekya Palla
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences, India
| | - Ivan Galic
- Departments of Research in Biomedicine and Health, University of Split, School of Medicine, Croatia
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Ravi V, Sp AS, Balla SB, Kanaparthi A, Ch G, N LP. Evaluation of secondary dentin deposition in lower first molars to indicate a legal age threshold of 14 years using receiver operating characteristic curves. MEDICINE, SCIENCE, AND THE LAW 2020; 60:249-256. [PMID: 32627673 DOI: 10.1177/0025802420936507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The age threshold of 14 years has become vital in proving legal violations involving children, particularly in cases of suspected child labour, child pornography and the minimum age of criminal responsibility. In recent years, there has been great interest in the evaluation of age in children and sub-adults using analysis of regressive changes in teeth, with a particular focus on age thresholds that are of medico-legal importance. This research aimed to compare the sensitivity and specificity of stages of root pulp visibility by Olze et al. in a sample of South Indian children aged between 12 and 16 years, with an age threshold of 14 years, using receiver operating characteristic curves and the area under the curve (AUC). Among the four stages of root pulp visibility, stage 2 showed the highest AUC in both female and male cohorts. For stage 2, lower sensitivity and higher specificity values were recorded, indicating the possibility of type II errors (i.e. false negatives). In both sexes, stage 2 had a higher AUC (i.e. 0.696 in females and 0.706 in males, respectively). Based on our findings, it can be concluded that this staging method in lower first molars is of limited value in indicating the legal age threshold of 14 years. Future research should validate the proposed approach in a larger sample and consider how to improve predictions in this area.
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Affiliation(s)
- Vishali Ravi
- Department of Periodontics, Panineeya Institute of Dental Sciences and Research Centre, India
| | | | - Sudheer B Balla
- Department of Forensic Odontology, Panineeya Institute of Dental Sciences and Research Centre, India
| | - Alekhya Kanaparthi
- Department of Oral Medicine and Radiology, 78273MNR Dental College and Hospital, India
| | - Gayathri Ch
- Department of Oral Pathology, Panineeya Institute of Dental Sciences and Research Centre, India
| | - Laxmi Prasanna N
- Department of Oral Pathology, 233614Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, India
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Pinchi V, Bianchi I, Pradella F, Vitale G, Focardi M, Tonni I, Ferrante L, Bucci A. Dental age estimation in children affected by juvenile rheumatoid arthritis. Int J Legal Med 2020; 135:619-629. [PMID: 32820356 PMCID: PMC7870602 DOI: 10.1007/s00414-020-02395-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
Abstract
Abstract Dental root calcification has proven to be a reliable biological evidence to estimate chronological age of children. The development of structures usually examined in the age estimation forensic practice (e.g. skeleton, teeth) is supposed to be influenced by diseases and nutritional, environmental, ethnic, and ultimately even socioeconomic factors. This research aims to study the age estimation in children affected by juvenile rheumatoid arthritis (JRA) with and without steroids treatment and compared with healthy subjects. Material and methods Dental age estimations based on 752 OPGs, 420 girls and 332 boys, aged from 3.3 to 15.99 years, were provided by applying Demirjian and Willems’ original methods. Of the whole sample, 103 individuals were affected by JRA and 40 received a continuous corticosteroid therapy, over 1 year long. Conclusions Willems’ and Demirjian’s original methods, as methods commonly applied to estimate age for sub-adults with unremarkable medical history, can be used for medico-legal purposes to children affected by JRA. Willems’ method tended to underestimate age while Demirjian’s method resulted to be prone to overestimation for both healthy and JRA-affected children. JRA showed to have no influence on root calcification process even in children that received steroid treatment for 1 year or longer. Electronic supplementary material The online version of this article (10.1007/s00414-020-02395-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vilma Pinchi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Ilenia Bianchi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Pradella
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Giulia Vitale
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Martina Focardi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Ingrid Tonni
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili, 25123, Brescia, Italy
| | - Luigi Ferrante
- Center of Epidemiology, Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, 60020, Ancona, Italy.
| | - Andrea Bucci
- Department of Economics, Università degli Studi G. d'Annunzio Chieti-Pescara, Viale Pindaro 42, 65127, Pescara, Italy
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da Luz LCP, Anzulović D, Benedicto EN, Galić I, Brkić H, Biazevic MGH. Accuracy of four dental age estimation methodologies in Brazilian and Croatian children. Sci Justice 2019; 59:442-447. [DOI: 10.1016/j.scijus.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 02/04/2019] [Accepted: 02/17/2019] [Indexed: 10/27/2022]
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Benedicto EN, Azevedo ACS, Michel-Crosato E, Biazevic MGH. Validity and accuracy of three radiographic dental age estimation methods in Brazilians. Forensic Sci Int 2017; 283:128-135. [PMID: 29301112 DOI: 10.1016/j.forsciint.2017.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/23/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To validate, analyse accuracy, and construct multiple regression formulae of three age estimation methods - Liliequist and Lundberg, Haavikko, and Mornstad - using mineralization stages of permanent teeth in Brazilians. METHODS Panoramic radiographs of 1009 Brazilian children and adolescents (387 males and 622 females) aged 8-15.99 years were analysed using the aforementioned methodologies. RESULTS The overall accuracy (absolute difference=AD and dental age-chronological age=DA-CA) of the methods was as follows: Liliequist and Lundberg, AD=0.97 and DA-CA=-0.58; Haavikko, AD=1.42 and DA-CA=-1.35; and Mornstad, AD=2.48 and DA-CA=0.78. After sex-based stratification, the values for males were as follows: Liliequist and Lundberg, AD=0.91 and DA-CA=-0.45; Haavikko, AD=1.80 and DA-CA=-1.75; and Mornstad, AD=2.74 and DA-CA=1.17. In females, the values were as follows: Liliequist and Lundberg, DA=1.01 and DA-CA=-0.67; Haavikko, AD=1.17 and DA-CA=-1.09; and Mornstad, AD=2.31 and DA-CA=0.53. The Liliequist and Lundberg technique predominated, followed by Haavikko and Mornstad when distinction was present between sex and age. Multiple regression formulae were constructed from the data presented for the Liliequist and Lundberg, Haavikko and Mornstad methodologies. CONCLUSIONS The validation of the methodologies in the Brazilian population is possible. The Liliequist and Lundberg method most closely represented the Brazilian sample.
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Affiliation(s)
- Eduardo Novaes Benedicto
- Community Dentistry Department, School of Dentistry, Universidade de São Paulo - FO-USP, São Paulo, SP, Brazil
| | - Alana Cássia Silva Azevedo
- Community Dentistry Department, School of Dentistry, Universidade de São Paulo - FO-USP, São Paulo, SP, Brazil
| | - Edgard Michel-Crosato
- Community Dentistry Department, School of Dentistry, Universidade de São Paulo - FO-USP, São Paulo, SP, Brazil
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Pinchi V, De Luca F, Focardi M, Pradella F, Vitale G, Ricciardi F, Norelli GA. Combining dental and skeletal evidence in age classification: Pilot study in a sample of Italian sub-adults. Leg Med (Tokyo) 2016; 20:75-9. [PMID: 27161928 DOI: 10.1016/j.legalmed.2016.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 04/24/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dental and skeletal maturation have proved to be reliable evidence for estimating age of children and prior studies and internationally accredited guidelines recommend to evaluate both evidence in the same subject to reduce error in age prediction. Nevertheless the ethical and legal justification of procedures that imply a double exposition of children stands as a relevant issue. This study aims to evaluate the accuracy of age estimation provided by a combination of skeletal and dental methods applied in the same sample of children. MATERIALS AND METHODS The sample consisted of 274 orthopantomographies and left hand-wrist X-rays of Italian children, (aged between 6 and 17years) taken on the same day. Greulich and Pyle's (GP), Tanner-Whitehouse's version 3 (TW3) and Willems' (W) and the Demirjian's (D) methods were respectively applied for estimating skeletal and dental age. A combination of skeletal and dental age estimates through Linear Discriminant Analysis (LDA) is proposed to obtain a classifier respect to an age threshold. RESULTS The combination of D and TW3 obtained an improvement of accuracy in classifying female subjects respect to the 12years threshold respect to the original methods (from about 77% using either original methods to 83.3% combining TW3+D) as well as a consistent reduction of false positives rate (from 17% to 21% for original methods to 5.6% with TW3+D). For males the LDA classifier (based on TW3 and W) enable a small improvement in accuracy, whilst the decreasing of false positives was as noticeable as for females (from 17.6 to 14.1% for original methods to 6.2% combining TW3+W). CONCLUSIONS Although the study is influenced by the limited size and the uneven age distribution of the sample, the present findings support the conclusion that age assessment procedures based on both dental and skeletal age estimation can improve the accuracy and reduce the occurrence of false positives.
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Affiliation(s)
- Vilma Pinchi
- Department of Health Sciences, Section of Medical Forensic Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Federica De Luca
- Department of Health Sciences, Section of Medical Forensic Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Martina Focardi
- Department of Health Sciences, Section of Medical Forensic Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Francesco Pradella
- Department of Health Sciences, Section of Medical Forensic Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Giulia Vitale
- Department of Health Sciences, Section of Medical Forensic Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Federico Ricciardi
- Department of Statistical Science, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Gian-Aristide Norelli
- Department of Health Sciences, Section of Medical Forensic Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
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