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Angelakopoulos N, Franco A, Mula AP, Moukarzel M, Sharma S, Balla SB. Effect of impaction on third molar development and age estimation-A study in a Lebanese population. Morphologie 2023; 107:100607. [PMID: 37543029 DOI: 10.1016/j.morpho.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND The effect of impaction on third molar development is disputable as the scientific literature is not uniform. In parallel, population-specific studies have been encouraged in dental age estimation. This study aimed to investigate the effect of impaction on third molar formation in a sample of Lebanese individuals. MATERIALS AND METHODS The sample consisted of 518 panoramic radiographs of females (n=229) and males (n=289) between 15 and 23.9 years. Mandibular third molars were classified based on their position as non-impacted and impacted (with horizontal, vertical, mesioangular, and distoangular impaction). Dental development was classified according to Demirjian's 8-level staging system. RESULTS Most teeth presented mesioangular impaction (#38=29.7%, #48=33%). Developing third molars were predominantly distributed between stages D and G. The mean age of most developmental stages was higher among impacted teeth, meaning that third molar mineralization could be slower in the presence of impaction. In general, the delayed dental development did not have statistically significant effects (P<0.05). However, descriptive data pointed out differences between (impacted and non-impacted) mean ages of >12 months-suggesting a potential clinical significance (despite the lack of a statistical one). Furthermore, differences changed based on sex and side (#38/#48). CONCLUSION Therefore, dental age estimation from third molars in the selected Lebanese population should preferably be performed in non-impacted third molars whenever available.
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Affiliation(s)
- N Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland.
| | - A Franco
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Campinas, Brazil.
| | - A P Mula
- Department of Public Health Dentistry, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India.
| | | | - S Sharma
- Krishna Institute of Medical Sciences, Karad, Maharashtra, India.
| | - S B Balla
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
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Angelakopoulos N, Franco A, Sezgin N, Cevik ZA, Canturk N, Panciera MC, Pinto PHV, Alves da Silva RH, Balla SB, Kumagai A, Zolotenkova G, Silveira Sousa AM, Ferrante L, Cameriere R. Ear identification: A multi-ethnic study sample. Morphologie 2023; 107:100602. [PMID: 37230829 DOI: 10.1016/j.morpho.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023]
Abstract
The external human ear is considered to be highly variable among individuals. Hence, forensic applications could be explored for human identification. This research compares the usefulness of Cameriere's ear identification method, in samples originating from six different countries (Brazil, India, Japan, Russia, South Africa and Turkey) in order to examine possible differences in their accuracy values. A sample of 2,225 photographs of the external human ear (1,134 left and 1,091 right ears) from 1,411 individuals (633 females and 778 males) was collected. The samples included healthy subjects with no systemic disorders and without any craniofacial trauma, maxillofacial abnormalities, auricular anomalies, ear diseases or previous auricular surgery. Cameriere's ear identification method was applied and measurements were performed on the images of each ear, considering four anatomic regions: helix, antihelix, concha, and lobe. The quantified measurement values were converted into a proposed coded number system. A search for identical codes was accomplished to find out the distinctiveness of the morphology of the human ear. The combined codes of left and right ears of each of the 814 subjects were not repeated in this multi-ethnic study sample. Dirichlet's distribution and the inherent study equation showed that the probability of two different individuals having the same code (false-positive identification) was found to be <0.0007. Because of the distinctive metrics of the ratios of external human ears, studies with Cameriere's ear identification method may be valuable for human identification. Studying the differences between the left and right ears of the same individual and across different ethnic groups could contribute to the development of supplementary tools for human identification.
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Affiliation(s)
- N Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland; Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, AgEstimation Project, Campobasso, Italy.
| | - A Franco
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - N Sezgin
- Department of Forensic Sciences, Faculty of Engineering and Natural Sciences, Kütahya Health Sciences University, Kutahya, Turkey
| | - Z A Cevik
- Department of Forensic Medicine, Medical School, Ankara University, Ankara, Turkey
| | - N Canturk
- Department of Forensic Medicine, Medical School, Ankara University, Ankara, Turkey
| | - M C Panciera
- Department of Pathology and Forensic Medicine, USP - University of São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil
| | - P H V Pinto
- Department of Pathology and Forensic Medicine, USP - University of São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil
| | - R H Alves da Silva
- Department of Stomatology, Public Health and Forensic Odontology, School of Dentistry of Ribeirão Preto, USP - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - S B Balla
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - A Kumagai
- Department of Forensic Science, Division of Forensic Odontology and Disaster Oral Medicine, Iwate Medical University, Iwate, Japan
| | - G Zolotenkova
- Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - A M Silveira Sousa
- School of Dentistry of Ribeirão Preto, USP-University of São Paulo, Ribeirão Preto, SP, Brazil
| | - L Ferrante
- Polytechnic University of Marche, Center of Epidemiology, Biostatistics and Medical Information Technology, Department of Biomedical Science and Public Health, Ancona, Italy
| | - R Cameriere
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, AgEstimation Project, Campobasso, Italy
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Angelakopoulos N, Galić I, Balla SB, Kiş HC, Gómez Jiménez L, Zolotenkova G, Mohd Yusof MYP, Hadzić Selmanagić A, Pandey H, Palmela Pereira C, Nóbrega JBM, Hettiarachchi K, Mieke SM, Kumagai A, Gulsahi A, Zelić K, Marinković N, Kelmendi J, Bianchi I, Soriano Vázquez I, Spinas E, Velezmoro-Montes YW, Oliveira-Santos I, De Luca S, Arrais Ribeiro IL, Moukarzel M, Cameriere R. Comparison of the third molar maturity index (I 3M) between left and right lower third molars to assess the age of majority: a multi-ethnic study sample. Int J Legal Med 2021; 135:2423-2436. [PMID: 34228192 DOI: 10.1007/s00414-021-02656-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/27/2021] [Indexed: 11/26/2022]
Abstract
The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10,181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.
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Affiliation(s)
- N Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopaedics, University of Bern, Bern, Switzerland
- AgEstimation Project, Macerata, Italy
| | - I Galić
- AgEstimation Project, Macerata, Italy
- Department of Oral Surgery, School of Medicine, University of Split, Split, Croatia
| | - S B Balla
- AgEstimation Project, Macerata, Italy
- Department of Forensic Odontology, Panineeya Institute of Dental Sciences and Research Center, Hyderabad, Telangana, India
| | - H C Kiş
- Faculty of Dentistry, Oral and Maxillofacial Radiology, Nuh Naci Yazgan University, Kocasinan, Kayseri, Turkey
| | - L Gómez Jiménez
- Instituto Nacional de Patología Dr. Sergio Sarita Valdez, Santo Domingo, República Dominicana
| | - G Zolotenkova
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Design Information Technologies Centre, Russian Academy of Sciences (DITC RAS), Moscow, Russia
| | - M Y P Mohd Yusof
- Centre for Oral & Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - A Hadzić Selmanagić
- Department of Dental Morphology With Dental Anthropology and Forensics Faculty of Dentistry, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - H Pandey
- Department of Forensic Medicine and Toxicology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - C Palmela Pereira
- Facultade de Medicina Dentária da Universidade de Lisboa, Lisboa, Portugal
| | - J B M Nóbrega
- Postgraduate Program in Dentistry, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brasil
| | - K Hettiarachchi
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Kandy, Central Province, Sri Lanka
| | - S M Mieke
- Department of Forensic Odontology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - A Kumagai
- Division of Forensic Odontology and Disaster Oral Medicine, Department of Forensic Science, Iwate Medical University, Iwate, Japan
| | - A Gulsahi
- AgEstimation Project, Macerata, Italy
- Faculty of Dentistry, Dentomaxillofacial Radiology Department, Baskent University, Ankara, Turkey
| | - K Zelić
- Laboratory of Anthropology, Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - N Marinković
- Clinic for Orthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - J Kelmendi
- Department of Orthodontics, Faculty of Medicine Alma Mater Europaea, University of Prishtina, Campus Rezonanca, Prishtina, Kosovo
| | - I Bianchi
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | | | - E Spinas
- Department of Surgical Sciences, Section of Dentistry, University of Cagliari , Cagliari, Italy
| | | | - I Oliveira-Santos
- Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Stefano De Luca
- AgEstimation Project, Macerata, Italy.
- Área de Identificación Forense, Unidad de Derechos Humanos, Servicio Médico Legal, Santiago de Chile, Chile.
| | - I L Arrais Ribeiro
- Postgraduate Program in Dentistry, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brasil
| | | | - R Cameriere
- AgEstimation Project, Macerata, Italy
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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Moukarzel M, Angelakopoulos N, De Luca S, Velandia Palacio L, Aquilanti L, Coccia E, Pigolkin Y, Cameriere R. Validity assessment of the third molar maturity index (I3M) in a Lebanese sample of adolescents and young adults. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1805008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- M. Moukarzel
- Dental School, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - N. Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - S. De Luca
- AgEstimation Project, University of Macerata, Macerata, Italy
- Área de Identificación Forense, Unidad de Derechos Humanos, Servicio Médico Legal, Santiago de Chile
| | | | - L. Aquilanti
- Department of Odontostomatologic and Specialized Clinical Sciences (DISCO), Polytechnic University of Marche, Ancona, Italy
| | - E. Coccia
- Department of Odontostomatologic and Specialized Clinical Sciences (DISCO), Polytechnic University of Marche, Ancona, Italy
| | - Y.I. Pigolkin
- Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - R. Cameriere
- AgEstimation Project, University of Macerata, Macerata, Italy
- Department of Forensic Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
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Angelakopoulos N, Galić I, De Luca S, Campobasso C, Martino F, De Micco F, Coccia E, Cameriere R. Skeletal age assessment by measuring planar projections of carpals and distal epiphyses of ulna and radius bones in a sample of South African subadults. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1766111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- N. Angelakopoulos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - I. Galić
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia
| | - S. De Luca
- Área de Identificación Forense, Unidad de Derechos Humanos, Servicio Médico Legal, Santiago de Chile, Chile
- AgEstimation Project, University of Macerata, Macerata, Italy
| | - C.P. Campobasso
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - F. Martino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Napoli, Italy
| | - F. De Micco
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
| | - E. Coccia
- Department of Odontostomatology and Specialized Clinical Sciences (DISCO), Polytechnic University of Marche, Ancona, Italy
| | - R. Cameriere
- AgEstimation Project, University of Macerata, Macerata, Italy
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Angelakopoulos N, De Luca S, Velandia Palacio LA, Coccia E, Ferrante L, Cameriere R. Third molar maturity index (I 3M) for assessing age of majority: study of a black South African sample. Int J Legal Med 2018. [PMID: 29520486 DOI: 10.1007/s00414-018-1818-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The evaluation of the cutoff value of I3M = 0.08 for discriminating black South African minors from adults, and its relationship with chronological age. MATERIAL AND METHODS A sample of 833 panoramic radiographs of healthy black South African subjects (500 females and 333 males), in the age range of 14 to 24 years (mean age 17.67 years in females and 17.42 years in males), was retrospectively evaluated. RESULTS ICC values were 99.10% (95% CI 97.70 to 99.70%) and 99.20% (95% CI 98.00 to 99.60%), for the intra- and inter-observer reliability, respectively. I3M decreased as the real age gradually increased in both sexes. According to the logistic regression model, the variable sex was not significant when the probability that an individual is 18 years or older was calculated. The I3M = 0.08 was valuable in discriminating between adults and minors. The overall accuracy (ACC = fraction of accurately classified subjects) is 0.90 (95% CI 0.87-0.91); the proportion of correctly classified subjects (Se = sensitivity) is 0.80 (95% CI 0.76-0.84), and specificity (Sp) is 0.95 (95% CI 0.93-0.97). The PPV (predictive positive value) is 0.96 (95% CI 0.95-0.97), and the negative predictive value is 0.76 (95% CI 0.72-0.80). CONCLUSION The results show that I3M is a valuable method to distinguish subjects who are around legal adult age in South Africa.
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Affiliation(s)
- N Angelakopoulos
- School of Dentistry, Division of Cariology and Endodontics and Pediatric Dentistry, University of Geneva, Geneva, Switzerland
| | - S De Luca
- Unidad Especial de Identificación Forense, Servicio Médico Legal, Santiago de Chile, Chile. .,AgEstimation Project, Institute of Legal Medicine, University of Macerata, Macerata, Italy.
| | - L A Velandia Palacio
- AgEstimation Project, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | - E Coccia
- Department of Odontostomatologic and Specialized Clinical Sciences (DISCO), Polytechnic University of Marche, Ancona, Italy
| | - L Ferrante
- Center of Epidemiology, Biostatistics and Medical Information Technology, Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - R Cameriere
- AgEstimation Project, Institute of Legal Medicine, University of Macerata, Macerata, Italy
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