Background: Counting the tooth cementum annulations (TCA) is a method for estimating the age at death of adults by sections of their tooth root. The objective of this study was to assess the precision of counting the cementum incremental lines and the congruence between known age and age estimates. Possible factors affecting the accuracy of the estimate were also analyzed. Methods: A sample of 67 permanent teeth extracted from individuals with known age (18-84 years) and sex was analyzed to calculate the dental age. Results: Results demonstrate an excellent inter-and intra-observer reliability of annuli counting, with dissimilarities within the limits of agreement. A moderate positive correlation was found between chronological age and TCA. Our results showed that age congruence rates differed across age groups (85% congruence in individuals ≤30 years; 75% in individuals aged 31-60 years; 60% in the over 60s). Considering the bias, this method showed a clear tendency to underestimate age in specimens from old people. After age 43, the TCA estimate is highly inaccurate exceeding the underestimation of 10 years, on average, in comparison to the chronological age. Both chronological age and dental arch seem to influence the accuracy of estimates, unlike sex and the tooth root number. Conclusions: TCA analysis is characterized by high precision and low accuracy, decreasing with age. Therefore, its applicability is limited in elderly subjects. The choice of methods for age estimation in adult skeletal remains should take into account the particular age range of individuals. We recommend using different age estimation methods to verify the reliability of the performed assessments.

Estimating age at death is a key element in the process of human identification of skeletal remains. The interest in dental cementum stems from its increase in thickness throughout life and, at the same time, from the fact it should not be affected by remodeling processes. Since the age assessment is particularly difficult in adults when using traditional anthropological methods on the skeleton, we tested a dental method based on maximum cementum thickness and developed new regression equations. We microscopically analyzed the histological sections of dental roots from a sample of 108 permanent teeth with known age and sex. Age at the time of dental extraction was in the range of 18–84 years. Our findings show that there were no differences in thickness between sexes, dental arch, and mono- and pluriradicular teeth. Separate regression equations were developed for individuals in the whole age range and individuals under 45 years. The equations were then tested on a hold-out sample from the same Mediterranean population demonstrating higher reliability for the equation developed for those under 45. Conversely, due to the increased error in age estimation in individuals over 45, this method should be used with caution in the forensic context when skeletal remains presumably belong to elderly individuals.

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In forensics, the positive identification of decomposed or skeletonized bodies is a fundamental task, with the age-at-death estimation of adult individuals as one of the main objectives. Among different dental methods, root dentin translucency (RDT) is often applied since it is easy to perform and non-destructive. However, this method has some biases, and several equations have been proposed in the literature. This study aimed to test the performance of the previously published equations in an Italian sample with known age and sex, and to develop an equation specific to the Italian population. In total, we examined a sample of 155 single and multi-rooted teeth from male and female individuals aged 18-85 years. The regression equation developed for Italians was tested on a holdout sample drawn from the same population. Intra- and inter-observer errors were calculated using ICC analysis. Both root length and RDT showed excellent repeatability and reproducibility regardless of tooth type. Two of the seven published equations tested performed better in our sample, but the newly proposed equation performed better than those on the Italian population. In conclusion, RDT has proven to be a reliable indicator for age estimation, and the proposed new formula may be effective in such estimation, especially in individuals aged <40.