Forensic Dental Age Estimation: Development of New Algorithm Based on the Minimal Necessary Databases

Abstract

Objectives Dental age determination relies on the presence of wisdom teeth, which can be assigned to specific age ranges according to their stage of development. The purpose of this study is to highlight the applicability of the Demirjian staging of layman compared to expert, as well as the inclusion of all four wisdom teeth in the overall assessment, in order to emphasize and critically highlight a precise age estimation in clinical practice, especially in the case of agenesis or the presence of less than all four wisdom teeth. Material and Methods: In this study, dental age determination is performed and compared by a trained layperson and an expert using 385 orthopantomograms. The radiographs of known chronological age from male patients in the age range of 11–22 years were acquired from the University Medical Center Mainz. All four wisdom teeth were radiologically viewed if present. Demirjian staging with stages A–H was applied, and regression analysis was performed. Results: The relationship between mineralization of wisdom teeth (18, 28, 38 and 48) and age was linear for all teeth (p < 0.01), except for tooth 18 (p = 0.02). Comparing the prediction of the four teeth individually revealed that the lower teeth gave better predictions than the upper ones (R2 ≥ 0.50 vs. R2 < 0.50). Conclusions: For clinical use, the mandibular wisdom teeth should be preferred when performing dental age estimation using the Demirjian staging method. As a result of the present analysis, two ways of determining dental age by wisdom teeth can be suggested. One is to take only tooth 38, with the formula: age = 3.3 + 0.73 × mineralization of tooth_38. The second recommendation would be to take tooth_48. If both are unavailable, the formula would be age = −0.5 + 0.94 × mineralization tooth_28. Utilizing tooth 18 would not lead to more precise results.

Forensic Age Estimation: A Multifactorial Approach in a Retrospective Population Study

“…The wisdom tooth used, which tends to be preferred here, should be either tooth 38 or 48. This was already shown in a previous study by the working group [ 42 ] and is consistent with other literature [ 58 ]. A study by Bassed et al also demonstrated the importance of clavicle and wisdom tooth cooccurrence for age determination in a population study of 600 deceased individuals in Australia [ 20 ].…”

“…Thus, the indication is patient-specific and does not always involve all four wisdom teeth of an individual at the same time. If all four wisdom teeth are discoverable, the literature indicates greater accuracy in the mandible’s wisdom teeth related to the biological age than in the wisdom teeth of the upper jaw [ 41 , 42 ]. Often the maxillary wisdom teeth are not located in this context due to reduced image quality, and a study by Bjelopavlovic et al showed that the combination of tooth 38 and another, preferably tooth 48, would show the most accurate results in terms of dental age diagnosis [ 42 ].…”

“…If all four wisdom teeth are discoverable, the literature indicates greater accuracy in the mandible’s wisdom teeth related to the biological age than in the wisdom teeth of the upper jaw [ 41 , 42 ]. Often the maxillary wisdom teeth are not located in this context due to reduced image quality, and a study by Bjelopavlovic et al showed that the combination of tooth 38 and another, preferably tooth 48, would show the most accurate results in terms of dental age diagnosis [ 42 ]. As a limitation of the generalizability, this study involved the evaluation of wisdom teeth using only 2D radiographs without including other methods such as staging of the clavicle.…”

Age Group Classification of Dental Radiography without Precise Age Information Using Convolutional Neural Networks

“…Oral age is calculated as an objectively measurable oral health index and is a biological age that reflects oral health status. Oral age reflects the development of modern medicine and lifestyle changes and can be considered a concept related to biological age that can be compared based on the average oral health status of an entire nation [ 27 , 28 ]. It is an age estimation method that is widely used to estimate an accurate age.…”

Adapting Demirjian Standards for Portuguese and Spanish Children and Adolescents

“…Simple and multiple linear regressions were used to obtain a parsimonious model, allowing estimation of chronological age from the measurements made of the seven teeth based on each method and the variables of sex and age group, since in previous studies the Demirjian method is shown to be sensitive to these variables [7,30,[35][36][37][38]. Using regression equations provides a more precise approach to chronological age based on Demirjian's staging method [43]. The statistical assumptions of the models were analyzed and fulfilled, namely those of normal distribution, homogeneity, and independence of errors.…”