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A systematic review and meta-analysis of the fully formed wisdom tooth as a radiological marker of adulthood

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Abstract

Assessment of third molar development on dental radiograms is one of the most commonly used methods of forensic age estimation. Despite widespread use and numerous studies, there is a paucity of aggregated data on how well a fully mature third molar identifies adulthood (> 18 years), the most important threshold in a medicolegal context. Therefore, a systematic review and meta-analysis was conducted. A total of 1229 studies were screened, and 82 studies were assessed for inclusion. Twenty-four studies, with a pooled cohort of 19,690 individuals, presented true positive (TP), true negative (TN), false positive (FP), and false negative (FN) outcomes, enabling meta-analysis. The outcomes were based on using the third molar in the fully mature stage as a diagnostic test to indicate age 18 years or above. The false positive rate (fall-out/1-specificity) was 3.1% (95% CI 2.1–4.6%), and the true positive rate (recall/sensitivity) was 51% (95% CI 44–58%). Diagnostic accuracy was 71%. These findings, while reassuring in terms of the low false positive rate, highlight the need for complementary age estimation methods to avoid a significant number of false negatives.

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Author information

Authors and Affiliations

  1. Landskrona Hospital, Vattenverksallén, S-261 36, Landskrona, Sweden

    Mattias Haglund

  2. FORODONT HB, Ängalagsvägen 419, S-269 95, Båstad, Sweden

    Håkan Mörnstad

Authors
  1. Mattias Haglund
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  2. Håkan Mörnstad
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Correspondence to Mattias Haglund.

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For this systematic review of published scientific literature, no separate ethics committee review or approval was obtained.

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The authors declare that they have no conflict of interest.

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HM has professionally performed age estimations on young asylum seekers.

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Haglund, M., Mörnstad, H. A systematic review and meta-analysis of the fully formed wisdom tooth as a radiological marker of adulthood. Int J Legal Med 133, 231–239 (2019). https://doi.org/10.1007/s00414-018-1842-4

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  • DOI: https://doi.org/10.1007/s00414-018-1842-4

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