International Journal of Legal Medicine

, Volume 132, Issue 4, pp 1151–1159 | Cite as

The third molar maturity index in indicating the legal adult age in Kosovar population

  • Jeta Kelmendi
  • Roberto Cameriere
  • Ferit Koçani
  • Ivan GalićEmail author
  • Blerim Mehmeti
  • Marin Vodanović
Original Article


The third molar tooth, known as the “wisdom tooth,” is the only tooth that can be used to determine legal adult age. This study aimed to test the accuracy of Cameriere’s third molar maturity index (I3M) in assessing the legal adult age of 18 years in the Kosovar population. Orthopantomographs (OPTs) of 1221 healthy living Kosovar individuals, aged between 12 and 23 years and with no congenital or developmental anomalies, were analyzed. Intra-class correlation coefficients were 0.858 (95% CI, 0.786 to 0.906) and 0.852 (95% CI, 0.779 to 0.903) for intra-rater and for inter-rater agreement, respectively. The sample was divided into training dataset (800 OPTs) and test dataset (421 OPTs). The training dataset was used to generate the logistic regression model, while the test dataset was used to study the performance of the model. I3M and gender as independent variables and adult age (≥ 18 years) or minor age (< 18 years) as the dependent variable were used for logistic regression analysis. The receiver operating curve (ROC) analysis was used to determine the specific cut-off value of I3M for predicting adult age. The results showed that only I3M statistically significantly contributed to discriminating adults and minors. ROC analysis showed that the cut-off value of I3M < 0.08 was the best in discriminating adults and minors. An analysis of the test dataset (421 OPTs) showed that as I3M decreased the age gradually increased. The performance of the cut-off value of I3M < 0.08, to discriminate between adults and minors, was analyzed by contingency tables for both sexes. In males, the accurate classification (Acc) was 0.968 (95% CI, 0.926 to 0.985), the sensitivity (Se) was 0.962 (95% CI, 0.925 to 0.978), and the specificity (Sp) was 0.976 (95% CI, 0.929 to 0.995). The Bayes post-test probability (Bayes PTP) was 0.975 (95% CI, 0.905 to 1.00). In females, Acc was 0.909 (95% CI, 0.870 to 0.917), Se and Sp were 0.826 (95% CI, 0.787 to 0.834) and 0.991 (95% CI, 0.953 to 1.00) respectively, while Bayes PTP was 0.989 (95% CI, 0.926 to 1.00). Our data support the usefulness of I3M < 0.08 to indicate legal adult age in a Kosovar population.


Legal medicine Third molar maturity index Legal adult age Kosovo 



The authors would like to express their thanks to Professor Ana Marušić for her help in preparing the manuscript.

Supplementary material

414_2017_1761_MOESM1_ESM.xlsx (21 kb)
ESM 1 (XLSX 20 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of OrthodonticsUniversity Dentistry Clinical Center of KosovoPristinaKosovo
  2. 2.Dental Science, School of Dental MedicineUniversity of ZagrebZagrebCroatia
  3. 3.AgEstimation Project, Institute of Legal MedicineUniversity of MacerataMacerataItaly
  4. 4.Department of Dental Pathology and EndodonticsUniversity Dentistry Clinical Center of KosovoPristinaKosovo
  5. 5.Department of Research in Biomedicine and HealthSplitCroatia
  6. 6.Department of Dental Anthropology, School of Dental MedicineUniversity of ZagrebZagrebCroatia
  7. 7.Department of Dental Dental MedicineUniversity Hospital Centre ZagrebZagrebCroatia

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