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Human age estimation combining third molar and skeletal development

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Abstract

The wide prediction intervals obtained with age estimation methods based on third molar development could be reduced by combining these dental observations with age-related skeletal information. Therefore, on cephalometric radiographs, the most accurate age-estimating skeletal variable and related registration method were searched and added to a regression model, with age as response and third molar stages as explanatory variable. In a pilot set up on a dataset of 496 (283 M; 213 F) cephalometric radiographs, the techniques of Baccetti et al. (2005) (BA), Seedat et al. (2005) (SE), Caldas et al. (2007) and Rai et al. (2008) (RA) were verified. In the main study, data from 460 (208 F, 224 M) individuals in an age range between 3 and 26 years, for which at the same day an orthopantogram and a cephalogram were taken, were collected. On the orthopantomograms, the left third molar development was registered using the scoring system described by Gleiser and Hunt (1955) and modified by Köhler (1994) (GH). On the cephalograms, cervical vertebrae development was registered according to the BA and SE techniques. A regression model, with age as response and the GH scores as explanatory variable, was fitted to the data. Next, information of BA, SE and BA + SE was, respectively, added to this model. From all obtained models, the determination coefficients and the root mean squared errors were calculated. Inclusion of information from cephalograms based on the BA, as well as the SE, technique improved the amount of explained variance in age acquired from panoramic radiographs using the GH technique with 48%. Inclusion of cephalometric BA + SE information marginally improved the previous result (+1%). The RMSE decreased with 1.93, 1.85 and 2.03 years by adding, respectively, BA, SE and BA + SE information to the GH model. The SE technique allows clinically the fastest and easiest registration of the degree of development of the cervical vertebrae. Therefore, the choice of technique to classify cervical vertebrae development in addition to third molar development is preferably the SE technique.

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References

  1. Mincer HH, Harris EF, Berryman HE (1993) The A.B.F.O. study of third molar development and its use as an estimator of chronological age. J Forensic Sci 38(2):379–390

    PubMed  CAS  Google Scholar 

  2. Liversidge HM (2008) Timing of human mandibular third molar formation. Ann Hum Biol 35(3):294–321, Erratum in: (2008) Ann Hum Biol. 35(4):452–3

    Article  PubMed  CAS  Google Scholar 

  3. Thevissen PW, Fieuws S, Willems G (2010) Human dental age estimation using third molar developmental stages: does a Bayesian approach outperform regression models to discriminate between juveniles and adults? Int J Legal Med 124(1):35–42

    Article  PubMed  CAS  Google Scholar 

  4. Garamendi PM, Landa MI, Ballesteros J, Solano MA (2005) Reliability of the methods applied to assess age minority in living subjects around 18 years old. A survey on a Moroccan origin population. Forensic Sci Int 154(1):3–12

    Article  PubMed  CAS  Google Scholar 

  5. Solheim T, Vonen A (2006) Dental age estimation, quality assurance and age estimation of asylum seekers in Norway. Forensic Sci Int 159(Suppl 1):S56–S60

    Article  PubMed  Google Scholar 

  6. Nuzzolese E, Di Vella G (2008) Forensic dental investigations and age assessment of asylum seekers. Int Dent J 58(3):122–126

    PubMed  Google Scholar 

  7. Schmeling A, Grundmann C, Fuhrmann A, Kaatsch HJ, Knell B, Ramsthaler F, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G (2008) Criteria for age estimation in living individuals. Int J Legal Med 122(6):457–460

    Article  PubMed  CAS  Google Scholar 

  8. Santoro V, De Donno A, Marrone M, Campobasso CP, Introna F (2009) Forensic age estimation of living individuals: a retrospective analysis. Forensic Sci Int 193(1–3):29.e1–4

    Google Scholar 

  9. Cunha E, Baccino E, Martrille L, Ramsthaler F, Prieto J, Schuliar Y, Lynnerup N, Cattaneo C (2009) The problem of aging human remains and living individuals: a review. Forensic Sci Int 193(1–3):1–13

    Article  PubMed  CAS  Google Scholar 

  10. Lewis JM, Senn DR (2010) Dental age estimation utilizing third molar development: a review of principles, methods, and population studies used in the United States. Forensic Sci Int 201(1–3):79–83

    Article  PubMed  Google Scholar 

  11. Demisch A, Wartmann P (1956) Calcification of the mandibular third molar and its relation to skeletal and chronological age in children. Child Dev 27(4):459–473

    PubMed  CAS  Google Scholar 

  12. Sierra AM (1987) Assessment of dental and skeletal maturity. A new approach. Angle Orthod 57(3):194–208

    PubMed  CAS  Google Scholar 

  13. Lewis AB (1991) Comparisons between dental and skeletal ages. Angle Orthod 61(2):87–92

    PubMed  CAS  Google Scholar 

  14. Flores-Mir C, Mauricio FR, Orellana MF, Major PW (2005) Association between growth stunting with dental development and skeletal maturation stage. Angle Orthod 75(6):935–940

    PubMed  Google Scholar 

  15. Başaran G, Ozer T, Hamamci N (2007) Cervical vertebral and dental maturity in Turkish subjects. Am J Orthod Dentofacial Orthop 131(4):447.e13–20

    Article  Google Scholar 

  16. Cho S, Hwang C (2009) Skeletal maturation evaluation using mandibular third molar development in adolescents. Korean J Orthod 39(2):120–129

    Article  Google Scholar 

  17. Chen J, Hu H, Guo J, Liu Z, Liu R, Li F, Zou S (2010) Correlation between dental maturity and cervical vertebral maturity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(6):777–783

    Article  PubMed  Google Scholar 

  18. Perinetti G, Contardo L, Gabrieli P, Baccetti T, Di Lenarda R (2011) Diagnostic performance of dental maturity for identification of skeletal maturation phase. Eur J Orthod. 23. Epub ahead of print.

  19. Różyło-Kalinowska I, Kolasa-Rączka A, Kalinowski P (2011) Relationship between dental age according to Demirjian and cervical vertebrae maturity in Polish children. Eur J Orthod 33(1):75–83

    Article  PubMed  Google Scholar 

  20. Nelki J, Grady P, Bailey S, Law H (2010) The challenges of psychological assessments of maturity. In: Black S, Aggrawal A, Payne-James J (eds) Age estimation in the living, 1st edn. Wiley-Blackwell, UK, pp 55–76

    Chapter  Google Scholar 

  21. Healy MJ (1992) Normalizing transformations for growth standards. Ann Hum Biol 19(5):521–526

    Article  PubMed  CAS  Google Scholar 

  22. Wright CM, Booth IW, Buckler JM, Cameron N, Cole TJ, Healy MJ, Hulse JA, Preece MA, Reilly JJ, Williams AF (2002) Growth reference charts for use in the United Kingdom. Arch Dis Child 86(1):11–14

    Article  PubMed  CAS  Google Scholar 

  23. Tanner JM (1986) Normal growth and techniques of growth assessment. Clin Endocrinol Metab 15(3):411–451

    Article  PubMed  CAS  Google Scholar 

  24. Solheim T, Sundnes (1980) Dental age estimation of Norwegian adults—a comparison of different methods. Forensic Sci Int 16(1):7–17

    Article  PubMed  CAS  Google Scholar 

  25. Kvaal SI, Kolltveit KM, Thomsen IO, Solheim T (1995) Age estimation of adults from dental radiographs. Forensic Sci Int 74(3):175–185

    Article  PubMed  CAS  Google Scholar 

  26. Star H, Thevissen P, Jacobs R, Fieuws S, Solheim T, Willems G (2011) Human dental age estimation by calculation of pulp-tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth. J Forensic Sci 56(Suppl 1):S77–S82

    Article  PubMed  Google Scholar 

  27. Olze A, Solheim T, Schulz R, Kupfer M, Pfeiffer H, Schmeling A (2010) Assessment of the radiographic visibility of the periodontal ligament in the lower third molars for the purpose of forensic age estimation in living individuals. Int J Legal Med 124(5):445–448

    Article  PubMed  Google Scholar 

  28. Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, Stanford, CA

    Google Scholar 

  29. Tanner JM (1975) Assessment of skeletal maturity and prediction of adult height (TW2 method). Academic Press, London, New York

    Google Scholar 

  30. Fishman LS (1982) Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films. Angle Orthod 52(2):88–112

    PubMed  CAS  Google Scholar 

  31. Leite HR, O'Reilly MT, Close JM (1987) Skeletal age assessment using the first, second, and third fingers of the hand. Am J Orthod Dentofacial Orthop 92(6):492–498

    Article  PubMed  CAS  Google Scholar 

  32. Tanner JM, Healey MRJ, Goldstein H, Cameron N et al (2001) Assessment of skeletal maturity and prediction of adult height (TW3 method) Ed 3. Saunders, Philadelphia

    Google Scholar 

  33. Gilsanz V, Ratib O (2005) Hand bone age: a digital atlas of skeletal maturity. Springer, Berlin

    Google Scholar 

  34. Negi K (2009) Reliability of middle phalanx of 3rd finger. Orthodontic Cyberjournal.

  35. Schmeling A, Schulz R, Reisinger W, Mühler M, Wernecke KD, Geserick G (2004) Studies on the time frame for ossification of the medial clavicular epiphyseal cartilage in conventional radiography. Int J Legal Med 118(1):5–8

    Article  PubMed  Google Scholar 

  36. Schulze D, Rother U, Fuhrmann A, Richel S, Faulmann G, Heiland M (2006) Correlation of age and ossification of the medial clavicular epiphysis using computed tomography. Forensic Sci Int 158(2–3):184–189

    Article  PubMed  Google Scholar 

  37. Schulz R, Zwiesigk P, Schiborr M, Schmidt S, Schmeling A (2008) Ultrasound studies on the time course of clavicular ossification. Int J Legal Med 122(2):163–167

    Article  PubMed  Google Scholar 

  38. Quirmbach F, Ramsthaler F, Verhoff M (2009) Evaluation of the ossification of the medial clavicular epiphysis with a digital ultrasonic system to determine the age threshold of 21 years. Int J Legal Med 123(3):241–245

    Article  PubMed  Google Scholar 

  39. Kellinghaus M, Schulz R, Vieth V, Schmidt S, Schmeling A (2010) Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med 124(2):149–154

    Article  PubMed  Google Scholar 

  40. Kellinghaus M, Schulz R, Vieth V, Schmidt S, Pfeiffer H, Schmeling A (2010) Enhanced possibilities to make statements on the ossification status of the medial clavicular epiphysis using an amplified staging scheme in evaluating thin-slice CT scans. Int J Legal Med 124(4):321–325

    Article  PubMed  Google Scholar 

  41. Hillewig E, De Tobel J, Cuche O, Vandemaele P, Piette M, Verstraete K (2011) Magnetic resonance imaging of the medial extremity of the clavicle in forensic bone age determination: a new four-minute approach. Eur Radiol 21(4):757–767

    Article  PubMed  Google Scholar 

  42. Moskovitch G, Dedouit F, Braga J, Rougé D, Rousseau H, Telmon NJ (2010) Multislice computed tomography of the first rib: a useful technique for bone age assessment. Forensic Sci Int 55(4):865–870

    Article  Google Scholar 

  43. Garamendi PM, Landa MI, Botella MC, Alemán I (2011) Forensic age estimation on digital X-ray images: medial epiphyses of the clavicle and first rib ossification in relation to chronological age. J Forensic Sci 56(Suppl 1):S3–S12

    Article  PubMed  Google Scholar 

  44. Baccetti T, Franchi L, McNamara J (2005) The cervical vertebral maturation (CVM). Method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 11:119–129

    Article  Google Scholar 

  45. Seedat AK, Forsberg CD (2005) An evaluation of the third cervical vertebra (C3) as a growth indicator in black subjects. SADJ 60(4):156, 158–60

    PubMed  CAS  Google Scholar 

  46. Hassel B, Farman AG (1995) Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 107(1):58–66, Erratum in: (1995) Am J Orthod Dentofacial Orthop 107(6):19

    Article  PubMed  CAS  Google Scholar 

  47. de Caldas MP, Ambrosano GM, Haiter Neto F (2007) New formula to objectively evaluate skeletal maturation using lateral cephalometric radiographs. Braz Oral Res 21(4):330–335

    Article  Google Scholar 

  48. de Caldas MP, Ambrosano GM, Haiter Neto F (2010) Computer-assisted analysis of cervical vertebral bone age using cephalometric radiographs in Brazilian subjects. Braz Oral Res 24(1):120–126

    Article  Google Scholar 

  49. Rai B, Krishan K, Kaur J, Anand S (2008) Age estimation from mandible by lateral cephalogram: a preliminary study. J Forensic Odontostomatol 27(1):24–28

    Google Scholar 

  50. Gleiser I, Hunt E (1955) The permanent mandibular first molar: its calcification, eruption and decay. Am J Phys Anthropol 13:253–283

    Article  PubMed  CAS  Google Scholar 

  51. Köhler S, Schmelzle R, Loitz C, Püschel K (1994) Development of wisdom teeth as a criterion of age determination. Ann Anat 176:339–345

    Article  PubMed  Google Scholar 

  52. Dibbets JM, Nolte K (2002) Effect of magnification on lateral cephalometric studies. Am J Orthod Dentofacial Orthop 122(2):196–201

    Article  PubMed  Google Scholar 

  53. Cohen JM (2005) Comparing digital and conventional cephalometric radiographs. Am J Orthod Dentofacial Orthop 128(2):157–160

    Article  PubMed  Google Scholar 

  54. Thevissen PW, Fieuws S, Willems G (2011) Third molar development: measurements versus scores as age predictor. Arch Oral Biol. May 6. Epub ahead of print.

  55. Ozer T, Kama JD, Ozer SY (2006) A practical method for determining pubertal growth spurt. Am J Orthod Dentofacial Orthop 130(2):131.e1–6

    Article  Google Scholar 

  56. Lamparski D (1972) Skeletal age assessment utilizing cervical vertebrae. [Thesis.] Pittsburgh: University of Pittsburgh.

  57. Gabriel DB, Southard KA, Qian F, Marshall SD, Franciscus RG, Southard TE (2009) Cervical vertebrae maturation method: poor reproducibility. Am J Orthod Dentofacial Orthop 136(4):478.e1–7, discussion 478–80

    Article  Google Scholar 

  58. Jaqueira LM, Armond MC, Pereira LJ, Alcântara CE, Marques LS (2010) Determining skeletal maturation stage using cervical vertebrae: evaluation of three diagnostic methods. Braz Oral Res 24(4):433–437

    Article  PubMed  Google Scholar 

  59. San Román P, Palma JC, Oteo MD, Nevado E (2002) Skeletal maturation determined by cervical vertebrae development. Eur J Orthod 24(3):303–311

    Article  PubMed  Google Scholar 

  60. Chen L, Liu J, Xu T, Long X, Lin J (2010) Quantitative skeletal evaluation based on cervical vertebral maturation: a longitudinal study of adolescents with normal occlusion. Int J Oral Maxillofac Surg 39(7):653–659

    Article  PubMed  CAS  Google Scholar 

  61. EUROPEAN COMMISSION (2004) European guidelines on radiation protection in dental radiology, RP 136, Luxembourg

  62. Gabriel P, Obertová Z, Ratnayake M, Arent T, Cattaneo C, Dose M, Tutkuviene J, Ritz-Timme S (2010) Schätzung des Lebensalters kindlicher Opfer auf Bilddokumenten Rechtliche Implikationen und Bedeutung im Ermittlungsverfahren. Rechtsmedizin 21:7–11

    Article  Google Scholar 

  63. Bocquet-Appel JP, Masset C (1996) Paleodemography: expectancy and false hope. Am J Phys Anthropol 99(4):571–583

    Article  PubMed  CAS  Google Scholar 

  64. Liversidge HM, Smith BH, Maber M (2010) Bias and accuracy of age estimation using developing teeth in 946 children. Am J Phys Anthropol 143(4):545–554

    Article  PubMed  Google Scholar 

  65. Gelbrich B, Lessig R, Lehmann M, Dannhauer K, Gelbrich G (2010) Altersselektion in Referenzstichproben. Auswirkung auf die forensische Altersschätzung. Rechtsmedizin 20:459–463

    Article  Google Scholar 

  66. Willems G, Van Olmen A, Spiessens B, Carels C (2001) Dental age estimation in Belgian children: Demirjian's technique revisited. J Forensic Sci 46:893–895

    PubMed  CAS  Google Scholar 

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Thevissen, P.W., Kaur, J. & Willems, G. Human age estimation combining third molar and skeletal development. Int J Legal Med 126, 285–292 (2012). https://doi.org/10.1007/s00414-011-0639-5

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