Abstract
Forensic age estimation is a challenging field in forensic sciences because of the increase of migratory flows. Medicolegal age assessment is a key point because it has many implications for authorities. Dental age estimation is an essential part of the global age assessment. The aim of this study was to evaluate and test the accuracy of Cameriere’s cutoff values of the third molar maturity index (I3M) in assessing legal adult age of 18 years in a French population. The sample was constituted of 431 orthopantomograms performed between January 2014 and August 2017 on patients aged between 14 and 22 years. The reproducibility and repeatability of the method were high. Age distribution gradually decreases as I3M increases in both sexes. 0.08 seemed to be the best I3M cutoff. For females, the sensitivity and specificity of the test were 74.51% and 88.23%, respectively. The sensitivity and specificity for males were 92.19% and 88.35%, respectively. The accuracies were 80.74% for female, 90.57% for male. Estimated post-test probabilities were 0.879 for female and 0.899 for male. To conclude, the specific cutoff value of I3M ˂ 0.08 may be a useful additional tool in discriminating adults and minors in French population.
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Code de l’action sociale et des familles - Article L111–2 [Internet]. [cited 2018 Mar 12]. Available from: https://www.legifrance.gouv.fr/affichCodeArticle.do?cidTexte=LEGITEXT000006074069&idArticle=LEGIARTI000006796413
European Parliament, Council of the European Union (2011) Directive 2011/95/EU of the European Parliament and the council of 13 December 2011 on standards for the qualification of third-country nationals or stateless persons as beneficiaries of international protection, for a uniform status for refugees or for persons eligible for subsidiary protection, and for the content of the protection granted. Off J Eur Union. Sect. L 337, 2011/95/EU p. 9–26
Ministère de l’Intérieur Demande d’asile au 11 juillet 2017: statistiques. In: http://www.immigration.interieur.gouv.fr/Info-ressources/Etudes-et-statistiques/Statistiques/Essentiel-de-l-immigration/Chiffres-clefs/Archives/Statistiques-publiees-en-juillet-2017. Accessed 17 Apr 2018
Ministère de l’Intérieur Chiffres clefs de l’immigration en France. In: http://www.immigration.interieur.gouv.fr/Info-ressources/Etudes-et-statistiques/Statistiques/Essentiel-de-l-immigration/Chiffres-clefs. Accessed 17 Apr 2018
Unaccompanied Minors | Canadian Council for Refugees [Internet]. [cited 2017 Dec 13]. Available from: http://ccrweb.ca/en/content/unaccompanied-minors
American Immigration Council (2015) A guide to children arriving at the border: Laws, Policies and Responses. https://www.americanimmigrationcouncil.org/research/guide-children-arriving-border-laws-policies-and-responses. Accessed 13 Nov 2017
United Nation High Commisionner for Refugees (2016) Global Report 2016. http://reporting.unhcr.org/sites/default/files/gr2016/pdf/Book_GR_2016_ENGLISH_complete.pdf
Schmeling A. Study Group on Forensic Age Diagnostics of the German Association of Forensic Medicine [Internet]. [cited 2018 Mar 12]. Available from: https://www.medizin.uni-muenster.de/en/rechtsmedizin/schmeling/agfad/about/home/
Schmeling A, Olze A, Reisinger W, Geserick G (2001) Age estimation of living people undergoing criminal proceedings. Lancet. 358:89–90
Schmeling A, Olze A, Reisinger W, Rösing FW, Geserick G (2003) Forensic age diagnostics of living individuals in criminal proceedings. Homo. 54:162–169
Schmeling A, Olze A, Reisinger W, Geserick G (2004) Forensic age diagnostics of living people undergoing criminal proceedings. Forensic Sci Int 144:243–245
Schmeling A, Reisinger W, Geserick G, Olze A (2006) Age estimation of unaccompanied minors. Part I. General considerations. Forensic Sci Int 159(Suppl 1):S61–S64
Schmeling A, Geserick G, Reisinger W, Olze A (2007) Age estimation. Forensic Sci Int 165:178–181
Schmeling A, Grundmann C, Fuhrmann A, Kaatsch H-J, 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 122:457–460
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 38:379–390
Demirjian A, Goldstein H, Tanner JM (1973) A new system of dental age assessment. Hum Biol 45:211–227
Thevissen PW, Kaur J, Willems G (2012) Human age estimation combining third molar and skeletal development. Int J Legal Med 126:285–292
Hjern A, Brendler-Lindqvist M, Norredam M (2012) Age assessment of young asylum seekers. Acta Paediatr 101:4–7
Demirjian A, Goldstein H (1976) New systems for dental maturity based on seven and four teeth. Ann Hum Biol 3:411–421
Willems G (2001) A review of the most commonly used dental age estimation techniques. J Forensic Odontostomatol 19:9–17
Cameriere R, Ferrante L, De Angelis D, Scarpino F, Galli F (2008) The comparison between measurement of open apices of third molars and Demirjian stages to test chronological age of over 18 year olds in living subjects. Int J Legal Med 122:493–497
Quispe Lizarbe RJ, Solís Adrianzén C, Quezada-Márquez MM, Galić I, Cameriere R (2017) Demirjian’s stages and Cameriere’s third molar maturity index to estimate legal adult age in Peruvian population. Leg Med (Tokyo) 25:59–65
Olze A, Schmeling A, Taniguchi M, Maeda H, van Niekerk P, Wernecke K-D, Geserick G (2004) Forensic age estimation in living subjects: the ethnic factor in wisdom tooth mineralization. Int J Legal Med 118:170–173
Cameriere R, Santoro V, Roca R, Lozito P, Introna F, Cingolani M et al (2014) Assessment of legal adult age of 18 by measurement of open apices of the third molars: study on the Albanian sample. Forensic Sci Int 245:205.e1–205.e5
De Luca S, Biagi R, Begnoni G, Farronato G, Cingolani M, Merelli V et al (2014) Accuracy of Cameriere’s cut-off value for third molar in assessing 18 years of age. Forensic Sci Int 235:102.e1–102.e6
Deitos AR, Costa C, Michel-Crosato E, Galić I, Cameriere R, Biazevic MGH (2015) Age estimation among Brazilians: younger or older than 18? J Forensic Legal Med 33:111–115
Galić I, Lauc T, Brkić H, Vodanović M, Galić E, Biazevic MGH et al (2015) Cameriere’s third molar maturity index in assessing age of majority. Forensic Sci Int 252:191.e1–191.e5
Dardouri AAK, Cameriere R, De Luca S, Vanin S (2016) Third molar maturity index by measurements of open apices in a Libyan sample of living subjects. Forensic Sci Int 267:230.e1–230.e6
Gulsahi A, De Luca S, Cehreli SB, Tirali RE, Cameriere R (2016) Accuracy of the third molar index for assessing the legal majority of 18 years in Turkish population. Forensic Sci Int 266:584.e1–584.e6
Cavrić J, Galić I, Vodanović M, Brkić H, Gregov J, Viva S, Rey L, Cameriere R (2016) Third molar maturity index (I3M) for assessing age of majority in a black African population in Botswana. Int J Legal Med 130:1109–1120
Zelic K, Galic I, Nedeljkovic N, Jakovljevic A, Milosevic O, Djuric M, Cameriere R (2016) Accuracy of Cameriere’s third molar maturity index in assessing legal adulthood on Serbian population. Forensic Sci Int 259:127–132
De Luca S, Aguilar L, Rivera M, Palacio LAV, Riccomi G, Bestetti F et al (2016) Accuracy of cut-off value by measurement of third molar index: study of a Colombian sample. Forensic Sci Int 261:160.e1–160.e5
Franklin D, Karkhanis S, Flavel A, Collini F, DeLuca S, Cameriere R (2016) Accuracy of a cut-off value based on the third molar index: Validation in an Australian population. Forensic Sci Int 266:575.e1–575.e6
Balla SB, Galic I, P K, Vanin S, De Luca S, Cameriere R (2017) Validation of third molar maturity index (I3M) for discrimination of juvenile/adult status in South Indian population. J Forensic Legal Med 49:2–7
AlQahtani S, Kawthar A, AlAraik A, AlShalan A (2017) Third molar cut-off value in assessing the legal age of 18 in Saudi population. Forensic Sci Int 272:64–67
Boyacıoğlu Doğru H, Gulsahi A, Burçak Çehreli S, Galić I, van der Stelt P, Cameriere R (2018) Age of majority assessment in Dutch individuals based on Cameriere’s third molar maturity index. Forensic Sci Int 282:231.e1–231.e6
Tafrount C, Galić I, Franchi A, Fanton L, Cameriere R (2019) Third molar maturity index for indicating the legal adult age in southeastern France. Forensic Sci Int 294:218.e1–218.e6
Chu G, Wang Y, Li M, Han M, Zhang Z, Chen T, Zhou H, Guo YC (2018) Third molar maturity index (I3M) for assessing age of majority in northern Chinese population. Int J Legal Med 132:1759–1768
Spinas E, De Luca S, Lampis L, Velandia Palacio LA, Cameriere R (2018) Is the third molar maturity index (I3M) useful for a genetic isolate population? Study of a Sardinian sample of children and young adults. Int J Legal Med 132:1787–1794
Różyło-Kalinowska I, Kalinowski P, Kozek M, Galić I, Cameriere R (2018) Validity of the third molar maturity index I3M for indicating the adult age in the Polish population. Forensic Sci Int 290:352.e1–352.e6
Antunovic M, Galic I, Zelic K, Nedeljkovic N, Lazic E, Djuric M, Cameriere R (2018) The third molars for indicating legal adult age in Montenegro. Legal Med 33:55–61
Angelakopoulos N, De Luca S, Velandia Palacio LA, Coccia E, Ferrante L, Cameriere R (2018) Third molar maturity index (I3M) for assessing age of majority: study of a black South African sample. Int J Legal Med 132:1457–1464
Cameriere R, Velandia Palacio LA, Pinares J, Bestetti F, Paba R, Coccia E et al (2018) Assessment of second (I2M) and third (I3M) molar indices for establishing 14 and 16 legal ages and validation of the Cameriere’s I3M cut-off for 18 years old in Chilean population. Forensic Sci Int 285:205.e1–205.e5
Kelmendi J, Cameriere R, Koçani F, Galić I, Mehmeti B, Vodanović M (2018) The third molar maturity index in indicating the legal adult age in Kosovar population. Int J Legal Med 132:1151–1159
R: The R Project for Statistical Computing [Internet]. [cited 2018 Apr 17]. Available from: https://www.r-project.org/
Bartko JJ (1966) The Intraclass correlation coefficient as a measure of reliability. Psychol Rep 19:3–11
Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20:37–46. https://doi.org/10.1177/001316446002000104
Crawford JR, Garthwaite PH, Betkowska K (2009) Bayes’ theorem and diagnostic tests in neuropsychology: interval estimates for post-test probabilities. Clin Neuropsychol 23:624–644
Ferrante L, Skrami E, Gesuita R, Cameriere R (2015) Bayesian calibration for forensic age estimation. Stat Med 34:1779–1790
Pyramides des âges − Bilan démographique 2017 | Insee [Internet]. [cited 2018 Apr 17]. Available from: https://www.insee.fr/fr/statistiques/1913143?sommaire=1912926
Santiago BM, Almeida L, Cavalcanti YW, et al (2018) Accuracy of the third molar maturity index in assessing the legal age of 18 years: a systematic review and meta-analysis. Int J Legal Med 132:1167–1184. https://doi.org/10.1007/s00414-017-1766-4
Walter SD (2002) Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med 21:1237–1256
Mazzilli LEN, Melani RFH, Lascala CA, Palacio LAV, Cameriere R (2018) Age estimation: Cameriere’s open apices methodology accuracy on a southeast Brazilian sample. J Forensic Legal Med 58:164–168
Rantanen AV (1967) The age of eruption of the third molar teeth: a clinical study based on Finnish university students. Acta odontol Scand 25(Suppl 48):1–86
Cunningham C, Scheuer L, Black S, Christie A (2000) Developmental Juvenile Osteology, 1st ed. Academic Press, Waltham
Moorrees CFA, Fanning EA, Edward E, Hunt JR (1963) Age variation of formation stages for ten permanent teeth. J Dent Res 42:1490–1502
Thevissen PW, Kvaal SI, Willems G (2012) Ethics in age estimation of unaccompanied minors. J Forensic Odontostomatol 30(Suppl 1):84–102
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This retrospective study performed on anonymized non pathological radiological data was conducted in accordance with the ethical standards of the country and the local committee.
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Ribier, L., Saint-Martin, P., Seignier, M. et al. Cameriere’s third molar maturity index in assessing age of majority: a study of a French sample. Int J Legal Med 134, 783–792 (2020). https://doi.org/10.1007/s00414-019-02123-z
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DOI: https://doi.org/10.1007/s00414-019-02123-z