Skip to main content
Log in

A new model of classification of third molars development and its correlation with chronological age in a Brazilian subpopulation

  • Original Article
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

The present study correlated the mineralization of third molars to chronological age using a modified classification based on Demirjian’s stages in a Brazilian subpopulation and compared with the original classification. A total of 1082 patients with age ranging from 6 to 26 years were included in the sample, with at least one third molar on panoramic radiographs. The third molars were classified according to the original Demirjian classification (8 stages) and a new model based on the Demirjian method, where the original stages were grouped into four stages: AB—enamel mineralization; CD—crown dentin mineralization; EFG—root formation; and H—complete development. Statistical analyses were performed by Kruskal-Wallis/Dunn tests (α = 0.05) and the multinomial logistic regression model. Data were analyzed according to percentiles for the probability of an individual being over 18 years old. The mean ages of the stages in both classifications did not present a significant difference between superior and inferior arches (p < 0.05). The differences in mean ages between all the stages of mineralization were statistically significant (p < 0.001) only for the 4-stage classification. Males attained root formation and complete formation earlier than females (p < 0.05) in the 4-stage classification. The modified classification system showed dependence between chronological age and mineralization stages of third molars, simplifying the age estimation process. At stage H, females present a 95.7% chance of being over 18, while for males, this probability is 89.6%. This modified classification system simplifies the dental age estimation process based on third molars and can be used as a reference for future studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Karadayi B, Kaya A, Kolusayin MO et al (2012) Radiological age estimation: based on third molar mineralization and eruption in Turkish children and young adults. Int J Legal Med 126:933–942. https://doi.org/10.1007/s00414-012-0773-8

    Article  PubMed  Google Scholar 

  2. Panchbhai A (2011) Dental radiographic indicators, a key to age estimation. Dentomaxillofac Radiol 40:199–212. https://doi.org/10.1259/dmfr/19478385

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Maggio A, Flavel A, Hart R, Franklin D (2016) Skeletal age estimation in a contemporary Western Australian population using the Tanner–Whitehouse method. Forensic Sci Int 263:e1–e8. https://doi.org/10.1016/j.forsciint.2016.03.042

    Article  PubMed  Google Scholar 

  4. Lefèvre T, Chariot P, Chauvin P (2016) Multivariate methods for the analysis of complex and big data in forensic sciences. Application to age estimation in living persons. Forensic Sci Int 266:581.e1–581.e9. https://doi.org/10.1016/j.forsciint.2016.05.014

    Article  Google Scholar 

  5. Esenlik E, Atak A, Altun C (2014) Evaluation of dental maturation in children according to sagittal jaw relationship. Eur J Dent 8:38–43. https://doi.org/10.4103/1305-7456.126238

    Article  PubMed  PubMed Central  Google Scholar 

  6. Birchler FA, Kiliaridis S, Combescure C, Vazquez L (2015) Dental age assessment on panoramic radiographs in a Swiss population: a validation study of two prediction models. Dentomaxillofac Radiol 45:20150137. https://doi.org/10.1259/dmfr.20150137

    Article  PubMed  PubMed Central  Google Scholar 

  7. Schmeling A, Geserick G, Reisinger W, Olze A (2007) Age estimation. Forensic Sci Int 165:178–181. https://doi.org/10.1016/j.forsciint.2006.05.016

    Article  CAS  PubMed  Google Scholar 

  8. Jurca A, Lazar L, Pacurar M et al (2014) Dental age assessment using Demirjian’s method – a radiographic study. Eur Sci J 10:1857–7881

    Google Scholar 

  9. De Angelis D, Gibelli D, Merelli V et al (2014) Application of age estimation methods based on teeth eruption: how easy is Olze method to use? Int J Legal Med 128:841–844. https://doi.org/10.1007/s00414-014-1006-0

    Article  PubMed  Google Scholar 

  10. Widek T, Genet P, Merkens H, Boldt J, Petrovic A, Vallis J, Scheurer E (2019) Dental age estimation: the chronology of mineralization and eruption of male third molars with 3T MRI. Forensic Sci Int 297:228–235. https://doi.org/10.1016/j.forsciint.2019.02.019

    Article  PubMed  Google Scholar 

  11. Manjunatha BS, Soni N (2014) Estimation of age from development and eruption of teeth. J Forensic Dent Sci 6:73–76. https://doi.org/10.4103/0975-1475.132526

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Zandi M, Shokri A, Malekzadeh H, Amini P, Shafiey P (2015) Evaluation of third molar development and its relation to chronological age: a panoramic radiographic study. Oral Maxillofac Surg 19:183–189. https://doi.org/10.1007/s10006-014-0475-0

    Article  PubMed  Google Scholar 

  13. Santiago BM, Almeida L, Cavalcanti YW, Magno MB, Maia LC (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

    Article  PubMed  Google Scholar 

  14. Haglund M, Mörnstad H (2019) 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. https://doi.org/10.1007/s00414-018-1842-4

    Article  PubMed  Google Scholar 

  15. Olze A, Bilang D, Schmidt S, Wernecke KD, Geserick G, Schmeling A (2005) Validation of common classification systems for assessing the mineralization of third molars. Int J Legal Med 119:22–26. https://doi.org/10.1007/s00414-004-0489-5

    Article  PubMed  Google Scholar 

  16. de Araújo AMM, dos Anjos Pontual ML, de França KP et al (2010) Association between mineralization of third molars and chronological age in a Brazilian sample. Rev Odonto Ciênc 25:391–394. https://doi.org/10.1590/S1980-65232010000400013

    Article  Google Scholar 

  17. Orhan K, Ozer L, Orhan AI, Dogan S, Paksoy CS (2007) Radiographic evaluation of third molar development in relation to chronological age among Turkish children and youth. Forensic Sci Int 165:46–51. https://doi.org/10.1016/j.forsciint.2006.02.046

    Article  CAS  PubMed  Google Scholar 

  18. Dhanjal KS, Bhardwaj MK, Liversidge HM (2006) Reproducibility of radiographic stage assessment of third molars. Forensic Sci Int 159:S74–S77. https://doi.org/10.1016/j.forsciint.2006.02.020

    Article  PubMed  Google Scholar 

  19. de Oliveira FT, Álvares Capelozza AL, Lauris JRP, de Bullen IRFR (2012) Mineralization of mandibular third molars can estimate chronological age-Brazilian indices. Forensic Sci Int 219:147–150. https://doi.org/10.1016/j.forsciint.2011.12.013

    Article  PubMed  Google Scholar 

  20. Soares CBRB, Figueiroa JN, Dantas RMX, Kurita LM, Pontual AA, Ramos-Perez FMM, Perez DEC, Pontual MLA (2015) Evaluation of third molar development in the estimation of chronological age. Forensic Sci Int 254:13–17. https://doi.org/10.1016/j.forsciint.2015.06.022

    Article  PubMed  Google Scholar 

  21. Demirjian A, Goldstein H, Tanner JM (1973) A new system of dental age assessment. Hum Biol 45:211–227

    CAS  PubMed  Google Scholar 

  22. Hayes RL, Mantel N (1958) Procedures for computing the mean age of eruption of human teeth. J Dent Res 37:938–947. https://doi.org/10.1177/00220345580370052401

    Article  CAS  PubMed  Google Scholar 

  23. Olze A, Schmeling A, Taniguchi M, Maeda H, van Niekerk P, Wernecke KD, Geserick G (2004) Forensic age estimation in living subjects: the ethnic factor in wisdom tooth mineralization. Int J Legal Med 118:170–173. https://doi.org/10.1007/s00414-004-0434-7

    Article  PubMed  Google Scholar 

  24. Nicodemo RA, Moraes LCMF (1974) Tabela cronológica da mineralização dos dentes permanentes entre brasileiros. Rev Fac Odontol São José Dos Campos 3:55–56

    CAS  PubMed  Google Scholar 

  25. Lopez TT, Arruda CP, Rocha M, Rosin ASAO, Michel-Crosato E, Biazevic MGH (2013) Estimating ages by third molars: stages of development in Brazilian young adults. J Forensic Legal Med 20:412–418. https://doi.org/10.1016/j.jflm.2012.12.001

    Article  Google Scholar 

  26. Mohammed RB, Koganti R, Kalyan SV, Tircouveluri S, Singh JRSE (2014) Digital radiographic evaluation of mandibular third molar for age estimation in young adults and adolescents of south Indian population using modified Demirjian’ s method. J Forensic Dent Sci 132:98–109

    Google Scholar 

  27. Harris EF (2007) Mineralization of the mandibular third molar: a study of American blacks and whites. Am J Phys Anthropol 132:98–109. https://doi.org/10.1002/ajpa.20490

    Article  PubMed  Google Scholar 

  28. Thevissen PW, Pittayapat P, Fieuws S, Willems G (2009) Estimating age of majority on third molars developmental stages in young adults from Thailand using a modified scoring technique. J Forensic Sci 54:428–432. https://doi.org/10.1111/j.1556-4029.2008.00961.x

    Article  PubMed  Google Scholar 

  29. Sisman Y, Uysal T, Yagmur F, Ramoglu SI (2007) Third-molar development in relation to chronologic age in Turkish children and young adults. Angle Orthod 77:1040–1045. https://doi.org/10.2319/101906-430.1

    Article  PubMed  Google Scholar 

  30. Zeng DL, Wu ZL, Cui MY (2010) Chronological age estimation of third molar mineralization of Han in southern China. Int J Legal Med 124:119–123. https://doi.org/10.1007/s00414-009-0379-y

    Article  PubMed  Google Scholar 

  31. Uys A, Bernitz H, Pretorius S, Steyn M (2018) Estimating age and the probability of being at least 18 years of age using third molars: a comparison between Black and White individuals living in South Africa. Int J Legal Med 132:1437–1446. https://doi.org/10.1007/s00414-018-1877-6

    Article  PubMed  Google Scholar 

  32. 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. https://doi.org/10.1016/j.legalmed.2018.05.006

    Article  PubMed  Google Scholar 

  33. Jung Y-H, Cho B-H (2014) Radiographic evaluation of third molar development in 6- to 24-year-olds. Imaging Sci Dent 44:185–191. https://doi.org/10.5624/isd.2014.44.3.185

    Article  PubMed  PubMed Central  Google Scholar 

  34. Roberts GJ, McDonald F, Andiappan M, Lucas VS (2015) Dental age estimation (DAE): data management for tooth development stages including the third molar. Appropriate censoring of stage H, the final stage of tooth development. J Forensic Legal Med 36:177–184. https://doi.org/10.1016/j.jflm.2015.08.013

    Article  Google Scholar 

  35. 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. https://doi.org/10.1016/j.jflm.2015.04.016

    Article  Google Scholar 

  36. Olze A, Pynn BR, Kraul V, Schulz R, Heinecke A, Pfeiffer H, Schmeling A (2010) Studies on the chronology of third molar mineralization in First Nations people of Canada. Int J Legal Med 124:433–437. https://doi.org/10.1007/s00414-010-0483-z

    Article  PubMed  Google Scholar 

  37. Rolseth V, Mosdøl A, Dahlberg PS, Ding Y, Bleka Ø, Skjerven-Martinsen M, Straumann GH, Delaveris GJM, Vist GE (2019) Age assessment by Demirjian’s development stages of the third molar: a systematic review. Eur Radiol 29:2311–2321. https://doi.org/10.1007/s00330-018-5761-z

    Article  PubMed  Google Scholar 

  38. 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 122:457–460. https://doi.org/10.1007/s00414-008-0254-2

    Article  CAS  PubMed  Google Scholar 

  39. Guo Y, Wang Y, Olze A, Schmidt S, Schulz R, Pfeiffer H, Chen T, Schmeling A (2020) Dental age estimation based on the radiographic visibility of the periodontal ligament in the lower third molars: application of a new stage classification. Int J Legal Med 134:369–374. https://doi.org/10.1007/s00414-019-02178-y

    Article  PubMed  Google Scholar 

  40. Balla SB, Ankisetti SA, Bushra A, Bolloju VB, Mir Mujahed A, Kanaparthi A, Buddhavarapu SS (2020) Preliminary analysis testing the accuracy of radiographic visibility of root pulp in the mandibular first molars as a maturity marker at age threshold of 18 years. Int J Legal Med 134:769–774. https://doi.org/10.1007/s00414-020-02257-5

    Article  PubMed  Google Scholar 

  41. Gok E, Fedakar R, Mustafa Kafa I (2020) Correction to: Usability of dental pulp visibility and tooth coronal index in digital panoramic radiography in age estimation in the forensic medicine. Int J Legal Med 134:1265–1265. https://doi.org/10.1007/s00414-019-02218-7

    Article  PubMed  Google Scholar 

  42. Ribier L, Saint-Martin P, Seignier M, Paré A, Brunereau L, Rérolle C (2020) Cameriere’s third molar maturity index in assessing age of majority: a study of a French sample. Int J Legal Med 134:783–792. https://doi.org/10.1007/s00414-019-02123-z

    Article  PubMed  Google Scholar 

  43. Pena SDJ, Bastos-Rodrigues L, Pimenta JR, Bydlowski SP (2009) DNA tests probe the genomic ancestry of Brazilians. Braz J Med Biol Res 42:870–876. https://doi.org/10.1590/S0100-879X2009005000026

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Hugo Gaêta-Araujo, Nicolly Oliveira-Santos, Eduarda Helena Leandro Nascimento, and Fernanda Nogueira-Reis. The first draft of the manuscript was written by Hugo Gaêta-Araujo, Nicolly Oliveira-Santos, Eduarda Helena Leandro Nascimento, and Fernanda Nogueira-Reis and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hugo Gaêta-Araujo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the ethics committee of Piracicaba Dental School (No. 89724318.2.0000.5418).

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Code availability

Not applicable.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaêta-Araujo, H., Oliveira-Santos, N., Nascimento, E.H.L. et al. A new model of classification of third molars development and its correlation with chronological age in a Brazilian subpopulation. Int J Legal Med 135, 639–648 (2021). https://doi.org/10.1007/s00414-020-02401-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-020-02401-1

Keywords

Navigation