Abstract
Objective
The aim of this study is to evaluate the accuracy of the methods from the past and present, such as Demirjian, Cameriere, and AlQahtani, as well as to determine the most reliable method for human age estimation under the request from the courts according to the effect size from each method in age estimation.
Design
Four hundred eighty-three orthopantomographic images were selected from 318 patients from Centro Hospitalar Universitário Lisboa Norte aged between 6 and 15 years old. Several measurements of widths and lengths and classification of tooth development stages were performed, according to each age estimation method. The listing of patients and orthopantomographic images were consulted through SECTRA®. All data was entered and analysed using SPSS version 28. Observations’ validity was verified through inter- and intraobserver validation.
Results
The correlation coefficients between age and age estimates by the three methods on both sides were close to 90%. Regarding the estimation error correlation coefficient, Demirjian and AlQahtani values were low, whereas Cameriere’s was significantly negative; i.e., underestimation increases as age increases. Between left and right, any significant difference in age estimation in AlQahtani and Cameriere methods was not observed, but there were great variability and large effect for the Demirjian method. Comparing females and males, the statistical analysis showed no significant differences and quite small effects in the precision of the estimates for any of the methods. Finally, although significant differences were detected when comparing estimated values and age, small effects were revealed except for the Demirjian method which attained a medium effect and, therefore, less consistency of estimation.
Conclusions
Since it was not possible to determine the most reliable method for age estimation, a combined application of different age estimation methodologies is recommended to be use in the courts with relevant statistical data such as effect size.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
De Donno A, Angrisani C, Mele F, Introna F, Santoro V (2021) Dental age estimation: Demirjian’s versus the other methods in different populations A literature review. Med, Sci Law 61(1_suppl):125–129. https://doi.org/10.1177/0025802420934253
Hostiuc S, Diaconescu I, Rusu MC, Negoi I (2021) Age estimation using the Cameriere methods of open apices: a meta-analysis. Healthcare 9(2):237. https://doi.org/10.3390/healthcare9020237
Minà G, Merelli V, Cattaneo C (2021) Age estimation in the living: a scoping review of population data for skeletal and dental methods. Forensic Sci Int 320:110689. https://doi.org/10.1016/j.forsciint.2021.110689
Pereira CP, Rodrigues A, Augusto D, Santos A, Salvado F, Santos R, Cameriere R (2021) Forensic age estimation using new models of mathematical regression formula constructed with molar indexes: dental age assessment. J Stomatol 74(2):95–100. https://doi.org/10.5114/jos.2021.106540
Cavrić J, Vodanović M, Marušić A, Galić I (2016) Time of mineralization of permanent teeth in children and adolescents in Gaborone Botswana. Ann Anat Anat Anz: Off Organ Anat Ges 203:24–32. https://doi.org/10.1016/j.aanat.2015.08.001
Pereira CP, Rodrigues A, Santos A, Salvado F, Santos R, Cameriere R (2021) Cut-off for the legal ages in the Portuguese population by third maturity index: measures of accuracy. Arch Oral Biol 125:105089. https://doi.org/10.1016/j.archoralbio.2021.105089
Augusto D, Pereira CP, Rodrigues A, Cameriere R, Salvado F, Santos R (2021) Dental age assessment by I2M and I3M: Portuguese legal age thresholds of 12 and 14 year old. Acta stomatol Croat 55(1):46–56. https://doi.org/10.15644/asc55/1/6
Karaday B, Afşin H, Ozaslan A, Karaday Ş (2014) Development of dental charts according to tooth development and eruption for Turkish children and young adults. Imaging Sci Dent 44(2):103–113. https://doi.org/10.5624/isd.2014.44.2.103
Demirjian A, Goldstein H, Tanner JM (1973) A new system of dental age assessment. Hum Biol 45(2):211–227
Cameriere R, De Angelis D, Ferrante L, Scarpino F, Cingolani M (2007) Age estimation in children by measurement of open apices in teeth: a European formula. Int J Legal Med 121(6):449–453. https://doi.org/10.1007/s00414-007-0179-1
Moorees CFA, Fanning EA, Hunt EE (1963) Age variation of formation stages for permanent teeth. J Dent Res 42(6):1490–1502
AlQahtani SJ, Hector MP, Liversidge HM (2010) Brief Communication: The London atlas of human tooth development and eruption. Am J Phys Anthropol 142(3):481–490. https://doi.org/10.1002/ajpa.21258
da Sousa AM, Jacometti V, AlQahtani S, da Silva RHA (2020) Age estimation of Brazilian individuals using the London Atlas. Arch Oral Biol 113:104705. https://doi.org/10.1016/j.archoralbio.2020.104705
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
Schmeling A, Kaatsch H-J, Marré B, Reisinger W, Riepert T, Ritz-Timme S, Rösing FW, Rötzscher K, Geserick G (2001) Empfehlungen für die Altersdiagnostik bei Lebenden im Strafverfahren. Rechtsmedizin 11:1–3
Sectra (2020) Sectra user’s guide version 21.2.12. https://sectra.com/
Pereira CP, Belo C, Sardinha J, Santos R, Salvado F, Cameriere R (2022) Quantitative and qualitative approaches for dental age assessment in sub adult Portuguese population: European regression formula and Demirjian stages. Acta Stomatol Croat 56(3):288–298. https://doi.org/10.15644/asc56/3/7
Latić-Dautović M, Nakaš E, Jelešković A, Cavrić J, Galić I (2017) Cameriere’s European formula for age estimation: a study on the children in Bosnia and Herzegovina. South Eur J Orthod Dentofac Res 4(2):26–30. https://doi.org/10.5937/sejodr4-15528
Yan J, Lou X, Xie L, Yu D, Shen G, Wang Y (2013) Assessment of dental age of children aged 3.5 to 16.9 years using Demirjian’s method: a meta-analysis based on 26 studies. PloS one 8(12):84672. https://doi.org/10.1371/journal.pone.0084672
Cohen J (1988) Statiscal power analysis for the behavioral sciences. Routledge Academic, New York, NY
Wolf TG, Briseño-Marroquín B, Callaway A, Patyna M, Müller VT, Willershausen I, Ehlers V, Willershausen B (2016) Dental age assessment in 6- to 14-year old German children: comparison of Cameriere and Demirjian methods. BMC Oral Health 16(1):120. https://doi.org/10.1186/s12903-016-0315-8
Nair VV, Thomas S, Thomas J, Salim SF, Thomas D, Thomas T (2018) Comparison of Cameriere’s and Demirjian’s methods of age estimation among children in Kerala: a pilot study. Clin Pract 8(1):991. https://doi.org/10.4081/cp.2018.991
Melo M, Ata-Ali J (2017) Accuracy of the estimation of dental age in comparison with chronological age in a Spanish sample of 2641 living subjects using the Demirjian and Nolla methods. Forensic Sci Int 270:276.e1-276.e7. https://doi.org/10.1016/j.forsciint.2016.10.001
Altman DG, Bland M (1995) Absence of evidence is not evidence of absence. BMJ 311:485. https://doi.org/10.1136/bmj.311.7003.485
Wasserstein RL, Lazar NA (2016) The ASA’s statement on p-values: context, process and purpose. Am Stat 70:129–33. https://doi.org/10.1080/00031305.2016.1154108
ADA (2020) Human age assessment by dental analysis. American Dental Association Technical Report No. 1077
Acknowledgements
The authors would like to thank the Director of the Stomatology Department of Hospital Universitário de Santa Maria, Diana Augusto, Adriana Resende, and Ana Rodrigues (researchers of the group) and Francisco Salvado, for all the help when concretizing this study.
Funding
This work was supported by Centro de Estatística e Aplicações da Universidade de Lisboa, CEAUL, FCT—Fundação para a Ciência e a Tecnologia, Grant Project reference UIDB/00006/2020.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval
Ethical approval for the study was obtained from the Ethics Committee of the Faculty of Dental Medicine and of the Faculty of Medicine, University of Lisbon.
Conflict of interest
The authors declare no conflict of interest.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Pereira, C.P., Santos, R., Nushi, V. et al. Dental age assessment: scoring systems and models from the past until the present—how is it presented in the court?. Int J Legal Med 137, 1497–1504 (2023). https://doi.org/10.1007/s00414-023-03011-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00414-023-03011-3