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Legal age determined by a new threshold value of third molar maturity index in subjects with impacted mandibular third molars: An orthopantomographic study in south Indian adolescents

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Abstract

Third molars are one of the few biological markers available for age estimation in juveniles, especially for the estimation of the 18-year-age threshold. Literature has indicated that impaction has an influence on the development of third molars, which could possibly result in age misclassifications. The present study is intended to identify an alternative cut-off value of the third molar maturity index (I3M) in impacted mandibular third molars and also to evaluate its applicability in estimating the major (≥ 18 years)/minor (< 18 years) status. A total of 1330 digital orthopantomograms (OPGs) of 665 male and 665 female south Indian adolescents aged from 15 to 22 years were collected and assessed. Eight hundred forty OPGs (63.1%) represented test sample, and 490 OPGs (36.9%) represented validation sample. I3M was measured for the total sample. Logistic regression, receiver operating characteristic (ROC) curve analysis, and Youden’s index were used to test the performance of the method in the test sample. An alternative cut-off value of I3M < 0.17 was established for the highest value of the Youden’s index of 0.598 for both sexes. When tested in validation sample, it has resulted in sensitivity and specificity values of 0.91 (95% CI; 0.86–0.95) and 0.90 (95% CI; 0.78–0.91) in males and 0.86 (95% CI; 0.80–0.92) and 0.90 (95% CI; 0.83–0.95) in females. In conclusion, cut-off value of I3M < 0.17 could accurately discriminate adults from minors with impacted mandibular third molars. However, more work is needed to be done among a more diverse sample to confirm these findings.

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Authors and Affiliations

  1. Department of Forensic Odontology, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India

    Sudheer Babu Balla

  2. CUNY School of Public Health and Health Policy, New York City, NY, USA

    Nandha Krishna Nambi

  3. New York Medical College, Valhalla, NY, USA

    Saravanan Nambi

  4. Warangal, India

    Bhavana Chinnala

  5. Department of Oral Pathology, Mallareddy Dental College for Women, Hyderabad, India

    Manasa Bojji

  6. Department of Public Health Dentistry, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India

    Asa Priyanka Mula

  7. Hyderabad, India

    Subhashini Kondakamalli

  8. Rochester, USA

    Deepika Vankdoth

  9. School of Medicine and Dentistry and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia

    Santosh Kumar Tadakamadla

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  1. Sudheer Babu Balla
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  2. Nandha Krishna Nambi
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Correspondence to Sudheer Babu Balla.

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Radiographs were collected retrospectively from the archives.

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Balla, S.B., Nambi, N.K., Nambi, S. et al. Legal age determined by a new threshold value of third molar maturity index in subjects with impacted mandibular third molars: An orthopantomographic study in south Indian adolescents. Int J Legal Med 136, 251–259 (2022). https://doi.org/10.1007/s00414-021-02715-8

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