Age estimation is a key component in forensic analysis, be it in legal proceedings or archeological research. Current methods in forensic odontology are based on manual measurements of a wide array ...of morphometric parameters, typically from dental x-ray images, and occasionally from material remains. While those parameters follow a set progression during human development, thereby allowing current methods to precisely estimate the age of juveniles, estimation for adults and seniors proves to be more difficult. In this study, we explore the applicability of deep learning to the problem of chronological age estimation. We determine the best convolutional neural network model derived from state-of-the-art architectures, we determine the best performing model parameters using pretrained general-purpose vision model parameters as the starting point, and we perform ablation experiments to highlight which anatomical regions of the dental system contribute the most to the estimation. The proposed approach attains the lowest estimation error in literature for adult and senior subjects, which we verify on one of the largest datasets of panoramic dental x-ray images in literature. The dataset consists of 4035 panoramic dental x-ray images of male and female subjects with ages between 19 and 90 years. This study also evaluates the feasibility of the proposed model for age estimations of individual teeth, achieving an estimation error competitive with current methods while being fully automated. The estimation error is verified on our dataset of 76416 individual tooth images, which is the largest dataset to date in forensic odontology literature. Unlike current methods, dental alterations, decay, illnesses, or missing teeth do not pose a problem to the proposed model. With a median estimation error of 2.95 years for panoramic dental x-ray images and 4.68 years for individual teeth, and by deriving the model from state-of-the-art architectures, verifying those results on the largest dataset in forensic odontology literature and demonstrating the importance of different anatomical regions of the dental system for estimation, this study sets the baseline for future research of automated chronological age estimation in forensic odontology.
•Age estimation of adults is a hard problem in forensic odontology.•Only manual measurement methods are currently used in practice.•This deep learning approach eclipses expert performance in a fraction of the time.•The interpretability analysis gives new insight into anatomical changes due to age.•The method is verified on the largest dataset in literature.
•A third molar maturity index (I3M) was used for indicating the legal adult age of 18 years in southeastern France.•Logistic regression showed that gender does not contribute to the model while I3M ...does.•Receiver operating curve analysis showed that I3M<0.08 discriminate the best adults from minors in southeastern France.•I3M may be useful method for indicating legal adult age of majority.
The estimation of age in living subjects is today a significant issue because of the increase in the situations in which it arises and its legal consequences. In line with the Study Group on Forensic Age Diagnostics of the German Association of Legal Medicine’s recommendations, it is based on the concomitant use of physical examination and methods for estimating bone age and dental age. Given the variations between the populations, the use of the latter requires their validation on all the ethnic groups on which they can be used. This aim of this study was to access the interest of the Cameriere’s third molar maturity index (I3M) to indicate if an individual had reached the age of 18 in a sample of individuals from southeastern France. The studied sample consisted of OPTs 339 (184 females and 155 males) subjects aged between 14 and 22 years old. A logistic regression analysis with the adult age and minor age as dichotomous dependent variable and gender and I3M as predictor variables showed that gender was not statistically significant in discriminating adults and minors. The receiver operating curve (ROC) analysis showed the best discrimination performance of the specific cut-off value of I3M<0.08 in discriminating adults from minors. The proportion of accurate classification was 0.897 and 0.916 for females and males, respectively. The specificity (Sp) and sensitivity (Se) results for females were 0.962 and 0.813, respectively. Sp and Se for males were 0.953 and 0.871, respectively. The Bayes post-test probability was 0.961 and 0.955 in females and males respectively. Obtained results showed that a cut-off value of I3M<0.08 may be an additional tool for indicating adult age in the tested population.
The aim of this cross-sectional study was to compare the accuracy of the Cameriere European formula (Cameriere), adopted Haavikko method from 1974 (Haavikko), and revisited Demirjian method by ...Willems (Willems) for age estimation on orthopantomograms (OPGs) of Bosnian–Herzegovian (BH) children age groups 6–13 years. The accuracy was determined as difference between estimated dental age (DA) and chronological age (CA) and the absolute accuracy (absolute difference) was assessed by analyzing OPGs of 591 girls and 498 boys. The Cameriere method overestimated the mean age by 0.09 year for girls and underestimated by −0.02 year for boys. The Haavikko method underestimated the mean age by −0.29 year for girls and −0.09 year for boys. The Willems method overestimated the mean age by 0.24 year in girls and by 0.42 year in boys. The absolute accuracies were 0.53 year for girls and 0.55 year for boys for Cameriere method; for Haavikko method, 0.59 year for girls and 0.62 year for boys; and for Willems method 0.69 year for girls and 0.67 year for boys. In conclusion, Cameriere method is the most accurate for estimating the age of BH children age groups 6–13 years using OPGs, following adopted Haavikko method and Willems method.
This study aimed to test radiographic projections of the posterior and anterior sides of the C4 vertebral body for age estimation in a cross-sectional sample of Turkish children and adolescents from ...the Baskent University Faculty of Dentistry. A sample of 232 x-rays from individuals aged between 5 and 15 years (101 boys and 131 girls) was analysed to investigate the correlation of age and changes in the projection ratio of the anterior and posterior sides of the body of the fourth cervical vertebra (Vba) in lateral cephalograms. The Normal Bayesian Calibration (NBC) model for age estimation was used to assess the relationship between Vba and age. The intra-observer repeatability and inter-observer agreement were 0.95 and 0.94, respectively. Age distribution gradually increased as Vba increased up to 14 years in both sexes. The difference between chronological and estimated ages did not increase with the increase in age. Calibration distributions of the dataset by the evaluation of Vba suggested mean absolute errors (MAEs) of 0.879 years and 0.906 years (mean interquartile ranges (MIQRs) 1.290 and 1.435 years)) in boys and girls, respectively. The biases of the estimates (
β
ERR
) were 0.013 and 0.027 for boys and girls, respectively. In conclusion, the NBC method on Vba variable appears to be suitable for age estimation in Turkish children and adolescents.
Highlights • Third molar maturity index ( I3M ) provide information about development of third molars. • Sensitivity and specificity of the 0.08 value for I3M to discriminate adults from minor are ...very good. • I3M could be used to discriminate adults from minors.
Abstract To evaluate applicability of Demirjian and Willems methods for calculating dental age of children in the Former Yugoslav Republic of Macedonia we analyzed panoramic radiographs of 966 ...children (485 female and 481 male, aged 6–13 years) treated at the University and Community Dental Clinics in Skopje using four Demirjian methods and a Willems method for determining dental ages. Intra-rater and inter-rater agreement of mineralization stages were 0.86 and 0.82, respectively. All methods significantly overestimated dental age when compared to the chronological age ( p < 0.001). In males, the lowest overestimation was shown using Willems method (0.52 ± 0.87 years), followed by Demirjian methods from 1976 using PM1 , PM2 , M1 , M2 teeth (0.69 ± 0.92 years) and using I2 , PM1 , PM2 , M2 teeth (0.80 ± 0.98 years). The greatest overestimation were shown using Demirjian methods using 7 teeth from 1976 (0.92 ± 0.99 years) and method from 1973 (1.06 ± 1.07 years). In females, the lowest overestimation was shown using Willems method (0.33 ± 0.83 years) than the Demirjian method using PM1 , PM2 , M1 , M2 teeth (1.00 ± 1.01 years), following methods from 1976 using 7 teeth (1.03 ± 1.01 years) and I2 , PM1 , PM2 , M2 teeth (1.12 ± 0.96 years). The greatest overestimation was for method from 1973 using 7 teeth (1.17 ± 0.98 years). Willems method was the most accurate while Demirjian's methods for dental age calculation are not suitable on children from the Former Yugoslav Republic of Macedonia.
This study aimed to assess the application of Cameriere's third molar maturity index (I
) to select an individual of 18years or older (adult) from younger than 18years (minor) in a sample of Polish ...individuals. The final sample of 982 panoramic images aged between 15 to 24years was analyzed. The specific cut-off value of I
<0.08 was analyzed. The specificity (Sp) and sensitivity (Se) for males were 91.2% and 86.2% respectively. The Sp and Se for females were 93% and 82.6% respectively. The probabilities of correctly classified individuals were 87.6% and 85.3%, and Bayes post-test probability was 96.3% and 97% in males and females respectively. Further analysis indicated the alternative cut-off value of I
<0.07, which improved the specificity, 95.3%, and 94.7%, and worsen correct classification, 86.5%, and 84.4%, in males and females, respectively. Our results showed that the specific cut-off point of I
<0.08 may be a useful tool for discriminating adults from minors in Poland.
Background/Aims
With the growing popularity of water polo across the world, there has been rising awareness of the risks for orofacial injures in water polo. The aim of this study was to evaluate ...knowledge and attitudes of water polo coaches regarding dental trauma, dental emergency procedures and awareness about prevention of such injuries.
Materials and Methods
A specific questionnaire comprising 25 questions regarding knowledge, experiences, and behaviors following dental trauma was distributed to 62 water polo coaches during the license renewal seminar held by the Croatian Water Polo Federation, in February 2018 in Split, Croatia. Chi‐square with Yates correction when necessary, and Fisher's exact tests were used in statistical analysis, and the results were considered statistically significant when P < .05.
Results
There were 51 water polo coaches who participated in this study. Their ages ranged from 19 to 60 years. Most of the coaches (90.2%) have seen a dental injury in their players during their coaching careers. Concerning the procedure with handling an avulsed tooth, there were 68.6% coaches who would maintain the avulsed tooth in a handkerchief or gauze along with four coaches (7.8%) who would rinse the avulsed tooth under water and wrap it in a handkerchief or gauze afterward. Only one participant (2%) would maintain the avulsed tooth in saline solution before its replantation. None of the coaches would use milk for maintaining the avulsed tooth. Only seven coaches (13.7%) have previously had education about sports‐related dental injuries, dental emergency procedures, and prevention of such injuries.
Conclusions
The results of this study demonstrated poor level of knowledge of water polo coaches about dental injuries and dental emergency procedures. Their knowledge and attitudes could be improved by educational programs on dental injuries and dental emergency procedures, as well as sports‐related dental injuries management.
Aim
This study aimed to evaluate the accuracy and precision of the Cameriere European formula, Demirjian, Haavikko, and Willems methods for estimating dental age in a sample of children with ...permanent dentition in Croatia.
Material and methods
The study consisted of a sample of 1576 panoramic radiographs; a sub-sample of 84 OPGs, in which all first seven mandibular teeth were maturated, was excluded from the study. A final sample of 1492 (704 males and 788 females) aged 6.0 to 13.9 years was evaluated. Seven mandibular teeth from the left side of the mandible were analyzed, and dental age (DA) was determined by the Cameriere European formula, Demirjian method from 1976, Haavikko, and Willems methods and compared to chronological age (CA). In addition, the mean age difference (DA-CA), the mean absolute error (MAE) between dental and chronological age, the percentage of the individuals of dental age within ± 0.25 to ± 2 years of chronological age, and intra-observer and inter-observer statistics were calculated.
Results
The Cameriere European formula estimated the best dental age compared to the chronological age; the mean underestimation was − 0.4 years for both sexes, Haavikko underestimated by − 0.17 years, while Demirjian and Willems overestimated by 1.02 years and 0.48 years, respectively. The most significant difference showed the Demirjian method in 11-year-old and 12-year-old females. The MAE were 0.50 years, 1.01 years, 0.61 years, and 0.78 years in males and 0.51 years, 1.18 years, 0.61 years, and 0.70 years in females for the Cameriere European formula, Haavikko, Willems, and Demirjian methods, respectively. Furthermore, the Cameriere European formula showed the highest proportions of individuals with DA within ± 0.5 year difference of the CA, 61.5% in males and 59.6% in females. In addition, the Cameriere method showed the best intra-observer and inter-observer agreements.
Conclusions
Although the Demirjian method was used previously in Croatian children for legal, medical, and clinical purposes, the Cameriere European formula, Haavikko, and Willems were more accurate in the tested sample. According to our findings, the Cameriere European formula showed the best accuracy and precision in dental age assessment in Croatian children following Haavikko, and we recommend it as the method of the first choice in forensic and clinical analyses.
Identification of living undocumented individuals highlights the need for accurate, precise, and reproducible age estimation methods, especially in those cases involving minors. However, when their ...country of origin is unknown, or it can be only roughly estimated, it is extremely difficult to apply assessment policies, procedures, and practices that are accurate and child-sensitive. The main aim of this research is to optimize the correct classification of adults and minors by establishing new cut-off values for four different continents (Africa, America, Asia, and Europe). For this purpose, a vast sample of 10,701 orthopantomographs (OPTs) from four continents was evaluated. For determination and subsequent validation of the new third molar maturity index (
I
3M
) cut-off values by world regions, a cross-validation by holdout method was used and contingency tables (confusion matrices) were generated. The lower third molar maturity indexes, from both left and right side (
I
3M
L
and
I
3M
R
) and the combination of both sides (
I
3M
L
_
I
3M
R
) were calculated. The new cut-off values, that aim to differentiate between a minor and an adult, with more than 74.00% accuracy for all populations were as follows (
I
3M
L
;
I
3M
R
;
I
3M
L
_
I
3M
R
, respectively): Africa = (0.10; 0.10; 0.10), America = (0.10; 0.09; 0.09), Asia = (0.15; 0.17; 0.14), and Europe = (0.09; 0.09; 0.09). The higher sensitivity (Se) was detected for the
I
3M
L
for male African people (91%) and the higher specificity (Sp) of all the parameters (
I
3M
L
;
I
3M
R
;
I
3M
L
_
I
3M
R
) for Europeans both male and female (> 91%). The original cut-off value (0.08) is still useful, especially in discriminating individuals younger than 18 years old which is the goal of the forensic methods used for justice.
