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Dental Age Estimation Methods in Forensic Dentistry
TS.BSCKII CAO HỮU TIẾN
KHOA RĂNG HÀM MẶT
ĐẠI HỌC Y KHOA PHẠM NGỌC THẠCH
Introduction
Age estimation is important in forensic medicine and odontology
for identification of deceased victims and also for crimes and
accidents. Dental maturity has played an important role in
estimating the chronological age of individuals because of the low
variability of dental indicators
Various methods have been constructed and tested to estimate the
age of young individuals. Among them are the physical
examinations using anthropometric measurements, skeletal
maturation, dental age estimation, a combination of dental
development and anthropometric measurements and a
combination of skeletal and tooth eruption
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Introduction
Age estimation is an important step in constructing a
biological profile from human skeletal remains. The goal of
the forensic anthropologist is to assist medico legal officials
with identification by presenting a probable age range of the
deceased. In adults, this is typically done by examining
various skeletal traits which have been shown to degenerate
with age in a predictable manner.
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Dental Age Estimation Methods
Various methods are utilized for determination of age from
dentition. Age assessment methods may be classified as:
A. According to the state of development of the dentition:
Methods applied to the forming dentition
Methods for the adult fully formed dentition
B. According to the technique of investigation:
Clinical or visual
Radiographic
Histological
Physical and chemical analysis
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Dental Age Estimation Methods
Clinical or visual method: Visual observation of the stage
of eruption of the teeth and evidence of changes due to function
such as attrition can give an approximate estimate of age
Radiographic method: Radiography can provide the gross
stage of dental development of the dentition
Histological method: Histological methods require the
preparation of the tissues for detailed microscopic examination,
which can determine more accurately the stage of development
of the dentition. This technique is more appropriate for
postmortem situations. It is also significant in estimation of age of
early development of dentition
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Dental Age Estimation Methods
Physical and chemical analysis: The physical and chemical
analysis of dental hard tissues to determine alterations in ion
levels with age have been proposed. While these techniques,
as yet, are not of great value to the forensic odontologist,
future developments might provide an adjunctive means of
collecting evidence of value in the dental context
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Methods to Be Employed in Dental Age Estimation
Age estimation using the dentition can be grouped into 3
phases
1. Age estimation in prenatal, neonatal and early postnatal
child
2. Age estimation in children and adolescents
3. Age estimation in adults
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AGE ESTIMATION IN PRENATAL, NEONATAL AND EARLY
POSTNATAL CHILD
The primary tooth germ begins to form at seven weeks in
utero (IU), and the enamel formation of all deciduous teeth is
usually complete by the first year. Among the permanent
teeth, the first molar shows germ formation first at about 3.5-
4 months IU. Age estimation in this group of individuals can
be very accurate
Determination of age during the development of dentition can
be obtained with an accuracy of “plus or minus one year” and
during the early part of this period, microscopic examination
of teeth may provide the age with an accuracy of “plus or
minus few days”
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AGE ESTIMATION IN PRENATAL, NEONATAL AND EARLY
POSTNATAL CHILD
In case of prenatal, natal and neonatal periods the histological
methods are used to assess the stage of tooth development
during the premineralization period
Mineralization of deciduous dentition commences from two to
four months in utero. Some of the histological methods can
detect early mineralization 12 weeks before being detectable
in the radiographs
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AGE ESTIMATION IN PRENATAL, NEONATAL AND EARLY
POSTNATAL CHILD
Age Assessment from the Neonatal line:
The ‘neonatal line’ is considered as an indicator of birth.
Neonatal lines are present in both enamel and dentine of
deciduous teeth and permanent first molars which indicate the
development during the transitional period between
intrauterine and extra uterine environments. So the neonatal
line can be used to assess the amount of pre and post natal
enamel formation
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AGE ESTIMATION IN PRENATAL, NEONATAL AND EARLY
POSTNATAL CHILD
Age assessment based on thickness of enamel and
dentin from the neonatal line:
Miles (1958) determined age at death by measuring the
thickness; of enamel and dentine from the neonatal line and
divided it by appropriate daily rate of formation. To give the
age at time of death, the measured distance is divided by the
appropriate daily rate of formation taken from tables
published by Massler and Schour (1941)
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AGE ESTIMATION IN PRENATAL, NEONATAL AND EARLY
POSTNATAL CHILD
Age Assessment from the Incremental lines:
In the dentine incremental lines of Von Ebner and contour
lines of Owen are present. These lines are used to estimate
age of the neonate or fetus at death
Incremental lines of Retzius are caused by variation in the
rhythmic mineralization of enamel prisms. This rhythmic
pattern may be altered by various external factors such as
metabolic disturbances so that the lines may appear closer or
the rest periods may be prolonged. (Teivens A., Mornstad H,
Noren)
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AGE ESTIMATION OF CHILDREN AND ADOLESCENTS
Odontological age estimation of
children and adolescents
depends on the eruption of teeth
which can be either visual or
through radiographic methods.
Another event that may be used to
measure dental age in children and
adolescents is tooth calcification
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AGE ESTIMATION OF CHILDREN AND ADOLESCENTS
Age assessment by examination of the incremental pattern of
tooth formation
The accuracy of age determination during the early part of the dental
developmental period may be increased beyond that available from
comparison with standard charts, by the use of a method described by
Boyde (1963). The method involves a microscopic examination of the
incremental markings found in longitudinal ground sections of the teeth,
and relies on the identification of the neonatal line in teeth forming at
birth. Starting from the neonatal line, the numbers of small incremental
lines that cross the enamel prisms are counted up to the edge of the
forming enamel front. Making the assumption that each increment
represents one day’s addition of enamel, the number of increments is
taken to represent the number of days of age
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AGE ESTIMATION OF CHILDREN AND ADOLESCENTS
THIRD MOLARS IN AGE ESTIMATION
Although the third molar is a valuable indicator of age in the
age-group 16-23 years when all other teeth have completely
developed, its accuracy in age estimation is questionable due
to their great variation in genesis, position, morphology and
time of formation.
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
At the end of the period of tooth formation, usually about 20-
22 years of age, the methods employing the stages of tooth
development, as age landmarks are no longer applicable. It
becomes difficult to estimate age using teeth.
In the adult dentition age estimation techniques are limited to
the assessment of the progression of ‘wear’ and ‘age’ changes
in the teeth. So most of the methods used in adults use
various regressive changes of hard and soft tissues of the
teeth
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
GUSTAFSON’S METHOD (1950):
In 1950, Gosta Gustafson developed a method for age
estimation based on morphological and histological changes of
the teeth. This assessed regressive changes such as:
• Amount of occlusal attrition (A)
• Coronal secondary dentine deposition (S)
• Loss of periodontal attachment (P)
• Cementum apposition at the root apex(C)
• Root resorption at the apex (R)
• Root dentine translucency (T)
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
AGE ESTIMATION USING
ATTRITION:
Different types of scoring methods
are used by different researcher to
estimate age in adults using attrition
of the teeth but all of them agreed
that it is not a reliable index when it
is used alone as it is affected by
food habits, para functional habits,
missing opposing tooth etc.
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
MILE’S METHOD OF AGE ESTIMATION (1963):
When considering dentitions from unsophisticated societies an
approximate guide to the age of an individual may be
obtained by assessing the relative ‘wear’ of the three molar
teeth (Miles, 1963)
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
SCOTT SYSTEM FOR SCORING SURFACE WEAR IN MOLARS (1979):
Score 0: No information available (tooth not occluding, unerupted, ante
mortem or postmortem loss, etc.)
Score 1: Wear facets invisible or very small
Score 2: Wear facets large, but large cusps still present and surface
features (crenulations, non carious pits) very evident. It is possible to
have pinprick size dentine exposures or dots which should be ignored.
This is a quadrant with much enamel.
Score 3: Any cusp in this quadrant is rounded rather than being clearly
defined as in 2. The cusp is becoming obliterated but is not yet worn flat.
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
Score 4: Quadrant area is worn flat (horizontal) but there is no
dentine exposure other than a possible pinprick sized dot.
Score 5: Quadrant is flat, with dentine exposure one-fourth of
quadrant or less. (Be careful not to confuse noncarious pits with
dentine exposure.)
Score 6: Dentine exposure greater: more than one-fourth of
quadrant area is involved, but there is still much enamel present. If
the quadrant is visualized as having three sides, the dentine patch
is still surrounded on all three sides by a ring of enamel.
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
Score 7: Enamel is found on only two sides of the quadrant.
Score 8: Enamel on only one side (usually outer rim) but the
enamel is thick to medium on this edge.
Score 9: Enamel on only one side as in 8, but the enamel is very
thin—just a strip. Part of the edge may be worn through at one
or more places.
Score 10: No enamel on any part of the quadrant—dentine
exposure complete. Wear is extended below the cervicoenamel
junction into the root.
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
AGE ESTIMATION USING
DEPOSIT OF PERITUBULAR
DENTINE
Peritubular dentine is a mineralised
deposit formed centripetally in the
dentine tubules with advancing
age, so that the tubular diameter is
smaller in teeth from older persons
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
HUMAN DENTINAL STRUCTURE
AS AN INDICATOR OF AGE
Microscopically observed aging
changes are seen in the shrinkage of
pulp tissue, the presence of a
predentin layer or in the dense
dentinal tissue which can be observed
by scanning electron microscopy
(SEM). The origin of these changes
may usually be found in the structural
changes of dentine
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
AGE ESTIMATION FROM
INCREMENTAL LINES OF CEMENTUM
Cementum is continuously deposited at the
root end and seen as incremental lines.
Many researchers have used cemental
annulations to determine age of adults. At
present there is controversy using this
method because different studies show vast
discrepancies in the results. Saglam S, Atsu
K. Gokdemir and Kedici PS. (1998)
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ESTIMATION OF AGE IN ADULTS (ABOVE 20 YEARS)
AGE ESTIMATION IN DENTAL PULP DNA
BASED ON HUMAN TELOMERE
SHORTENING
Tomoya Takasaki et al (2003) conducted a study
for the estimation of age based on evidence found in
teeth has received considerable attention within the
field of forensic science. They determined the
terminal restriction fragment (TRF) length, as
telomere length, to estimate age. Using dental pulp
DNA they found that the average TRF length showed
a tendency to shortening with aging. Their findings
show that telomere shortening, based on dental pulp
DNA is a new and useful approach to estimate age
of the subject at the time of death.
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TRÂN TRỌNG CẢM ƠN!
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