DENTAL AGE ESTIMATION OF THIRD MOLAR MATURITY INDEX THROUGH RADIOGRAPHIC EVALUATION: A RECENT ADVANCEMENT IN FORENSIC DENTISTRY
DOI:
https://doi.org/10.17720/vd7ze343Keywords:
Demirjian’s classification system, third molar development, dental age estimation, forensic dentistry, inter-observer agreement, dental maturityAbstract
Objective: This study aimed to evaluate the reliability of Demirjian’s classification system for determining whether individuals have reached the legal age of adulthood through the assessment of third molar development. The study also examined the level of agreement between two independent observers and identified gender-based differences in dental maturation.
Methodology: A cross-sectional study was conducted at the Department of Radiology and Oral and Maxillofacial Surgery, including 200 participants aged 5 to 35 years. Radiographic assessments of mandibular third molars were performed using orthopantomograms (OPGs) and classified according to Demirjian’s classification system (Stages A–H). Data were analyzed using SPSS version 25.0, with chi-square tests and Cohen’s Kappa used to assess inter-observer agreement and variability.
Results: The majority of participants were classified in the advanced stages of dental development, specifically Stage G and Stage H. Observer A classified 38.5% of subjects in Stage H, while Observer B classified 33%. A chi-square test revealed statistically significant differences between the observers (p = 0.000), but Cohen’s Kappa showed a high agreement (Kappa = 0.908). Females tended to reach advanced stages earlier than males, aligning with previous research on dental maturity.
Conclusion: Demirjian’s classification system is a reliable tool for age estimation in forensic dentistry, with strong inter-observer agreement. However, some variability in classification highlights the need for standardized training. The study supports using third molar development as a marker for determining adulthood, especially in forensic settings.
Downloads
References
Lawn BR, Lee JJ-W, Chai HJARoMR. Teeth: among nature's most durable biocomposites. 2010;40(1):55-75.
Milani OH, Atici SF, Allareddy V, Ramachandran V, Ansari R, Cetin AE, et al. A fully automated classification of third molar development stages using deep learning. 2024;14(1):13082.
Zigante M, Pavlic A, Morelato L, Vandevska-Radunovic V, Spalj SJIjoer, health p. Presence and maturation dynamics of mandibular third molars and their influence on late mandibular incisor crowding: a longitudinal study. 2021;18(19):10070.
Patil MA, Tivaskar MS, Luharia MA, Dhande R, Pathade AJJoPNR. Age Estimation Using Digital Radiography Of Epiphysial Union Of Shoulder Joint. 2022:23-9.
Nino-Sandoval TC, Doria-Martinez AM, Escobar RAV, Sánchez EL, Rojas IB, Álvarez LCV, et al. Efficacy of the methods of age determination using artificial intelligence in panoramic radiographs—a systematic review. 2024:1-38.
Sezer B, Çarıkçıoğlu B, Kargül BJAoOB. Dental age and tooth development in children with molar-incisor hypomineralization: A case-control study. 2022;134:105325.
Phulari RG, Dave EJJEJoFS. Evolution of dental age estimation methods in adults over the years from occlusal wear to more sophisticated recent techniques. 2021;11:1-14.
Siqueira R, Fernandes G, Di Gianfilippo R, Wang JCJSFOTAIA. Evolution, Development, and Physiology of the Dentoalveolar Bone Evolution of the Human Jawbone and Dentoalveolar Bone Dentoalveolar bone, as part of the jaw and skull bone, is an. 2023:299.
Caggiano M, Scelza G, Amato A, Orefice R, Belli S, Pagano S, et al. Estimating the 18-Year threshold with third molars radiographs in the Southern Italy population: Accuracy and reproducibility of demirjian method. 2022;19(16):10454.
Han M-q, Jia S-x, Wang C-X, Chu G, Chen T, Zhou H, et al. Accuracy of the Demirjian, Willems and Nolla methods for dental age estimation in a northern Chinese population. 2020;118:104875.
Angelakopoulos N, Chaitanya NC, Balla SBJAoLM. Effect of impaction on third molar development and age estimation–A study in a female black South African population. 2024:200477.
Bozorgnia Y, Mafinejad S, Dokohaki S, Razavi N, Shabani RJCOI. The effect of birth weight on tooth development by Demirjian’s method. 2024;28(7):411.
Bunyarit SS, Nambiar P, Naidu MK, Ying RPY, Asif MKJPDJ. Dental age estimation of Malay children and adolescents: Chaillet and Demirjian's data improved using artificial multilayer perceptron neural network. 2021;31(2):176-85.
Farrington DP, Piquero AR, Jennings WG, Jolliffe D. Offending from childhood to late middle age: Recent results from the Cambridge study in delinquent development: Springer Nature; 2023.
Plascencia H, Díaz M, Ordinola-Zapata R, Vázquez-Sánchez ME, Juárez-Broon N, Ruíz-Gutiérrez A, et al. Intra-and interobserver agreement during the assessment of the different stages of root development using 4 radiographic classifications. 2021;47(6):906-13.
Hedge C, Powell G, Sumner PJBrm. The reliability paradox: Why robust cognitive tasks do not produce reliable individual differences. 2018;50:1166-86.
Toledo JP, Yermani RR, Pinto AO, Conejeros RVJFSIR. Development of the third molar in Chileans: A radiographic study on chronological age. 2021;3:100177.
De Micco F, Martino F, Velandia Palacio LA, Cingolani M, Campobasso CPJM, Science, Law t. Third molar maturity index and legal age in different ethnic populations: Accuracy of Cameriere’s method. 2021;61(1_suppl):105-12.
Abdullah NA-W, Al-Aghbari BA, Mokbel AHAJUoAJoN, Sciences A. Radiographic evaluation of third molars development in relation to chronological age among children and youth in Aden city. 2020;24(1):251-61.
Kasper KA, Austin D, Kvanli AH, Rios TR, Senn DRJJofs. Reliability of third molar development for age estimation in a Texas Hispanic population: a comparison study. 2009;54(3):651-7.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
