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Age estimation from tooth-pulp area ratio: A preliminary study
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MEDLEG-289; No. of Pages 4 La revue de médecine légale (2019) xxx, xxx—xxx
Available online at
ScienceDirect www.sciencedirect.com
ORIGINAL ARTICLE
Age estimation from tooth-pulp area ratio: A preliminary study ˆ ge `a partir du rapport surface/pulpe : Estimation de l’a ´ liminaire une ´etude pre N. Kapoor a, P. Kothari b, R.K. Shukla c, S.D. Mishra d, A. Badiye a,* a
Department of Forensic Science, Govt. Institute of Forensic Science, R.T. Road, Civil Lines, Nagpur- 440001, Maharashtra, India b Aayush Dental Clinic and Orthodontic Care Centre, Dhantoli, Nagpur, Maharashtra, India c Biological and Life Sciences, School of Arts and Sciences, Ahmedabad University, Central Campus, Ahmedabad, Gujarat, India d Shri Vaishnav Vidyapeeth Vishwavidyalaya, Indore, Madhya Pradesh, India
KEYWORDS Forensic science; Odontology; Age estimation; Forensic dentistry; OPG; Tooth
Summary The teeth are considered as a reliable indicator of age and provide several parameters for age estimation. Age estimation from dental radiographs is a non-destructive and straightforward method to obtain information. This preliminary study aimed to establish a relationship between chronological age and the tooth/pulp area ratio in a central Indian population. The digital dental X-ray- OPGs of 46 randomly selected consenting subjects belonging to the age group 18 to 60 years were examined. The tooth area and pulp area of upper maxillary right permanent canine were calculated. A Graph was also plotted on the scattered points to get a linear trend line and equation of the relationship between chronological age and tooth/pulp area ratio. Statistical analysis shows a significant strong positive correlation (R2= 0.99) between age and tooth /pulp area ratio. Linear Regression equation was derived for estimation of age, i.e., y = 6.6554x - 22.578 (where y is the estimated age and x is the tooth-pulp area ratio). The estimated age was accurate up to 2 years of the actual age. The result of this preliminary study shows that the tooth/pulp area ratio of the canine may serve as a reliable tool for estimation of age. # 2019 Elsevier Masson SAS. All rights reserved.
* Corresponding author. E-mail address: [email protected] (A. Badiye). https://doi.org/10.1016/j.medleg.2019.11.003 1878-6529/# 2019 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
+ Models
MEDLEG-289; No. of Pages 4
2
N. Kapoor et al.
MOTS CLÉS Science médico-légale ; Odontologie ; Estimation de l’âge ; Médecine dentaire légale ; OPG ; Dent
Re ´sume ´ Les dents sont considérées comme un indicateur fiable de l’âge et fournissent plusieurs paramètres pour l’estimation de l’âge. L’estimation de l’âge à partir de radiographies dentaires est une méthode simple et non destructive pour obtenir des informations. Cette étude préliminaire visait à établir une relation entre l’âge chronologique et le rapport surface dent/ pulpe dans une population du centre de l’Inde. Les radiographies dentaires numériques (OPG) de 46 sujets consentants choisis au hasard appartenant au groupe d’âge des 18 à 60 ans ont été examinées. La région de la dent et de la pulpe de la canine permanente supérieure droite du maxillaire supérieur ont été calculées. Un graphique a également été tracé sur les points dispersés pour obtenir une ligne de tendance linéaire et une équation de la relation entre l’âge chronologique et 1 le rapport la région dent/pulpe. L’analyse statistique montre une corrélation positive forte significative (r carré 0,99) entre l’âge et l le rapport la région dent/pulpe. L’équation de régression linéaire a été calculée pour l’estimation de l’âge, c’est-à-dire, y = 6,6554x - 22,578 (où y est l’âge estimé et x est le rapport de la surface dent-pulpe). L’âge estimé était précis jusqu’à 2 ans de l’âge réel. Le résultat de cette étude préliminaire montre que le rapport région dent/pulpe de la canine peut constituer un outil fiable d’estimation de l’âge. # 2019 Elsevier Masson SAS. Tous droits réservés.
Introduction Estimation of age is one of the four most vital aspects in establishing the identity of a person [1]. It is vital in cases wherein questions are raised as to the age of living individuals or deceased. The study of the teeth and jaws as evidence for justice is known as Forensic Odontology or Forensic Dentistry [2]. The teeth are well-thought-of as reliable age indicators as they offer plenty of parameters for its estimation. It is possible to establish multi-factorial methods that may be of assistance in age estimation, ‘‘taking into consideration the secondary changes in teeth with advancing age like attrition (wear and tear), periodontal disease, secondary dentin deposition, root translucency, cementum apposition, root resorption, color changes, pulp changes and increase in root roughness, etc.’’[3,4]. The traditional methods of adult dental age estimation require tooth extraction and processing. Extracting normal healthy teeth, unless indicated, is neither ethical nor practical in living individuals. It may also not be permitted even in cases of deceased in light of diverse legal and cultural reasons. Also, tooth processing has the added disadvantage that it necessitates the destruction of dental evidentiary material. However, radiographic evaluation is devoid of all these demerits and may be considered as a more straightforward, safer, hassle-free, and non-destructive method [5—7]. Digitalization of radiographs and the use of image processing to get metric data has been recently gaining acceptance for the reason of them being relatively precise and accurate, and sidestep the bias inherent in observer subjectivity [8]. The estimation of age at the time of death is often an essential step in the identification of unidentified remains [9]. If the age bracket can be accurately determined, it will significantly narrow the pool of possible identities that will have to be compared in order to establish identification. The purpose of the present study was to develop a method for assessing the chronological age based on the relationship between age and measurement of the pulp/tooth area ratio
on single-rooted teeth, i.e., maxillary canine, using digital orthopantomogram (OPG).
Materials and methodology The study included the digital OPGs of 46 healthy adult individuals aged between 18—60 years. Informed consent was enrolled for the study per the Helsinki declaration. The OPGs with fully erupted right maxillary canine were included while those with any prosthesis, known/visible periodontal or periapical disease, severe attrition, pathological calcification in the pulp, rotation, or any pathological condition of the right maxillary canine were excluded from the study. All the radios were taken with the same radio device, by the same operator placing the patients in the same position. The digital OPG of various patients were loaded on an image processing software, i.e., Auto CAD 2010, and after appropriate magnification, various points were marked on the tooth surface and the pulp outline (Figs. 1 and 2). The tooth area and the pulp area were separately calculated and tabulated. Various statistical calculations were done on the obtained readings, including the tooth/pulp area ratio. Descriptive statistics, correlation, and regression equations were calculated. The results were statistically analyzed using the t-test, wherein a value of P < 0.05 was considered as significant.
Result and discussion The descriptive statistics are shown in Table 1. A linear regression equation was obtained to get the relation between chronological age and tooth/pulp area ratio. A Scatter plot graph was plotted to obtain the linear trendline with yaxis showing the chronological age (actual age) and the x-axis showing the tooth/pulp area ratio (Fig. 3). The linear regression equation was calculated as y = 6.6554x - 22.578, where y is the calculated age, and x is the tooth/pulp area ratio (as obtained from the OPG).
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
+ Models
Age estimation from tooth-pulp area ratio: A preliminary study
3
Figure 1
Orthopantomogram (OPG) showing the marked points of the tooth area of the right maxillary canine.
Figure 2
Orthopantomogram (OPG) showing the marked points of the pulp area of the right maxillary canine.
Table 1
n Mean Variance Std. Dev. Std. Err.
Descriptive statistics. X
Y’
Y
46 8.29 2.09 1.44 0.21
46 32.61 93.13 9.65 1.42
46 32.61 92.42 9.61 1.42
n: number; X: tooth-pulp area ratio; Y’: age of the individual; Y: estimated age using the derived regression equation.
The correlation coefficient R2 was found to be 0.99 showing a strong positive relationship between the tooth/pulp area ratio and the chronological age (Table 2). For the actual age and the calculated age using the derived regression formula,
Figure 3
the value of t is 0.16265. The value of P is .87152, which is not significant at P < 0.05. It shows that there is no significant difference between the chronological age and the estimated age using the derived linear regression equation. In the present study, the estimated age was modeled as a linear function of the chronological age. Studies have found out that the width of the pulp had a strong correlation with age [6,7,10]. The width of the pulp has been considered as a better indicator of the age in the previous studies conducted by Bosmans et al. [7], Cameriere et al. [8], Kvaal [10] and Solheim [11]. Dehghani et al. [12] used the pulp/tooth area ratio in an Iranian population; Juneja et al. [13] in Karnataka population; Jeevan et al. [14] in Indian population; by Zaher et al. in Egyptians [15]; by Babshet et al. [16] in Indian population; by Afify et al. [17] in Egyptian population and by Misirlioglu et al. [18] in Turkish population.
Graph showing age on the y-axis and Tooth/Pulp Area ratio on the x-axis.
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
+ Models
MEDLEG-289; No. of Pages 4
4
N. Kapoor et al. Table 2 Correlation coefficient (r and r2), slope and Y Intercept as per the graph.
X-Y’ X-Y *
*R
*R 2
Slope
Y Intercept
0.9962 0.9996
0.9924 0.9992
6.6554 —
—
22.578
Findings are significant at P < 0.05 and P < 0.01 levels
There was no significant difference between the chronological age and the estimated age using the derived linear regression equation, which was in accordance with the previous studies [6,7,12—18,4]. The canines emerged as number one choice owing to the reasons that they are regularly found in people with old age, and they are less likely to suffer dental attrition than their counterparts [19,20]. The need to derive population-specific regression equations have been emphasized by researchers [19]. Among the various techniques available, dental radiography is a convenient, simple, and much less expensive method that can be as practical in many circumstances. The destructive method may not be acceptable and feasible in many scenarios. The sample size is small, as this is a preliminary study. Also, the result cannot be used in a generalized sense. The sample size needs to be scaled up. Male-female specific and population-specific datasets and regression equations need to be drawn soon. It is also advisable to come up with regression equations for mixed/ non-homogenous populations.
Conclusion This study shows that the tooth/pulp area ratio of permanent canine can be reliably employed in estimating the chronological age of a person between the ages of 18 to 60 years. It is shown that there is a strong positive correlation between the chronological age and the tooth/pulp area ratio. Thus, this non-invasive and convenient method can be easily used for routine forensic works where the age of the person of interest is unknown. It would be beneficial in civil cases, criminal cases, as well as in claims of disputed age in age category sports, child labour and in cases of the marriage of a minor.
Disclosure of interest The authors declare that they have no competing interest.
Acknowledgments All the authors express heartfelt thanks to the participants of this study for their OPGs. NK & AB gratefully acknowledges the Director, Government Institute of Forensic Science, Nagpur, and Department of Higher Education, Government of Maharashtra, for their continuous encouragement and support.
References [1] Rai B, Krishan K, Kaur J, Anand S. Age estimation from mandible lateral cephalogram: a preliminary study. J Forensic Odontostomatol 2008;26:24—8.
[2] Barsley RE. Forensic and legal issues in oral diagnosis; Topics in oral diagnosis II. Dent Clin N Am 1993;37:133—56. [3] Chandler S. A study to determine the accuracy of Gustafson’s method of age estimation on adult teeth when applied to a sample of the population of the Western Cape. A mini-thesis submitted in partial fulfillment of the requirements for the degree of Magister Scientiae in the Department of Oral & Maxillofacial Pathology and Forensic Sciences, Faculty of Dentistry, University of the Western Cape; 2013. p. 1-63. [4] Singaraju S, Sharada P. Age estimation using pulp/tooth area ratio: a digital image analysis. J Forensic Dent Sci 2009;1:37—41. [5] Bblenkin MR. Forensic dentistry and its application in age estimation from the teeth using a modified Demirjian system. Available from: http://ses.library.usyd.edu.au/handle/2123/669. [6] Aschmeling, Reisinger W, Geserick G, Olze A. Age estimation of unaccompanied minors- Part- I. Forensic Sci Int 2006; 159:s61—4. [7] Bosmans N, Ann P, Aly M, Williams G. The application of Kvaal’s dental age calculation technique on panoramic dental radiographs. Forensic Sci Int 2005;153:208—12. [8] Cameriere R, Ferrante L, Cingolani M. Variations in pulp/tooth area ratio as an indicator of age: a preliminary study. J Forensic Sci 2004;49:317—9. [9] Burns KR, Maples WR. Estimation of age from individual adult teeth. J Forensic Sci 1975;7:343—6. [10] Kvaal SI, Kolltveit KM, Thomsen IO, Solheim T. Age estimation of adults from dental radiographs. Forensic Sci Int 1995;74: 175—185. [11] Solheim T. A new method for dental age estimation in adults. Forensic Sci Int 1993;59:137—47. [12] Dehghani M, Shadkam E, Ahrari F, Dehghani M. Age estimation by canines’ pulp/tooth ratio in an Iranian population using digital panoramic radiography. Forensic Sci Int 2018;285:44— 9. http://dx.doi.org/10.1016/j.forsciint.2018.01.016. [13] Juneja M, Devi YB, Rakesh N, Juneja S. Age estimation using pulp/tooth area ratio in maxillary canines-A digital image analysis. J Forensic Dent Sci 2014;6(3):160—5. http:// dx.doi.org/10.4103/0975-1475.137047. [14] Jeevan MB, Kale AD, Angadi PV, Hallikerimath S. Age estimation by pulp/tooth area ratio in canines: Cameriere’s method assessed in an Indian sample using radiovisiography. Forensic Sci Int 2011;204(1—3):. http://dx.doi.org/10.1016/j.forsciint.2010.08. 017 [209.e1-209.e5]. [15] Zaher JF, Fawzy IA, Habib SR, Ali MM. Age estimation from pulp/ tooth area ratio in maxillary incisors among Egyptians using dental radiographic images. J Forensic Leg Med 2011;18(2):62—5. http:// dx.doi.org/10.1016/j.jflm.2010.12.004. [16] Babshet M, Acharya AB, Naikmasur VG. Age estimation from pulp/tooth area ratio (PTR) in an Indian sample: a preliminary comparison of three mandibular teeth used alone and in combination. J Forensic Leg Med 2011;18(8):350—4. http:// dx.doi.org/10.1016/j.jflm.2011.07.003. [17] Afify MM, Zayet MK, Mahmoud NF, Ragab AR. Age estimation from pulp/tooth area ratio in three mandibular teeth by panoramic radiographs: study of an Egyptian sample. J Forensic Res 2014;5:231. http://dx.doi.org/10.4172/2157-7145.1000231. [18] Misirlioglu M, Nalcaci R, Adisen MZ, Yilmaz S, Yorubulut S. Age estimation using maxillary canine pulp/tooth area ratio, with an application of Kvaal’s methods on digital orthopantomographs in a Turkish sample. Aust J Forensic Sci 2013;46(1):27— 38. http://dx.doi.org/10.1080/00450618.2013.784357. [19] Babshet M, Acharya A, Naikmasur VG. Age estimation in Indians from pulp/tooth area ratio of mandibular canines. Forensic Sci Int 2010;197 [125.e1—125.e4]. [20] Cameriere R. Age Estimation project: Cameriere’s methods for age estimation. Macerata (Italia): Eum, Edizioni Università di Macerata; 2008.
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
MEDLEG-289; No. of Pages 4 La revue de médecine légale (2019) xxx, xxx—xxx
Available online at
ScienceDirect www.sciencedirect.com
ORIGINAL ARTICLE
Age estimation from tooth-pulp area ratio: A preliminary study ˆ ge `a partir du rapport surface/pulpe : Estimation de l’a ´ liminaire une ´etude pre N. Kapoor a, P. Kothari b, R.K. Shukla c, S.D. Mishra d, A. Badiye a,* a
Department of Forensic Science, Govt. Institute of Forensic Science, R.T. Road, Civil Lines, Nagpur- 440001, Maharashtra, India b Aayush Dental Clinic and Orthodontic Care Centre, Dhantoli, Nagpur, Maharashtra, India c Biological and Life Sciences, School of Arts and Sciences, Ahmedabad University, Central Campus, Ahmedabad, Gujarat, India d Shri Vaishnav Vidyapeeth Vishwavidyalaya, Indore, Madhya Pradesh, India
KEYWORDS Forensic science; Odontology; Age estimation; Forensic dentistry; OPG; Tooth
Summary The teeth are considered as a reliable indicator of age and provide several parameters for age estimation. Age estimation from dental radiographs is a non-destructive and straightforward method to obtain information. This preliminary study aimed to establish a relationship between chronological age and the tooth/pulp area ratio in a central Indian population. The digital dental X-ray- OPGs of 46 randomly selected consenting subjects belonging to the age group 18 to 60 years were examined. The tooth area and pulp area of upper maxillary right permanent canine were calculated. A Graph was also plotted on the scattered points to get a linear trend line and equation of the relationship between chronological age and tooth/pulp area ratio. Statistical analysis shows a significant strong positive correlation (R2= 0.99) between age and tooth /pulp area ratio. Linear Regression equation was derived for estimation of age, i.e., y = 6.6554x - 22.578 (where y is the estimated age and x is the tooth-pulp area ratio). The estimated age was accurate up to 2 years of the actual age. The result of this preliminary study shows that the tooth/pulp area ratio of the canine may serve as a reliable tool for estimation of age. # 2019 Elsevier Masson SAS. All rights reserved.
* Corresponding author. E-mail address: [email protected] (A. Badiye). https://doi.org/10.1016/j.medleg.2019.11.003 1878-6529/# 2019 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
+ Models
MEDLEG-289; No. of Pages 4
2
N. Kapoor et al.
MOTS CLÉS Science médico-légale ; Odontologie ; Estimation de l’âge ; Médecine dentaire légale ; OPG ; Dent
Re ´sume ´ Les dents sont considérées comme un indicateur fiable de l’âge et fournissent plusieurs paramètres pour l’estimation de l’âge. L’estimation de l’âge à partir de radiographies dentaires est une méthode simple et non destructive pour obtenir des informations. Cette étude préliminaire visait à établir une relation entre l’âge chronologique et le rapport surface dent/ pulpe dans une population du centre de l’Inde. Les radiographies dentaires numériques (OPG) de 46 sujets consentants choisis au hasard appartenant au groupe d’âge des 18 à 60 ans ont été examinées. La région de la dent et de la pulpe de la canine permanente supérieure droite du maxillaire supérieur ont été calculées. Un graphique a également été tracé sur les points dispersés pour obtenir une ligne de tendance linéaire et une équation de la relation entre l’âge chronologique et 1 le rapport la région dent/pulpe. L’analyse statistique montre une corrélation positive forte significative (r carré 0,99) entre l’âge et l le rapport la région dent/pulpe. L’équation de régression linéaire a été calculée pour l’estimation de l’âge, c’est-à-dire, y = 6,6554x - 22,578 (où y est l’âge estimé et x est le rapport de la surface dent-pulpe). L’âge estimé était précis jusqu’à 2 ans de l’âge réel. Le résultat de cette étude préliminaire montre que le rapport région dent/pulpe de la canine peut constituer un outil fiable d’estimation de l’âge. # 2019 Elsevier Masson SAS. Tous droits réservés.
Introduction Estimation of age is one of the four most vital aspects in establishing the identity of a person [1]. It is vital in cases wherein questions are raised as to the age of living individuals or deceased. The study of the teeth and jaws as evidence for justice is known as Forensic Odontology or Forensic Dentistry [2]. The teeth are well-thought-of as reliable age indicators as they offer plenty of parameters for its estimation. It is possible to establish multi-factorial methods that may be of assistance in age estimation, ‘‘taking into consideration the secondary changes in teeth with advancing age like attrition (wear and tear), periodontal disease, secondary dentin deposition, root translucency, cementum apposition, root resorption, color changes, pulp changes and increase in root roughness, etc.’’[3,4]. The traditional methods of adult dental age estimation require tooth extraction and processing. Extracting normal healthy teeth, unless indicated, is neither ethical nor practical in living individuals. It may also not be permitted even in cases of deceased in light of diverse legal and cultural reasons. Also, tooth processing has the added disadvantage that it necessitates the destruction of dental evidentiary material. However, radiographic evaluation is devoid of all these demerits and may be considered as a more straightforward, safer, hassle-free, and non-destructive method [5—7]. Digitalization of radiographs and the use of image processing to get metric data has been recently gaining acceptance for the reason of them being relatively precise and accurate, and sidestep the bias inherent in observer subjectivity [8]. The estimation of age at the time of death is often an essential step in the identification of unidentified remains [9]. If the age bracket can be accurately determined, it will significantly narrow the pool of possible identities that will have to be compared in order to establish identification. The purpose of the present study was to develop a method for assessing the chronological age based on the relationship between age and measurement of the pulp/tooth area ratio
on single-rooted teeth, i.e., maxillary canine, using digital orthopantomogram (OPG).
Materials and methodology The study included the digital OPGs of 46 healthy adult individuals aged between 18—60 years. Informed consent was enrolled for the study per the Helsinki declaration. The OPGs with fully erupted right maxillary canine were included while those with any prosthesis, known/visible periodontal or periapical disease, severe attrition, pathological calcification in the pulp, rotation, or any pathological condition of the right maxillary canine were excluded from the study. All the radios were taken with the same radio device, by the same operator placing the patients in the same position. The digital OPG of various patients were loaded on an image processing software, i.e., Auto CAD 2010, and after appropriate magnification, various points were marked on the tooth surface and the pulp outline (Figs. 1 and 2). The tooth area and the pulp area were separately calculated and tabulated. Various statistical calculations were done on the obtained readings, including the tooth/pulp area ratio. Descriptive statistics, correlation, and regression equations were calculated. The results were statistically analyzed using the t-test, wherein a value of P < 0.05 was considered as significant.
Result and discussion The descriptive statistics are shown in Table 1. A linear regression equation was obtained to get the relation between chronological age and tooth/pulp area ratio. A Scatter plot graph was plotted to obtain the linear trendline with yaxis showing the chronological age (actual age) and the x-axis showing the tooth/pulp area ratio (Fig. 3). The linear regression equation was calculated as y = 6.6554x - 22.578, where y is the calculated age, and x is the tooth/pulp area ratio (as obtained from the OPG).
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
+ Models
Age estimation from tooth-pulp area ratio: A preliminary study
3
Figure 1
Orthopantomogram (OPG) showing the marked points of the tooth area of the right maxillary canine.
Figure 2
Orthopantomogram (OPG) showing the marked points of the pulp area of the right maxillary canine.
Table 1
n Mean Variance Std. Dev. Std. Err.
Descriptive statistics. X
Y’
Y
46 8.29 2.09 1.44 0.21
46 32.61 93.13 9.65 1.42
46 32.61 92.42 9.61 1.42
n: number; X: tooth-pulp area ratio; Y’: age of the individual; Y: estimated age using the derived regression equation.
The correlation coefficient R2 was found to be 0.99 showing a strong positive relationship between the tooth/pulp area ratio and the chronological age (Table 2). For the actual age and the calculated age using the derived regression formula,
Figure 3
the value of t is 0.16265. The value of P is .87152, which is not significant at P < 0.05. It shows that there is no significant difference between the chronological age and the estimated age using the derived linear regression equation. In the present study, the estimated age was modeled as a linear function of the chronological age. Studies have found out that the width of the pulp had a strong correlation with age [6,7,10]. The width of the pulp has been considered as a better indicator of the age in the previous studies conducted by Bosmans et al. [7], Cameriere et al. [8], Kvaal [10] and Solheim [11]. Dehghani et al. [12] used the pulp/tooth area ratio in an Iranian population; Juneja et al. [13] in Karnataka population; Jeevan et al. [14] in Indian population; by Zaher et al. in Egyptians [15]; by Babshet et al. [16] in Indian population; by Afify et al. [17] in Egyptian population and by Misirlioglu et al. [18] in Turkish population.
Graph showing age on the y-axis and Tooth/Pulp Area ratio on the x-axis.
Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003
+ Models
MEDLEG-289; No. of Pages 4
4
N. Kapoor et al. Table 2 Correlation coefficient (r and r2), slope and Y Intercept as per the graph.
X-Y’ X-Y *
*R
*R 2
Slope
Y Intercept
0.9962 0.9996
0.9924 0.9992
6.6554 —
—
22.578
Findings are significant at P < 0.05 and P < 0.01 levels
There was no significant difference between the chronological age and the estimated age using the derived linear regression equation, which was in accordance with the previous studies [6,7,12—18,4]. The canines emerged as number one choice owing to the reasons that they are regularly found in people with old age, and they are less likely to suffer dental attrition than their counterparts [19,20]. The need to derive population-specific regression equations have been emphasized by researchers [19]. Among the various techniques available, dental radiography is a convenient, simple, and much less expensive method that can be as practical in many circumstances. The destructive method may not be acceptable and feasible in many scenarios. The sample size is small, as this is a preliminary study. Also, the result cannot be used in a generalized sense. The sample size needs to be scaled up. Male-female specific and population-specific datasets and regression equations need to be drawn soon. It is also advisable to come up with regression equations for mixed/ non-homogenous populations.
Conclusion This study shows that the tooth/pulp area ratio of permanent canine can be reliably employed in estimating the chronological age of a person between the ages of 18 to 60 years. It is shown that there is a strong positive correlation between the chronological age and the tooth/pulp area ratio. Thus, this non-invasive and convenient method can be easily used for routine forensic works where the age of the person of interest is unknown. It would be beneficial in civil cases, criminal cases, as well as in claims of disputed age in age category sports, child labour and in cases of the marriage of a minor.
Disclosure of interest The authors declare that they have no competing interest.
Acknowledgments All the authors express heartfelt thanks to the participants of this study for their OPGs. NK & AB gratefully acknowledges the Director, Government Institute of Forensic Science, Nagpur, and Department of Higher Education, Government of Maharashtra, for their continuous encouragement and support.
References [1] Rai B, Krishan K, Kaur J, Anand S. Age estimation from mandible lateral cephalogram: a preliminary study. J Forensic Odontostomatol 2008;26:24—8.
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Please cite this article in press as: Kapoor N, et al. Age estimation from tooth-pulp area ratio: A preliminary study. La revue de médecine légale (2019), https://doi.org/10.1016/j.medleg.2019.11.003