DR. RATNA .

SAMUDRAWAR
III YEAR PG
DEPARTMENT OF ORAL MEDICINE &
RADIOLOGY
RCDSR, BHILAI
Contents :
 Introduction
 Types of age – chronolgical age
height & weight
skeletal age
Dental age
 Skeletal age determination
 Dental age estimation
morphologic /visual examination
radiographic examination
histological examination
biochemical examination
 Age estimation using the dentition in three phase
Ageing in prenatal, neonatal & early post natal
Age estimation in children & adolscents
Age estimation in adults
 Factors useful in dental age estimation
 Conclusion
 References
Introduction :

 Age estimation is an important factor in biological

identification in many forensic fields, such as forensic
odontology, forensic medicine, forensic anthropology, and
forensic osteology.

 Age estimation assists in narrowing the search possibilities

for unidentified deceased or living individuals for legal
purposes.

 Additionally, age estimation helps determine the age of

perpetrators and their subsequent penalty for criminal
liability, particularly in young people
 According to The Criminal Code of the Kingdom of
Thailand, the critical ages for criminal liability in young
people are 10, 13, 15, 18, and 20 years old.

 Especially important is the age of 18 years, which indicates

adult status.

 Therefore, accuracy of age estimation methods for suspects

with unknown chronological age, who are involved in a
serious crime, is needed in the interest of justice.
 In 2000, an international and interdisciplinary study group on
forensic age estimation in Berlin, Germany recommended that
methods for age estimation in living people should consist of
a physical examination, radiographic examination of the hand
bones, and dental examination using panoramic radiographs.

 All of these methods have advantages and disadvantages, for

example a drawback of evaluating ossification of the hand
bones is that the development of these bones is completed at
about 18 years of age, which is earlier than tooth development
(third molar teeth) that continues until the early twenties.
 Furthermore, skeletal indicators can present disadvantages
due to variations in bone development, which can be
influenced by many factors such as nutritional and
environmental effects.

 Tooth development, on the other hand, is controlled more by

genetics rather than by environmental and nutritional factors.

 Additionally, teeth are the strongest structures in the human

body and are protected by the soft and hard tissues of the
face, this makes dental structures highly resistant to external
factors, such as the decomposition process and extreme
temperatures (up to 1100 °C).

 It is these factors that make teeth a superior biological

indicator for age estimation.
TYPES OF AGE:
 CHRONOLOGICAL AGE OR REAL AGE: It is the
measured by the calender, whether it be a period of IU
development or number of years after birth
 HEIGHT AND WEIGHT: Age of a person can be roughly
determined from the standard charts of height & weight,
but is least accurate & reliable
 SKELETAL AGE: Determined by the degree of
ossification / development of various bones known to occur
at particular time in average individual
 DENTAL AGE: Determined by studying development of
various teeth from the time of crypt is visible till the time
of root completion
SKELETAL AGE DETERMINATION
Age Changes in Craniofacial Bones
 Neonatal : Edentulous jaws, orbit size
relatively large
 I year : Fusion of midline symphysis of
mandible, Metopic sutures of two halves of
frontal bone fuse, Lat. Sphenoidal
synchondrose fuse.
 Fontanelles: Post & ant. Lateral fuse by 3
months.
 Ant. Fontanelle by 1 ½ yr (18 MONTHS).
 3 years : Condylar portion of occipital bone
fuses with squamous part of petrous temporal
bone.
 5 years :Condylar position of occipital bone
fuses with basoocciput.
 SPHENOOCCIPITAL SYNCHONDROSIS
[between basal part of occipital bone & adj. body of sphenoid] –
Major skull cartilage centre, fuses by 18-21 years – most useful
skeletal ageing factor.
 Neonatal skull : in this neonatal skull the lack of eruption of
the dentition places the age at less than six months after birth.
The height of the face is small compared with an older child,
whereas the relative size of the orbits is large. In most infants
the midline symphysis of the mandible is fused by about one
year after birth, and the lack of fusion in this specimen
indicates a much lower age. The metopic suture (arrow)
between the two halves of the frontal bone fuses at about one
year, but there are racial variations.
 The fontanelles : the fontanelles of the skull may be an
indication of age in that the anterior fontanelle is said to close
by about one and half years of age, the posterior and
anterolateral fontanelles by about one year. These dates are
somewhat imprecise for particular individuals.
 In this skull the anterolateral fontanelle is still open,
indicating that skull is less than three months after birth.
(1) The large anterior fontanelle between the frontal and parietal
bones closes at about 18 months of age. This structure may
be readily seen on radiographs which provide a non invasive
method of determining approximate age.
 Skull cartilages: bones developing in cartilage can be used to
age a skull. At the base of the skull the lateral sphenoidal
synchondroses (1) are said to fuse within the first year of life,
but the spheno-occipital synchondrosis(2), lying between the
basal part of the occipital bone and adjacent body of the
sphenoid, is a major growth centre until later life.
 In skeletonized material the cartilage itself is lost but
radiographs will show whether ossification has occurred.

 Growth at this site producing an anteroposterior lengthening

of the skull base is thought to be associated with the
downward and forward movement of the upper face.

 The eruption of the upper second molars occurs at around the

age of 12 or 13 years.

 The spheno occipital synchondrosis begins to fuse shortly

after this. It provides one of the most useful skeletal ageing
factors at this period of development.
  Skull sutures : once the end of the second decade has been reached
there is relatively little change in the skull, but in later life the
sutures between the cranial bones are obtained, usually from the
inside of the cranium.

 This process begins in the third and fourth decades of life and the
sutures varies markedly from individual to individual.

In this case the lambdoid suture, although

patent externally (arrow) was in the process
of obliteration on its inner aspect, suggesting
an age at death of 30 to 55 years.
SKULL SUTURES
From 25 years- Coronal, Sagittlal,
lambdoid sutures start closing
32 – 35yrs - Sagittal
40 yrs - Coronal
45yrs - Lambdoid
60yrs - Squamous portion of
temporal bone fuses with
parietal bone.
CRANIAL SUTURES
Open - < 30 yrs
Closing - 30-55 yrs
Closed - > 55yrs.
MANDIBULAR ANGLE
Infancy- 160 – 1750
1 – 3years - 150 - 1600
6 – 12years - 125 - 1400
15-17years - 120 - 1300
18-21years - 900-1250
30-40years - 950-1150
> 40 year - obtuse angle
 Evaluation of Cervical Vertebrae Maturity Index on Lateral
Cephalogram

 CVMI were evaluated by classifying C2, C3, and C4 into six

groups depending on their maturation patterns on the lateral
cephalogram using the classification of Hassel and Farman.
Hand wrist method:

 The most commonly used method is based on a single x-ray

of the left hand, fingers, and wrist .

 The bones in the x-ray are compared to the bones of a

standard atlas, usually "Greulich and Pyle”. sometimes called
as atlas, or inspectional, method.

 A more complex method also based on hand x-rays is the

"TW2"or the "TW3"method (TW = Tanner Whitehouse)
method.
 The atlas contains reference images of male and female
standards of the left wrist and hand from birth till 18 years for
females and 19 years for males.

 The method entails the matching of a hand – wrist X-ray of a

specific child as closely as possible with a series of standard
X-ray plates, which correspond to successive levels of
skeletal maturity at specific chronological ages.

 Eg : if the hand wrist X-ray of a 7 year old child matches the

standard plate of 8-year-old children, the child’s SA is 8
years. This method is simpler and faster than other radiograph
based methods.
OSSIFICATION CENTRES

From 2nd month IU to Primary Ossification centres

2nd year of extra uterine life appear in the skeleton

From 3rd yr to mid teens – Secondary Ossification centres appear

Next decade- Primary Ossification centre (Diaphyses) unite
with secondary ossification centres (epiphyses)
 MANDIBULAR CHARACTERISTICS USEFUL
IN AGEING
Infancy Adult Oldage

Body Shallow Thick & long Shallow

Ramus Forms an obtuse angle Forms an approximate Obtuse angle

with the body right angle

Mental Located near the lower Midway between upper Near alveolar margin
foramen margin of the body & lower margin

Condyle Occupies a level lower to Elongated and projects Neck is bent

the coronoid process above the coronoid backwards
DENTAL AGE ESTIMATION
 Important Subspeciality of forensic sciences, also has
application in living individuals. Literature describes several
techniques that address age estimation in adults.

 Edwin Saunders, a dentist, was the first to publish

information regarding dental implications in age assessment
by presenting a pamphlet entitled “Teeth A Test of Age” to the
English parliament in 1837.

Dental Age Estimation Methods

a. Morphologic / visual Examination
b. Radiographic Examination
c. Histological Examination and
d. Biochemical Examination
MORPHOLOGICAL METHODS:
 Morphological methods are based on assessment of teeth (ex-
vivo). Hence, these methods require extracted teeth for
microscopic preparation. However, these methods may not be
acceptable due to ethical, religious, cultural, or scientific
reasons.

 Gustafson (1950), Dalitz (1962), Bang and Ramm (1970),

Johanson (1971), Maples (1978), Solheim (1993) are few
morphological methods.
 Disadvantage: Cannot be used in living person.
BIOCHEMICAL METHODS
 The biochemical methods are based on the racemization of amino
acids.

 The racemization of amino acids is a reversible first-order reaction

and is relatively rapid in living tissues in which metabolism are slow.

 Aspartic acid has been reported to have the highest racemization rate
of all amino acids and to be stored during aging.

 In particular, L-aspartic acids are converted to D-aspartic acids and

thus the levels of D-aspartic acid in human enamel, dentine, and
cementum increase with age.

Some of the methods are:

 1. Helfman and Bada method (1975, 1976)4
 2. Ritz et al. method (1995)4
Helfman and Bada Method (1975, 1976)
 The authors reported studies that focused on the racemization
of amino acids and obtained a significant correlation between
age and ratio of D-/l-enantiomers in aspartic acid in enamel
and coronal dentin.

Ritz et al. Method (1995)

 Used the racemization method in dentinal biopsy specimens
in order to estimate the age of living individuals. This method
emerged from the need to identify the age of living
individuals without extracting teeth.
RADIOGRAPHIC METHODS
 Radiology plays an indispensable role in the human age
determination.

 Radiological images are utilized in the process of age estimation,

which is one of the essential tools in identification in forensic
science.

 Radiographic assessment of age is a simple, non-invasive and

reproducible method that can be employed both on living and
unknown dead.

 Various radiographic images that can be used in age

identification are intraoral periapical radiographs, lateral oblique
radiographs, cephalometric radiographs, panoramic radiographs,
digital imaging and advanced imaging technologies.
The radiological age determination is based on assessment of various features as follows:

• Jaw bones prenatally

• Appearance of tooth germs

• Earliest detectable trace of mineralization or beginning of mineralization

• Early mineralization in various deciduous teeth during intrauterine life

• Degree of crown completion

• Eruption of the crown into the oral cavity

• Degree of root completion of erupted or unerupted teeth.

• Degree of resorption of deciduous teeth

• Measurement of open apices in teeth

• Volume of pulp chamber and root canals/formation of physiological secondary dentine

• Tooth-to-pulp ratio

• Third molar development and topography

Age estimation using the dentition may be grouped into three
phases
a. Ageing in prenatal, neonatal & early Post natal
b. Age estimation in children and adolescents
c. Age estimation in adults
FACTORS USEFUL IN DENTAL AGE ESTIMATION:
1. Appearance of tooth germs
2. Earliest detectable trace of mineralization
3. Degree of Completion of unerupted teeth
4. Rate of formation of enamel and formation of the neonatal line
5. Clinical eruption
6. Degree of completion of the roots of erupted teeth
7. Degree of resorption of the roots of deciduous teeth
8. Attrition of the crown
9 . Formation of physiologic secondary dentine
10. Formation of cementum
11. Transparency of root dentine
12. Gingival recession
13. Root surface resorption
14. Discoloration and staining of the teeth
15. Influence of disease or malnutrition on tooth eruption
16. Influence of Sex on tooth eruption
17. Changes in the chemical composition of the teeth Dental &
skeletal ages correspond closely in the male, in the female, the
skeletal age is one year ahead of dental age.
Miscellaneous
Some odontologists advocate, the use of aspartic acid
racemization, claiming an accuracy of ±4 years.

Additional methods include the use of SEM-EDXA, a method

used to examine dentine in relation to age determination.

A recent study from the UK examined the use of root length, in

the determination of age in paediatric cases
AGE ESTIMATION IN PRENATAL, NEONATAL AND
EARLY POST NATAL CHILD

1. Primary tooth germ begins to form at seven weeks in

utero(IU) & enamel formation of all deciduous teeth complete
by first year.
2. Permanent tooth germ begins to form at 3.5 to 4 months IU
3. Prenatal age estimation uses histological techniques, enables
observation of tooth mineralization upto 12 weeks before it is
apparent on radiographs.
4. Neonatal line – indicator of birth, - slowing down of
enamel prism growth rate, thus creating an apparent line
of demarcation.
5. Amount of enamel & dentin before & after birth taken as
basis & enamel & dentin formed after birth divided by
daily rate of formation 16mm/day indicates approximate
age.
 Radiographically, the mineralization of deciduous incisors starts at the
16th week of intrauterine life.

 Before the mineralization of tooth germs starts, the tooth germs may be
visible as radiolucent areas on the radiograph; the subsequent
radiographs of the mandible will depict the deciduous teeth in various
stages of mineralization as per the pre-natal age of the fetus.

 One of the methods employed is:

Stages by Kraus and Jordan (1965)-

 They studied the early mineralization in various deciduous teeth as well
as the permanent first molar. The development is described in 10
stages, denoted by Roman numerals from I to X; the IXth stage
includes three stages and the Xth stage includes five stages.
B. AGE ESTIMATION IN CHILDREN AND
ADOLESCENTS
1. Tooth emergence or Eruption
2. Tooth calcification

1. ERUPTION:- Convenient clinical method

visual assessment of teeth & compared with radiographs &
charts.

Main drawback is emergence patterns are under the influence

of intraoral environment [infection, arch space, premature
tooth loss]
2. CALCIFICATION:- better alternative, since,
 Calcification can be observed for a period of several years
from radiographs

 not altered by local factors

 assess age at periods when no emergence takes place [2.5 –

6yrs & more than 12yrs]
Methods for estimating age in Children and adolescents
SCHOUR AND MASSLER’S METHOD:-

1. In 1941, Schour and Masseler studied the development of

deciduous and permanent teeth, describing 21 chronological
steps from 4 months to 21 years of age and published the
numerical development charts for them.

2. These charts do not have separate surveys for males and

females.

Ubelaker’s improved charts should be used since the original

schour & Massler chart had serious drawbacks
Nolla’s method (1960)

 Nolla evaluated the mineralization of permanent dentition in

10 stages. After every tooth is assigned a reading, a total is
made of the maxillary and mandibular teeth and then the total
is compared with the table given by Nolla.

 The advantages of this method are that it can be applied to an

individual with or without the third molar and that girls and
boys are dealt with separately.
Age estimation using open apices (Cameriere method)
 Various studies assessed the relationship between the age and
measurement of open apices in teeth.

 The seven left permanent mandibular teeth were valued. The

number of teeth with root development completed with apical
ends completely closed was calculated (N0).

 For the teeth with incomplete root development, that is, with
open apices, the distance between inner sides of the open
apex was measured (A).
 For the teeth with two roots, the sum of the distances between
inner sides of two open apices was evaluated.

 To nullify the magnification, the measurement of open apex

or apices (if multirooted) was divided by the tooth length (L)
for each tooth and these normalized measurements of seven
teeth were used for age estimation.
 The dental maturity was calculated as the sum of normalized
open apices (s) and the numbers of teeth with root
development complete (N0).

 The values are substituted in the following regression formula

for age estimation.

 Age = 8.971 + 0.375 g + 1.631 × 5 + 0.674 N0 – 1.034 s –

0.176 s N0

 Where g is a variable equal to 1 for boys and 0 for girls.

Age Estimation in Adults
 Clinically, the development of permanent dentition completes
with the eruption of the third molar at the age of 17-21 years,
after which the radiographic age estimation becomes difficult.

 The two methods commonly followed are the assessment of

the volume of teeth and the development of the third molar.
1. Volume assessment of teeth
a. Pulp-to-tooth ratio method by Kvaal
b. Coronal pulp cavity index

2. Development of third molar

a. Harris and Nortje method
b. Van Heerden system
. THIRD MOLARS IN AGE ESTIMATION:-
All four third molars are calcified, the chances of the
individual being 18yrs old is 96.3% in males & 95.1% in
females.

Van Harden developed five stage system measuring mesial root

of developing mand 3rd molar.

Stage 1:- Crown complete, 16.8 – 16.9yrs

Radiographic evidence of root formation
Stage 2:- Root length >1/3 <1/2 17.5 years
Stage 3:- Root length >2/3 17.8 – 17.9 yrs
but not complete
Stage 4:- Root fully formed18.4 – 18.5yrs
with open apex
Stage 5:- Apex closed18.9 – 19.2yrs
RADIOGRAPHIC METHOD OF KVAAL AND
ASSOCIATES
Developed a method that used Pulp size measurement of Six
teeth (Max CI & LI, 2nd PM, Mand CI, LI, canine & 1st PM)
on periapical radiographs.
Pulp - Root length (P)
Pulp - tooth length (R)
Tooth - Root length(T)
Pulp - root width at CEJ (A)
Pulp - root width at mid root level (C)
Pulp - root width at midpoint between level C & A (B),
Mean value of width ratios B and C (W)
Mean value of length ratios P and R (L)
Mean values of all ratios excluding T (M)
Regression formula,
Age = 129.8 – 316.4 (M) – 66.8 (W-L)
DEMIRJIAN’S METHOD:-

 In 1973, Demirjian introduced a method (DemI973) which

estimated chronological age based on developments of seven
teeth from the left side of the mandible.

 This method was similar to that of Tanner, Whitehouse, and

Healy, who estimated chronological age based on the maturity
of hands and wrists.

 Demirjian, Goldstein, and Tanner used the stages have usually

been marked by recognizable tooth shapes, from the beginning
of calcification through to final mature form. Useful stages
must be easily recognizable, and such that a tooth always
passes through the same stages in every individual
 Since the stages are indicators of maturity and not of the size,
they cannot be defined by any absolute length measurements.

 In it the final scores for each tooth, previously constrained

each to be 100, are allowed to vary so that only their sum (or
average) over all the teeth is 100.

 This makes allowance for the different ages at which different

teeth maturity scores for girls and boys are given.
Assigning the ratings:

1. The mandibular permanent teeth are rated in the following

order: 2nd molar, 1st molar, 2nd bicuspid, 1st bicuspid,
canine, lateral incisor, central incisor.

2. All teeth are rated on a scale A-H. The rating is assigned by

following carefully the written criteria for each stage and by
comparing the tooth with the diagrams and X-ray pictures
given for comparison. For each stage, there are one, two or
three written criteria marked a, b, c.
 If only one criterion is given, this must be met for the stage to
be taken as reached; if two criteria are given, then it is
sufficient if the first one of them is met for the stage to be
recorded as reached; if three criteria are given, the first two of
them must be met for the stage to be considered reached.

 At each stage, in addition to the criteria for that stage, the

criteria for the previous stage must be satisfied.

 In borderline cases, the earlier stage is always assigned.

3. There are no absolute measurements to be taken. A pair of
dividers is sufficient to compare the relative length
(crown/root). To determine apex closure stages, no
magnifying glass is necessary. The ratings should be made
with the naked eye.

4. The crown height is defined as being the maximum distance

between the highest tip of the cusps and the cementoenamel
junction. When the buccal and lingual cusps are not at the
same level, the midpoint between them is considered as the
highest point.
Dental Formation Stages
 If there is no sign of calcification, the rating 0 is given: The crypt
formation is not taken into consideration.

Stage Description
 In both uniradicular and multiradicular teeth, a beginning of
calcification is seen at the superior level of the crypt in the form of
an inverted cone or cones. There is no fusion of these calcified
points.

 Fusion of the calcified points forms one or several cusps which

unite to give a regularly outlined occlusal surface.
C. a. Enamel formation is complete at the occlusal surface. Its
and convergence toward the cervical region is seen.

b. The beginning of a dentinal deposit is seen.

c. The outline of the pulp chamber has the outline of the pulp
chamber has a curved shape at the occlusal border.
D. a. The crown formation is completed down to the
cementoenamel junction.

b. The superior border of the pulp chamber in the uniradicular

teeth has a definite curved form, being concave toward the
cervical region. The projection of the pulp curved shape at the
occlusal border horns if present, gives an outline shaped like
an Umbrella top in molars the pulp chamber has a trapezoidal
form.

c. Beginning of root formation is seen in the form of a spicule.

E. Uniradicular teeth

a. The walls of the pulp chamber now form straight lines,

whose continuity is broken by the presence of the pulp horn,
which is larger than in previous stage the crown height.

b. The root length is less than the crown height.

• Molars:

a. Initial formation of the radicular bifurcation is seen in the

form of either a calcified point or a semi-lunar shape.

b. The root length is still less than crown height.

F. Uniradicular teeth

a. The walls of the pulp chamber now form a more or less

isosceles triangle. The apex ends in a funnel shape.

b. The root length is equal to or greater than the crown height.

• Molars:

a. The Calcified region of the bifurcation has developed further

down from its semi-lunar stage to give the roots a more
definite and distinct outline with funnel shaped endings.

b. The root length is equal to or greater than the crown.

G. The walls of the root canal are now parallel and, its apical end
is still partially open.

H. The apical end of the root canal is completely closed.

a. The periodontal membrane has a uniform width around the

root and the apex.
Using the Scoring System
1. Each tooth will have a rating (A-H), assessed by the procedure
described.
2. This is converted into a score using the table for boys or girls as
appropriate.
3. The scores for all seven teeth are added together to give the
maturity score.
4. The maturity score may be plotted on the centile charts (boys or
girls as appropriate) where the age of the child is known.
5. The maturity score may be converted directly into a dental age
either by reading off on the horizontal scale the age at which
the 50th centile attains the maturity score value, or by using
table which has been constructed by this means.
Advantages
 Demirjian and Goldstein’s method is simple, as it is an
orthopantomogram based method and it enables more reliable
standardization and has good reproducibility and intra-
examiner/inter-examiner reliability.
 One of the reasons for the widespread acceptance of this method is
that the maturity scoring system that it creates is universal in
application, although the conversion to dental age depends on the
population being considered.
 Furthermore, this conversion can be made with the use of relatively
small local samples and can reach an equivalent dental age by
comparison for different populations.
Limitations
1. Demirjian method use orthopantomograms which are difficult to
obtain in young children, due to both technical reasons, as well as
legal and ethical considerations.
2. Since simultaneous evaluation of seven left mandibular teeth are
required, cannot apply it in children with lacking teeth inborn or
acquired.
3. This method may not express, agenesis of teeth, distinctive
retardation of dental development (excluding third molars), and
systemic diseases and various developmental stages of the tooth.
4. The appreciation of developmental stage may become difficult as
the choice of the tooth developmental stage is quite subjective.
5. This method does not give maturity scores for stages 1-4 in case of
1st molar, central and lateral incisor; thus excluding the individuals
below the age of 4-4.5 years
Nutshell – demirjian’s system - made up of scoring system
- development of seven mandibular teeth was divided into
eight stages each [A to H].
- each tooth is assigned a maturity score that corresponds to
its developmental stage.
- maturity score for each tooth is added and a total maturity
score obtained
- Total maturity score is plotted on a chronologic ‘age
conversion table’ [Separate for both sexes]
Stage Characteristics
Stage Calcification of single occlusal points without fusion of different calcifications.
A
Stage Fusion of mineralization points; the contour of the occlusal surface is
B recognizable.
Stage Enamel formation has been completed at the occlusal surface, and dentin
C formation has commenced. The pulp chamber is curved, and no pulp horns are
visible.

Stage Crown formation has been completed to the level of the cementoenamel junction.
D Root formation has commenced. The pulp horns are beginning to differentiate, but
the walls of the pulp chamber remain curved.
Stage The root length remains shorter than the crown height. The walls of the pulp
E chamber are straight, and the pulp horns have become more differentiated than in
the previous stage.
In molars, the radicular bifurcation has commenced to calcify.
Stage The walls of the pulp chamber now form a triangle, and the root length is equal to
F or greater than the crown height. In molars, the bifurcation has developed
sufficiently to give the roots a distinct form.

Stage The walls of the root canal are now parallel, but the apical end is partially open. In
G molars, only the distal root is rated.

Stage The root apex is completely closed (distal root in molars). The periodontal
H membrane surrounding the root and apex is uniform in
width throughout.
 Considering differences in tooth development between males
and females, Chaillet and Demirjian provided separate
maturity scores for each sex (Tables 21.4 and 21.5).

 The score assigned for each of the eight teeth is added and a
total maturity score (S) obtained. The total is substituted in
regression formulae to derive age.

 The following formulae may be used when estimating age in

Indians:
Males: Age = 27.4351 − (0.0097 × S2) + (0.000089 × S3)
Females: Age = 23.7288 − (0.0088 × S2) + (0.000085 × S3)
Other Modifications of Demirjian’s Method

 In 1976, Demirjian developed three more methods.

 First (DemI976) was based on the same seven teeth; second

(DemI976PM,) on four teeth, specifically the first premolar
(PMI l, second premolar (PM2), first molar (M1), and second
molar (M2); and the third (Dem1976IN2) on four teeth,
specifically the second incisive (12), first premolar (PM1),
second premolar (PM2), and second molar (M2)
GUSTAFSON’S METHOD OF AGE ESTIMATION
In 1950, Gosta Gustafson developed age estimation
method based on morphological and histological changes
of the teeth.
1. Amount of occlusal Attrition (A)
2. Loss of periodontal attachment (P)
3. Coronal secondary dentine deposition (S)
4. Root resorption at the apex (R)
5. Dentine translucency (T)
6. Cementum apposition at the root apex (C)

For each regressive changes, 0-3 scores were assigned

0 - unchanged (from development completion stage)
1 - Minimal Change
2 - Moderate change
3 - Severe changes
The points awarded to each feature are added
(e.g. A3 + S2 + P2 + C1 + R2 + T1 =X)
↑ in total score (X) → ↑ in age
Age was estimated using the formula
Age = 11.43 + 4.56 X with an average error of 3.6yrs.

Maples and Rice Corrected the above formula

as Age = 13.45 + 4.26 X

According to Johanson
Instead of four grades (0-3), he proposed seven grades (0,
0.5, 1, 1.5, 2, 2.5 & 3). Using these grades
Age = 11.02 + (5.14A) + (2.3S) +(4.14P) + (3.71C) + (5.57R) +
(8.98T) was suggested
DENTINE TRANSLUCENCY
Bang & Ramm – first to use dentine translucency for age estimation.
Root dentine starts translucent during 3rd decade of life, begins at the
apex & advances coronally.
Solheim suggested translucency length (in mm) or area (mm2)
measured on intact or sectioned teeth.

Two equations were given

Age = B0 + B1 + B2 X2 for zones of translucency ≤ 9mm
Age = B0 + B1 X for zones of translucency >9mm
Where B0 is regression constant, B1 & B2 are regression coefficients, X
is the translucency length.

Disadvantages:-
1. Irregular junction of translucent & non translucent zones.
2. Under estimation of age in old age groups due to slowing down of
dentinal sclerosis, restricting further ↑ in translucency
AGE ESTIMATION FROM INCREMENTAL LINE OF
CEMENTUM
Kagerer & Grupe suggested age estimation from acellular
cementum incremental lines.
Mineralized unstained cross-sections of teeth [preferably
mand. CI & 3rd molars] are used.

Disadvantage:-
Necessity to extract and / or section the teeth
possible in the dead but not in living individuals.
OTHER METHODS
Age estimation from changes in tooth color
Martin–de las Heras & co workers proposed the use of
spectro radio metry for dentine color Measurements.
Dentinal colors white, cream & yellow – 12 – 37yrs
Dentinal colors dark yellow & brown – 55 – 64yrs.
Kvaal & Solheim suggested the use of dentine & cementum
fluorescence for age estimation
↑ deepening of tooth color - ↑ fluorescence intensity - ↑ in
age.
CONCLUSION
 In terms of legal representation, age estimation is one of the most
important steps for identification in forensic odontology when
predicting the age of a deceased or living person.

 Determination of dental age is done by reference to the ever-

growing human deciduous and permanent dentitions.

 The importance of age estimation includes an assessment of

minor/major status in individuals without legal documents,
Demirjian method, the widely used method with appropriate
modifications shall be a reliable method. .
Reference :
 A colour atlas of forensic dentistry – Whittaker and MacDonald
 Text book of forensic Odontology – KMK Masthan
 Shafer’s textbook of oral pathology - 6th edn
 Text book of forensic Odontology – Pramod K Dayal.
 Age estimation in forensic odontologyodontology maninder kaur
,world journal of pharmaceutical And medical research2016,2(5),
260-265.
 Age Estimation Methods In Forensic Odontology Phuwadon
Duangto Journal of Dentistry Indonesia 2016;23(3):74-80 .
 Age estimation: a dental approach shamim t, jpafmat, 2006; 6. Issn
0972-5687