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Accurate methods of age estimation are more essential than ever due to the rise in undocumented individuals without proper identification, often linked to illegal immigration and criminal activities. This absence of reliable records presents challenges within the legal systems, where age thresholds in the context of children's rights vary across countries. Age 14 has global significance, as established by the UN Convention on the Rights of the Child and the EU for administrative purposes. Accurate age estimation is crucial in medical decisions, reproductive health, and forensics. This study focuses on age estimation via dental radiographs, proposing a method for estimating the likelihood of having attained the age of 14. Orthopantomograms were analyzed from two samples, 191 Italian children (aged 5–15) and 822 Chilean subjects (aged 11–22), using dental maturity indices. These indices evaluated open tooth apices and complete root development. Statistical analysis confirmed the method's reliability in identifying individuals aged 14 or older, with sex-specific cut-offs. The proposed method particularly advocates an approach based on dental mineralization, which could surpass those relying on bone growth. The collaboration between medical experts, including pediatricians and diagnostic imaging specialists, is vital for standardized age estimation strategies. Ethical concerns regarding radiation exposure and accountability are recognized, although the method's low radiation doses are deemed acceptable. The proposed method will help health professionals to accurately predict whether or not the 14-year threshold has been reached, opening up new avenues of medico-legal interest and laying the foundations for a legal framework that would allow the pediatrician, when involved, to use a valid and recognized diagnostic approach. [ABSTRACT FROM AUTHOR]

Orbital and nasal parameters among modern humans show considerable variation, which affects facial shape, and these characteristics vary according to race, region, and period in evolution. The aim of the study was to ascertain whether there are sex differences in the orbital and/or nasal indexes and/or the single measurements used to calculate these in a Kosovar population. The following parameters were taken into consideration: orbital height (OH), orbital width (OW), nasal height (NH), and nasal width (NW). The ratios between orbital index/nasal index (RONI) were calculated. All measurements were obtained from a population sample comprising 408 individuals. The accuracy in sex prediction was 52.86% (CI95% = 45.05%–60.67%) for NW and 64.96% for NH (CI95% = 57.50%– 72.42%). The difference between male and female indexes was statistically significant (P < 0.05). The anthropometric study revealed that only NW and NH are configured as predictors of sexual dimorphism. It could be useful to increase the number of samples to test the discriminant function in other population groups. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic raised concerns about the potential for co-infection or over-infection with other respiratory infections, as they can complicate the diagnosis, treatment and prognosis of the disease. This is also a challenge for forensic pathologists, who may come across cases where the presence of co-infection or over-infection is suspected or confirmed, and it is important that they take this into account when determining the cause of death. The aim of this systematic review is to analyse the prevalence of each specific pathogen co-infecting or over-infecting patients with SARS-CoV-2 infection. In total, 575 studies were selected from the Scopus and Pub-Med online databases and 8 studies were included in a meta-analysis. Male gender, advanced age and nursing home care are risk factors associated with the development of co-infection, whereas age, tachypnoea, hypoxaemia and bacterial infection are predictors of mortality. Overall, however, having a SARS-CoV-2 infection does not represent a real risk for the development of co-infections/super-infections. [ABSTRACT FROM AUTHOR]

Featured Application: Roberto Cameriere and Ivan Galić equally contributed to this paper. This paper aims to propose a statistical model to assess pubertal growth spurt using the ratio of the anterior height projection to the posterior (Vba) of the fourth cervical vertebra body (C4) on cephalograms and to calculate the residual proportion of skeletal maturation and the time for the pubertal growth spurt to end for a given Vba. A sample of 538 cephalograms from healthy-living children aged between 5 and 15 years was analyzed. A segmented regression model was used to explain the different Vba stages relative to the pubertal growth spurt. In addition, the time to achieve skeletal maturation was evaluated for a given Vba between the beginning (Vba1) and the end (Vba2) of the pubertal growth spurt. A longitudinal sample of 25 males and 25 females was analyzed to validate the proposed method. The values of Vba corresponding to higher pubertal development rate ranged from Vba1 = 0.677 (95%CI, 0.644–0.711) to Vba2 = 0.966 (95%CI, 0.905–1.028) and from Vba1 = 0.669 (95%CI, 0.645–0.693) to Vba2 = 1.073 (95%CI, 1.044–1.101) in males and females, respectively. The validation process results showed that our model did not produce any incorrect forecasts. The proposed method estimates the beginning and the end of the pubertal growth spurt together with the residual proportion of skeletal maturation for a given Vba. [ABSTRACT FROM AUTHOR]

This article presents an effective model for estimating the age of subjects without identification documents, in accordance with Italian legislation covering unaccompanied minors, using instrumental methods recognized by the scientific community for age estimation. A decision-making tree has been developed, in which the first step is a physical examination. If secondary sexual characteristics are fully developed and there are no obvious signs of abnormal growth, dental X-rays are the next step. If the roots of the seven left mandibular teeth between the central incisor and the second molar are completely developed, the focus then moves to the third molar. If the index of the third molar (I3M) value is less than 0.08, or if third molars are not assessable, the following step is to study the clavicle which, if fully formed, indicates that the subject is an adult with 99.9% probability; otherwise, the probability is 96%. In all other cases (where the I3M is over 0.08), the probability that the subject has reached 18 years is less than 60%. The research, carried out initially on x-rays of the wrist, teeth and clavicle, highlighted the uselessness of the x-ray of the wrist for determining the age of majority, because in our sample, all subjects with incomplete maturity of hand/wrist bones were under 16 years of age; thus, OPT was necessary anyway. What we propose is a practical, easily feasible, fast, economical, and extremely reliable method, which can be used on Caucasian populations and beyond for multiple forensic purposes. [ABSTRACT FROM AUTHOR]

Hand-wrist X-rays are the most objective tools for forensic age estimation. The aim of this study is to compare the accuracy of skeletal age (SAg) versus chronological age (CAg) assessments using Bo/Ca and TW2 methods in a South African sample of 224 individuals, aged between 6 and 16 years, focusing on ancestry and biological sex. The differences between estimated SAg and CAg were considered the method performance indicators. Accuracy, sensitivity and specificity have been calculated based on the age limit of 13 years (yrs). Bo/Ca and TW2 correctly classified Europeans (Eu) and Africans (Af) (−0.08 and 0.18 yrs vs −0.07 and −0.20 yrs, respectively) as well as boys and girls (−0.19 and 0.19 yrs vs −0.03 and −0.21 yrs, respectively). The standard error (SE) was calculated for each method according to biological sex and ancestry in children younger than 13 yrs (SE range for Bo/Ca: ±0.123–0.179 and for TW2 ±0.095–0.140) and in subadults 13 yrs or older (SE range for Bo/Ca: ±0.143–0.157 and for TW2: ±0.092–0.183). Bo/Ca seems to be less influenced by ancestry and biological sex in respect to TW2. According to previous studies, both methods showed greater inaccuracy in subadults aged 13 yrs or older compared with younger. [ABSTRACT FROM AUTHOR]

The present study aimed to assess the performance of second (I2M) and third (I3M) molar maturity indices, the sum of both indices (I2M+3M), and the sum of the seven mandibular teeth indices (S) in terms of determining whether an individual is at least 12 or 15 years old. The panoramic radiographs of 763 individuals aged between 10–17 years were analysed. For the 12-year age threshold, I2M was found to be the highest specific indicator for both sexes. The optimal cut-off values for the I2M were determined to be 0.072 in females and 0.106 in males. The sensitivity, specificity, and area under the ROC curve (AUC) were 0.749, 0.978, and 0.925 in females, while they were 0.776, 0.953, and 0.925 in males, respectively. With regard to the 15-year age threshold, an optimal I2M cut-off value of 0.026 was established for females, as it showed the best discriminative ability. The sensitivity, specificity, and AUC were 0.893, 0.779, and 0.885, respectively. For males, an optimal cut-off value of 0.593 was obtained for I2M+3M with the highest specificity (0.900) and AUC (0.931) as well as a sensitivity of 0.857. In conclusion, the identified cut-off values may represent alternative methods in forensic age diagnostics. [ABSTRACT FROM AUTHOR]

This study aimed to validate the accuracy of five different formulas based on the Cameriere method for age estimation in Kenyan children. We analyzed panoramic radiographs of 350 Kenyan children (184 males and 166 females) aged between 6 and 13 years. The dental development of each child was estimated by the analysis of the first seven left permanent teeth in the left mandible. Dental age was calculated by the Italian, European, North German, Malaysian, and South African black formulas previously published in peer-review journals. The children's mean chronological age (CA) was 9.34 ± 2.02 years and 9.26 ± 2.01 years for males and females. In males, the South-African formula overestimated CA least, by 0.12 years, followed by the Italian formula by 0.22 years, the European formula by 0.37 years, the Malaysian formula by 0.48 years, and the North-German formula overestimated the most, by 0.57 years. In females, the South-African formula underestimated CA by − 0.12 years. The Italian overestimated by 0.12 years, followed by the North-German formula by 0.29 years, the European formula by 0.31 years, and the Malaysian formula by 0.40 years. The Italian formula provided the best accuracy in the absolute difference within ± 1 year, by 75.72% and 75%, following the North-German formula by 66.47% and 70.27% for males and females, respectively. Therefore, the findings suggest that the Italian formula best estimates dental age in Kenyan children. [ABSTRACT FROM AUTHOR]

This study evaluated the accuracy of Cameriere's method based on normalized measurement of open apices of developing permanent teeth (xi) and a number of teeth with closed apices (N0) in a sample of 121 cone-beam computed tomography (CBCT) scans of children (60 males and 61 females), aged between 5 and 13 years from Krakow, Poland. Intra-class correlation coefficient on randomly selected 30 CBCT scans showed good to exceptional intra-observer, and inter-observer agreement of normalized open apices, while Kappa score showed an absolute agreement of the number of teeth with complete maturation. Dental age overestimated by 0.17 years (p = 0.120) and 0.18 years (p = 0.149) in males and females, respectively. The mean absolute errors between dental and chronological age of MAE between dental and chronological age of the complete sample were 0.73 years and 0.77 years in males and females, respectively. In conclusion, the present results support usage of Cameriere's method for age estimation in Polish children in cases where CBCT scans are available and previously taken for a specific clinical indication and taking into account the more demanding procedure of measuring variables in a non-orthogonal projection of teeth compared to a panoramic image. [ABSTRACT FROM AUTHOR]

Age estimation in children is fundamental in both clinical and forensic fields. The aim of this study was to evaluate the accuracy of the Cameriere's European and Italian formulae for age estimation in Sardinian children and adolescents, a genetically isolated population. A sample of 202 orthopantomograms of healthy Sardinian children and adolescents (100 females and 102 males) aged between 6 and 17 years was retrospectively evaluated. The seven left mandibular teeth were assessed with the Cameriere's European and Italian formulae. The teeth with closed apex (N0) were counted and, in the teeth with open apex, the distance between the inner sides was calculated. All variables showed a significant and negative correlation with age except N0 and g. Sex (g), the variables s, N0, and the first-order interaction between them, contributed substantially to the age measurement (p < 0.001). Although the value of x5 had a low prediction level, it generated the following multiple linear regression formula, specific for the Sardinian sample: Age = 10.372 + 0.469 g + 0.810 N0 − 1.079 s − 0.398 s ∙ N0 − 0.326 × 5. Only the Sardinian and European formulae allowed to obtain an acceptable interclass agreement (both the lower and upper >0.7). The results showed that the European formula could be accurate for assessing age in this sample of children and adolescents. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In forensic science, age estimation for identification purposes of living and deceased individuals, is of great importance. It is crucial for humanitarian reasons in both civil and criminal cases. Objectives: The aim of this study was to contribute to the process of forensic age estimation using dental age assessment with mineralization stages of Demirjian method, and maturity indexes of permanent mandibular second (I2M) and third molars (I3M). MATERIAL AND METHODS: Two samples were used from a Portuguese population; for I2M, 591 orthopantomography's aged between 7 and 15 years and for I3M, 350 orthopantomography's aged between 12 and 23 years. Age estimation was obtained using linear regression models, each model was estimated with all observations and without observations, in which I2M or I3M = 0. RESULTS: The results of ICC for intra- and inter-observer validation varied between 0.608 and 0.999 for both indexes. Pearson correlation coefficient between each index and chronological age showed that all indexes were significantly negatively correlated with chronological age. The standard error of estimate and the mean absolute error were continually low without patients with null index. CONCLUSIONS: Application of I2M is reproducible in a Portuguese population for medical-legal application in a population aged 7 to 15 years, when the corresponding index is positive. Third molar must be used only if its index is positive. The inclusion of Demirjian staging in both models significantly increases accuracy. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to test the accuracy of the third molar maturity index ( I 3 M ) cut-off value (0.08) to distinguish between individuals above and below the adult age of legal responsibility (18 years) in a Russian population. A sample of 571 digital panoramic radiographs of healthy Russian minors and young adults (363 females and 208 males), aged between 14 and 24 years, was evaluated. The lower left third molars were analyzed by applying the cut-off value of 0.08 determined by Cameriere et al. (2008). Lin's concordance correlation coefficient ( ρ c ) and Cohen's kappa coefficient (κ) showed that repeatability and reproducibility are high for both intra- and interobserver errors. The I 3 M value decreased with age in both sexes. Age distribution gradually decreases as I 3 M increases in both girls and boys. In the male group, molar maturity stages 0-0.04, 0.04-0.08, 0.08-0.3, 0.3-0.5, and 0.9-1.4 were reached slightly earlier than in the female group. The results demonstrated that sensitivity is 0.96 in boys and 0.93 in girls; associated specificity values were both 0.98. The cut-off value of I 3 M is statistically robust and thus valid for forensic application in a Russian population to determine whether or not a subject has reached 18 years of age. Finally, we compared our results with those of other studies in which the same I 3 M cut-off value was tested on different populations. The method is novel as it is reliable and easily reproducible, thus ensuring a universal way of comparing the results obtained (based on a cut-off value) among many populations, in order to develop an ever-increasing database. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to test the accuracy of the third molar maturity index ( I 3 M ) cut-off value (0.08) to distinguish between individuals above and below the adult age of legal responsibility (18 years) in a Russian population. A sample of 571 digital panoramic radiographs of healthy Russian minors and young adults (363 females and 208 males), aged between 14 and 24 years, was evaluated. The lower left third molars were analyzed by applying the cut-off value of 0.08 determined by Cameriere et al. (2008). Lin's concordance correlation coefficient ( ρ c ) and Cohen's kappa coefficient (κ) showed that repeatability and reproducibility are high for both intra- and interobserver errors. The I 3 M value decreased with age in both sexes. Age distribution gradually decreases as I 3 M increases in both girls and boys. In the male group, molar maturity stages 0-0.04, 0.04-0.08, 0.08-0.3, 0.3-0.5, and 0.9-1.4 were reached slightly earlier than in the female group. The results demonstrated that sensitivity is 0.96 in boys and 0.93 in girls; associated specificity values were both 0.98. The cut-off value of I 3 M is statistically robust and thus valid for forensic application in a Russian population to determine whether or not a subject has reached 18 years of age. Finally, we compared our results with those of other studies in which the same I 3 M cut-off value was tested on different populations. The method is novel as it is reliable and easily reproducible, thus ensuring a universal way of comparing the results obtained (based on a cut-off value) among many populations, in order to develop an ever-increasing database. [ABSTRACT FROM AUTHOR]

The importance of age estimation in the forensic field is inherent to the process of establishing the biological profile of children, sub-adults and adults. The established profile might be useful for the identification of deceased victims or living individuals when it comes to age of legal interest. In parallel, age estimation is also investigated for clinical purposes, especially for the diagnosis of dental and bone maturation. Several studies were developed to provide accurate age estimation methods based on skeletal and dental development. This study aimed to apply and compare Cameriere's and Willems' methods for dental age estimation in a Brazilian sample. Two examiners performed image analysis and method application in 180 panoramic radiographs of Brazilian children aged 6-14 years old. The ages estimated with both methods revealed a good correlation with the chronological ages of Brazilian boys and girls. Cameriere's method showed a slight underestimation of 0.05 years for girls and 0.03 for boys. Willems' me thod, on the othe r hand, showed an overestimation of -0.47 years for girls and -0.39 for boys. Better age estimates were obtained combining the outcomes of both methods. In practice, Cameriere's and Willems' methods reached reliable outcomes and could be applied for dental age estimation purposes. [ABSTRACT FROM AUTHOR]

The aim of this work is to study a sample of girls from 15 different countries using Third Molar Maturity Index (I3M), to assess the probability that a girl has reached the legal age of 18 years. The studied sample consisted of 3228 Orthopantomograms of healthy female subjects from 15 different countries. The cutoff value of I3M = 0.08 was tested to discriminate adults (=18 years) and minors (<18 years). X-ray images were processed by computer-aided drafting program ImageJ. The information on sensitivity and specificity of I3M coming from the 15 countries was pooled together using a bivariate Bayesian modeling approach. Specificity of the I3M test did not change when the country was considered, and its value remains greater than 85% for each studied country. This method is useful to estimate the age of the girls involved in suspected early marriage because of the high probability of correctly identifying a minor with similar results observed among tested populations. [ABSTRACT FROM AUTHOR]

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 (βERR) 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. [ABSTRACT FROM AUTHOR]

Dental age (DA) estimation is an extensively investigated resource used by forensic science. This study aimed to evaluate the applicability of the Measurement of Open Apices for DA estimation in north east Brazilians. A total of 429 orthopantomographs of individuals aged 5 to 14.99 years were used. The sample was distributed according to the age groups 5-6.99, 7-8.99, 9-10.99, 11-12.99 and 13-14.99 years, and the data were analyzed descriptively and by linear regression (a= 5%). The majority of the radiographs were from females (n = 241; 56.2%), with an overall mean age of 12 years (± 2.12). A significant difference was obser ved between DA and chronological age (CA) in the total sample and specifically in females and males. The method underestimated CA by 0.31 year (total sample) and by 0.3 and 0.32 year in females and males, respectively. In contrast, the method overestimated CA in the groups 5-6.99 and 7-8.99 years, with a mean difference (MD) of 0.48 year (p = 0.007) and 0.17 year (p = 0.182), respectively. In the other groups, DA was predicted to be below CA, with a significant difference in the group 13-14.99 (0.75 year). Based on the regression analysis, a correction factor was proposed from the original formula for this population, thereby reaching a predictive power of approximately 80%. To conclude, this method is applicable to the study population aged 5 to 13 years as the estimates obtained did not exceed the error limit of ±1 year. [ABSTRACT FROM AUTHOR]

Background: Cameriere's method has been tested in many populations and is widely accepted for dental age estimation. Aim: To establish a new formula for age estimation by measurement of open apices of mandibular teeth based on Cameriere's European formula. Subjects and methods: Panoramic radiographs of 333 healthy Serbian children aged 5–14 years were analysed by two independent researchers. The new formula – Belgrade Age Formula (BAF) – was created and tested on the same Serbian sample. Furthermore, BAF was tested on the Serbian validation sample of 126 children and 2115 Italian children aged 5–14 years. Results: In the Serbian sample, the residuals of the BAF and European formula demonstrated that BAF is significantly better in age estimation than the European formula. No significant difference was found in females from the Serbian validation sample between dental and chronological age when BAF was applied. For males, the BAF and European formula had similar accuracy. In the Italian sample, the mean differences between estimated and real age for the European formula were −0.214 ± 0.934 and 0.109 ± 0.773 for females and males, respectively, while for BAF these differences were 0.182 ± 0.951 and −0.195 ± 0.923 for females and males, respectively. Conclusion: BAF was found to be accurate in the Serbian and Italian populations. [ABSTRACT FROM AUTHOR]

Throughout the ancient Greek, world mass burials are rare. Of the 10,000 excavated burials in the western necropolis of the Greek colony of Himera (649–409), only 16 contained more than one individual; seven of these can in all possibility be traced back to the two battles fought by Himera against the Carthaginians in 480 and 409 BCE. Written sources (Diod. 11.20ff.) state that the Himerans, accompanied by numerous Greek allies, defeated the Carthaginian forces in the first conflict whereas the loss of Greek allied support in the second battle resulted in the city's defeat and subsequent destruction. The anthropological and taphonomical studies of the human remains aim at testing the archaeological hypothesis that individuals interred in the seven mass graves can be related to the two battles. Skeleton density (skeletons per square metre), position, orientation, and conservation levels of the individuals in the mass burials were analysed and compared with a larger sample of 1,000 single burials from the same necropolis along with mass graves in other forensic and archaeological contexts. Sex, age at death, presence of skeletal stress indicators, and perimortal traumas were recorded using standard anthropological methods. In the case of poorly preserved remains, sex was estimated using site‐specific discriminant functions. Although representing catastrophic samples, the results from the seven mass burials all lead to the assumption that the graves can be associated with the interment of warriors fallen in battle. Moreover, burial differences have permitted to distinguish the mass burials dating to 480 BCE from those attributed to 409 BCE. [ABSTRACT FROM AUTHOR]

The study of frontal sinuses for personal identification is a considered approach in the forensic field. In Yoshino's system, the frontal sinus patterns of a given person were formulated as a code number (codY) obtained by arranging the class numbers in each classification item. The aim of this work was to use a new code number (codC) with eight digits that includes other two continuous variables obtained as ratios SOR1 (left frontal sinus area/left orbit area) and SOR2 (right frontal sinus area/right orbit area), comparing the results with that of Yoshino. Digital radiographic images of the skulls of 150 Chinese people were analyzed. Spearman's partial correlation coefficients were evaluated between variables characterizing frontal sinus patterns. We used a maximum‐weight dependence tree for statistical analysis. Results demonstrated that codC significantly reduced the probability of having the same personal code number compared with codY. Our scientific approach results valid for personal identification purposes. [ABSTRACT FROM AUTHOR]

This retrospective study aims to test the third molar maturity index (I3M) cut-off value of 0.08 for 18 years old in Dominican Republic population. Orthopantomograms of 513 subjects (284 females and 229 males) were evaluated, intra- and interobserver agreement, ICC (intra-class correlation coefficient) values were 0.88% (95 % CI 0.86% to 0.91%), and 0.93% (95% CI 0.90% to 0.96%), for the intra- and inter-observer reliability, respectively. Accuracy in females was 0.96 (95% CI: 0.93-0.97); the sensitivity was 0.99 (95% CI: 0.96-0.99) and specificity was 0.92 (95% CI: 0.86-0.95). In males, the accuracy was 0.96 (95% CI: 0.93-0.98); the sensitivity was 0.94 (95% CI: 0.88-0.97) and specificity was 0.99 (95% CI: 0.95-0.99). The PPV (Positive Predictive Value) was 0.93 for females and 0.99 for males. The results of this study show that I3M can be used for discriminating adults from minors in Dominican Republic subjects around the legal age of 18 years old. [ABSTRACT FROM AUTHOR]

Forensic age estimation is receiving growing attention from researchers in the last few years. Accurate estimates of age are needed both for identifying real age in individuals without any identity document and assessing it for human remains. The methods applied in such context are mostly based on radiological analysis of some anatomical districts and entail the use of a regression model. However, estimating chronological age by regression models leads to overestimated ages in younger subjects and underestimated ages in older ones. We introduced a full Bayesian calibration method combined with a segmented function for age estimation that relied on a Normal distribution as a density model to mitigate this bias. In this way, we were also able to model the decreasing growth rate in juveniles. We compared our new Bayesian‐segmented model with other existing approaches. The proposed method helped producing more robust and precise forecasts of age than compared models while exhibited comparable accuracy in terms of forecasting measures. Our method seemed to overcome the estimation bias also when applied to a real data set of South‐African juvenile subjects. [ABSTRACT FROM AUTHOR]

The aim of this study is to develop a new formula for age estimation in a longitudinal study of a sample from the radiological collection of wrist bones of growing infants, children, and adolescents recorded at the Burlington Growth Centre. A sample of 82 individuals (43 boys and 39 girls), aged between 3 and 16 years, were analyzed with a total of 623 X-rays of left hand-wrist bones by measuring the area of carpal bones and epiphyses of the ulna and radius (Bo) and carpal area (Ca). The intra-class correlation coefficient (ICC) and its 95% confidence interval were used to evaluate intra-observer agreement. Hierarchical Bayesian calibration has been adopted to exceed the bias deriving from the classical regression approach used for age estimation in forensic disciplines, since it tends to overestimate or underestimate the age of the individuals. Calibration distributions of the dataset obtained by the evaluation of BoCa (the ratio of Bo and Ca) suggested mean absolute errors (MAE) of 1.07 and 1.34 years in boys and girls, respectively. The mean interquartile range (MIQR) was 1.7 and 2.42 years in boys and girls, respectively. The respective bias of the estimates was βERR = − 0.025 and − 0.074. Furthermore, a correspondence between different BoCa values and estimated age with its standard deviation (SD) was calculated for boys and girls, respectively. In conclusion, the Bayesian calibration method appears to be suitable for assessing both age and its distribution in subadults, according to hand-wrist maturity. Furthermore, it can easily incorporate other age predictors, obtaining a distribution of the subjects with multivariate predictors. [ABSTRACT FROM AUTHOR]

The third molar tooth, known as the “wisdom tooth,” is the only tooth that can be used to determine legal adult age. This study aimed to test the accuracy of Cameriere’s third molar maturity index (I3M) in assessing the legal adult age of 18 years in the Kosovar population. Orthopantomographs (OPTs) of 1221 healthy living Kosovar individuals, aged between 12 and 23 years and with no congenital or developmental anomalies, were analyzed. Intra-class correlation coefficients were 0.858 (95% CI, 0.786 to 0.906) and 0.852 (95% CI, 0.779 to 0.903) for intra-rater and for inter-rater agreement, respectively. The sample was divided into training dataset (800 OPTs) and test dataset (421 OPTs). The training dataset was used to generate the logistic regression model, while the test dataset was used to study the performance of the model. I3M and gender as independent variables and adult age (≥ 18 years) or minor age (< 18 years) as the dependent variable were used for logistic regression analysis. The receiver operating curve (ROC) analysis was used to determine the specific cut-off value of I3M for predicting adult age. The results showed that only I3M statistically significantly contributed to discriminating adults and minors. ROC analysis showed that the cut-off value of I3M < 0.08 was the best in discriminating adults and minors. An analysis of the test dataset (421 OPTs) showed that as I3M decreased the age gradually increased. The performance of the cut-off value of I3M < 0.08, to discriminate between adults and minors, was analyzed by contingency tables for both sexes. In males, the accurate classification (Acc) was 0.968 (95% CI, 0.926 to 0.985), the sensitivity (Se) was 0.962 (95% CI, 0.925 to 0.978), and the specificity (Sp) was 0.976 (95% CI, 0.929 to 0.995). The Bayes post-test probability (Bayes PTP) was 0.975 (95% CI, 0.905 to 1.00). In females, Acc was 0.909 (95% CI, 0.870 to 0.917), Se and Sp were 0.826 (95% CI, 0.787 to 0.834) and 0.991 (95% CI, 0.953 to 1.00) respectively, while Bayes PTP was 0.989 (95% CI, 0.926 to 1.00). Our data support the usefulness of I3M < 0.08 to indicate legal adult age in a Kosovar population. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and validate a gas chromatography-mass spectrometry method to detect drugs of abuse in a single sample of tooth. Pulverized samples of dental materials were subjected to acid hydrolysis to detect opiates, cocaine and their metabolites. The residual dental materials from these analyses were subjected to basic extraction to detect cannabis products (Δ9-tetrahydrocannabinol, cannabidiol and cannabinol). The method showed a good linearity between 0.05 and 2 ng/mg for all substances. The limit of detection ranged from 0.02 to 0.03 ng/mg, and the limit of quantification was 0.05 ng/mg. The application of the method to samples of teeth obtained from drug addicts was successful. It can be applied in post-mortem cases, especially when limited amounts of sample are available. [ABSTRACT FROM AUTHOR]

Assessment of legal age, also known as age of majority, is a controversial issue as there are few body biomarkers or evidence during late adolescence differentiating a subject from being a minor or adult. The third molar was recognized as a suitable site for age examination in late adolescence. We analyzed the development of the left mandibular third molar by the third molar maturity index (I) and a specific cut-off value of I = 0.08, established by Cameriere et al. in 2008 and used it for discriminating between minors and adult black Africans from Gaborone, Botswana. A final sample of panoramic radiographs (OPTs) of 1294 people (582 males and 712 females) aged between 13 and 23 years was evaluated. The real age decreased as I gradually increased. There was no statistically significant difference in the third molar development evaluated using I between males and females ( p > 0.05) across different I classes. Results of 2 × 2 contingency tables for different cut-off values indicated that I = 0.08 was useful in discriminating between adults and minors. Precisely, for I = 0.08, the values of accuracy or overall fraction of correctly classified were 0.91 in males with a 95 % confidence interval (95 % CI) of 0.88 to 0.93 and 0.92 (95 % CI, 0.90 to 0.93) in females. Values of sensitivity of the test or the proportion of participants being 18 years and older were 0.88 (95 % CI, 0.87 to 0.90) in males and 0.88 (95 % CI, 0.90 to 0.93) in females, while values of specificity or proportion of individuals younger than 18 who have I <0.08 were 0.94 (95 % CI, 0.91 to 0.96) in males and 0.96 (95 % CI, 0.94 to 0.98) in females. Positive predictive values of the test, where the participants whose I <0.08 were adults, were 0.94 (95 % CI 0.91 to 0.96) in males and 0.97 (95 % CI, 0.94 to 0.98) in females, while negative predictive values of the test, where the participants whose I was ≥0.08 were minors, were 0.88 (95 % CI 0.85 to 0.90) in males and 0.97 (95 % CI, 0.94 to 0.98) in females. The likelihood ratios of the positive test (LR+) were 13.67 (95 % CI, 9.21 to 21.02) in males and 23.73 (95 % CI, 14.20 to 42.28) in females, while likelihood ratios of the negative test (LR−) were 0.12 (95 % CI 0.10 to 0.16) in males and 0.12 (95 % CI, 0.11 to 0.15) in females. Bayes post-test probabilities, p, were 0.94 (95 % CI 0.90 to 0.98) in males and 0.97 (95 %CI, 0.93 to 1.00) in females. These results indicate with high accuracy that I may be a useful alternative method in legal and forensic practice to discriminate individuals of black African origin who are around the legal adult age of 18 years in Botswana. Further studies should address the usefulness of this method and specific cut-off for different adolescent populations. [ABSTRACT FROM AUTHOR]

Important aspects of forensic practice are age estimation and discrimination of individuals of unknown age as adults and minors. The developing knee joint was recognized as a potential site for age examination in late adolescence. We analyzed a sample of anteroposterior x-rays of the knee joints from 446 living individuals from Umbria, Italy (234 males and 212 females), aged between 12 and 26 years. We evaluated the ossification of the distal femoral (DF), proximal tibial (PT), and proximal fibular (PF) epiphyses. We took into account possible persistence of the epiphyseal scars in the ossified epiphyses by the adopted stages of those previously introduced by Cameriere et al. (2012). We also used measurements from all three epiphyses to calculate the total score of maturation for the knee joint (SKJ). Cohen Kappa coefficients of intrarater agreement for staging the DF, PT, and PF epiphyses were 0.839, 0.894, and 0.907, while interrater agreement was 0.919, 0.791, and 0.907, respectively. The resulting receiver operating characteristic (ROC) curves of SKJ show better discriminatory power than those for DF, PT, and PF epiphyses in predicting that the participant, either male or female, was an adult or a minor. The areas under the curves for SKJ were 0.991 and 0.968 vs. 0.944, 0.962, 0.974 and 0.891, 0.910, 0.918 for males and females, respectively. The results of the 2 by 2 contingency tables showed that SKJ score of 4 in males and SKJ score of 5 in females were the most suitable cut-off value in discriminating between adults and minors. Principally, the sensitivity test for males was 0.94, with 95 % confidence interval (95 % CI) 0.90 to 0.97 and specificity was 0.96 (95 % CI 0.91 to 0.98). The proportion of correctly classified individuals was 0.95 (95 % CI 0.91 to 0.97). For females, the sensitivity test was 0.89 (95 % CI 0.84 to 0.92) and specificity was 0.92 (95 % CI 0.87 to 0.96), the proportion of correctly classified individuals was 0.90 (95 % CI 0.85 to 0.94). These results indicate that the SKJ method may give valuable supporting information in forensic procedures for discriminating individuals of legal adult age of 18 years. Further studies should address the usefulness of the SKJ method in different populations. [ABSTRACT FROM AUTHOR]

Improved age estimation of African lions Panthera leo is needed to address a number of pressing conservation issues. Here we present a formula for estimating lion age to within six months of known age based on measuring the extent of pulp closure from X-rays, or Ratio Of tooth AReas (ROAR). Derived from measurements taken from lions aged 3–13 years for which exact ages were known, the formula explains 92% of the total variance. The method of calculating the pulp/tooth area ratio, which has been used extensively in forensic science, is novel in the study of lion aging. As a quantifiable measure, ROAR offers improved lion age estimates for population modeling and investigations of age-related mortality, and may assist national and international wildlife authorities in judging compliance with regulatory measures involving age. [ABSTRACT FROM AUTHOR]

Analysis of the frontal sinus is an important tool in personal identification. Cone beam-computed tomography (CBCT) is also progressively replacing conventional radiography and multi-slice computed tomography (MSCT) in human identification. The aim of this study is to develop a reproducible technique and measurements from 3D reconstructions obtained with CBCT, for use in human identification. CBCT from 150 patients (91 female, 59 male), aged between 15 and 78 years, was analysed with the specific software program MIMICS 11.11 (Materialise N.V., Leuven, Belgium). Corresponding 3D volumes were generated and maximal dimensions along 3 directions (x, y, z), X, Y, Z (in mm), total volume area (in mm), V, and total surface (in mm), S, were calculated. Correlation analysis showed that sinus surfaces were strongly correlated with their volume ( r = 0.976). Frontal sinuses were separate in 21 subjects (14 %), fused in 67 (44.6 %) and found on only one side (unilateral) in 9 (6 %). A Prominent Middle of Fused Sinus (PMS) was found in 53 subjects (35.3 %). The intra- (0.963-0.999) and inter-observer variability (0.973-0.999) showed a great agreement and a substantial homogeneity of evaluation. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives: The estimation of an individual's age at the time of death is one of the most important components in anthropological studies and is the basis for demographic studies on ancients. However, the different methods commonly used in anthropology for adult age estimation at death provide results with a high level of uncertainty. The consequence is the inability to develop demographic studies with a good degree of reliability. A non-destructive method currently available is the analysis of the apposition of secondary dentine on which Cameriere's method is based. Materials and Methods: The purpose of this work was age estimation using Cameriere's method on a sample of 18 adult Neolithic skeletons from four sites in Southern Italy (Apulia): Carpignano, Masseria della Marina, Samari and Serra Cicora. The estimates derived from the study of mandibular and maxillary canines were compared with the age ranges obtained with commonly used anthropological indicators: fusion of cranial sutures, degree of tooth wear, remodelling of the pubic symphysis and the auricular surface of the ilium. The latter two provide intervals which encompass the ages estimated with Cameriere's method. Results: The results show that the population was composed of individuals of advanced age, even beyond the age of 50, hardly distinguishable by other methods. Discussion: This finding may support the hypothesis that individuals aged 50+ are rare in prehistoric skeletal samples due to the unreliability of classical anthropological methods, not only because they were actually rare in prehistoric populations, or absent for taphonomical reasons. Am J Phys Anthropol 158:423-430, 2015. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Forensic medicine is increasingly called upon to assess the age of individuals. Forensic age estimation is mostly required in relation to illegal immigration and identification of bodies or skeletal remains. A variety of age estimation methods are based on dental samples and use of regression models, where the age of an individual is predicted by morphological tooth changes that take place over time. From the medico-legal point of view, regression models, with age as the dependent random variable entail that age tends to be overestimated in the young and underestimated in the old. To overcome this bias, we describe a new full Bayesian calibration method (asymmetric Laplace Bayesian calibration) for forensic age estimation that uses asymmetric Laplace distribution as the probability model. The method was compared with three existing approaches (two Bayesian and a classical method) using simulated data. Although its accuracy was comparable with that of the other methods, the asymmetric Laplace Bayesian calibration appears to be significantly more reliable and robust in case of misspecification of the probability model. The proposed method was also applied to a real dataset of values of the pulp chamber of the right lower premolar measured on x-ray scans of individuals of known age. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the accuracy of three methods for age estimation in children: the measurements of open apices in tooth roots (T), the ratio between the total area of carpal bones and epiphyses of the ulna and radius (HW), and the combined method (THW). The sample consisted of 288 Caucasian Italian children (152 boys and 136 girls) aged between 5 and 15 years. Accuracy was determined as the difference between estimated age and chronological age, and accuracy was assessed by analyzing individuals' orthopantomograms and hand-wrist radiographs. Accuracies were 0.41 years for girls and 0.54 years for boys with the THW method; for the HW method, 1.00 years for girls and 0.92 years for boys; and for the T method, 0.62 years for girls and 0.71 years for boys. THW is the most accurate technique for age estimation in these children. [ABSTRACT FROM AUTHOR]

Accurate age estimation has always been a problem for forensic scientists, and apposition of secondary dentine is often used as an indicator of age. Cameriere et al. studied the pulp/tooth area ratio by peri-apical X-ray images of the canines, to observe the apposition of secondary dentine. The present study examines the application of this technique in a Mexican identified sample coming from the Department of Physical Anthropology of the INAH, at Mexico City. The main aim of this work is to test the reliability of this method in a skeletal sample of a specific population, different from the samples used for its development. The obtained regression model explained 96.2% of total variance ( R2 = 0.962) with a standard error of estimate of 1.909 and a standard deviation of 1.947. These results demonstrate great reliability and that the age/secondary dentine relationship is not variable in this specific population. [ABSTRACT FROM AUTHOR]

Although several papers have recently been devoted to establishing the validity of identification using the ear, this part of the human body still remains under exploited in forensic science. The perfect overlap of two images of the same ear is not really possible, but photographs of the ears as a reliable means of inferring the identity of an individual are poorly treated in the literature. In this study, we illustrate a simple, reproducible method, which divides the photograph of an ear into four parts—helix, anti helix, concha, and lobe—by means of a suitable grid of four straight lines. Although the division does not follow exact anatomical features, their edges do join anatomical points which are more easily identifiable. Measurement of certain areas of these parts can be combined to produce a code allowing personal identification. This method produces false positive identifications of <0.2%. Last, the repeatability and reproducibility aspects of the method are tested. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The aim of this paper is twofold: first, to evaluate an Indian sample by Cameriere’s European formula; and second, if this formula turns out to be unsuitable, to study a specific formula for Indian children. Orthopantomographs taken from 480 Indian children (227 girls and 253 boys) aged between 3 and 15 years were analyzed. Following the pilot study, subjects’ age was modeled as a function of gender ( g), region of country ( C), and morphological variables (predictors: x5, the distance between the inner sides of the open apex of the second premolar divided by the tooth length; $$ s = x_{1} + x_{2} + x_{3} + x_{4} + x_{5} + x_{6} + x_{7} $$, sum of normalized open apices; N0, the number of teeth with root development complete. Results showed that all these variables except gender and second premolar contributed significantly to the fit so that all were included in the regression model, yielding the following linear regression formula: where C is a dummy variable equal to 0 for the center or north of India and 1 for the south. The above equation, with the variables considered, explained 89.7% ( R2 = 0.897) of total deviance. The median of the residuals (observed age minus predicted age) was –0.063 years, with an interquartile range of 1.10 years. [ABSTRACT FROM AUTHOR]

Changes in the size of the pulp canal, caused by apposition of secondary dentine, are the best morphometric parameters for estimating age by X-rays. The apposition of secondary dentine is the most frequently used method for age estimation in adult subjects. In two previous papers, we studied the application of the pulp/tooth area ratio by peri-apical X-rays as an indicator of age at death. The aim of the present study was to test the accuracy of age evaluation by combined analysis of labio-lingual and mesial peri-apical X-rays of lower and upper canines. A total of 200 such X-rays were assembled from 57 male and 43 female skeletons of Caucasian origin, aged between 20 and 79 years. For each skeleton, dental maturity was evaluated by measuring the pulp/tooth area ratio according to labio-lingual and mesial X-rays on upper ( x1, x2) and lower ( x3, x4) canines. Very good agreement was found between intra-observer measurements. Statistical analysis showed that all variables x1, x2, x3, and x4 and the first-order interaction between x1 and x3 contributed significantly to the fit, so that they were included in the regression model, yielding the following regression formula: The residual standard error of estimated ages was 3.62 years, with 94 degrees of freedom, and the median of the residuals was −0.155 years, with an interquartile range of 4.96 years. The accuracy of the method was ME = 2.8 years, where ME is the mean prediction error. The model also explained 94% of total variance ( R2 = 0.94). [ABSTRACT FROM AUTHOR]

Estimation of age in individuals has received considerable attention in forensic science, in which it is a widely used method for individual identification, together with paleo-demographic analyses to establish mortality patterns in past populations. The present investigation, which is a continuation of a previously published pilot study, was conducted to examine the possible application of the pulp/tooth area ratio by peri-apical images as an indicator of age at death. A total of 200 peri-apical X-rays of upper and lower canines were assembled from 57 male and 43 female skeletons of Caucasian origin, aged between 20 and 79 years. They belong to the Frassetto osteological collection of Sassari (Sardinia) and are housed in the Museum of Anthropology, Department of Experimental and Evolutionistic Biology, University of Bologna. For each skeleton, dental maturity was evaluated by measuring the pulp/tooth area ratio on upper ( x1) and lower ( x2) canines. Very good agreement was found between intraobserver measurements. Statistical analysis was performed in order to obtain multiple regression formulae for dental age calculation, with chronological age as dependent variable, and gender, and upper and lower canines as independent variables. Stepwise regression analysis showed that gender did not contribute significantly to the fit ( p=0.881) whereas variables x1 and x2 and the first-order interaction between them did. These two variables explained 92.5% of variations in estimated chronological age and the residual standard error was 4.06 years. Lastly, two simple linear regression equations were obtained for age estimation using canines from the maxilla and mandible separately. Both models explained 86% of variations in estimated chronological age and allowed an age-at-death estimate with a residual standard error of about 5.4 years. [ABSTRACT FROM AUTHOR]

Estimation of age of skeletal remains is one of the most complex questions for anthropologists. The most common macroscopic methods are based on dental wear and histological evaluation of bone remodeling. These methods are often qualitative, require great technical expertise, and have proved inexact in the estimation of ages over 50 years. Certain dental methods investigate the apposition of secondary dentine, in the study of tooth cross-sections, and X-rays to study width, height, and pulp area. The primary author previously proposed a method of estimating the age of a living person based on the pulp/tooth ratio (PTR) method in the upper canines. The aim of the present study is to verify whether the PTR method can also be used to estimate the age at death of skeletal remains. This paper investigates the study of historical samples of known age as a means to validate the proposed method. [ABSTRACT FROM AUTHOR]

Discusses the importance of M. Yoshino's proposed identification system of frontal sinus patterns. Background of the identification system; Daubert Guidelines for determining whether evidence is scientifically based and therefore admissible under Federal rule; Comparison between ante-mortem and postmortem X-rays; Attempt of estimating the probability of misclassification.

Examines a skeleton, kept at the Church of Santa Chiara in Urbino, Italy, which was traditionally thought to be that of the Duchess Eleonora Gonzaga della Rovere (1493-1550). Suspicions as to whether or not the remains might belong to another important personage of the Urbino Renaissance, Battista Sforza (1447-1472); External observation of the skull; Odontological examination of the mandible; Age estimates of the skeleton consistent with the age at death of della Rovere; Results which highlight the potential of forensic methods as a key to understanding the work of earlier painters.

Describes a method for assessing adult age based on the relationship between age and measurement of the pulp/tooth area ratio of the second molar teeth. Possibility of involving the third molar as a decisive element for dental age estimation; Suggestion that a logistic model must produce a valid assessment of the probability of being of age to be of use in forensic odontology.

Age estimation is a major step in forensic and legal procedures. Its relevance has been increasing due to growing society issues, such as identification of missing people, crimes against minors or lack of valid identification papers from locals or foreigners. Evaluation of the cut-off value of the Third Molar Maturation Index (I3M) = 0.08 for discriminating minors from adults in the Portuguese population. The left lower third molars were analysed by applying a specific cut-off value of 0.08 determined by Cameriere et al. in 2008. A sample of 778 digital panoramic radiographs of a representative Portuguese sample (442 females and 336 males), in the age range of 12–24 years (mean age 17.7 ± 2.98 years in females and 18.1 ± 3.0 years in males), was retrospectively evaluated. I3M decreased as the real age gradually increased in both sexes. The 0.08 cut-off score was valuable in discriminating adults from minors. According to the pooled results, the accuracy, by means of area under the curve, was 92.8% (95% confidence interval (CI) 91.0–94.6%). The proportion of correctly classified subjects (sensitivity) was 90.7% (95% CI 88.7–92.8%) and the specificity was 94.9% (95% CI 93.3–96.4%). The results show that I3M is a valuable method to differentiate minors from adults in the Portuguese population. [ABSTRACT FROM AUTHOR]

A response by Stefano De Luca and colleagues to a letter to the editor about their article "Age-at-death estimation by pulp/tooth area ratio in canines: study of a 20th-century Mexican sample of prisoners to test Cameriere's method," in the 2011 issue, is presented.