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Journal of Statistics on Health Decision, vol. 3 n.º 1 (2021): Special Issue - Statistics on Health Decision Making: Public Health

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’ method, on the other 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.

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 (α= 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 observed 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.

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The aim of this work is to study a sample of girls from 15 different countries using Third Molar Maturity Index (I(3M)), 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 cut-off value of I(3M) = 0.08 was tested to discriminate adults (≥18 years) and minors (

This retrospective study aims to test the third molar maturity index (I(3M)) 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 inter-observer 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 I(3M) can be used for discriminating adults from minors in Dominican Republic subjects around the legal age of 18 years old.

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.

Los objetivos principales de este trabajo son los siguientes: 1) presentar los resultados, obtenidos en muestras procedentes de varios países (Italia, Albania, Croacia, Turquía, Libia y Colombia), de un método de estimación de la edad legal de 18 años basado en el análisis del índice de madurez del tercer molar mediante radiografías panorámicas digitales ; 2) ampliar, con la colaboración de los especialistas forenses interesados, el alcance de aplicación de esta técnica y comprobar su precisión en los territorios que lo requieran. El Coeficiente de Correlación Intraclase (ρc) y el Coeficiente kappa de Cohen (κ) se han usado para determinar el grado de acuerdo intra- e inter-observador de las mediciones realizadas. Además, se ha aplicado el Coeficiente kappa de Cohen (κ) para establecer el grado de acuerdo intra- e inter-observador a la hora de decidir si un sujeto es mayor o menor de 18 años. Para conocer el grado de precisión de la técnica, se ha llevado a cabo un análisis de la sensibilidad, de la especificidad, de los valores predictivos positivos y negativos y, finalmente, de las ratios de probabilidad positiva y negativa de la prueba diagnóstica. La proporción de sujetos correctamente identificados varía entre 93, 8% y 95, 1%. Los resultados obtenidos en las muestras estudiadas hasta la fecha demuestran que el índice de madurez del tercer molar puede ser, si aplicado junto a otros métodos de estimación, de gran utilidad para diferenciar entre sujetos mayores y menores de 18 años, una edad altamente trascendental en las legislaciones de muchos países.

Estimation of chronological age of an individual is one of the main challenges in forensic science. Legally to be able to treat a person as a minor or an adult, it is necessary to determine whether their age of majority (if they are older or younger than 18, in most countries). Methods for estimating age are especially important when an individual in question lacks personal documents or other means of identification. As the dental age differs in various populations, the aim of this study was to evaluate applicability of third molar method for assessing age of majority in Croatia. Cameriere's third molar maturity index (I3M) value of 0.08, measured by the open apices of the teeth, was verified in sample of 1336 panoramic images aged between 14 to 23 years. Chronological age gradually decreased as I3M increased in both genders. Males showed statistically significant advanced maturation when I3M was between 0.0 and 0.3 value. The results indicate that the sensitivity of the test for 0.08 value was 84.3% (95%CI 80.6%, 87.5%) for females and 91.2% (95%CI 88.7%, 93.1) for males. Specificity was 95.4% (95%CI 92.5%, 97.5%) and 91.9% (95%CI 88.8%, 94.3%). The proportions of accurately classified males were 88.8% and that of females 91.5%. The estimated post-test probabilities, of individuals, in other word the probability that a Croatian individual with an I3M

Procjena dobi djece temeljno je pitanje u sudskoj medicini, pedijatrijskoj endokrinologiji i ortodontskom liječenju. Za to se koristi nekoliko metoda, uključujući i onu na osnovi razvoja kostiju i zuba. Budući da je nekoliko autora ustanovilo da se dentalne metode mogu razlikovati prema točnosti procjene, ovaj se rad temelji na poboljšanjima metode koju su razvili Cameriere i suradnici te ih proširuje na veći uzorak djece iz nekoliko europskih regija - 505 iz Italije, 304 s Kosova i 291 iz Slovenije. Također se ispitala učinkovitost metode u situacijama kada se različite populacije analiziraju zajedno. Koeficijenti korelacije procjenjivali su se između dobi i predvidivih varijabli. Statistička analiza obavljena je u statističkom programu S-PLUS 6 (SPLUS 6.1 za Windowsov operativni sustav - Professional Edition, Release 1). Razina znatnosti postavljena je na 5%. Statistička analiza pokazala je da spol, zbroj normalno otvorenih apeksa i broj zuba s potpuno razvijenim korjenovima znatno utječu na procjenu starosti. Pripadnost različitim europskim regijama nije utjecala na parametre modela.

Estimation of age at death is an essential part of reconstructing information from skeletal material. Given that skeletal remains coming from archaeological series are very often poorly preserved, fragmentary, and demand careful handling to prevent further damage, age determination can be particularly complex. The research was carried out on 192 skulls from excavations from the crypt at St. Theresa's Cathedral, Požega, Croatia. The exhumation of the burials was done in 2004. The skeletal remains were dated from the 18th and 19th century. The aim of the investigation was to reconstruct the chronological age of the archaeological samples from Croatia using cranial skeletal remains and subsequently to make an evaluation of the methods used for age estimation. For this purpose, four age calculation methods were used: palatal suture closure, occlusal tooth wear, tooth root translucency and pulp/tooth area ratio. Cramer's V test was used to test the association between the age calculation methods. According to the time of palatal suture obliteration, 51.4% of the population was younger than 35 years at time of death. Results of the analysis of occlusal tooth wear showed an average age at death of 31.4 years. Age estimation using root dentine translucency was performed on 77 intact upper permanent canines and showed an average age at death of 51.0 years. Age estimation using pulp/tooth area ratio was performed on radiographs of 88 intact upper permanent canines and showed an average age at death of 48.2 years. Cramer's V test showed high association (0.677) between age determination results using palatal suture closure and occlusal tooth wear, and low association (0.177) between age determination results using palatal suture closure and pulp/tooth area ratio. Simple methods like palatal suture closure can provide data about age at death for large number of individuals, but with less accuracy. More complex methods which require qualified and educated personnel can provide data about age for a smaller number of individuals, but with more accuracy. Using different, both simple and complex, age calculation methods in archaeological samples can raise the level of confidence and percentage of success in determining age.

Children and adolescents will have different support and punishment when experiencing situations that classify them as defendants or victims. For definitions of these cases, age information is crucial. In view of the above, it's necessary to carry out studies in order to identify methodologies capable of estimating whether an individual has reached or not the legal ages of greatest relevance to civil and criminal law. The objective was to determine cutoff points capable of estimating legal ages of 12 and 14 years, using Maturation Index of the Second Molar (I2M) and Third Molar (I3M). This is an observational, cross-sectional study by analyzing panoramic radiographic images taken in the following states: Bahia, Pará, Goiás, Rio de Janeiro and Paraná. The project was previously submitted and approved by CEP (CAAE: 31776720.0.0000.5188). Universe was comprised of radiographs taken in accordance with 10 to 15 years, from 2013 to 2019. For sample calculation, a pilot study was carried out with 73 images using methodology applied in the subsequent data collection. From the calculation of the size of Cohen's d effect, the minimum number reached by the comparison group was 250. Sample was balanced by sex and region, with 125 images of each sex (n = 250), 50 of each region, taken for clinical and/or orthodontic diagnostic reasons and presenting the second and third left lower molars. No radiography was performed for this research. The sample selection was carried out by same researcher who performed sample blinding. All radiographs that were part of sample were added to a cloud bank shared with the researcher who collected data. The inter-examiner (k = 1,000; ICC = 0.963) and intra-examiner (k = 0.855; ICC = 0.996) agreement was found, where the gold standard for inter-examiner analysis was the originator of the I3M. Data collection followed the methodology originally proposed in I3M, from the measurement of the internal widths of the roots and longitudinal length of the teeth 37 and 38, using ImageJ® software. Data were analyzed in a descriptive and inferential manner (α