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Third molars are one of the few biological markers available for age estimation in juveniles, especially for the estimation of the 18-year-age threshold. Literature has indicated that impaction has an influence on the development of third molars, which could possibly result in age misclassifications. The present study is intended to identify an alternative cut-off value of the third molar maturity index (I3M) in impacted mandibular third molars and also to evaluate its applicability in estimating the major (≥ 18 years)/minor (

Forensic age estimation, after completion of third molar mineralization, regressive features such as apposition of secondary dentin, which is seen as narrowing of the pulp space in the radiographs, can be used as an alternative. In the present study, we explored the radiographic visibility of the root pulp of mandibular first molars using stage classification of Olze et al. (Int J Legal Med 124(3):183-186, 2010) in a sample of 901 orthopantomograms (404 males and 497 females) of south Indian origin with age ranging from 14 to 22 years. Descriptive statistics for the stages according to age was performed for both sexes separately. The strength and direction of the relationship between the chronological age and pulp visualization stages was tested using spearman's rho correlation statistics. The relationship between age and stage attainment showed statistical significance for both sexes. A strong, positive correlation was seen between the stage and chronological age. All males and females presenting stage 0 of root pulp visibility were younger than 18 years. If stage 1 is determined, it is highly possible that an individual regardless of sex is younger than 18 years. Stage 2 was attained in 79.6% males and 83.1% females who were at least 18 years. One hundred percent males and 92.8% females with stage 3 were at least 18 years. The accuracy of this method in mandibular first molars for estimating age threshold of 18 years ranged from moderate to high. However, it is recommended to use this method in conjunction with other age estimation methods.

Legal age of 12 years has been set as the minimum age of criminal responsibility in many countries. This paper concerned a method for predicting the legal age 12 years based on the maturation of lower first and second premolars. The sample consisted of 900 digital pantomographs of south Indian children (450 males, 450 females) aged between 8 and 16 years. Among them, 580 DPTs were used as test sample and 320 DPTs as validation sample. New cut-offs at the age threshold 12 years were determined by using the measurement of open apices in first premolars (IPM1 0.10), second premolars (IPM2 0.14) and the combined method (IPM1 + IPM2 0.12). The sensitivity (Se), specificity (Sp) and posttest probability (PTP) were established. For IPM1 0.10, the Se, Sp and PTP were 92.4 %, 91.3 % and 91.1 % for males and 90.8 %, 87 % and 86.5 % for females. For IPM2 0.14, they were 92.6 %, 93.6 % and 93.4 % for males and 91.5 %, 83.1 % and 83.4 % for females. And, for the combined predictor (IPM1 + IPM2 0.12), these values were 92.6 %, 94.8 % and 94.6 % and 90.5 %, 84.9 % and 84.7 % in males and females respectively. The best score of positive predictive value and specificity was obtained for males with the combined predictor (IPM1 + IPM2 0.12) and with single predictor (IPM1 0.10) for females. To conclude, the combined predictor has resulted in better discrimination in males, while in females the single predictor (IMP1 0.10) did slightly better. Further studies are warranted to test the combination of dental and skeletal indicators for the prediction of 12 years in the studied population.

Identification of living undocumented individuals highlights the need for accurate, precise, and reproducible age estimation methods, especially in those cases involving minors. However, when their country of origin is unknown, or it can be only roughly estimated, it is extremely difficult to apply assessment policies, procedures, and practices that are accurate and child-sensitive. The main aim of this research is to optimize the correct classification of adults and minors by establishing new cut-off values for four different continents (Africa, America, Asia, and Europe). For this purpose, a vast sample of 10,701 orthopantomographs (OPTs) from four continents was evaluated. For determination and subsequent validation of the new third molar maturity index (I3M) cut-off values by world regions, a cross-validation by holdout method was used and contingency tables (confusion matrices) were generated. The lower third molar maturity indexes, from both left and right side (I3ML and I3MR) and the combination of both sides (I3ML_I3MR) were calculated. The new cut-off values, that aim to differentiate between a minor and an adult, with more than 74.00% accuracy for all populations were as follows (I3ML; I3MR; I3ML_I3MR, respectively): Africa = (0.10; 0.10; 0.10), America = (0.10; 0.09; 0.09), Asia = (0.15; 0.17; 0.14), and Europe = (0.09; 0.09; 0.09). The higher sensitivity (Se) was detected for the I3ML for male African people (91%) and the higher specificity (Sp) of all the parameters (I3ML; I3MR; I3ML_I3MR) for Europeans both male and female (> 91%). The original cut-off value (0.08) is still useful, especially in discriminating individuals younger than 18 years old which is the goal of the forensic methods used for justice.

This paper concerns a method to estimate age in children using third molar maturity index (I3M) as independent variable and age as the dependent variable. Total of 1283 digital orthopantomograms (OPTs) of south Indian children aged between 7 and 22 years was included. Training sample of 933 OPTs was used to derive regression formulae, and validation sample of 350 OPTs used to verify accuracy of newly derived regression models. Regression analysis performed revealed that cubic function gave the best correlation between the studied variables. The models exhibited a high correlation coefficient for third molar development in both sexes (0.81 for boys and 0.84 for girls). When new models were verified, slight overestimation of dental age i.e., 0.2 years in boys and 0.13 years in girls was observed. Therefore, we conclude by recommending newly derived regression models as they provided better age predicting performances.

Development of third molars and their influence on the dental arch is a major concern in clinical dentistry especially, orthodontics and oral surgery. Lately, their position, eruption potential and development has become a subject of interest in forensic practice. The present study was aimed to determine whether if there is any difference in the development of the mandibular third molars according to the impaction type. Orthopantomographs (n = 1112) from 478 males and 634 females between 15 and 22 years old were analysed. In each radiograph, impaction status and the developmental stage of mandibular third molars were determined. Descriptive statistics were performed at developmental stages D to H. For stage G, there was a delay by 0.74 and 0.62 years for mesioangular impaction, 0.89 and 0.33 years for horizontal impaction, 1.43 and 0.9 years for distoangular impaction and 1.74 and 1.1 years for vertical impaction, in males and females. For stage H, delay by 0.17 and 0.74 years, 0.05 and 0.06 years, 0.48 and 1.48 years and 0.62 and 0.62 years, respectively for all impaction variants in both sexes. Mean chronological age of the distoangular and vertically impacted mandibular third molars were higher in certain developmental stages than mesioangular and horizontal impactions. Our findings concluded that distoangular and vertical impaction variants mineralize more slowly than mesioangular and horizontal variants, however these differences were smaller. Therefore, no distinction is required between impaction types for dental age estimation especially in the prediction of the age of majority (18 years).

Assessment of third molar mineralization is a basic forensic odontological method available for age estimation in children and adolescents. Due to their protracted development into the late adolescence, their development has become the subject of interest and acquired great forensic importance. It is clearly evident in the literature that impaction factor has an influence on the rate of maturation of the third molars. In this regard, the present study was undertaken to test the relationship between impaction and its concomitant effect on the mineralization of the third molar and forensic age estimation. A total of 520 digital orthopantomograms (OPG) of 260 males and 260 females of south Indian origin were assessed retrospectively. Maturation of the third molars (I3M) was assessed using the method of Cameriere et al. (Int J Leg Med 122 (6):493–497, 2008). Impaction status was determined according to the position of lower right and left third molars in relation to the long axis of the second molars. Out of the total sample, 68.1% of lower left third molars and 71.2% of lower right molars were impacted. Statistical measures for I3M were calculated in the males and females for both impacted and non-impacted third molars. It was ascertained that the mean age and I3M values were higher in impacted third molars, indicating the slower rate of maturation than non-impacted ones. The sensitivity and specificity of the test (I3M

The diagnostic accuracy of the I3M to assess the legal age of 18 years has already been tested in several specific-population samples. The left lower third molar has been extensively used for discriminating between minors and adults. This research aimed to compare the usefulness of lower third molar maturity indexes, from both left and right side (I3ML and I3MR), in samples originating from four distinct continents in order to examine possible differences in their accuracy values. For this purpose, a sample of 10, 181 orthopantomograms (OPGs), from Europe, Africa, Asia and America, was analysed and previously scored in other studies. The samples included healthy subjects with no systemic disorders with both third molars and clear depicted root apices. Wilcoxon Signed Rank test for left and right asymmetry did not show any significant differences. Data about sensitivity, specificity, predictive values, likelihood ratio and accuracy were pooled together and showed similar results for I3ML and I3MR, respectively. In addition, all these quantities were high when only the I3MR was considered to discriminate between adults and minors. The present referable database was the first to pool third molar measurements using panoramic radiographs of subjects coming from different continents. The results highlighted that both I3ML and I3MR are reliable indicators for assessing the legal age of 18 years old in those jurisdictions where this legal threshold has been set as the age of majority.

Age estimation is an integral part of forensic medical and dental practice. In many countries, the age threshold of 14 years is set to determine the minimum age for criminal responsibility. In the present study, the authors studied the final maturation of the first (IPM1) and second mandibular premolars (IPM2) by Cameriere maturity index and determined cut-offs at the age threshold of 14 years, and validate on the test sample. Orthopantomograms of 960 healthy south Indian children and sub-adults (480 boys and 480 girls) aged between 10 and 18 were analysed, 640 as training sample and 320 as a test sample. The results of logistic regression analysis with age (

In the context of dental age assessment, two significant factors can be studied; tooth mineralisation and tooth emergence. Little is known about the role of a second molar eruption in forensic age estimation. This paper aims to contribute to forensic age estimation using an age threshold of 14 years, studying the eruption stages of permanent mandibular premolars and second molars. Totally 640 orthopantomograms (OPGs) of south Indian children, aged between 10 and 18 years, were evaluated using Olze et al. staging of tooth eruption stages (A–D). Spearman's rho correlation showed a strong, positive, and statistically significant correlation between the chronological age and the eruption stages of both sexes' teeth. Accuracy, sensitivity, specificity, likelihood ratios, and post-test probability values were calculated for all tested teeth. The best performance to discriminate individuals above or below 14 years showed stage D in second molars. The sensitivity varied between 89% and 94% and specificity between 75% and 84%, respectively. Receiver operating characteristic curve analysis revealed high diagnostic performance for stage D, with area under the ROC curve (AUC) values of 84% and 85% for tooth 37 and 85% and 83% for tooth 47 in males and females, respectively. In conclusion, it is possible to predict age over 14 years in south Indian children using tooth emergence stages from OPGs with a relatively high interobserver agreement and good diagnostic accuracy. However, there are some limitations and, therefore, must be used in conjunction with other methods.

Forensic odontologists often confront with conceptually simple medicolegal question of whether an individual is a juvenile or an adult. The demand for additional research into extending dental age estimation methods in late adolescence is never the less, especially in those who have passed 15 years and are suspected older than 18 years. The present research investigated the regressive dental characteristic, i.e. radiographic visibility of the root pulp in mandibular second molars for the purpose of age assessment, especially for determining the age over 18 years. Nine hundred thirty-six orthopantomograms comprised of 436 males and 500 females aged from 14 to 22 years were examined. Descriptive statistics were performed for each stage in both sexes. The correlation statistics revealed that there is a strong, positive correlation between the chronological age and root pulp visibility stages. The analysis revealed that stage 0 occurred first at the age of 14 years in both sexes. Stage 1 first occurred at the age of 14.26 years in females and 14.74 years in males. Stage 2 was first achieved at the age of 18.6 and 15.2 years in males and females, respectively. The suitability of the studied characteristics in mandibular second molars for age estimation could be confirmed but of limited value. The presence of this stage 2 root pulp visibility in male subjects represents a potential criterion for indicating the age over 18 years. In future studies, the pattern of secondary dentin formation in other tooth types should be investigated.

It has been argued that the impaction of the third molars could result in delayed maturation, which, in turn, could affect age estimations in criminal proceedings. In view of this, the present study was undertaken to determine whether the impaction status could delay the chronological process of third molar mineralization in a sample of south Indian children and young adults. The orthopantomograms (OPGs) of 915 children and young adults of south Indian origin aged between 15 and 22��years were evaluated. Mineralisation stage and impaction status were determined for all lower third molars. Descriptive statistics were performed at stages D to H of Demirjian staging system. The results of independent t-test show that the impaction resulted in statistically significant slower mineralization in impacted lower third molars at stages D to F in both sexes. It was ascertained that the mean ages with the impacted lower third molars at stage G were 0.98-1.38��years higher in males and 0.50-0.80��years higher in females than those with non-impacted lower third molars. For stage H, the mean ages were 0.14-0.21��years higher in males and 0.25-0.44��years higher in females. The probabilities of being 18��years and above is higher for non-impacted lower third molars at stages G and H than those with impacted ones. It is concluded that the impaction could result in delayed maturation in the lower third molars of the studied sample. Further studies are warranted in a more diverse sample.

Deliberate falsification of age was considered to be one of the main reasons for the forensic age estimation of living individuals. This posed to be a challenging task during criminal and legal proceedings, and ultimate care must be taken not to classify juveniles as adults. Third molars are the only developing teeth during late adolescence and early adulthood. Our study was designed to analyze the usefulness of the third molar maturity index (I3M) specific cut-off value (I3M < 0.08) to discriminate between adults (≥18 years) and juveniles (

Age estimation in living individuals has attained importance in forensic sciences from legal proceedings and has been a frequent request from concerned authorities to ascertain whether the person in question has reached the age of imputability and legal responsibility. The purpose of age estimation is not just limited to juvenile or sub-adult delinquents but also required in situations like a violation of child rights such as child employment, commercial sexual exploitation involving minor girls. Indian Law strictly forbids any employment of the children under the age of 14 and sexual exploitation of minor girls (< 18 years). In this study, we assessed the skeletal and dental ages and correlate to reported chronological ages in a sample of 85 male child labourers and 31 female commercial sex workers. Statistical analysis of the results was performed to verify the similarities or differences between reported and biological age. The results had revealed a statistically significant difference between the reported age, skeletal, dental, and calculated biologic age (p < 0.05). The results indicate the need to establish a more reliable method for determining the biological age in an age-specific population.

Age estimation in forensic context is of prime importance for criminal, civil and administrative laws. The objective of this study is to test the accuracy of 3 methods of age estimation in South Indian children (preadolescents) aged between 7 and 15 years. It is a retrospective study of orthopantamograms (OPGs) of 150 children among which 79 were boys and 71 were girls. Cameriere's, Willems and Acharya's age estimation methods were used to predict chronological age. Paired t-test was used to compare all data and relationships between continuous variables were examined using Pearson's correlation coefficient. The Cameriere's method Underestimated the real age by -0.62 years in boys and -0.54 years in girls. Both Willems and Acharya's methods overestimated age in both sexes by 0.41, 0.18 years and 0.41, 0.47 years respectively.

Today, in most of the countries forensic dental identification is considered as one of the most accurate and reliable method of identification of human remains. This application of forensic dentistry has proven successful in both single identification cases as well as in multiple fatality incidents such as world trade center disaster in 2001, the Asian tsunami in December 2004 etc. Comparative dental identification is one of the primary means of identification along with DNA and fingerprint analysis and also the most common method of identification of human remains. Identification of human remains from dental records is mandated by the law in some countries. India is one of the most disaster-prone countries of the world. It has had some of the world's most severe droughts, famines, earthquakes, road accidents, and rail accidents. In this paper, few multiple fatality incidents that took place over the last decade in India are reported. A brief analysis of all the reported cases and difficulties encountered during identification were discussed. The purpose of this paper is to discuss some of the issues involved in body identifications following disasters in India. The author also discussed to what extent Indian government is successful in utilizing the expertise of a forensic dentist in body identifications and also compared the present practice of forensic dental identification in India to Western countries. The goal is to cite situations and to bring issues into better focus, and hence that the identification procedures can be refined and changes can be made as necessary.

The aims of the present study were to validate the discriminatory potential of Cameriere’s third molar maturity index (I3M) cut-off value of I3M < 1.1 and whether closed apices of permanent second mandibular molar (I2M = 0.0) and I3M < 1.1 indicate the legal age of 14 years and older. A digital orthopantomograms of 804 healthy South Indian children, aged between 10 and 18 years, were collected retrospectively, and mineralization of the third and second left mandibular molars was analyzed by Cameriere’s method. The proportion of accurately classified (Ac) individuals using the cut-off value of I3M < 1.1 was 79.4% for males, with Bayes post-test probability (Bayes PTP) of 68.8%. For females, Ac was 79.9% and Bayes PTP was 70.9%. The sensitivity was 94.8% and 98.2% for males and females, and the specificity was 58.7% and 62.8%, respectively. The combination of both variables, I3M < 1.1 and I2M = 0.0, increased the Ac to 87.2% and 94.4% in males and females, the specificity to 98.6% and 99.2%, and Bayes PTP to 98.2% and 94.4%, respectively. In conclusion, the suggested cut-off value of I3M < 1.1 is of moderate accuracy in discriminating individuals between 14 years or older from those under 14 years in the studied population. A combination of both variables, I2M = 0.0 and I3M < 1.1, the discriminating test achieves an excellent specificity and Bayes PTP, which is mandatory for the forensic and medicolegal purposes.

Providing appropriate legal mechanisms, that evaluate the progression of development from the age of childhood innocence to maturity and full responsibility, considered one of the difficult areas of criminal justice policy. The minimum age of criminal responsibility (MACR) in children varies among countries and differs widely owing to history and culture. Due to rising and brutality of criminal offenses, particularly by juveniles, few countries have lowered the minimum age of criminal responsibility, and many have considered/considering to do the same. India is one such country in which is under the proposal of lowering the age of criminal responsibility to 16 years. As there is lack of useful age assessment methods, that can indicate whether if the individual in question is younger (

Context: For a dental practitioner, HIV-TB co-infection which is a lethal aliment is an occupational hazard by the virtue of abundant aerosol formation in day to day dental practice. Aim: To assess the prevalence of TB co-infection among HIV patients. To assess the infectivity by culturing Mycobacterium Tuberculosis and Mycobacterium avium complex using Lowenstein Jensen medium and Middlebrook medium. Setting and Design: One hundred and forty one recently diagnosed HIV seropositive patients were selected. They were divided into two group based on their clinical symptomatology. Sputum samples, CD4 counts and brief case history were collected from these patients. Subjects and Methods: Sputum samples were homogenized using modified Petroff 's method. The samples were cultured using Lowenstein Jensen and Middlebrook media. Cultures were interpreted after two weeks of incubation and the cultures were quantified based on their number of colonies produced on them. Statistical Analysis: Descriptive statistical analyses followed by Chi square test were performed to assess the prevalence and variation of TB co-infection. Results: Prevalence of TB in our sample is 25.53%. Higher CFU of MTB and MAC are obtained in patients symptomatic for TB. MB yields higher CFU than LJ. Conclusion: Clinical symptoms alone cannot act as basis for suspecting TB in HIV patients. Mycobacterial cultures should be used as diagnostic aids and preferably both the mediums have to be used.

The ultimate goal of the disaster victim identification team during a mass disaster situation is to make the correct identification of the victims before social closure to the families. There has been many methods are present to identify the bodies of which DNA analysis, fingerprint analysis and identification using dental records plays utmost role. Among these, the latter considered to be the most effective method and also takes comparatively less time than others. In western countries, there is a separate dental disaster victim identification unit within the team and it readily deploys to the disaster site during mass disasters. This team consists of a group of well-trained forensic odontologists and also works in collaboration with other forensic personnel. There is no such dental disaster victim identification team is present at a national level in countries like India. The aim of this article is to provide information regarding formation of the dental disaster victim identification team and it collates all the information regarding, personnel involved, roles and responsibilities, standard operating protocols, training, and so forth.