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Marcellin N’Zébo Nouaman, David G Meless, Viviane D Danho, Aboudramane Sangare, Serge Kanga N’Zore, Sébastien Atta Datte, Mamadi Traore, Marcellin Aye, Mamadou Samba, Jean-Bertin Beugre, Jean Claude Guinan
Background: Age estimation by invasive dental methods is a destructive, costly and time-consuming approach, whereas, age estimation methods using dental radiographs are simple, non-destructive and provide reliable information. Age estimation by the Kvaal radiographic method has proven to be a reliable method, but possible ethnic variations may limit its uses inother populations. The objective of this study was to reproduce the original Kvaal method with CBCT for the estimation of the age of the adult melano-African subject in Côte d’Ivoire, in order to propose an age estimation formula, specific to our study population, by taking into account the measurements of tooth and pulp ratios. Methods: A cross-sectional study used 102 radiographic data from a CBCT Planmeca® examination in a private dental clinic in Abidjan. It was data from subjects of at least 18 years of age. Dental measurements in length and width of the entire tooth, root and pulp were performed on maxillary central incisors and the different ratios were calculated according to the Kvaal method. The correlation between age and ratios was also assessed. Age estimated using the Kvaal formula was compared to the chronological age. A linear regression equation was developed using ratios and age predictive factors to evaluate the accuracy of the Kvaal formula. Results: In all, a total of 102 radiographs of 102 subjects, of whom 55 (53.9%) were females, were analyzed. The median age was 51 years (inter-quartile range [IQR] 41- 58). Using the Kvaal formula, the Standard error of the estimated age was higher in the African melanoderma population compared to the Kvaal population. The new formula derived from that of the Kvaal formula was developed and applied to our study population (Age = 84.7- 114.2 (M) – 29.4 (W – L) gave more than double the standard error of estimated age by Kvaal (26.03). Conclusion: Our study showed that the measurements made by Kvaal are reproducible with CBCT and there is a correlation between age and the dental parameters studied. However, the age estimation formula determined by Kvaal et al. is not valid for African melanoderma subjects living in Côte d’Ivoire.
(J Forensic Odontostomatol 2022, 40; 1-2:11)
Application of third molar maturity index for Indonesia minimum legal age of marriage: a pilot study
Rizky Merdietio Boedi, Haliza Ermanto, Tira Hamdillah Skripsa, Yoghi Bagus Prabowo
Background: Child marriage is recognised as a harmful practice. Recently, Indonesia enacted a new law to raise the minimum age of marriage from 16 to 19 years old for women, creating no minimum age difference between males and females. However, this improvement may be detrimental for individuals in remote areas with no legal documentation and the common practices of age falsification to reach the minimum age of marriage. Therefore, implementing an age estimation technique for juveniles is mandatory to reduce the risk of child marriage. Methods: this study used the third molar maturity index (I3M) to distinguish an individual under or over 19 years old. I3M values from 222 digital OPGs aged between 15 to 23.99 years were calculated. The sample was randomly assigned as a training dataset (n = 156) and testing dataset (n = 66). The logistic regression model was created using a 5-fold cross-validation method, and the Youden’s Index Value was used to establish the I3Mcut-off value. Results: the logistic regression model showed significance in both sex and I3M value for predicting the probability of minimum age of marriage. I3M cut-off values of 0.08 and 0.09 for males and females, respectively, were taken. The accuracy of this test was 80% for both sexes in the testing dataset. Conclusions: the outcome of this pilot study showed a promising result of using I3M as a dental age estimation method to determine whether an individual is over or under 19 years old to comply with the newly enacted legal age of marriage in Indonesia. Future research should be carried out using a balanced age cohort for each sex and a more extensive training sample size to investigate the influence of sex in the cut-off value calculation.
(J Forensic Odontostomatol 2022, 40; 1-12:19)
Utility of radiomorphometrics indexes of the mandible for age estimation in adults
Mónica Piña-D´Abreu, Ana Isabel Ortega-Pertuz
Introduction: the mandible undergoes changes in morphology and density related to the aging process. These changes are measured by radiomorphometric indices that allow inferring bone density indirectly. Also, the age estimation process in adults is challenging since the modifications in the anatomical structures are gradual and require long intervals of time to be noticeable. Objective: this study aimed to evaluate the usefulness of radiomoformometric indices of the mandible in age estimation in adults. The sample consisted of 230 digital panoramic radiographs of individuals of both genders (115 men and 115 women), with chronological ages between 20 and 81 years, where radiomorphometric indices were obtained in the premolar region and the mandible ramus, using the software ImageJ. An analysis of variance was conducted considering individuals’ gender and age group classification categories with Tukey’s post hoc test. Results: a downward trend was observed in means indices values for the older age groups, showing lower values for females. Based on the interaction detected between gender and age groups, multiple regression models were applied to estimate age. These showed a better adjustment for males between 50 and 59 years (R2=82,85%) and males over 60 (R2=80,16%). Conclusions: the radiomorphometric indices used in this study allowed to infer age from 50 years onwards in males.
(J Forensic Odontostomatol 2022, 40; 1-20:33)
Antonio De Donno, Federica Mele, Carmelinda Angrisani, Roberto Maselli, Monica Cozzolino, Pasquale Pedote, Francesco Introna, Valeria Santoro
The aim of this study was to collect soft tissue thickness (STT) values of an Italian population from 12 bone landmarks, to improve the facial approximation process for identification purposes. 100 Italian adults (50 males and 50 females), who had undergone head CT for clinical purposes, were analysed in order to expand the database of the Italian population. Average values, standard deviation and range were collected according to gender and age and the obtained values were statistically analysed in order to evaluate any possible significant difference. Only one landmark was statistically significant associated with sex, females showed significantly higher values for para-zygomaxillary. Two landmarks were statistically significant associated with age, upper incisor and pogonion. The obtained results were compared with the existing literature. Such information can be useful in the forensic craniofacial reconstruction process and can facilitate choosing the most suitable STT values according to osteological analysis of the human remains.
(J Forensic Odontostomatol 2022, 40; 1-34:41)
Non-accidental head and neck injuries in children and adolescents
Wahaj Anees, Ademir Franco, Scheila Manica
Child abuse or maltreatment has been a global problem and research shows that more than half of the cases present with head and neck injuries. This study aimed to propose an online referencing platform for dental professionals to know more about signs of child abuse and neglect (CAN) and how suspicious head and neck injuries might look like in real-life scenarios by proposing a 3D design.
The study was divided into two parts: i) Integrative literature review, ii) Survey. The first part included an integrative literature review to check if there are enough publications by dentists containing real-life images of injuries related to CAN. Using appropriate keywords and searching across four well-known databases 264 publications relevant to CAN were found, of which, only 3 contained real-life images.
Part II of the study included a JISC online survey, consisting of two sections, amongst general dentists, pediatric and forensic dentists. The first section of the survey was about the basic knowledge related to CAN management. A total of 61 dentists from 10 different countries filled the survey, of which 83.1% had seen common head and neck injuries involved in CAN, 61% knew about the dentist’s role in reporting such cases, and 66.1% were familiar with local law enforcements to contact. The second section of the survey involved going through real-life scenarios to check the participants understanding of how to tackle a real-life case concluding that only 4-10 participants managed to figure the aspects vital to check before reporting such cases which include a proper detailed history, any previous injuries and their stage of progression, clinical examination of injuries and finally whether the injuries are consistent with the history given.
To conclude, there is insufficient representation of the real-life head and neck injuries for dentists to see related to child abuse. Also, all specialists agreed that they require further training regarding CAN management with real-life examples. To address this, a 3d model of commonly seen head and neck injuries in CAN along with some other tools, was created for training and educational purposes and was embedded in a website https://3datlasofchildabuse.webflow.io/.
(J Forensic Odontostomatol 2022, 40; 1-42:52)
Role of mandibular anatomical structures in sexual dimorphism in Turkish population: a radiomorphometric CBCT study
Gulsum Buse Senol, Mehmet Koray Tuncer, Nureda Nalcaci, Kader Cesur Aydin
Sex determination is one of the primary concerns of forensic science. The cranial bones, pelvis, and mandible have been used for determining the sex of specimens. Because the mandible is robust and sexually dimorphic, studies have evaluated its metric and morphological traits.
This study was designed as a retrospective study involving cone beam computed tomography (CBCT) images to assess sexual dimorphism of the mandible in the Turkish population. Total sample group consisted of 176 bimaxillary CBCT scans (71 males and 102 females; ages 19–67 years). Sixteen mandibular parameters were measured using two different software programmes. Measurements were recorded in various planes of three-dimensional (3D) reconstructions of the scans.
All parameters aside from SIMaCD were found to be statistically significant. The highest diagnostic accuracy rate was associated with IMaF, and the overall accuracy rate of the fourteen parameters was found to be 80%.
(J Forensic Odontostomatol 2022, 40; 1-53:64)
Use of non-clinical smile images for human identification: a systematic review
Raquel Porto Alegre Valente Franco, Ademir Franco, Rhonan Ferreira da Silva, Paulo Henrique Viana Pinto, Ricardo Henrique Alves da Silva
Human identification using Forensic Dentistry occurs through comparative analysis of ante-mortem (AM) and post-mortem (PM) data. With the constant improvement of technology, photographs became a common source of AM data. When clinical dental records are not available, images showing the smile can be useful in human identification. The aim of this study was to investigate human identification techniques through the analysis of smile images in the available literature. Studies on human identification through the analysis of smile images were searched in the scientific literature. The search resulted in 4,043 studies. After screening, 14 studies were considered eligible. Eleven were case reports, two were pilot studies and one a technical note. From the eligible studies, in addition to the methodological data, information about the sample, used techniques and results regarding human identification were extracted. Three techniques were detected: direct comparison of morphological characteristics, AM/PM image overlap, and the analysis of smile lines. One or more associated techniques were used for human identification. Authors highlighted as a common limitation of the techniques the quality of the available images, the difficulty in reproducing PM the same images AM, and the eventual image modifications performed by the victim before posting in social media. Advantages included the low-cost aspect of the technique, as well as a potential fast and accurate procedure (depending on the quantity and quality of evidence). In general, studies considered the technique useful and adjuvant for human identification.
(J Forensic Odontostomatol 2022, 40; 1-65:73)