Do upper third molars provide more accurate age estimation in the adult based on the pulp-to-tooth ratio than lower third molars? A cone-beam CT study

Salah A Al-Omoush; Abeer Alhadidi; Awni Al-Kayed; Hamza Saoud; Firas Alsoleihat

doi:10.1016/j.sdentj.2020.04.006

Do upper third molars provide more accurate age estimation in the adult based on the pulp-to-tooth ratio than lower third molars? A cone-beam CT study

Saudi Dent J. 2021 Nov;33(7):702-706. doi: 10.1016/j.sdentj.2020.04.006. Epub 2020 Apr 18.

Authors

Salah A Al-Omoush¹, Abeer Alhadidi², Awni Al-Kayed³, Hamza Saoud⁴, Firas Alsoleihat³

Affiliations

¹ Department of Removable Prosthodontics, School of Dentistry, University of Jordan, Amman 11942, Jordan.
² Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Periodontology, School of Dentistry, University of Jordan, Amman 11942, Jordan.
³ Department of Conservative Dentistry and Fixed Prosthodontics, School of Dentistry, University of Jordan, Amman 11942, Jordan.
⁴ Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan.

Abstract

Introduction: Age-at-death estimation is an essential part of the identification process of individuals in many forensic dentistry cases where identity of the individual cannot be resolved by visual recognition or other means. Dental age estimation in adults is more of a challenge as most teeth complete their development by the age of 18 years.

Aim: This study aims at using the mesio-distal (MD) pulp-to-tooth ratio taken at the cervix of upper third molars (UM3) to estimate age at the time of radiographic imaging.

Materials and methods: A set of 135 Cone-beam computed tomography (CBCT) radiographs of UM3s for a random sample of 135 Jordanian adults (65 females, 70 males; age range = 18-63 years, mean age = 34.4 years, SD = 11.2 years) were used. Both pulp and tooth MD diameters were measured at the cervix. MD pulp-to-tooth ratios for UM3s were correlated with age.

Results: Statistically significant negative moderate correlation was found between the age of the individual and the cervix MD pulp/tooth ratio (r = -0.516). This indicates that only 26.6% of the variation in age can be explained by the cervix MD pulp-to-tooth ratio.

Conclusions: This study concludes that cervix MD pulp-to-tooth ratio of UM3s, although apparently stronger than that of lower M3s (r = -0.361), is not a sufficiently reliable estimator of age in adults, and this is perhaps attributed to the greater variability in the time line of third molars development.

Keywords: Age-at-death estimation; Cone-beam computed tomography; Forensic dentistry; Secondary dentin; Third molars.