Keywords
Cone beam computed tomography
Pulp/tooth area
How to Cite
Abstract
Introduction: Dental age estimation based on the Pulp Tooth area ratio (PTR) of the maxillary canines obtained from Cone Beam Computed Tomography (CBCT) image may be a reliable method for age estimation in living or deceased individuals.
Objectives: To determine the age estimation based on PTR of the maxillary canines in three planes (sagittal, coronal and axial) with the help of CBCT images in Nepalese population.
Methodology: CBCT images were used for the age estimation by determining the PTR of maxillary canines. For each tooth, midsagittal, midcoronal, and three axial sections at cementoenamel junction (CEJ), onefourth root level from CEJ, and midroot were assessed. The radiographic images were saved as JPEG file and processed using Image J software. PTR were calculated and data obtained were subjected to regression analysis; their correlation to chronologic age as well as the standard error of the estimate (SEE) were derived.
Results: Our study included, 43 (57.33%) males and 32 (42.66%) females with mean age of 30.25 years. The mean of PTR for maxillary canines were 0.053797 at CEJ, 0.067992 at onefourth root level from CEJ and 0.053794 at midroot in axial section, 0.138715 at midsagittal plane and 0.108110 at midcoronal plane respectively. The PTR for maxillary canine was found to be statistically significant at mid coronal plane (p<0.05).
Conclusion: This study showed that PTR calculation of maxillary canines is a reliable parameter with a significant correlation for human age estimation and concluded that CBCT can be used as a conservative approach with reasonable accuracy.
References
Rai A, Acharya AB, Naikmasur VG. Age estimation by pulp-to-tooth area ratio using cone-beam computed tomography: A preliminary analysis. J Forensic Dent Sci. 2016;8(3):150–4. [ PubMed | Full text | DOI ]
Dedouit F, Savall F, Mokrane F-Z, Rousseau H, Crubézy E, Rougé D, et al. Virtual anthropology and forensic identification using multidetector CT. Br J Radiol. 2014;87(1036):20130468. [ PubMed | Full text | DOI ]
Agrawal NK, Hackman L, Dahal S. Dental age assessment using Demirjian’s eight teeth method and Willems method in a tertiary hospital. J Nepal Med Assoc. 2018;56(214):912–6. [ PubMed | Full text | DOI ]
Ekizoglu O, Hocaoglu E, Inci E, Sayin I, Solmaz D, Bilgili MG, Can IO. Forensic age estimation by the Schmeling method: computed tomography analysis of the medial clavicular epiphysis. International journal of legal medicine. 2015 Jan;129(1):203-10. [ PubMed | Full text | DOI ]
Cunha E, Baccino E, Martrille L, Ramsthaler F, Prieto J, Schuliar Y, et al. The problem of aging human remains and living individuals: a review. Forensic Sci Int. 2009;193(1–3):1–13. [ PubMed | Full text | DOI ]
Ohtani S, Yamamoto K. Estimation of age from a tooth by means of racemization of an amino acid, especially aspartic acid—comparison of enamel and dentin. Journal of Forensic Sciences. 1992 Jul 1;37(4):1061-7. [ PubMed | Full text |DOI ]
Cameriere R, Ferrante L, Cingolani M. Precision and reliability of pulp/tooth area ratio (RA) of second molar as indicator of adult age. J Forensic Sci. 2004;49(6):1319–23. [ PubMed | Full text | DOI ]
Asif MK, Nambiar P, Mani SA, Ibrahim NB, Khan IM, Sukumaran P. Dental age estimation employing CBCT scans enhanced with Mimics software: Comparison of two different approaches using pulp/tooth volumetric analysis. J Forensic Leg Med. 2018;54:53– 61. [ PubMed | Full text | DOI ]
Cameriere R, Ferrante L, Cingolani M. Variations in pulp/tooth area ratio as an indicator of age: a preliminary study. J Forensic Sci. 2004;49(2):317–9. [ PubMed | Full text | DOI ]
Cameriere R, Ferrante L, Belcastro MG, Bonfiglioli B, Rastelli E, Cingolani M. Age estimation by pulp/tooth ratio in canines by peri-apical X-rays. J Forensic Sci. 2007;52(1):166–70. [ PubMed | Full text | DOI ]
Jeevan MB, Kale AD, Angadi PV, Hallikerimath S. Age estimation by pulp/tooth area ratio in canines: Cameriere’s method assessed in an Indian sample using radiovisiography. Forensic Sci Int. 2011;204(1– 3):209.e1-5. [ PubMed | Full text | DOI ]
Singh N, Grover N, Puri N, Singh S, Arora S. Age estimation from physiological changes of teeth: A reliable age marker? Journal of forensic dental sciences. 2014 May 1;6(2):113-21. [ PubMed | Full text | DOI ]
Gustafson G, Malmö DO. Age determinations on teeth. J Am Dent Assoc . 1950;41(1):45–54. [ PubMed | Full text | DOI ]
Verma M, Verma N, Sharma R, Sharma A. Dental age estimation methods in adult dentitions: An overview. Journal of forensic dental sciences. 2019 May 1;11(2):57-63. [ PubMed | Full text | DOI ]
Maples WR. An improved technique using dental histology for estimation of adult age. J Forensic Sci. 1978;23(4):764–70. [ PubMed | Full text | DOI ]
Solheim T. Amount of secondary dentin as an indicator of age. Scand J Dent Res. 1992;100(4):193– 9. [ PubMed | Full text | DOI ]
Star H, Thevissen P, Jacobs R, Fieuws S, Solheim T, Willems G. Human dental age estimation by calculation of pulp–tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth. Journal of forensic sciences. 2011 Jan;56:S77-82. [ PubMed | Full text | DOI ]
Ge ZP, Ma RH, Li G, Zhang JZ, Ma XC. Age estimation based on pulp chamber volume of first molars from cone-beam computed tomography images. Forensic science international. 2015 Aug 1;253:133-e1. [ PubMed | Full text | DOI ]
Philippas GG, Applebaum E. Age factor in secondary dentin formation. Journal of dental research. 1966 May;45(3):778-89. [ PubMed | Full text | DOI ]
Atar M, Körperich EJ. Systemic disorders and their influence on the development of dental hard tissues: a literature review. Journal of dentistry. 2010 Apr 1;38(4):296-306. [ PubMed | Full text | DOI ]
Cameriere R, Brogi G, Ferrante L, Mirtella D, Vultaggio C, Cingolani M. Reliability in age determination by pulp/ tooth ratio in upper canines in skeletal remains. J Forensic Sci. 2006;51:861–4. [ PubMed | Full text | DOI ]
Afify MM, Salem WS, Mahmoud NF. Age estimation from pulp/tooth area ratio of canines using cone- beam computed tomography image analysis: study of an Egyptian sample. J Forensic Res. 2019;10(1):1-7. [ Full text | DOI ]
Marroquin TY, Karkhanis S, Kvaal SI, Vasudavan S, Kruger E, Tennant M. Age estimation in adults by dental imaging assessment systematic review. Forensic Sci Int. 2017;275:203–11. [ PubMed | Full text | DOI ]
Bansal V, Konidena A, Nagi R, Kataria APS, Yumnam N, Farooq F. Correlation of pulp-to-tooth area ratio with age and gender using CBCT of maxillary central incisor and canine: A comparative study. J Indian Acad Oral Med Radiol. 2022;34(1):87–94. [ Full text | DOI]
Misirlioglu M, Nalcaci R, Adisen MZ, Yilmaz S, Yorubulut S. Age estimation using maxillary canine pulp/tooth area ratio, with an application of Kvaal’s methods on digital orthopantomographs in a Turkish sample. Aust J Forensic Sci. 2014;46(1):27–38. [ Full text | DOI ]
Haghanifar S, Ghobadi F, Vahdani N, Bijani A. Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth. J Appl Oral Sci. 2019;27:e20180722. [ PubMed | Full text | DOI ]
Nemsi H, Haj Salem N, Bouanene I, Ben Jomaa S, Belhadj M, Mosrati MA, et al. Age assessment in canine and premolar by cervical axial sections of cone-beam computed tomography. Leg Med (Tokyo) . 2017;28:31–6. [ PubMed | Full text | DOI ]
Liu B, Zhang M, Chen Y, Yao Y. Tooth wear in aging people: an investigation of the prevalence and the influential factors of incisal/ occlusal tooth wear in northwest China. BMC Oral Health. 2014;14. [ PubMed | Full text | DOI ]
Dahal S, Forgie A, Manica S. Age estimation using monoradicular teeth by comparing pulp/tooth area ratios between Bucco-lingual and mesio-distal periapical radiographs. J Nepal Health Res Counc [Internet]. 2021;19(3):577–81. [ PubMed | Full text | DOI ]
Bajracharya D, Ojha B, Koju S, Maharjan N, Shah A. Applicability of pulp tooth area ratio in age estimation using mandibular premolars. Orthod J Nepal [Internet]. 2022;12(1):12–6. [ Full text | DOI ]