Download PDF
CC BY 4.0 · Eur J Dent 2023; 17(01): 200-209
DOI: 10.1055/s-0042-1744373
Original Article

Application of Third Molar Maturity Index (I3M) for Assessing Adult Age of 18 Years in a Southern Italian Population Sample

Nino Giannitto
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Angela Militi
2   School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Daniela Sapienza 
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Serena Scurria
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Patrizia Gualniera
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Cristina Mondello 
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Elvira Ventura Spagnolo
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Antonella Terranova
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Marco Portelli
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Gabriele Cervino 
2   School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
,
Luca Fiorillo 
2   School of Dentistry, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
3   Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli,” Naples, Italy
4   Department of Dentistry, University of Aldent, Tirana, Albania
,
Aida Meto 
5   Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Bologna, Italy
,
Angela Alibrandi
6   Department of Economics, University of Messina, Piazza Pugliatti, Messina, Italy
,
Alessio Asmundo 
1   School of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, Messina, Italy
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective Age estimation of living or dead individuals has a strategic importance in medicine, anthropology, and forensic science, in the context of mass disasters and in civil or criminal matters such as adoption or asylum. Teeth play a major role in this context in particular, the third molars are useful for determining whether an individual has reached the legal age of 18 years because they are still in development from the age of 14.

Materials and Methods In this study, a sample of 307 panoramic radiographs performed on healthy subjects aged between 13 and 23 was analyzed to consider the correlation between the maturity index of the third molar (I3M) and age to verify the reliability of the cutoff 0.08 indicated by Cameriere et al in a sample of Italian subjects living in the Province of Messina (Sicily, South Italy) to discern the adult subjects from the minors.

Statistical Analysis The analysis of 307 panoramic radiographs resulted in a sensitivity of 89.2% with a confidence interval of 95%, a specificity of 96.5% with a confidence interval of 95%, and a positive predictive value of 96.7%.

Results The method proved itself reliable in estimating adulthood in the population of the Messina- Sicily, but the I3M should not be used as the sole indicator to determine whether a person is younger or older than 18 years because age estimation based on dental methods alone has limitations as the third molars suffer from many variations related to their morphology, their location, and their development.

Conclusion We recommend a combination of several methods that are available to increase accuracy of age estimation, depending on the different legal requirements in civil or criminal cases.

Keywords

forensic science - forensic anthropology - age estimation - third molar - orthopantomography - immigration - accompanied minors

Authors' Contributions

A.M. and M.P. conceptualized the study; P.G. was involved in methodology and software; G.C., A.T., C.M., and A.Me. were involved in data curation; N.G. was involved in writing—original draft preparation; A.M. and L.F. helped in writing—review and editing; D.S., S.S., and E.V.S contributed in visualization; A.As. and G.C. supervised the study; A.Al. and A.M helped in project administration. All authors have read and agreed to the published version of the manuscript.




Publication History

Article published online:
27 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Thevissen PW, Kaur J, Willems G. Human age estimation combining third molar and skeletal development. Int J Legal Med 2012; 126 (02) 285-292
    CrossrefPubMedGoogle Scholar
  • 2 “Testo unico delle disposizioni concernenti la disciplina dell'immigrazione e norme sulla condizione dello straniero”. (Decreto Legislativo 25 luglio. 1998 , n. 286). Accessed February 4, 2022 from http://www.camera.it/parlam/leggi/deleghe/98286dl.htm
    PubMedGoogle Scholar
  • 3 Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol 1973; 45 (02) 211-227
    PubMedGoogle Scholar
  • 4 Mincer HH, Harris EF, Berryman HE. The A.B.F.O. study of third molar development and its use as an estimator of chronological age. J Forensic Sci 1993; 38 (02) 379-390
    CrossrefPubMedGoogle Scholar
  • 5 Tuteja M, Bahirwani S, Balaji P. An evaluation of third molar eruption for assessment of chronologic age: a panoramic study. J Forensic Dent Sci 2012; 4 (01) 13-18
    CrossrefPubMedGoogle Scholar
  • 6 Cameriere R, Ferrante L, De Angelis D, Scarpino F, Galli F. The comparison between measurement of open apices of third molars and Demirjian stages to test chronological age of over 18 year olds in living subjects. Int J Legal Med 2008; 122 (06) 493-497
    CrossrefPubMedGoogle Scholar
  • 7 Sisman Y, Uysal T, Yagmur F, Ramoglu SI. Third-molar development in relation to chronologic age in Turkish children and young adults. Angle Orthod 2007; 77 (06) 1040-1045
    CrossrefPubMedGoogle Scholar
  • 8 Rai B, Kaur J, Jafarzadeh H. Dental age estimation from the developmental stage of the third molars in Iranian population. J Forensic Leg Med 2010; 17 (06) 309-311
    CrossrefPubMedGoogle Scholar
  • 9 Aboshi H, Takahashi T, Komuro T. Age estimation using microfocus X-ray computed tomography of lower premolars. Forensic Sci Int 2010; 200 (1-3): 35-40
    CrossrefPubMedGoogle Scholar
  • 10 Liversidge HM, Marsden PH. Estimating age and the likelihood of having attained 18 years of age using mandibular third molars. Br Dent J 2010; 209 (08) E13
    CrossrefPubMedGoogle Scholar
  • 11 Martin-de las Heras S, García-Fortea P, Ortega A, Zodocovich S, Valenzuela A. Third molar development according to chronological age in populations from Spanish and Magrebian origin. Forensic Sci Int 2008; 174 (01) 47-53
    CrossrefPubMedGoogle Scholar
  • 12 Meinl A, Tangl S, Huber C, Maurer B, Watzek G. The chronology of third molar mineralization in the Austrian population–a contribution to forensic age estimation. Forensic Sci Int 2007; 169 (2-3): 161-167
    CrossrefPubMedGoogle Scholar
  • 13 de Oliveira FT, Capelozza ALA, Lauris JRP, de Bullen IR. Mineralization of mandibular third molars can estimate chronological age–Brazilian indices. Forensic Sci Int 2012; 219 (1-3): 147-150
    CrossrefPubMedGoogle Scholar
  • 14 Cantekin K, Yilmaz Y, Demirci T, Celikoglu M. Morphologic analysis of third-molar mineralization for eastern Turkish children and youth. J Forensic Sci 2012; 57 (02) 531-534
    CrossrefPubMedGoogle Scholar
  • 15 Cunha E, Baccino E, Martrille L. et al. The problem of aging human remains and living individuals: a review. Forensic Sci Int 2009; 193 (1-3): 1-13
    CrossrefPubMedGoogle Scholar
  • 16 Knell B, Ruhstaller P, Prieels F, Schmeling A. Dental age diagnostics by means of radiographical evaluation of the growth stages of lower wisdom teeth. Int J Legal Med 2009; 123 (06) 465-469
    CrossrefPubMedGoogle Scholar
  • 17 Schmeling A, Geserick G, Reisinger W, Olze A. Age estimation. Forensic Sci Int 2007; 165 (2-3): 178-181
    CrossrefPubMedGoogle Scholar
  • 18 Schmeling A, Reisinger W, Geserik G. et al. Age estimation of unaccompanied minors. Part I. General considerations. Forensic Sci Int 2006; 159 (Suppl. 01) 61-64
    CrossrefPubMedGoogle Scholar
  • 19 Acharya AB, Bhowmik B, Naikmasur VG. Accuracy of identifying juvenile/adult status from third molar development using prediction probabilities derived from logistic regression analysis. J Forensic Sci 2014; 59 (03) 665-670
    CrossrefPubMedGoogle Scholar
  • 20 Caldas IM, Júlio P, Simões RJ, Matos E, Afonso A, Magalhães T. Chronological age estimation based on third molar development in a Portuguese population. Int J Legal Med 2011; 125 (02) 235-243
    CrossrefPubMedGoogle Scholar
  • 21 Orhan K, Ozer L, Orhan AI, Dogan S, Paksoy CS. Radiographic evaluation of third molar development in relation to chronological age among Turkish children and youth. Forensic Sci Int 2007; 165 (01) 46-51
    CrossrefPubMedGoogle Scholar
  • 22 Lee SH, Lee JY, Park HK, Kim YK. Development of third molars in Korean juveniles and adolescents. Forensic Sci Int 2009; 188 (1-3): 107-111
    CrossrefPubMedGoogle Scholar
  • 23 Zeng DL, Wu ZL, Cui MY. Chronological age estimation of third molar mineralization of Han in southern China. Int J Legal Med 2010; 124 (02) 119-123
    CrossrefPubMedGoogle Scholar
  • 24 Lopez TT, Arruda CP, Rocha M, Rosin AS, Michel-Crosato E, Biazevic MG. Estimating ages by third molars: stages of development in Brazilian young adults. J Forensic Leg Med 2013; 20 (05) 412-418
    CrossrefPubMedGoogle Scholar
  • 25 Blankenship JA, Mincer HH, Anderson KM, Woods MA, Burton EL. Third molar development in the estimation of chronologic age in American blacks as compared with whites. J Forensic Sci 2007; 52 (02) 428-433
    CrossrefPubMedGoogle Scholar
  • 26 De Luca S, Biagi R, Begnoni G. et al. Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age. Forensic Sci Int 2014; 235: 102.e1-102.e6
    CrossrefPubMedGoogle Scholar
  • 27 Deitos AR, Costa C, Michel-Crosato E, Galić I, Cameriere R, Biazevic MG. Age estimation among Brazilians: younger or older than 18?. J Forensic Leg Med 2015; 33: 111-115
    CrossrefPubMedGoogle Scholar
  • 28 Brazilian Institute of Geography and Statistics (IBGE). 2010 Demographic census. Rio de Janeiro: IBGE;. 2011
    Google Scholar
  • 29 Focardi M, Pinchi V, De Luca F, Norelli GA. Age estimation for forensic purposes in Italy: ethical issues. Int J Legal Med 2014; 128 (03) 515-522
    PubMedGoogle Scholar
  • 30 Dreiseidler T, Mischkowski RA, Neugebauer J, Ritter L, Zöller JE. Comparison of cone-beam imaging with orthopantomography and computerized tomography for assessment in presurgical implant dentistry. Int J Oral Maxillofac Implants 2009; 24 (02) 216-225
    Google Scholar
  • 31 Cameriere R, Santoro V, Roca R. et al. Assessment of legal adult age of 18 by measurement of open apices of the third molars: study on the Albanian sample. Forensic Sci Int 2014; 245: 205.e1-205.e5
    CrossrefPubMedGoogle Scholar
  • 32 Galić I, Lauc T, Brkić H. et al. Cameriere's third molar maturity index in assessing age of majority. Forensic Sci Int 2015; 252: 191.e1-191.e5
    CrossrefPubMedGoogle Scholar
  • 33 Schmeling A, Grundmann C, Fuhrmann A. et al. Criteria for age estimation in living individuals. Int J Legal Med 2008; 122 (06) 457-460
    CrossrefPubMedGoogle Scholar
  • 34 Vozza I, Barone A, Quaranta M, De Paolis G, Covani U, Quaranta A. A comparison between endodontics and implantology: an 8-year retrospective study. Clin Implant Dent Relat Res 2013; 15 (01) 29-36
    CrossrefPubMedGoogle Scholar
  • 35 Quaranta A, Ronconi LF, Di Carlo F, Vozza I, Quaranta M. Electrochemical behaviour of titanium in ammine and stannous fluoride and chlorhexidine 0.2 percent mouthwashes. Int J Immunopathol Pharmacol 2010; 23 (01) 335-343
    CrossrefPubMedGoogle Scholar
  • 36 Luzzi V, Ierardo G, Corridore D. et al. Evaluation of the orthodontic treatment need in a paediatric sample from Southern Italy and its importance among paediatricians for improving oral health in pediatric dentistry. J Clin Exp Dent 2017; 9 (08) e995-e1001
    PubMedGoogle Scholar
  • 37 Chirico V, Lacquaniti A, Vinci S. et al. High-mobility group box 1 in allergic and non allergic upper airway inflammation. J Biol Regul Homeost Agents 2015; 29 (02, Suppl 1): 55-57
    PubMedGoogle Scholar
  • 38 Caragliano AA, Papa R, Pitrone A. et al. The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms - immediate and midterm results: an Italian multicenter registry. J Neuroradiol 2020; 47 (06) 421-427
    CrossrefPubMedGoogle Scholar
  • 39 Mormina E, Arrigo A, Calamuneri A. et al. Optic radiations evaluation in patients affected by high-grade gliomas: a side-by-side constrained spherical deconvolution and diffusion tensor imaging study. Neuroradiology 2016; 58 (11) 1067-1075
    CrossrefPubMedGoogle Scholar
  • 40 Stacchi C, Lombardi T, Cusimano P. et al. Bone scrapers versus piezoelectric surgery in the lateral antrostomy for sinus floor elevation. J Craniofac Surg 2017; 28 (05) 1191-1196
    CrossrefPubMedGoogle Scholar
  • 41 Lo Giudice G, Lo Giudice R, Matarese G. et al. Evaluation of magnification systems in restorative dentistry. An in-vitro study. Dent Cadmos 2015; 83: 296-305
    Google Scholar
  • 42 Tangmose S, Thevissen P, Lynnerup N, Willems G, Boldsen J. Age estimation in the living: transition analysis on developing third molars. Forensic Sci Int 2015; 257: 512.e1-512.e7
    CrossrefPubMedGoogle Scholar
  • 43 Schmeling A, Dettmeyer R, Rudolf E, Vieth V, Geserick G. Forensic age estimation. Dtsch Arztebl Int 2016; 113 (04) 44-50
    CrossrefPubMedGoogle Scholar
  • 44 Pradella F, Pinchi V, Focardi M, Grifoni R, Palandri M, Norelli GA. The age estimation practice related to illegal unaccompanied minors immigration in Italy. J Forensic Odontostomatol 2017; 35 (02) 141-148
    PubMedGoogle Scholar
  • 45 Dallora AL, Kvist O, Berglund JS. et al. Chronological age assessment in young individuals using bone age assessment staging and nonradiological aspects: machine learning multifactorial approach. JMIR Med Inform 2020; 8 (09) e18846 DOI: 10.2196/18846.
    CrossrefPubMedGoogle Scholar
  • 46 Militi A, Cicciù M, Sambataro S. et al. Dental occlusion and sport performance. Minerva Stomatol 2020; 69 (02) 112-118 DOI: 10.23736/S0026-4970.20.04350-2.
    CrossrefPubMedGoogle Scholar