Kelmendi Jeta, Cameriere Roberto, Koçani Ferit, Galić Ivan, Mehmeti Blerim, Vodanović Marin
Department of Orthodontics, University Dentistry Clinical Center of Kosovo, 10000, Pristina, Kosovo.
Dental Science, School of Dental Medicine, University of Zagreb, HR-10000, Zagreb, Croatia.
Int J Legal Med. 2018 Jul;132(4):1151-1159. doi: 10.1007/s00414-017-1761-9. Epub 2017 Dec 16.
The third molar tooth, known as the "wisdom tooth," is the only tooth that can be used to determine legal adult age. This study aimed to test the accuracy of Cameriere's third molar maturity index (I) in assessing the legal adult age of 18 years in the Kosovar population. Orthopantomographs (OPTs) of 1221 healthy living Kosovar individuals, aged between 12 and 23 years and with no congenital or developmental anomalies, were analyzed. Intra-class correlation coefficients were 0.858 (95% CI, 0.786 to 0.906) and 0.852 (95% CI, 0.779 to 0.903) for intra-rater and for inter-rater agreement, respectively. The sample was divided into training dataset (800 OPTs) and test dataset (421 OPTs). The training dataset was used to generate the logistic regression model, while the test dataset was used to study the performance of the model. I and gender as independent variables and adult age (≥ 18 years) or minor age (< 18 years) as the dependent variable were used for logistic regression analysis. The receiver operating curve (ROC) analysis was used to determine the specific cut-off value of I for predicting adult age. The results showed that only I statistically significantly contributed to discriminating adults and minors. ROC analysis showed that the cut-off value of I < 0.08 was the best in discriminating adults and minors. An analysis of the test dataset (421 OPTs) showed that as I decreased the age gradually increased. The performance of the cut-off value of I < 0.08, to discriminate between adults and minors, was analyzed by contingency tables for both sexes. In males, the accurate classification (Acc) was 0.968 (95% CI, 0.926 to 0.985), the sensitivity (Se) was 0.962 (95% CI, 0.925 to 0.978), and the specificity (Sp) was 0.976 (95% CI, 0.929 to 0.995). The Bayes post-test probability (Bayes PTP) was 0.975 (95% CI, 0.905 to 1.00). In females, Acc was 0.909 (95% CI, 0.870 to 0.917), Se and Sp were 0.826 (95% CI, 0.787 to 0.834) and 0.991 (95% CI, 0.953 to 1.00) respectively, while Bayes PTP was 0.989 (95% CI, 0.926 to 1.00). Our data support the usefulness of I < 0.08 to indicate legal adult age in a Kosovar population.
第三磨牙,即“智齿”,是唯一可用于确定法定成年年龄的牙齿。本研究旨在检验卡梅里埃第三磨牙成熟指数(I)在评估科索沃人群法定成年年龄(18岁)时的准确性。分析了1221名年龄在12至23岁之间、无先天性或发育异常的健康科索沃人的口腔全景X线片(OPT)。组内相关系数在评估者内一致性和评估者间一致性方面分别为0.858(95%可信区间,0.786至0.906)和0.852(95%可信区间,0.779至0.903)。样本分为训练数据集(800张OPT)和测试数据集(421张OPT)。训练数据集用于生成逻辑回归模型,而测试数据集用于研究模型的性能。以I和性别作为自变量,成年年龄(≥18岁)或未成年年龄(<18岁)作为因变量进行逻辑回归分析。采用受试者工作特征曲线(ROC)分析来确定I预测成年年龄的具体临界值。结果表明,只有I在区分成年人和未成年人方面具有统计学显著贡献。ROC分析表明,I<0.08的临界值在区分成年人和未成年人方面效果最佳。对测试数据集(421张OPT)的分析表明,随着I值降低,年龄逐渐增加。通过列联表分析了I<0.08的临界值在区分成年人和未成年人方面的性能。在男性中,准确分类(Acc)为0.968(�5%可信区间,0.926至0.985),敏感性(Se)为0.962(95%可信区间,0.925至0.978),特异性(Sp)为0.976(95%可信区间,0.929至0.995)。贝叶斯检验后概率(贝叶斯PTP)为0.975(95%可信区间,0.905至1.00)。在女性中,Acc为0.909(95%可信区间,0.870至0.917),Se和Sp分别为0.826(95%可信区间,0.787至0.834)和0.991(95%可信区间,0.953至1.00),而贝叶斯PTP为0.989(95%可信区间,0.926至1.00)。我们的数据支持I<0.08在科索沃人群中用于指示法定成年年龄的有效性。