Haglund Mattias, Mörnstad Håkan
Landskrona Hospital, Vattenverksallén, S-261 36, Landskrona, Sweden.
FORODONT HB, Ängalagsvägen 419, S-269 95, Båstad, Sweden.
Int J Legal Med. 2019 Jan;133(1):231-239. doi: 10.1007/s00414-018-1842-4. Epub 2018 May 10.
Assessment of third molar development on dental radiograms is one of the most commonly used methods of forensic age estimation. Despite widespread use and numerous studies, there is a paucity of aggregated data on how well a fully mature third molar identifies adulthood (> 18 years), the most important threshold in a medicolegal context. Therefore, a systematic review and meta-analysis was conducted. A total of 1229 studies were screened, and 82 studies were assessed for inclusion. Twenty-four studies, with a pooled cohort of 19,690 individuals, presented true positive (TP), true negative (TN), false positive (FP), and false negative (FN) outcomes, enabling meta-analysis. The outcomes were based on using the third molar in the fully mature stage as a diagnostic test to indicate age 18 years or above. The false positive rate (fall-out/1-specificity) was 3.1% (95% CI 2.1-4.6%), and the true positive rate (recall/sensitivity) was 51% (95% CI 44-58%). Diagnostic accuracy was 71%. These findings, while reassuring in terms of the low false positive rate, highlight the need for complementary age estimation methods to avoid a significant number of false negatives.
在牙科X光片上评估第三磨牙的发育情况是法医年龄估计最常用的方法之一。尽管该方法被广泛使用且有大量研究，但关于完全成熟的第三磨牙在鉴定成年人（>18岁）方面的表现，即法医学背景下最重要的年龄界限，却缺乏汇总数据。因此，我们进行了一项系统综述和荟萃分析。共筛选了1229项研究，评估了82项研究以确定是否纳入。24项研究纳入了总计19690名个体的队列，呈现了真阳性（TP）、真阴性（TN）、假阳性（FP）和假阴性（FN）结果，从而能够进行荟萃分析。这些结果基于将完全成熟阶段的第三磨牙作为诊断测试来指示18岁及以上的年龄。假阳性率（误诊率/1-特异性）为3.1%（95%置信区间2.1-4.6%），真阳性率（召回率/敏感性）为51%（95%置信区间44-58%）。诊断准确率为71%。这些发现虽然假阳性率较低令人安心，但也凸显了需要补充年龄估计方法以避免大量假阴性的情况。
