牙齿年龄估计:利用3T磁共振成像技术对男性第三磨牙矿化和萌出的时间顺序研究
Dental age estimation: The chronology of mineralization and eruption of male third molars with 3T MRI.
作者信息
Widek Thomas, Genet Pia, Merkens Heiko, Boldt Julian, Petrovic Andreas, Vallis Jacquie, Scheurer Eva
机构信息
Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/II, 8010 Graz, Austria; Medical University of Graz, 8010 Graz, Austria; BioTechMed-Graz, Austria.
University Centre of Legal Medicine Lausanne, Lausanne University Hospital, Chemin de la Vulliette 4, 1000 Lausanne 25, Switzerland; University Centre of Legal Medicine Geneva, Geneva University Hospital, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland.
出版信息
Forensic Sci Int. 2019 Apr;297:228-235. doi: 10.1016/j.forsciint.2019.02.019. Epub 2019 Feb 22.
Forensic age estimation has recently become an important topic due to a steady increase of cross border migration. Dental age assessment is one pillar of the forensic age estimation in living persons. Currently it is done by evaluating an orthopantomogram, which is generated using ionizing radiation. Nevertheless, the use of X-ray without medical indication is ethically questionable. Therefore, the aim of the study was to provide reference values for dental MRI to have an alternative radiation-free method for the assessment of dental age. In this cross-sectional study, 316 adolescent, male individuals were investigated. Two dentists evaluated the stage of mineralization and eruption of the third molars of the upper and lower jaws, according to the staging systems established by Demirjian and Olze. Following data analysis and the creation of reference tables, the likelihood ratios to be over specific age limits were calculated. In the mineralization evaluation mainly stages D-H were seen (range A-H); regarding eruption, all four stages (A-D) appeared. A significant difference between the teeth was only found for eruption stage A. However, the evaluation of participants who had all four third molars, showed partly different stages for the individual teeth as well for mineralization as for the eruption. Therefore, it seems to be important to include all available teeth in the age estimation. The likelihood ratios showed about 99% probability to be 18 years or older for stage H (mineralization), but only about 93% for stage D (eruption). In summary, it can be concluded that dental MRI holds promise as an alternative to conventional orthopantomogram based age assessment.
由于跨境移民人数稳步增加,法医年龄估计最近已成为一个重要课题。牙齿年龄评估是活体法医年龄估计的一个支柱。目前,这是通过评估全景X线片来完成的,全景X线片是使用电离辐射生成的。然而,在没有医学指征的情况下使用X射线在伦理上是有问题的。因此,本研究的目的是提供牙科MRI的参考值,以获得一种替代的无辐射方法来评估牙齿年龄。在这项横断面研究中,对316名青春期男性个体进行了调查。两名牙医根据Demirjian和Olze建立的分期系统,评估了上下颌第三磨牙的矿化和萌出阶段。经过数据分析和参考表的创建,计算了超过特定年龄限制的似然比。在矿化评估中,主要观察到D-H期(范围A-H);关于萌出,所有四个阶段(A-D)都出现了。仅在萌出A期发现牙齿之间存在显著差异。然而,对拥有全部四颗第三磨牙的参与者的评估显示,个别牙齿在矿化和萌出方面的阶段也有所不同。因此,在年龄估计中纳入所有可用牙齿似乎很重要。似然比显示,对于H期(矿化),18岁及以上的概率约为99%,但对于D期(萌出),仅约为93%。总之,可以得出结论,牙科MRI有望成为基于传统全景X线片的年龄评估的替代方法。