Pereira Cristiana Palmela, Russell Lucianna Maria, de Pádua Fernandes Maria, Alves da Silva Ricardo Henrique, de Sousa Santos Rui Filipe Vargas
Faculty of Dental Medicine, University of Lisbon, Portugal.
Faculty of Dental Medicine, University of Ribeirão Preto, Brazil. Undergraduate Student, Dental Medicine.
Acta Stomatol Croat. 2019 Dec;53(4):307-317. doi: 10.15644/asc53/4/1.
Forensic estimation of chronological age has played an increasingly important role as part of cadaver identification, and also in living individuals due to the phenomenon of immigration and sexual abuse of undocumented trafficked children.
This research aimed to validate the already used dental mineralization and eruption atlas in normal children and adolescent population in estimating chronological age in a young population, particularly those with special needs, majority of them with systemic diseases.
A sample of 163 orthopantomograms from two independent medical institutions was collected from 133 patients aged between 4 and 23 years.
The orthopantomograms were divided into two groups, 95 from patients with systemic pathologies that have repercussions on dental development and 68 with systemic pathologies without dental repercussions. Dental ages were estimated by the London Atlas using the left side and then independently the right side of the maxilla. The intraobserver and interobserver agreements were evaluated. The difference between dental age estimates and the chronological age and its absolute value were calculated and analyzed.
Statistically significant differences were found between estimates and chronological age, revealing a general prevalence for underestimation; except for those under the age of 12. Nevertheless, the underestimation in individuals under the age of 16 was not significant (with an average of less than one month), while the underestimation was significant for persons who were at least 16 years old (with an average over 26 months). Furthermore, for those persons with systemic diseases with dental repercussions a greater error in underestimation was obtained, which indicates that the midpoint values should be reassessed in persons with Down's syndrome, chromosomal alterations, syndromes and central nervous system disorders.
This atlas can be potentially used as a tool for age estimation in a population with special needs and, also, in a population with systemic diseases, but we suggest further studies with larger international samples to create adequate atlases for all the required scenarios, mainly, diagrams for people with systemic diseases who are over the age of 16.
法医对实足年龄的估计在尸体身份识别中发挥着越来越重要的作用，并且由于移民现象以及无证被贩运儿童遭受性虐待的情况，在活体个体中也具有重要意义。
本研究旨在验证已在正常儿童和青少年群体中使用的牙齿矿化和萌出图谱，以估计年轻人群，特别是有特殊需求人群（其中大多数患有系统性疾病）的实足年龄。
从两家独立医疗机构收集了163例曲面断层片，这些片子来自133名年龄在4至23岁之间的患者。
将曲面断层片分为两组，95例来自患有对牙齿发育有影响的系统性疾病的患者，68例来自患有无牙齿影响的系统性疾病的患者。使用伦敦图谱通过上颌左侧然后独立地通过上颌右侧估计牙齿年龄。评估了观察者内和观察者间的一致性。计算并分析了牙齿年龄估计值与实足年龄之间的差异及其绝对值。
在估计值与实足年龄之间发现了具有统计学意义的差异，表明普遍存在低估现象；12岁以下人群除外。然而，16岁以下个体的低估并不显著（平均少于1个月），而对于至少16岁的人，低估则很显著（平均超过26个月）。此外，对于患有对牙齿有影响的系统性疾病的人，获得了更大的低估误差，这表明对于唐氏综合征、染色体异常、综合征和中枢神经系统疾病患者的中点值应重新评估。
该图谱有可能用作有特殊需求人群以及患有系统性疾病人群年龄估计的工具，但我们建议进行更大规模的国际样本进一步研究，以创建适用于所有所需情况的图谱，主要是为16岁以上患有系统性疾病的人绘制图表。
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