Hassan Fatma Mohamed, Moawad Asmaa Mohammad, Samir Walaa, Helaly Yara Rabia, Abu-Taleb Noha Saleh
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Cairo University, Kasr Alainy Street, Cairo 11562, Egypt.
Department of oral and maxillofacial radiology, Faculty of Dentistry, Beni-Suef University, Beni-Suef 62511, Egypt.
Homo. 2021 Jun 25;72(2):87-97. doi: 10.1127/homo/2021/1344.
Determination of the age of majority is of critical importance in forensic and legal practice. This study aimed to assess the mandibular third molar maturation stage in discriminating adults and minors in an Egyptian population sample using two methods: Cameriere's third molar maturity index (I) and Demirjian's stage of maturation; further, the I cut-off value of < 0.08 for age 18 years and older was tested. The study included 350 digital panoramic radiographs of 14-24 years old participants. The effectiveness of I < 0.08 and Demirjian's stages were assessed using sensitivity, specificity, accuracy, post-test probability, positive likelihood ratio, and negative likelihood ratio. Receiver operating characteristic (ROC) curves were constructed to detect the overall effectiveness of I and Demirjian's stages to determine adults. I < 0.08 showed accuracy, sensitivity, specificity, post-test probability, positive and negative likelihood ratios of 88.65%, 91.74%, 83.67%, 90.6%, 5.62 and 0.10 respectively in males, and 82.76%, 80.16%, 87.04%, 91.03%, 6.18 and 0.23 in females. Stage H showed the best specificity and post-test probability within Demirjian stages; 91.84% and 94.06% in males and 90.74% and 91.84% in females. Both I and Demirjian's stage H of the mandibular third molar were useful indicators for discriminating between Egyptian adults and minors. The cut-off value of I < 0.0625 in males and I < 0.104 in females showed a better discrimination performance than I < 0.08 among Egyptians.
在法医和法律实践中，确定法定年龄至关重要。本研究旨在通过两种方法评估埃及人群样本中下颌第三磨牙成熟阶段以区分成年人和未成年人：卡梅里埃第三磨牙成熟指数（I）和德米尔坚成熟阶段；此外，还测试了18岁及以上年龄的I截止值<0.08。该研究纳入了350张14 - 24岁参与者的数字化全景X线片。使用灵敏度、特异性、准确性、检验后概率、阳性似然比和阴性似然比评估I<0.08和德米尔坚阶段的有效性。构建受试者工作特征（ROC）曲线以检测I和德米尔坚阶段确定成年人的总体有效性。I<0.08在男性中的准确性、灵敏度、特异性、检验后概率、阳性和阴性似然比分别为88.65%、91.74%、83.67%、90.6%、5.62和0.10，在女性中分别为82.76%、80.16%、87.04%、91.03%、6.18和0.23。在德米尔坚阶段中，H阶段显示出最佳的特异性和检验后概率；男性为91.84%和94.06%，女性为90.74%和91.84%。下颌第三磨牙的I和德米尔坚H阶段都是区分埃及成年人和未成年人的有用指标。在埃及人中，男性I<0.0625和女性I<0.104的截止值比I<0.08表现出更好的区分性能。
