de Araújo Priscila Santiago Paiva, Pinto Paulo Henrique Viana, da Silva Ricardo Henrique Alves
Department of Stomatology, Public Health and Forensic Odontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Int J Legal Med. 2024 Mar;138(2):451-465. doi: 10.1007/s00414-023-03110-1. Epub 2023 Oct 20.
The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults.
利用法医常规可获取的方法对成年人进行年龄估计是法医专家追求的目标。卡梅里埃、费兰特和钦戈拉尼（2004年）提出将犬齿的牙髓/牙齿面积比作为一个有前景的变量，但在科学文献中其可靠性呈现出相互矛盾的结果。本文旨在进行一项系统评价并进行荟萃分析，以验证犬齿的牙髓/牙齿面积比是否包含一个可单独用于估计成年人牙齿年龄的变量。使用葡萄牙语、英语和西班牙语中与该主题相关的关键词在六个数据库中进行了系统检索。研究选择过程遵循预先确定的纳入标准。对所选研究的偏倚风险和发表偏倚进行了评估，并以牙髓/牙齿面积比与实际年龄之间的皮尔逊相关系数作为效应量进行了荟萃分析。大多数所选研究显示出较低的偏倚风险；当考虑所有研究时未发现发表偏倚，而去除异常值时发现了潜在的发表偏倚。尽管研究之间存在高度异质性且需要更多研究，但可以观察到牙髓/牙齿面积比与实际年龄呈强烈负相关，并且牙髓/牙齿面积比可从根尖片和全景片中得出。因此，建议有科学证据表明从犬齿获得的牙髓/牙齿面积比对于成年人牙齿年龄估计是可靠的。
