Timme Maximilian, Bender Jostin, Steffens Laurin, Shay Denys, Schmeling Andreas
Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149 Münster, Germany.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
Biology (Basel). 2023 Nov 5;12(11):1403. doi: 10.3390/biology12111403.
The evaluation of third molar eruption in dental panoramic radiographs (DPRs) constitutes an evidence-based approach for forensic age assessment in living individuals. Existing methodologies involve staging morphological radiographic findings and comparing them to reference populations. Conversely, the existing literature presents an alternative method where the distance between third molars and the occlusal plane is measured on dental plaster models. The aim of this study was to adapt this measurement principle for DPRs and to determine correlation between eruption and chronological age. A total of 423 DPRs, encompassing 220 females and 203 males aged 15 to 25 years, were examined, including teeth 38 [FDI] and 48. Two independent examiners conducted the measurements, with one examiner providing dual assessments. Ultimately, a quotient was derived by comparing orthogonal distances from the mesial cementoenamel junctions of the second and third molars to a simplified radiological occlusal plane. This quotient was subsequently correlated with the individual's age. We estimated correlations between age and quotients, as well as inter- and intra-rater reliability. Correlation coefficients (Spearman's rho) between measurements and individuals' ages ranged from 0.555 to 0.597, conditional on sex and tooth. Intra-rater agreement (Krippendorf's alpha) ranged from 0.932 to 0.991, varying according to the tooth and sex. Inter-rater agreement ranged from 0.984 to 0.992, with distinctions drawn for different teeth and sex. Notably, all observer agreement values fell within the "very good" range. In summary, assessing the distance of third molars from a simplified occlusal plane in DPRs emerges as a new and promising method for evaluating eruption status in forensic age assessment. Subsequent reference studies should validate these findings.
牙科全景X线片（DPR）中第三磨牙萌出情况的评估是对活体进行法医年龄评估的一种循证方法。现有方法包括对形态学影像学表现进行分期，并将其与参考人群进行比较。相反，现有文献提出了另一种方法，即在石膏牙模上测量第三磨牙与咬合平面之间的距离。本研究的目的是将这种测量原理应用于DPR，并确定萌出与实际年龄之间的相关性。共检查了423张DPR，涵盖220名女性和203名年龄在15至25岁之间的男性，包括牙齿38[FDI]和48。两名独立的检查人员进行测量，其中一名检查人员进行了两次评估。最终，通过比较第二和第三磨牙近中牙骨质釉质界到简化放射学咬合平面的正交距离得出一个商数。随后将该商数与个体年龄相关联。我们估计了年龄与商数之间的相关性，以及检查者之间和检查者内部的可靠性。测量值与个体年龄之间的相关系数（Spearman氏rho）在0.555至0.597之间，取决于性别和牙齿。检查者内部一致性（Krippendorf氏alpha）在0.932至0.991之间，因牙齿和性别而异。检查者之间的一致性在0.984至0.992之间，不同牙齿和性别之间存在差异。值得注意的是，所有观察者一致性值都在“非常好”的范围内。总之，在DPR中评估第三磨牙到简化咬合平面的距离是法医年龄评估中评估萌出状态的一种新的有前景的方法。后续的参考研究应验证这些发现。
