Movahhedian Najmeh, Nikmanesh Sara, Bazooband Amirreza
Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
J Forensic Odontostomatol. 2024 Dec 30;42(3):9-19. doi: 10.5281/zenodo.14561902.
The life-altering effects of criminal trials necessitate providing reliable methods to distinguish adults (≥18) from minors (< 18). The present study aims to evaluate the accuracy of the third molar maturity index (I3M) introduced by Cameriere et al. (2008) in distinguishing adults from minors in the Iranian population. Panoramic radiographs of 800 Iranian individuals (400 males and 400 females) aged 14-23 were evaluated. The cut-off value of I3M=0.08 was analysed to determine whether the individual is younger or older than 18. All male or female subjects with I3M above 0.7 were below 18 years old. The cut-off value of 0.08 showed a sensitivity of 80.83% and 63.33% and a specificity of 88.12% and 93.12%, respectively, in males and females. The positive predictive values were 91.08% and 93.25%, and the negative predictive values were 75.40% and 62.87%, respectively, for males and females. The Bayes' post-test probability was 94% for females and 92% for males. 83.75% of males and 75.25% of females correctly classified as adults or minors. The most remarkable error rate occurred at 18 years old (67.5 % in females and 57.5% in males). By ROC curve analysis, the population-specific cut-off values of I3M 0.097 for males, 0.116 for females, and 0.099 regardless of sex, were acquired, which improved the sensitivity of discrimination between adults and minors (86.3%, 73.8%, and 78.1 %, respectively). The results showed that I3M is a reliable method for distinguishing between minors and adults in the Iranian population. This method provides a higher accuracy level in identifying individuals under 18 years old. Population-specific I3M cut-off values increased accuracy, sensitivity, and NPV, especially for females. The I3M method produced better results in diagnosing adult males than adult females and a higher accuracy level in identifying individuals under 18.
刑事审判对生活产生的改变作用使得有必要提供可靠的方法来区分成年人（≥18岁）和未成年人（<18岁）。本研究旨在评估Cameriere等人（2008年）提出的第三磨牙成熟指数（I3M）在区分伊朗人群中的成年人和未成年人方面的准确性。对800名年龄在14 - 23岁的伊朗个体（400名男性和400名女性）的全景X线片进行了评估。分析I3M = 0.08的临界值，以确定个体是小于还是大于18岁。所有I3M高于0.7的男性或女性受试者均未满18岁。0.08的临界值在男性和女性中的敏感性分别为80.83%和63.33%，特异性分别为88.12%和93.12%。男性和女性的阳性预测值分别为91.08%和93.25%，阴性预测值分别为75.40%和62.87%。女性和男性的贝叶斯检验后概率分别为94%和92%。83.75%的男性和75.25%的女性被正确分类为成年人或未成年人。最显著的错误率出现在18岁时（女性为67.5%，男性为57.5%）。通过ROC曲线分析，获得了男性I3M的人群特异性临界值为0.097，女性为0.116，不分性别为0.099，这提高了区分成年人和未成年人的敏感性（分别为86.3%、73.8%和78.1%）。结果表明，I3M是区分伊朗人群中未成年人和成年人的可靠方法。该方法在识别18岁以下个体方面具有更高的准确性。人群特异性的I3M临界值提高了准确性、敏感性和阴性预测值，尤其是对女性。I3M方法在诊断成年男性方面比成年女性产生了更好的结果，并且在识别18岁以下个体方面具有更高的准确性。
