Forensic Age Estimation: Bone And Dental Age Assessment

In forensic science, age assessment is essential for establishing a living person’s criminal and legal responsibilities. Medico-legal age estimation exam, which usually involves radiographic assessment of bone and dental development, is necessary when an individual’s age is unknown. This study aimed to estimate and classify bone and dental ages in a Portuguese population aged 6 to 21 years, using the Baccetti and Moorrees, Fanning and Hunt (MFH) methods. A total of 466 lateral cephalograms and 767 orthopantomograms, from individual’s aged between 6 and 21 years, were analyzed. Baccetti stages were assigned to the lateral cephalograms, and cephalometric analysis was performed using ImageJ® software. For orthopantomograms, each tooth in the third quadrant was assigned a stage based on MFH method. The study was approved by the Ethics Committee with the reference number 217/23. Cohen's weighted kappa coefficients were 0.987 (intra-observer) and 0.977 (inter-observer) for the Baccetti method and MFH method validations ranged from 0.655 to 1.00. Correlation coefficients for dental and bone regressions were 0.894 and 0.907, with adjusted determination coefficients of 0.798 and 0.822, respectively. The dental regression underestimated age, unlike the bone regression. The methods’ accuracy and reliability varied based on the age being classified. Both regression methods accurately estimated age, with the dental method being preferred for its tendency to underestimate, high precision and consistency. No significant sex differences were observed, and both methods should be used together for legal age classification.