Comparative Evaluation of Cementum Annulation and Root Translucency for Dental Age Estimation in an Adult Indian Population

AbstractBackground: Accurate determination of chronological age from dental tissue is central to forensic odontology, particularly in populations lacking reliable documentation. Cementum annulation (CA) and root translucency (RT) are two histological and morphological methods widely applied in adult age estimation. Their comparative accuracy in the Indian population which presents distinct dietary, occlusal, and genetic influences on dental ageing remains insufficiently studied.Aim: To compare the accuracy of CA and RT for dental age estimation in adult Indians and to evaluate intra- and inter-observer reliability for both methods.Methods: A cross-sectional study was conducted using 120 extracted single-rooted permanent teeth from individuals aged 20–70 years. Ground sections (90 􀀀m) were prepared for CA counting under polarised light microscopy, while root translucency length was measured on longitudinal sections under transmitted light. Two blinded examiners performed all assessments independently. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used for reliability and agreement analysis. Mean absolute error (MAE) served as the primary accuracy metric.Results: CA yielded a MAE of 4.2 ± 2.1 years and RT yielded a MAE of 5.8 ± 2.9 years. ICC values were 0.91 (95% CI: 0.87–0.94) for CA and 0.84 (95% CI: 0.79–0.89) for RT. Bland- Altman analysis revealed a mean bias of 􀀀0.3 years for CA and 􀀀1.1 years for RT. CA demonstrated significantly lower estimation error (p < 0.05).Conclusion: CA provides more accurate age estimation than RT in this Indian adult sample, though its technical complexity limits routine forensic use. A combined approach may optimise accuracy in practice.