print 13-16 dimention face

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INDIAN JOURNAL OF FORENSIC ODONTOLOGY

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Indian Journal of ForensicOdontology (ISSN 0974-505X)presents peer-reviewed surveyand original research articles.Detailed reviews of newlypublished books relevant tofuture studies in the field are alsoincluded. Accessible to a broadrange of scholars, each surveypaper contains all necessarydefinitions and explanations; acomplete over-view of theproblem discussed; and adescription of its importance andrelationship to basic research onthe subject. This publication alsofeatures authoritativecontributions describing ongoinginvestigations and innovativesolutions to unsolved problems.The journal serves as a valuabletool for helping Librarian,Students, faculties etc. dealeffectively with the challenges ofthe field. It emphasizes articlesand reports that are directlyrelevant to practice.

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Editor-in-ChiefBalwant Rai

Health and Safety Officer, Crew, Mars Mission, NASA (USA)

Executive EditorRajnish K. Jain

Dy. EditorsJasdeep Kaur, Maria Catalina: NASA (USA)

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Lojain Jibawi, SyriaR Cameriere, Italy

Ulrich Suchner, Germany

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INDIAN JOURNAL OF FORENSIC ODONTOLOGY

January - March 2009; Volume 2 Number 1

Contents

Page

Determination of Cameriere Regression Equation Accuracy 05in Haryana Population

Balwant Rai, Jasdeep Kaur, Rajnish K. Jain, R. Cameriere, L. Ferrante

Forensic Orhtodontics- An Innovation 09Paramjot Singh Jagdev, Praveen Mehrotra, Namrata Rastogi

Use of Facial Dimensions in Prediction of Stature 13Swranjit Kaur, Surinder Nath

Maxillary Lateral Incisor as Biomarker of Age – An in-Vivo Radiographic Study 17Karthikeya Patil, Mahima V.G, Suchetha N. Malleshi

Efficacy of Pulp/Tooth Area Ratio in Age Estimation by Using Radiographs of 21Permanent Canine - A Preliminary Study

Deepak Pateel G. S.

Proposed Recommendation of Dental Age Estimation in Indian Population 25Jasdeep Kaur, Balwant Rai

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Determination of Cameriere Regression Equation Accuracy in HaryanaPopulation

*Balwant Rai, **Jasdeep Kaur, ***Rajnish K. Jain, ****R. Cameriere, *****L. Ferrante*Editor- in- Chief, **162, Model Town, Kapurthala – 144 601, Punjab, ***Asst. Prof, Teerthanker

Mahaveer Dental College & Research Centre, Moradabad, ****Institute of Legal Medicine,University of Macerata,Via Don Minzoni 9, 62100 Macerata, Italy,

*****Institute of Microbiology and Biomedical Sciences, Polytechnic University of Marche,Ancona, Via Ranieri 65, 60100 Ancona, Italy

Reprint requests: Dr. Balwant RaiEditor in Chief &Health and Safety Officer, CrewMars Mission, NASA (USA)Email: [email protected]

IntroductionTooth formation is widely used to assess

maturity and predict age. In clinical dentistry,this information aids in diagnosis and treatmentplanning.1 The continuous patterns of toothdevelopment can be observed on a longitudinalseries of radiographs and various mineralizationstages. 2-6 Previously number of methods havebeen proposed to determine dental age,7-15 but,the system developed by Demirijian has gainedwide acceptance.9 During developmental stagesparticularly in root formation, a notabledifference between sexes arises with femalesbeing advanced when compared with males.9-19 Previously Cameriere et al proposed aregression equation for age determination fromOpen and closed apices in children 16-17. It hasbeen reported that teeth development dependupon number of factors such as genetic,environmental, nutritional f and geographicalfactors 4-7 . Since these factors play major rolein tooth formation, they may have effect ondental age estimation. Hence the aim of thisstudy was to determine the accuracy ofCameriere equation for age estimation fromopen and closed apices on Haryana sub

Population.Material and MethodsThe orthopantomographs sample of 50

healthy children (25 boys: 25 girls) aged between5-15 years taken during the course of diagnosisand treatment was selected. Panoramicradiographs that were unclear or that showedhypodentia, gross pathology and previousorthodontic treatment were excluded.

The chronological age for each subject wascalculated by subtracting the date radiographwas taking from the date of birth.

Orthopantomographs were digitized using ascanner (HP) at 150dpi. Images obtained wereimported to Adobe Photoshop 7.

The number of teeth with closed apices (N0)and open apices (S), were calculated. The lengthof left and right permanent mandibular teethwere measured, measurement was done twiceand mean value was taken.

Age estimation was done by applyingCameriere regression equation,

Age?=?8.387?+?0.282 g?-?1.692?x?5?+?0.835N 0?-?0.116 s?-?0.139 s?×?N 0

The variable g is 1 for male and 0 for female... ResultsThe estimated age obtained was compared

with chronological age using student paired ttest.

when the whole data is consider (i.e.male and

Balwant Rai et al. Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

AbstractAge estimation in children is important in clinical as well as forensic dentistry. The

orthopantomograph samples of 50 healthy children (25boys: 25girls) aged between 5-15 yearswas selected and Cameriere regression equation was applied. We observed underestimation ofestimated age in boys and overestimation in girls as compared to their chronological age.

Keywords: Forensic dentistry, Cameriere regression equation, Haryana population OPG, Ageestimation.

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female) there is no significant difference betweenchronological age and estimated age (P= 0.6954)but when male and female data were consideredseparately there is a significant differencebetween chronological age and estimated age.(Male Pr = 0.0001, Female = 0.0001)We observedan underestimation of age in boys andoverestimation in girls as compared to theirchronological age.

DiscussionsThe need to estimate the age of living

individuals is becoming increasingly importantin forensic odontology since there are increasingnumbers of illegal immigrants without anydocuments of birthday. We observed thatunderestimation of age in boys andoverestimation in girls as compared to theirchronological age (Table 1,p) .While there is nosignificant difference data were analysedwithout taking gender into consideration.Thismay be due to overestimation in girls same asunderestimation for boys .From this finding weconcluded that we have to add some correctionfactor for applying this equation. It may be dueto different in geographical ,genetic andenvironment factors 4-6. So this equation variousfrom population to population, hence it shouldbe required more study on different population.As the results did show statistically significant

Sr.No Chronological age

Estimated age

1 4.5 3.8 2 6.8 5.7 3 8.7 7.6 4 8.9 8.2 5 11.2 10.9 6 6.7 5.6 7 7.8 6.7 8 12.7 11.6 9 15.3 13.2 10 13.2 12.7 11 10.6 9.8 12 7.8 6.9 13 11.8 11.5 14 15.9 14.9 15 16.9 15.9 16 12.5 12.1 17 14.6 13.9 18 15.6 15.4 19 8.9 8.7 20 5.1 4.9 21 5.9 5.1 22 9.1 8.3 23 7.5 6.9 24 6.3 6.1 25 8.5 8.1 Table a showing chronological and estimated age years in boys .

Table b Sr.N o Chronological age

Estim ated age

1 8.3 8.6 2 11.9 12.3 3 10.4 10.7 4 14.5 14.8 5 8.8 9.6 6 7.9 8.1 7 11.9 13.8 8 11.2 . 12.2 9 6.5 8.8 10 9.7 10.2 11 11.9 12.9 12 7.3 8.8 13 11.2 13.9 14 9.6 10.2 15 8.5 9.6 16 5.6 5.7 17 5.9 6.3 18 6.1 6.9 19 11.5 12.9 20 11.8 12.6 21 13.5 14.2 22 14.9 15.6 23 11.3 11.6 24 11.6 12.1 25 13.5 13.9 Table b show ing chronological and estim ated age( years) in girls


Table a

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difference between European countries, oneregression equation could not be applied toIndian populations .So new equation will berequired for Indian population on this conceptor adding some correction factor to apply onIndian populations.

References1. Maber M, Liversidge HM, Hector MP. Accuracy of

age estimation of radiographic methods usingdeveloping teeth. Forensic Sci Inter 2006 (159S), S68-S73.

2. Haaviko K. The formation and the alveolar andclinical eruption of the permanent teeth. Anorthopantomographic study. Thesis Suom. Hamm aslaak Toim 1970; 66: 103-70.

3. Nystrom M, Peck L, Kleemola-Kujala E, EvalahtiM, Kataja M. Age estimation in small children: referencevalues based on counts of deciduous teeth in Finns.Forensic Sci Int 2000 Jun 5; 110 (3): 179-88.

4. Flores-Mir C, Mauricio FR, Orellana MF, Major PW.Association between growth stunting with dentaldevelopment and skeletal maturation state. AngleOrthod 2005 Nov; 75 (6): 935-40.

5. Nielson HG, Ravn JJ. A radiographic study ofmineralization of permanent teeth in a group of childrenaged 3-7 years. Scand J Dent Res 1976; May 84: 109-118.

6. Staaf V, Mornstud H, Welander U. Age estimationbased on tooth development: a test of reliability andvalidity. Scand J Dent Res 1991; 99: 281-86.

7. Hagg U, Matsson L. Dental maturity as an indicatorof chronological age: the accuracy and precision of threemethods. Eur J Orthod 1985; 7: 25-34.

8. Demirijian A, Goldstein H, Tanner JM. A newsystem of dental age assessment. Hum Biol 1973; 45:211-227.

9. Olze A, van Niekerk P, Schmidt S, Wernecke KD,Rosing FW, Geserick G, Schmeling A. Studies on theprogress of third-molar mineralization in a BlackAfrican population. Homo. 2006: 57 (3): 209-17.

10.Lee SE, Lee SH, Lee JY, Park HK, Kim YK. Ageestimation of Korean children based on dental maturity.Forensic Sci Int. 2008 Jul 4;178(2-3):125-31.

11. TeMoananui R, Kieser JA, Herbison GP, LiversidgeHM. Estimating age in Maori, Pacific Island, andEuropean children from New Zealand. J Forensic Sci.2008 Mar;53(2):401-4.

12.Roberts GJ, Parekh S, Petrie A, Lucas VS.. Dentalage assessment (DAA): a simple method for childrenand emerging adults. Br Dent J. 2008 Feb 23;204(4):E7;discussion 192-3;

13. Tao J, Wang Y, Liu RJ, Xu X, Li XP.Accuracy ofage estimation from orthopantomograph usingDemirjian’s method. Fa Yi Xue Za Zhi. 2007Aug;23(4):258-60.

14. Rózy³o-Kalinowska I, Kiworkowa-RaczkowskaE, Kalinowski P. Dental age in Central Poland. ForensicSci Int. 2008 Jan 30;174(2-3):207-16.15. Cameriere R, Brkic H, Ermenc B, Ferrante L, OvsenikM, Cingolani M. The measurement of open apices ofteeth to test chronological age of over 14-year olds inliving subjects. Forensic Sci Int. 2008 Jan 30;174(2-3):217-21

16 Cameriere R, Ferrante L, Cingolani M. Ageestimation in children by measurement of open apicesin teeth.Int J Legal Med 2006; 120 (1): 49-52.

17. Cameriere R, Ferrante L, Cingolani M. Ageestimation in children by measurement of open apicesin teeth: a European formula.Int J Legal Med 2007; 121:449-553.

18. Rai B,. Anand S.C: Age Estimation in Childrenfrom dental Radiograph: A Regression Equation. TheInternet Journal of Biological Anthropology . 2008.Volume 1 Number 2 (http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijba/vol1n2/r a d i o g r a p h . x m l ) 19. Cameriere R, Ferrante L, Liversidge HM, Prieto JL,Brkic H. Accuracy of age estimation in children usingradiograph of developing teeth. Forensic Sci Int. 2008Apr 7;176(2-3):173-7


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Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

9

Forensic Orthodontics – An InnovationParamjot Singh Jagdev, Praveen Mehrotra, Namrata Rastogi

Department of Orthodontics and Dentofacial OrthopaedicsSardar Patel Institute of Dental and Medical Sciences, Lucknow

IntroductionForensic dentistry has, up to recent years, only been

more or less a hobby for some people interested inthis field. There have been few internationalcongresses dealing exclusively with the pertinentproblems concerning identification with the aid ofdental data. Assistance has been given to the police insome cases where only the dentist could evaluate thedetails given. A turning point has been reached in thehistory of forensic dentistry, and this may be due mainlyto the greatly intensified international traffic, in the airor at sea.1 Up to a hundred individuals may now losetheir lives at the same time, and, furthermore, theseaccidents leave behind them bodies that are mutilatedto a degree previously unknown. In such cases, theonly remains still recognizable may be the teeth ordental restorations, because these are more resistantto fire and water than other parts of the body orpersonal belongings. It is natural that the specialist,i.e., the dentist, is called when identification turns outto be difficult. As will be seen in the paper presentedby Keiser-Nielsen1, the internationalization of airtraffic will give rise to many difficulties, which can becleared up only by people really trained for this

purpose.Some of the ordinary methods for establishing

identity can be said to be more or less uncertain.Personal belongings may be sold, borrowed, orstolen, and various articles may be placed on avictim in order to hide a crime. Unfortunately,it can be said that all identifications made onbelongings or on something not continuous withthe body are not real identifications. This is whereforensic science comes in - a truemultidisciplinary speciality which amalgamatesvarious sciences including forensic dentistry toderive its objective, which in a nutshell is toestablish identity. Forensic odontology may bedivided into three major fields of Activity - Civil,Criminal, and Research - and in all three theinterests of justice demand the proper handlingand examination of dental evidence.2

Civil3: It is concerned with mass disasters likeAirline accidents, Earth quakes or trainaccidents, require identification of the victimsin advanced stages of physical destruction,malpractice and different types of fraud.

Criminal3: Identification of the persons fromtheir dental remains alone in cases of suicide orhomicide through bite mark analysis, rugoscopy,cheiloscopy.

Research3: Forensic Odontology training fordentists working in criminology or policedepartments.

Reprients reqiests: Dr. Paramjot Singh JagdevMDS (3rd Year), Department of Orthodontics andDentofacial Orthopaedics, Sardar Patel Institute ofDental and Medical Sciences, Lucknow

Paramjot Singh Jagdev et al. Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

AbstractIdentifying human remains by dental characteristics is a well-established component of forensic

science with a definite scientific basis. A turning point has been reached in the history of forensicdentistry, and this may be due mainly to the greatly intensified international traffic, in the air orat sea. Up to a hundred individuals may now lose their lives at the same time, and, furthermore,these accidents leave behind them bodies that are mutilated to a degree previously unknown. Insuch cases, the only remains still recognizable may be the teeth or dental restorations, becausethese are more resistant to fire and water than other parts of the body or personal belongings.From Orthodontic point of view, we can help the forensic team in some respects by puttingidentification marks on Removable, Functional and Fixed Appliances so that it would be easyfor the team to identify the dead bodies. Identification marks can be put in the form of Stripmarking, Bar coding etc.

Keywords: Forensic Odontology, Strip marking, Bar coding.

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The concept of dental identification is widelyknown, thanks to the media. But the nuancesand complexities of the process are rarelyunderstood. The central dogma of dentalidentification is that postmortem dental remainscan be compared with antemortem dentalrecords, including written notes, study casts,radiographs, etc, to confirm identity.4 (Figure-1)

A range of conclusions can be reached whenreporting a dental identification. The AmericanBoard of Forensic Odontology recommendsconclusions from the above comparison:5

• Positive identification: The antemortem andpostmortem data match in sufficient detail, withno unexplainable discrepancies, to establish thatthey are from the same individual.

• Possible identification: the antemortem andpostmortem data have consistent features but,

because of the quality of either thepostmortem remains or the antemortemevidence, it is not possible to establish identitypositively.

• Insufficient evidence: The availableinformation is insufficient to form the basis for aconclusion

• Exclusion: The antemortem andpostmortem data are clearly inconsistent.

Record Maintainance:Identification depends on the existence of

antemortem records to compare withpostmortem remains. With up to 32 teeth tocharacterize a person, there are 160 surfaces thatmay receive tooth restorations. Furthermore, inpatient dental records that also includedescriptions of tooth rotations, anomalies,supernumeraries, cavities and radiographicdocumentation,the number of possibilitiesbecomes very large. Essentially, no twodentitions are literally identical.Unfortunately,dental patient records are not yetstandardized. Various fields of dentistry likeProsthodontics, Oral Pathology and Endodonticsare contributing their role in forensic odontology.Can we as Orthodontists chip in with thisregard? And if so, how and why?

Methods1. Strip making2. Bar codingStrip MakingAny appliance which is having a acrylic

portion in it, a strip containing the informationsuch as name of the patient or institute andpatient identification number can be placed init during the curing process (Figure-2).

Step 1. The patient’s name, hospital numberor any other detail is typed on a paper. If thestrip is too long, it can be reduced in sizeaccording to the appliance. The strip is then cutand sized.Step 2. This strip is placed in the applianceduring the curing stage.

The details on the strip such as patientidentification number are to be written in thepatient’s case sheet (Figure-3). In case of somemishap, the forensic experts after reading theinformation from the strip can approach theinstitute or clinic and hence can identify thepatient.

Bar CodingA bar code is a machine-readable code

consisting of a series of bars and spaces printedin defined ratios. Bar code symbologies areessentially alphabets in which different widthsof bars and spaces are combined to formcharacters and, ultimately, a message. Becausethere are many ways to arrange these bars andspaces, numerous symbologies are possible. Barcode technology has been helping businessminimize data entry errors, speed processes, andreduce costs for over thirty years.

Symbology is considered a language in barcode technology. Just as you might speak Frenchwhile traveling in France, a symbology allows ascanner and a bar code to “speak” to each other.When a bar code is scanned, it is the symbologythat enables the information to be readaccurately. And then when a bar code is printed,it is the symbology that allows the printer tounderstand the information that needs to beturned into a label.

All bar codes have start/stop characters thatallow the bar code to be read from both left toright and right to left (Figure-4). The stop/startcharacters are unique characters placed at the


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beginning and end of each bar code and providetiming references, symbology identification, andthe direction that the information is read by thescanner. By convention, the unique character onthe left of the bar code is considered the “start”and the character on the right of the bar code isconsidered the “stop.” Immediately precedingthe start character and following the stopcharacter is an area of no markings called thequiet zone. Because there is no printing in thisarea, a scanning signal is not produced, thus theterm “quiet.” The quiet zone helps the scannerfind the leading edge of the bar code so readingcan begin. Combining these components, we geta complete bar code such as the one foundbelow. Notice the leading quiet zone followedby a start character, data, a stop character, anda final quiet zone.

We can ask the manufacturer to make apersonalised bar code which would designatethe name of the institute or dental clinic.

Where to Place Bar Code?In Fixed Orthodontics, we have a limited

space to place bar codes. Molar band can be usedfor its placement. On the molar band, we havechosen mesial or distal surface as these surfacesare more protected than buccal or palatal surfaces(Figure-5). The number written on the top of barcode is to be written in the patient’s case sheet(Figure-6). If some however some mishappeningtakes place with the patient, the forensic expertsafter analyzing the bar code can approach theinstitute and by correlating the number with thepatient’s case sheet can identify the patient.

Conclusion and ScopePersons who have been deceased for some

time before discovery present unpleasant anddifficult visual identifications. Dentalidentifications have always played a key role innatural and manmade disaster situations and,in particular, the mass casualties normallyassociated with aviation disasters. Hence, thereis a need to address the issue of denture markingfor social and legal reasons. Orthodontists canbecome valuable members of the dentalidentification process by using these techniqueswhich would be valuable in restoring theirpatient’s identity. The research from this pointshould be focused on newer, technologicallyadvanced, more viable and foolproof methods

which would strengthen the scope ofOrthodontics in the field of forensics, ensuringour continual and complete commitment inserving the society in general and humanity inparticular, however banal or prosaic thecontribution may be.

References1. Gosta Gustafson. J. dent. Res. Supplement to no.1

1963; 42: 252-254.2. AJC Balfour. Some aspects of Forensic

Dentistry(Report). 1977; 70 :263-264.3. Avon. S.L., Forensic Odontology: the roles and

responsibilities of the Dentist, Journ. Cana Dent Assoc2004; 70: 453-458.

4. A look at forensic dentistry-Part 1:The role of teethin the determination of human identity. British DentalJournal 2001; 190: 359-366.

5. American Board of Forensic Odontology. Bodyidentification guidelines. J Am Dent Assoc 1994; 125:1244-1254.

6. Malkowski FS. Forensic Dentistry, A study ofpersonal identification. Dent Stud 1972; 51: 42-44.

7. Morlang WM. Mass disaster management update.CDAJ 1986; 14: 49-57.

8. Rothwell BR, Haglund W, Morton TH. Dentalidentification in serial homicides: the Green RiverMurders. J Am Dent Assoc 1989; 119: 373-379.

9. Clark DH. An Analysis of the Value of ForensicOdontology in Ten Mass Disasters. Int Dent J 1994; 44:241-50.

10. American Board of Forensic Odontology. Bodyidentification guidelines. J Am Dent Assoc 1994; 125:1244-1254.

11. Borrman H, Thomas CJ, Engstrom EU. DentureMarking. Clinical and Technical Aspects. J ForensicOdontostomatol 1995; 13: 14-7.

12. Silverstein H. Comparison of antemortem andpostmortem findings. In: Bowers CM Bell G, (eds).Manual of Forensic Odontology. 3rd ed.Ontario:Manticore, 1995.

13. Whittaker DK, Richards BH, Jones ML.Orthodontic Reconstruction in a victim of murder. Br JOrthod 1998; 25: 11-14.

14. Delattre VF, Stimson PG. Self Assessment of theForensic Value of Dental Records J Forensic Sci 1999;44: 906-9.

15. Borrman HI, DiZinno JA, Wasen J, Rene N. Ondenture marking. J Forensic Odontostomatol 1999; 17:20-6.

16. Brannon RB, Kessler HP. Problems in MassDisaster Dental Identification: A Retrospective Review.J Forensic Sci 1999; 44: 123-7.


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DEPARTMENT OF ORTHODONTICS AND

DEPARTMENT OF ORTHODONTICS AND


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AbstractIn the present study an attempt has been made to explore the correlation between stature, and

the two facial measurements, i.e. nasal height and ear length among the male and female Rajputsof Himachal Pradesh. Secondly to observe if these facial measurements could be used to reconstructstature, under the circumstances when only head of an individual is recovered from a remotearea and the complete identity is not possible through visual examination. A total of 165 Rajputs(89males and 76 females) in the range from 20 to 40 years were measured for the nasal heightand ear length besides stature in accordance with the standard measurement technique (Martinand Saller, 1959). Analysis of data reveals that males have significantly taller with longer noseand ear than the females Both nasal height and ear length have a relatively low correlation withstature for either sex .Ear length among males exhibit greater correlation than the nasal heightwhile among females nasal height exhibits higher correlation than the nasal height. Howeverthe error of estimate is greater for both the measurements with females exhibiting lesser errorthan the males.

Use of Facial Dimensions in Prediction of Stature *Swranjit Kaur, **Surinder Nath

*Department of Anthropology, University of Delhi, Delhi-110007 **E-mail: [email protected]

IntroductionStature or body height is one of the most

significant and functional anthropometricparameter which determines the physicaldistinctiveness of an individual. Most of thestudies pertaining to estimation of stature haveconsidered long bone lengths only. Howeverthere are certain studies reported from differentparts of the world on use of other bodydimensions than the long bone lengths, like handlength, foot length, palm length and mid-fingerlength (Allbrook, 1961; Bhavna and Nath, 2006;Nath, 1997; Sethi and Nath, 2001; Singla et. al.,2005; Majumdar et. al., 2006; Sarajlic et al., 2007)

Some researchers have taken intoconsideration the head and face dimensions forreconstruction of stature, for example headlength, head breadth, morphological facialheight, total facial height, nasal height and earlength (Kler, et al. 1992; Miyashita andTakahashi, 1971; Jain and Nath, 1999; Krishnanand Kumar, 2006, Tiwary and Nath, 2005; Deviand Nath, 2001). Keeping this in view anattempt has been made to determine the level ofrelationship between nasal height and ear length

with stature and formulate prediction equationsfor estimation of stature among male and femaleRajputs of Himachal Pradesh.

Material and MethodsData for the present study comprises of a total

of 165 Rajputs (89 males and 76 females) rangingin age from 20-40 years. All the subjects includedin the present study belonged to the middlesocio-economic status, inhabiting the nearbyvillages. Followingmeasurements have been obtained on eachsubject using the standard measurementtechniques recommended (Martin and Saller,1959).

1. Stature (S): It is obtained as the projectivedistance between the standing surface and thehighest point on the head (vertex), usinganthropometre rod.

2. Nasal Height (NH): It measures the straightdistance between the nasion and subnasion,using sliding caliper.

3. Ear Length (EL): It measures the straightdistance between superaurale to suburale, usingsliding caliper.

Data were subjected to statistical treatmentfor assessing the sex differences in the bodymeasurements as well as for computingMultiplication Factors (MFs) for estimation ofstature on the basis of these facial measurements

Reprints request: Dr. Swranjit KaurDepartment of AnthropologyUniversity of DelhiDelhi-110007

Swranjit Kaur et al. Indian Journal of Forensic Odontology, Janwary-March 2009; Volume 2 Number 1

14

for both the male and the female Rajputs.Subsequently the data on facial dimensionswere treated for correlation and regressionanalysis to formulate sex specific predictionequations for estimation of stature.

Results and DiscussionNasal height and ear length are not commonly

used measurements for reconstruction of statureas both these measurements can be obtained ondead bodies that are not old and the facial skinhas not degenerated and the morphology of theface is partly recognizable. Nasal height has beenused by a couple of researchers earlier for thispurpose bur the ear length is being used perhapsfor the first time as a parameter to formulatemeans of stature estimation.

Table 1 presents the basic statistical constants

for stature, nasal height and ear length for maleand female Rajputs of Himachal Pradesh. It isapparent from the table that males are not onlytaller than the females but they have longer noseand ear dimensions too.

On subjecting the data to test of significance(t-test) it is exposed that the sex differences inall the three body dimensions are highlysignificant (at 0.01% level of significance).

On observing highly significant sex differencesdata on male and female Rajputs have beentreated separately for further analysis.

TABLE 1: Sex differences in different facialdimensions and stature among the Rajputsmales and females of Himachal Pradesh

Table 2 presents the mean M.F. values of nasalheight and ear length computed for estimationof stature among male and female Rajputs. It isevident from the table that males exhibit greaterM.Fs than the females for both the facialdimensions Females show higher value for nasalheight while for ear length males exhibit greatervalue of multiplication factor.

The different values of multiplication factorsfor males and females Rajputs of HimachalPradesh clearly reflect variation in their physique

TABLE 2: Multiplication Factors (M.F.) forestimation of stature through different facialmeasurements of Rajput males and females

Males(89) Females(76)

S. No

Body Dimensions

Mean ( X ) (cm)

Standard Error Of Mean ( S.E. )

Mean ( X ) (cm)

Standard Error Of Mean (S.E.)

t-Value

1. Stature (S) 169.19 0.75 156.26 0.65 12.70* 2. Nasal Height

(NH) 5.13 0.04 4.78 0.03 5.96*

3. Ear Length (EL) 6.08 0.04 5.83 0.03 4.46* significant at 0.01% level

S. No Body Dimensions

Males

Females

1. Nasal Height (NH) 33.14 32.82 2. Ear Length (EL) 27.92 26.83


15

The regression equations formulated forprediction of height from these two facialdimensions for male and female Rajputs arepresented in Tables 3 and 4 respectively. it isevident from these tables that the value ofcorrelation between ear length and stature is

greater for males as compared to the females,while the error of estimate (SEE) is lower forfemales than that of the males.

TABLE 3: Regression Equations for estimationof stature from different facial measurementsamong male Rajputs

In case of nasal height the situation is reversedas the females express a higher value ofcorrelation with stature than the males, therebysuggesting that the nasal height may be a betterindicator for prediction of stature among femaleRajputs of himachal Pradesh. This fact is furthersupplemented by the relatively low value of the

error of estimate (SEE) for females than themales.

TABLE 4: Linear Regression Equations forestimation of stature from different facialMeasurements among female Rajputs

It may be inferred from the present study thatboth the facial dimensions,, i.e., could be usedfor prediction of stature under the circumstanceswhen only chopped out head of an individual isrecovered from a scene of crime and all the facialfeatures are not indistinct but it is beyondrecognition .

Under such circumstances one should conductthe relevant measurements on nose height andear length and enter these values into concernedprediction equations or use multiplications forreconstruction of stature.

References1. Allbrook, D. 1961. The estimation of stature in

British and East African males based on tibial and ulnarbone lengths.J. For. Med. 8:15 – 28

2. Bhavna and Nath, S. 2006. Reconstruction ofstature among Shia Muslims of Delhi using hand andfoot length. In Modern Trends in Forensic Science, (Eds.)Ramesh Chandra, Surinder Nath and Parveen Janjua.Shree Publishers & Distributors, Delhi

3. Devi, L.S. and Nath, S. 2001. Prediction of statureamong male Maieties of Manipur through hand, footand facial dimensions. In Advances in Forensic Science(Eds.) M.K. Bhasin and Surinder Nath, Department ofAnthropology, University of Delhi, Delhi. 117-121.

4. Jain, P., Roy, S. and Nath, S. 1999. Regressionequations for prediction of stature from hand and footmeasurements of Jats females of Delhi. In Press.

5. Kler, G.S., Butt, N.A. and Chattopadhyay, P.K. 1992.Estimation of stature from nasal height. Ind. J. For. Sci.,6:87: 87-93

6. Krishan, K., Kumar, R. 2007. Determination ofstature from cephalo-facial dimensions in a northIndian Population. Legal Medicine, 9:128-133.

7. Majumdar, P., Arora, P., Nath, S. and Singla, A.2006. A reconstruction of stature using hand and footlengths of Yadavs of Jhansi. In Modern Trends inForensic Science, (Eds.) Ramesh Chandra, SurinderNath and Parveen Janjua. Shree Publishers &Distributors, Delhi; 120-128.

8. Martin, R. and Saller, K. 1959. Lehrbuch der

S. No Body Dimensions Equations

Standard error of Estimate (SEE)

Correlation value (r)

1 EL S = 148.67 + 3.37(EL) ±7.03 0.18 2 NH S = 158.93 + 1.99(NH) ±7.10 0.11

S . N o

B o d y D im en sio n s

E q u ation s

S tan d ard erro r o f E stim ate (SE E )

C o rrela tion va lu e (r)

1 N H S = 141 .9 + 3 .0 (N H ) ± 5.67 0 .18 2 E L S = 138 .3 + 3 .0 (E L ) ± 5.69 0 .16


16

Anthropologie in Systematischer. Fischer Darstellung,Stuttgart.

9. Miyashita, T. and Takahashi, E.1971. Stature andNose height of Japanese. Hum. Bio. 43:327-339

10. Nath, S. 1997. Estimation of stature through handand foot length among Jats of Rajasthan. PoliceResearch and Development, Qr.IV:20-22.

11. Sarajlic, N., Chilarz, Z., Klonowski, E.E. and Selak,I. 2006. Stature estimation for Boasnian MalePopulation. Bosn. J. Basic.Med.Sci., 6:62-67.

12. Sethi, V. and Nath, S. 2001. Prediction of staureusing upper limb bone dimensions among Jain femalesof Delhi. In Advances in Forensic Science, (eds.) M.K.Bhasin and Surinder Nath. Department of

Anthropology, University of Delhi; 103-110.13. Singla, A., Nath, S. and Chandra, R. 2005.

Prediction of staure using upper limb and lower limbdimensions among male and female Brahmins ofBundelkhand. In An Interdisciplinary Approach toForensic Science, (Eds.) Dr. Parveen Kumar Janjua,Dr.G.Sunil Babu and Dr. Navjot kaur Kanwal. Selective& Scientific Books, Delhi; 31-147.

14. Tiwary, D and Nath. S., 2005. Prediction of staturefrom head and face dimensions among Jats. In anInterdisciplinary approach to Forensic Science, (Eds)Dr. Parveen Kumar Janjua, Dr. Sunil Babu and Dr.Navjot Kaur Kanwal. Selective & Scientific Books, Delhi;113-130.


17

Maxillary Lateral Incisor as Biomarker of Age – An in-Vivo Radiographic Study

*Karthikeya Patil, **Mahima V.G, ***Suchetha N. Malleshi * Professor and Head, **Professor, ***PG Student, Department of Oral Medicine and

Radiology, J.S.S. Dental College, Mysore

AbstractEstimation of age is one of the perplexing problems faced by forensic experts and

anthropologists. Changes in the size of pulp canal caused by apposition of secondarydentin as a person ages is one of the parameters employed in age estimation by X-rays.Radiographic method scores over the other methods because it is non-invasive, inexpensiveand easily accomplished. This study measured the Pulp/tooth ratio mesiodistally of themaxillary lateral incisor radiographically. The model explained 74.1% of total variance.

Key Words: Maxillary Lateral Incisor, Pulp/Tooth Ratio, Radiograph, Mesiodistal Dimension

IntroductionAge refers to a period of human life, measured

by years from birth. It is usually marked by acertain degree or stage of mental or physicaldevelopment and involves legal responsibilityand capacity. Estimation of age assumesimportance from a forensic, anthropologic andmedico-legal point of view. Teeth were first usedas barometer of age in the 1800s.1

Fully formed teeth show aging changes thatmirror those seen systemically. Hence, teeth canbe used to estimate an age range foranthropologic and forensic purpose and act asbiomarker of age. Many techniques have evolvedover the years using teeth as medium for ageestimation. In children and adolescents ageestimations are based on developmental stageof permanent and deciduous dentition. Ageestimation using teeth in adults is challengingand many methods have been explored. Studiesreveal that for correlation with chronological agebest results are provided by the analysis of toothcementum annulations, and by determinationof aspartic acid racemization.2 These methodsthough are invasive and cannot be used in living

individuals.2 In comparision the radiographictechnique is non-invasive, simple and can beused even in living and dead alike and thereforean easy co-relation is possible.

This study is based on the concept that as aperson ages the pulp chamber size decreases dueto secondary dentin deposition. This size changecan be measured radiographically and analysed.The purpose of this in –vivo study was to find areliable method for chronological age estimationof adults by examining the pulp/tooth widthratio of maxillary lateral incisors at theradiographic cemento-enamel junction (CEJ).

Materials and Methods70 Individuals within the age group of 19 –

58 years were selected for the study (Table 1).Intraoral Periapical Radiographs (IOPARS) ofeither of the maxillary lateral incisors of theseindividuals were exposed using size 2 Kodak Espeed films (Eastman Kodak, Rochester, NewYork). Paralleling method was followedthroughout the study to avoid exposure errors.All the peri-apical radiographs were at anexposure of 70 kVp and 8 mA (Evolution X -300machine, Toshiba Co, Italy). All the radiographswere manually processed in a single batch withnewly prepared processing solutionsmaintaining standard time and temperature.

The inclusion criteria included teeth whichwere in normal functional occlusion, without

Karthikeya Patil et al. Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

Reprints Requests: Dr Karthikeya PatilProfessor and Head, Department of OralMedicine and RadiologyJ.S.S. Dental College, Mysore, Karnataka

18

any clinical or radiographic evidence of caries,trauma or restoration or any periapicalpathology. IOPARS with any incidentalpathologic findings in relation to area of interestwere excluded from study.

Table 1: Age and Sex Cross-tabulation

Radiographic images of maxillary lateralincisors so obtained were digitized by indirectmethod (Canon SX 100 camera, 8.0 megapixel)and stored in a computer file in JPEG format(Adobe Photoshop 7.0 ®). Iconico software (ver.4.0) screen calipers were used to carry out the

Fig 1

Fig. 1 and Fig 2 : Schematic representation oftechnique of measurement

The values so obtained were entered in Excelworksheet. Pulp-tooth ratio (x/y) of each toothwas calculated from the above measurementsand tabulated the descriptive analysis of whichis given in Table 2. This ratio method helped toreduce the effect of possible variation inangulations and magnification.

Table 2: Descriptive analysis

N M in im u m M a x im u m M e a n S td . D e v ia t io n

A G E 7 0 1 9 .0 0 5 8 .0 0 3 7 .4 4 2 9 1 2 .0 8 2 6

R A T I O 7 0 0 .1 1 0 .3 0 0 .2 0 9 0 4 .3 3 8 E -0 2

Statistical analysis and results:All measurements were carried out by same

observer. To test intra-observer variability 20peri-apical radiographs were randomly selectedand re-examined after 2 weeks. The pulp-toothratio was used as the morphological variable.The values were entered in Excel worksheet withactual age and gender tabulated against therespective ratio.

Statistical analysis was performed using SPSSfor windows (SPSS statistical software, Ver. 16).In order to assess the difference between actualchronological age and predicted age, a linearregression model with first order interaction was

developed. The regression analysis was carriedout with age as the dependant variable and ratioand gender as independent variables. As genderdid not contribute significantly a step downanalysis was done. Following the regressionanalysis the following regression formula wasobtained.

Age = 87.5703 - 239.84 X 2, (X 2 = ratio)This model could explain 74.1 % of

variation (Graph 1). The residual statisticsobtained are given in Table 3.

measurements on the computer for the imagesstored in JPEG format.

Fig 2

Measurements of all the selected radiographs(Fig. 1 and Fig. 2) were carried out along:

1. Mesiodistal direction of the pulp along theCEJ in cms and recorded (x)

2. Mesiodistal direction of the tooth along theCEJ in cms (y)


19

Minimum Maximum Mean Std. Deviation

Predicted Value 15.6170 61.1875 37.4429 10.4038

Residual -12.8046 13.1877 -3.4614E-14 6.1441

Std. Predicted Value -2.098 2.282 .000 1.000

Std. Residual -2.069 2.131 .000 .993

Correlation co-efficient were obtained betweenactual age and predicted variables. Thestandard error of the estimate was 6.1891 .

AGE

605040302010

RAT

IO

.4

.3

.2

.1

Graph 1. Scatter graph showing relationbetween age and ratio

DiscussionAdulthood heralds many time–related

biological changes, many of which can be usedto determine age. Current macroscopic methodsof age estimation involve teeth, cranial suture,pubis, auricular surface of ilium and sternal rib.3Teeth are commonly employed for ageestimation when skeletal remains are in poorcondition as humidity, fire or trauma rendersmany parts not usable.4 Dental wear is themethod commonly used by anthropologists butsince attrition is related to diet and culture, thismethod has little significance except for thepopulation where the data was collected.4Secondary dentin deposition was introduced byGustafson for age estimation along with attrition,periodontal recession, cementum apposition,apical translucency and external root resorptionas other factors. 2 The apposition of secondary

dentine is often preferred because pulp issurrounded by dentin, which changes duringan individual’s life and leads to reduction in sizeof pulp cavity. Secondary dentin has beenstudied using several methods, both by sectionand radiographic. 4,5 Radiographic study is anon-invasive, simple and reproducible methodthat can be employed both on living individualsand unknown dead, either in identification casesor archaeological investigations.3,5,6 Manystudies using radiographic applicability of pulp-tooth ratio for age estimation have found apositive co-relation. 3,5,6,7 However Meinl et alfound that the application of regression formulagiven by various researchers to their sampleeither lead to over or under estimation. 2However, it must be noted that radiographicdifferentiation between secondary andreparative dentin is not possible.6

This study is unique in the concept that thepulp – tooth width ratio of maxillary lateralincisors at radiographic cemento enameljunction (CEJ) of digitized IOPARs wereconsidered for predicting age. Maxillary lateralincisor was the tooth chosen because the studyby Paewinsky, Pfeiffer and Brinkmann showedthat this tooth had the strongest correlationcoefficient for age amongst the anterior teeth atCEJ level.7 Moreover maxillary anteriors showconsiderably less crowding and attrition ascompared to their mandibular counterpart. Thestudy by Kvaal et al did not find any statisticaldisparity in teeth between right and left side ofjaw for age estimation, hence lateral incisor fromeither side was randomly selected.6

Table 3: Residuals Statistics


20

Various studies on pulpal morphology haveshown that width of pulp is a better indicator ofage than length.5,6 This study is in tandem withother studies which have highlighted thecorrelation between pulp-tooth ratio as a goodpredictor of age.1,5,7,8 In this study minimumpredicted age value was 15.6170 and themaximum 61.1875, as in comparison to theactuals which were 19 and 58 years respectively.Other studies using the same concept as oursgave a correlation coefficient value in the rangeof 71 – 91% as compared to 74 % obtained inthis study. 5,1 The result indicates theappropriateness of using maxillary lateral incisoras a viable variable in chronological ageprediction. The advantage of this method ofstudy is that it can be safely applied in livingindividuals also. It should however be notedthat maxillary lateral incisors are one of thecommonly missing and malformed teeth,although fortunately bilateral incidence of theseanomalies is quite rare.

The accuracy of the study depends mainly onthe exactitude of measurements and techniqueof the radiograph exposure. This study gives ananalysis of contemporary local population andresults could vary in different racial populations.Therefore it would be worthy to note thevariations in a larger and more heterogeneouspopulation, with increased variables.

References1. Morse DR, Esposito JV, Schoor RS, Williams FL,

Furst ML: A review of aging of dental components anda retrospective radiographic study of aging of dentalpulp and dentin in normal teeth. Quintessence Int 1991;22:711-720.

2. Meinl A, Tangi S, Pernicka E, Fenes C, Watzek G:On applicability of secondary dentin formation toradiological age estimation in young adults. J ForensicSci,2007,52(2),438-441

3. Cameriere R et al: Reliability in age determinationby pulp/tooth ratio in upper canines in skeletalremains. J Forensic Sci,2006,51(4),861-864

4. Cameriere R, Ferrante L, Belcastro MG, BonfiglioliB, Rastelli E, Cingolani M: Age estimation by pulp/tooth ratio in canines by peri-apical X-rays.J ForensicSci,2007, 52(1),166-170

5. Cameriere R, Ferrante L, Belcastro MG, BonfiglioliB, Rastelli E, Cingolani M: Age estimation by pulp/tooth ratio in canines by mesial and vestibular peri-apical X-rays.J Forensic Sci,2007, 52(5),1151-1155

6. Kvaal SI, Kolltveit KM, Thomsen IO, Solheim T:Age estimation of adults from dental radiographs.Forensin Sci. Intl, 1995,74,175-185

7.Paewinsky E, Pfeiffer H, Brinkmann B:Quantification of secondary dentin formation fromorthopantamograms – a contribution to forensic ageestimation methods in adults.Int J Legal Med,2005,119,27-30

8. Morse DR, Esposito JV, Schoor RS: A radiographicstudy of aging changes of the dental pulp and dentin innormal teeth. Quintessence Int 1993;24:329-333.


21

Efficacy of Pulp/Tooth Area Ratio in Age Estimation by UsingRadiographs of Permanent Canine - A Preliminary Study

Deepak Pateel G. S.Senior Lecturer, Department of Oral Pathology and Microbiology, KM Shah Dental College and

Hospital, Sumandeep University, Piparia - 391760, Vadodara, GujaratAbstractObjective: To examine the possible application of pulp/tooth area ratio of canine in Intra Oral Periapical X-

ray using RVG for estimation of age of an individual.Material and Method: 25 Individuals aged between 18 to 27years, with apparently normal canine were

included in the present study. Radiovisuographic images of canine of upper and lower jaws were obtained.These images will be then transformed to CAD2007 software from which area of pulp/tooth ratio will be calculatedwith the help of 10 points from each tooth outline and 5 points for each pulp outline. By using regressive formulathe age was calculated.

Results: The estimated age using maxillary canine (x1) showed no statistically significant difference betweenthe estimated age and the real age (p=0.1) which means that there is little difference between real age andestimated age. So, it is feasible to estimate age using Pulp to tooth area ratio of maxillary canine.

Key words: Age Estimation, Radiographs, Canine

IntroductionThe new millennium has entered with renewed

hopes of finding solutions to the existing problemsand also with new challenges resurfacing in ourday-to-day lives. Although last century haswitnessed major breakthroughs in the field ofscience and technology, crime still persists in allaspects of our lives.

Forensic sciences comprise a vast area ofexpertise right form conventional forensic medicineto the modern “white collared” cyber forensics,but as progress is being made at the advancingfront of this science, its backdrop still suffers fromlack of specificity and sensitivity of certainprocedures such as “Age Determination.”

Age estimation of living or deadindividuals is an important aspect of forensicsciences and amongst the various methodsinvolved in the determination of age, thoseinvolving teeth have given consistent results. Mostof the dental age estimation methods reported arebased on the age related changes in the teeth likeRoot dentine translucency (1-3), tooth cemental

annulations(4,5) and apposition of secondarydentine(6,7). But the quantification of thesemorphological changes nearly always requiresextraction and sectioning of teeth which isimpossible and unethical in living individuals8.Hence, the techniques which are being developedfor age estimation in living individuals mostly onradiological imaging of teeth.

Apposition of secondary dentine is a continuingregular process resulting in the reduction in thepulp area with the advancement of age. Thisreduction in pulp area can be measuredradiographically and has been the basis of manyradiological age estimation methods9.

Roberto Cameriere et. al (2007) have developedone such age estimation method, which uses Pulp/Tooth area (P/T) ratio as an indicator of age.Canines were preferred for present study. Thepresent study was carried out to examine thepossible application of P/T area ratio by periapicalradiographs for age estimation of an individualusing Autocad 2007 software10.

Material and MethodsSource of Data: The present study was carried

out in the Department of Oral Pathology andMicrobiology, KLES’s Institute of Dental Sciences,Belgaum. Students aged between 18 – 25 years withapparently normal canine were included in the

Deepak Pateel G.S. Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

Reprint Requests: Dr. Deepak Pateel G. S.Senior Lecturer, Department of OralPathology and Microbiology, KM Shah DentalCollege and Hospital, Sumandeep University,Piparia - 391760, Vadodara, Gujarat

22

present study. Of the 25 individuals 13 were malesand 12 were females.

Exclusion CriteriaCanines with caries, periapical pathology,

abrasion, erosion and any other developmentalanomalies.

Method of Collection of DataAll the students aged between 18 to 25 years

were given numbers and 25 students among themwere selected randomly by using table of randomnumbers. After obtaining an informed consent, abrief case history was recorded. The real age ofthe individual was calculated based on the subject’sdate of birth. Each of the selected individuals wasassigned an identification number from 1-25.

AGE USING X2 & X1: 114:624 - 431:183x1 - 456:692x2 +1798:377x1x2 ………………(1)AGE USING X1: 89:456 - 461:873x1………………………………………………………… (2)AGE USING X2: 99:937 - 532:775x2…………………………….…………………………... (3)

IOPA radiographs of both maxillary andmandibular canines were obtained from eachindividual by a radiologist using Radiovisuography(Kodak 5000 Radiovisuography system). Theobtained RVG images were labeled according totheir corresponding identification number andwere analyzed for estimation of age.

Estimation of AgeThe obtained RVG images of canine were

processed using a Autocad 2007 software. Pulp andtooth area were obtained by identifying 25 pointson the tooth outline and 15 points for pulp outline.From the obtained pulp and tooth areas P/T arearatio was calculated. P/T areas of maxillary canineswere designated (X2) and that of mandibular

ResultsThe real and estimated age of the study groups

and their means are shown in Table No 1. Themean difference between the real age and theestimated ages (X2, X1, and X2 X1,) werecalculated. In the present study, the estimated age

using maxillary canine showed no statisticallysignificant difference between the estimated ageand the real age (p=0.1) which means that there islittle difference between real age and estimatedage (Table no 2). The Karl Pearson’s correlationcoefficients between Real age and the estimatedage using the means are displayed in Table No 3.

Table No. 1: Comparison of real age andestimated age.

S l . N o R e a l a g e( Y e a r s )

E s t i m a t e d a g eu s i n g x 2 ( Y e a r s )

E s t i m a t e d a g eu s i n g x 1 ( Y e a r s )

E s t i m a t e d a g eu s i n g x 1 x 2 ( Y e a r s )

1 1 8 2 1 2 5 . 5 2 4 . 3 1 2 2 3 2 5 . 1 2 2 . 4 2 4 . 5 3 2 5 2 6 . 1 3 2 2 9 . 0 4 4 1 9 1 5 2 3 2 1 . 3 5 2 0 2 2 . 8 2 7 2 5 . 6 6 2 1 2 6 . 1 3 1 . 2 2 6 . 1 7 2 0 2 3 . 5 1 8 . 7 2 2 . 5 8 2 1 2 3 . 4 2 2 . 5 2 6 . 2 8 9 2 2 1 9 . 6 2 4 . 1 2 3 . 1 3 1 0 2 2 2 6 . 8 5 3 1 . 8 9 2 8 . 2 5 1 1 2 0 1 8 . 2 2 3 . 5 7 2 2 . 3 1 2 1 2 2 0 2 2 . 2 3 0 . 8 2 6 . 1 6 1 3 1 8 1 6 . 7 1 6 . 9 1 9 . 0 7 1 4 2 0 2 8 . 1 3 0 . 3 2 8 . 5 1 5 1 8 1 5 . 5 2 6 . 2 2 2 . 1 1 6 2 6 1 8 . 2 2 0 . 2 2 1 . 8 1 7 1 9 1 6 . 8 1 0 . 8 1 7 . 7 1 8 1 9 2 1 . 1 6 1 6 . 4 2 0 . 9 1 9 2 0 2 0 . 1 2 0 . 3 2 2 2 0 1 8 2 4 . 2 2 6 2 5 . 2 2 1 2 1 2 3 . 2 2 5 . 4 2 5 2 2 2 1 2 9 2 9 2 9 2 3 2 4 2 4 . 9 2 6 2 6 2 4 2 7 2 3 . 1 3 3 . 9 2 8 . 1 2 5 2 2 2 5 . 5 2 3 . 3 2 5 M e a n ±S D ( a g e i ny e a r s )

2 1 . 0 ± 2 . 5 2 2 . 3 ± 3 . 9 2 4 . 7 ± 5 . 6

2 4 . 4 ± 3 . 1

canine (X1). Using X1 and X2 parameters, age ofthe individual was calculated using the followingregression formulae’s.


23

Table No. 2: Paired t-tests between real age andestimated age

Variables

Mean difference

t-value

p-value

significance

Real age and X2

1.3 ± 3.9

1.68 0.1 NS

Real age and X1

3.74±5.18

3.60 <0.01 S

Real age and X2X1

3.4 ± 2.9 5.84

<0.01 S

Table No. 3: Karl Pearson’s coefficient betweenreal age and estimated age

Variables r-value

p-value Standard error

R2

Real age and X2

+0.34 0.09(NS) 2.4 12%

Real age and X1

+0.38 0.06 (NS)

2.3 14%

Real age and X2X1

+0.45 0.02 (S) 2.2 21%

DiscussionThe present study utilizes P/T area ratio as a

parameter for age estimation. Previous studieshave produced reliable results with reduced interand intra-observer variability. Canines areusually preferred for the following reasons.

*Usually present in old age.*Undergo less wear when compared to the

posterior teeth.*Are less likely to suffer wear when compared

to other anterior teeth.*Are the single-root teeth with the largest pulp

area and thus the easiest to analyze. In the present study the estimated age using

maxillary canine showed no statisticallysignificant difference between the estimated ageand the real age (p=0.1) which means that thereis little difference between real age and estimated

age. This is in accordance with the studies doneby Roberto et.al.

Estimated age using mandibular canines aloneand combined maxillary and mandibularcanines showed statistically significantdifference between real age and estimated agewith a p value of <0.01, which means that thereis more difference between real age andestimated age. These results are in contrast withstudies done by Robert et al. In the mandibularcanines, the difference between real age andestimated age was more which may be becauseof difficulty to adopt RVG sensor to the mandiblearch due to lack of space to accommodate it.

Nevertheless, the present age estimationmethod has the following distinctive advantages.

*This method does not require sectioning oftooth.

*Method is tested in subjects aged between 18-79 years.

*Possible to use in both living subjects andskeletal remains.

*This method can be used even though theskeletal remains are in poor conditions.

*Is a fast and chip method (needsapproximately just 30 min for age estimation).

Future scope of this study lies in analyzinglarger sample sizes in order to reduce thestandard errors of the estimates andinvestigating the effect of race and culture.

ConclusionBased on the results of the present study, we

can conclude that P/T area ratio of the maxillarycanine can be used as a reliable method to predictthe age of the individual.

References1. Bang G, Ramm E. “Determination of age in humans

from root dentine transparency”. Acta Odonto Scand1970; 28:3–35.

2. Drusini AG. “Age-related changes in roottransparency of teeth in males and females”. Am J HumBiol, 1991; 3:629–37.

3. Lamendin H, Baccino E, Humbert JF, Tavernier JC,Nossintchouk RM. “A simple technique for ageestimation in adult corpus: the two criteria dentalmethod”. J Forensic Sci 1992; 37:1373–9.

4. Wittwer-Backofen U, Gampe J, Vaupel JW. “Tooth


24

cementum annulations for age estimation: results froma large known-age validation study”. Am J PhysAnthropol 2004; 123:119–29.

5. Jankauskas R, Barakauskas S, Bojarun R.“Incremental lines of dental cementum in biological ageestimation. Homo 2001; 52:59–71.”

6. Lopez-Nicolas M, Canteras M, Luna A. “Ageestimation by IBAS image analysis of teeth”. ForensicSci Int 1990; 45:143–50.

7. Drusini A, Toso O, Ranzato C. “The coronal pulpcavity index: a biomarker for age determination inhuman adults”. Am J Phys Anthropol 1997; 103:353–63.

8. Bosmans N, Ann P, Aly M, Willems G. “Theapplication of Kvaal’s dental age calculation techniqueon panoramic dental radiographs”. Forensic Sci Int,2005; 153:208–12.

9. Roberto Cameriere, Luigi Ferrante, Maria GiovannaBelcastro, Benedetta Bonfiglioli, Elisa Rastelli, MarianoCingolani. “Age Estimation by pulp/tooth ratio incanines by periapical x-rays”. Journal of Forensicscience, 2007; 52:1.

10. Roberto Cameriere, Luige Ferrante, Math. D,Mariano Cingolani. “Variation in pulp/tooth area ratioas a indicator of age, a preliminary study”. Journal ofForensic science, 2004; 49: 2.


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Proposed Recommendation of Dental Age Estimation in IndianPopulation

*Jasdeep Kaur, **Balwant Rai*Forensic Odontologist, 162, Model Town, Kapurthala – 144 601, Punjab

**Editor-in-Chief & Health and Safety Officer, Crew, Mars Mission, NASA (USA)

Reprient Requests: Dr. Jasdeep KaurForensic Odontologist, 162, Model TownKapurthala – 144 601, PunjabPhone: 09888022123

IntroductionDental age estimation can be divided into two

periods in life. The first period is when the teethare developing in the jaws up to 20 years.Comparison of the developmental stages withtables for the different stages may here be usedas a scientific statistical method. Later, when allteeth are fully formed regressive age relatedchanges might be used as a scientific method.Such methods are less accurate than methodsbased on the developmental stages.Dental ageestimation may be performed both in living anddead persons. The same methods may beapplicable. However for dead persons it is rarelypossible to get any information about the livingconditions and diseases of the individual. Inaddition, the teeth may be extracted and groundaccording to the different techniques for moreaccurate studies.An examination of the mouthand the dental conditions is an integrated partof age estimation in both living and deadpersons. Such an examination should end witha visual assessment of the age of the individual.In many identification cases where we havegood dental records the age estimation is of lessimportance. Thus a visual assessment may beenough. However, in cases where the ageestimation may be greater importance, at leasttwo scientific methods should be used.

Age estimation of individuals below 20years of age

Most scientific studies have been aimed at theconstruction of developmental tables for thedifferent stages of tooth formation and how finethese stages can be graded without beingimprecise and difficult to determine.Generally,only studies made after 1960 have sufficientlylarge material and fine grading so they shouldbe used to calculate the age of the individual.These methods, based upon the developmentalstages, are more accurate than age estimationbased on the stages of eruption of teeth.Therefore, visual age assessment methods havenot often been performed in these age periodsand the trust in the statistical scientific tableshas been strong. However, the dentaldevelopment may be retarded by severe and longlasting diseases. This may also be the case inmany congenital syndromes. Only rarehormonal hyper secretion may accelerate thedevelopment. Also nutritional deficiencies mayretard the dental development. Severe dentaldiseases and tooth extraction may also influencethe dental development. For a most accurateassessment of the age it is necessary to assessthese factors and take them into consideration.In India we are using at one age estimationtechniques in cases of age estimation inindividuals below 20 years of age. Generally weare using the tables from Balwant rai in NorthanIndian population 1 .

Jasdeep Kaur et al. Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

AbstractThe historical development of age estimation and the different techniques are presented. Also it

is important to separate individuals below 18 years where tooth development can be used andthose above 20 years of age where regressive changes must be used and where the visual assessmentmay be more important. Suggestions for new recommendations are presented. Finally the Indiandental age estimation project of BR in Northan Indian who claim to be below 18 years of age isdescribed.

Keywords: Age estimation; Quality assurance, Project

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Age estimation of individuals above 20years of age

In dental age estimation of individuals above20 years scientific methods must rely uponregressive age changes such as attrition, loss ofperiodontal attachment and secondary dentinformation. Such parameters are partlyinfluenced by function and also by pathologicprocesses and are thus far less accuratecompared to the developmental stages of theteeth. Thus, in these cases the visual assessmentmay be almost as accurate as the calculated ageaccording to a specific technique. A visualassessment may thus be an importantsupplement to scientific methods.The firstscientific technique for age calculation in adultswas presented by Gustafson 2. It was based onlongitudinal sections of teeth cut through thecentral area. It can not be used for living person,only in dead when extraction of a tooth isallowed. The technique consisted in attributingscores from 0 to 3 for the presence and amountof age related changes such as attrition,periodontal ligament retraction, secondarydentin formation, root translucency and rootresorption. The scores were added and aregression analysis with age as dependentvariable was performed.Later his method hasbeen modified by several researchers 2-6.Allthese formulae are based upon regressionanalysis e.g. multiple regression with age asdependent variable and the different age relatedchanges as independent variables. The formulaeare generally most accurate around 40–50 yearsand with increasing inaccuracy in younger andespecially in older age groups. Also anotherdifficulty is that there is a pronounced tendencyfor overestimation of younger persons andunderestimation of older persons. These factsmust be taken into consideration when makingthe final conclusion.

In living persons, it is not possible to extractteeth and grind them according to the differenttechniques. Thus a radiologic technique like theone developed by Jasdeep kaur and Balwantrai is one of the few that can be used. It is basedonly on the size of the pulp in relation to thewhole tooth and gives a measure of thesecondary dentin formation. However it is partlydependent on the anatomy of the tooth and

pulp. Formulae exist for each of different teeth7.

An alternative morphologic technique inliving persons is the morphologic technique byBalwant rai 4 . This technique is based only uponattrition, and recession of the periodontalattachment, all variables that can be assessed ina living individual.For most methods of agecalculation there is only one regression formulathat is used for all types of teeth. This is obviouslyinaccurate as teeth emerge in the oral cavity atdifferent times. Also the contribution of differenttypes of teeth in chewing vary and thus theexpected changes. We therefore hold that thebest method should have one formula for eachtype of tooth.

It is difficult to collect extracted teeth to beused as material for methods of age calculations.Therefore, for some methods more than onetooth from the same individual has been used.For others the material is not described accuratelyenough so that the use of only one tooth fromeach individual can be verified. It may beobvious that the variation within one individualis less than between different individual. Thusthis may result in a too small standard deviationand it may look like the method is more accuratethan it really is.

New recommendation for quality assurancein age estimation

In the following the recommendations areproposed by Jasdeep Kaur and Balwant rai .

The purpose of the age examination is to:1. Estimate the most likely age of the

individual;2. Make reference to the methods used.All agreed on these steps. These are the more

mechanical looking up a stage in a table or applya formula. There is no assessment by the expertin this and the age estimation could in fact bedone by anyone. There is no requirement ofstating a standard deviation or confidenceinterval. It would always be incorrect as it is onlyvalid for the individuals the method is basedupon. We should never give any wrong figuresin our reports and especially when it comes tostatistics. However, the figures for thedistribution of the data must only be taken as


27

indicative for the real variation in the actualpopulation.

As optional steps were that the purpose alsois to:

3. Express the likelihood of an official age, if itexists;

4. Express the likelihood of an alternative ageif it exists.

If the commission is given by the police theywill ask explicitly for what they want to know.However others like private persons or schools,etc. do not know what to ask for. In my mind itis self evident that we have to take the officialage and the alternative age into consideration,instead of just saying something about thestandard deviation. We should express thelikelihood of these two ages and if one can beexcluded. If we do not do this, it is left to lawyersto argue without proper statisticalunderstanding. The question is, however,whether forensic odontologists have sufficientunderstanding of statistics.

Optional is also the way of arriving at the finalestimate by using:

1. The expert’s own assessment;2. Information from the person on the living

conditions and diseases;3. The results from scientific statistical

methods.As some dentists are not interested in

background information the collection of theseare also optional. They should be: familyeconomy, food supply, water supply, seriousdiseases, previous dental problems andtreatment, dental hygiene.

There was only agreement on checking theidentity of the examined person during theclinical examination. Evaluating the oral mucosaand describing the dentition as far as occlusion,teeth present in the mouth, individualcharacteristics of the teeth, degree of attrition,colour of the teeth, staining and calculus,periodontal conditions and visual ageassessment, solely based upon the teeth, areoptional.

It was agreed to carry out a radiographicexamination which should include radiographs

that may enable the age estimation methodsdecided upon and which should describe thedentition and individual characteristics of theteeth. It was also agreed to use as manyappropriate parameters as possible, to usemethods as originally described in the literatureand to use as many teeth as possible. Using atleast two independent statistical methods wasleft as an option. Finally the conclusion shouldend with a complete assessment of the most likelychronological age.

As some of the participants would not makea clinical assessment nor ask for backgroundfactors, they had naturally difficulty with takingthese factors into consideration in the finalassessment of the age.

The optional factors were:1. Assess if the methods are appropriate in

relation to the individual;2. Assess factors which may have influenced

the tooth development or ageing;3. Assess especially if pathologic factors or

other may have influenced the findings.Final remarksWe believe that this is the way to go for

international guidelines on quality assurance inforensic odontology and in age estimation inparticular. Steps to be observed should bespecified on an international level and the exacttechnique to be used at each step should be leftto the national societies. We have shown thatthis type of quality assurance is practicable inour age estimation . We have also suggested aimprovements in the recommendations with dueconsideration to those who do not want to makeany expert assessment, but confine themselvesto reporting the result from a table or a formula.

References1. Rai B. Primary and Permanent teeth eruption in

North Indian Population: Age estimation. Clinical Dent.2009; 1(1): 12-16.

2. Gustafson G, Age determination on teeth, J. Am.Dent. Assoc. 1950,;41 : 45–54.

3. Rai B, Dhattarwal S.K., Anand S. C., Kharb S.Modification in Gustafson’s Method: Age Estimation.Medico- Legal update. 2007;7(1):98-106.


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4. Rai B, S.K. Dhatterwal & S.C. Anand, Five Markersof Changes in Teeth: An Estimating of Age, InternetJournal of Forensic Science (2006).http://w w w . i s p u b . c o m / o s t i a / i n d e x . p h p ?xmlFilePath=journals/ijfs/vol1n2/age.xml)

5. Dalitz G.D., Age determination of adult humanremains by teeth examination, J. Forensic Sci. Soc.1962.3. 11–21.

6. Maples W.R., An improved technique using dentalhistology for estimation of adult age, J. Forensic Sci.1978;23:764–770.

7.Kaur J, Rai B. Periapical radiographs of individualteeth: Age estimation. Romain J Legal Medicine ( Inpress).

8. Rai B. Two Radiographic Methods Evaluation ofTeeth Development in North Indian Children andYoung People. Advances in Medical and DentalSciences, 2008; 2(1): 20-22.

9. Rai B, Anand S. : Secondary Dentin for AgeDetermination . The Internet Journal of Forensic Science.2007 Volume 2 Number 1


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About the journalIndian Journal of Forensic Odontology

(ISSN 0974-505X) presents peer-reviewed surveyand original research articles. Detailed reviewsof newly published books relevant to futurestudies in the field are also included. Accessibleto a broad range of scholars, each survey papercontains all necessary definitions andexplanations; a complete over-view of theproblem discussed; and a description of itsimportance and relationship to basic researchon the subject. This publication also featuresauthoritative contributions describing ongoinginvestigations and innovative solutions tounsolved problems. The journal serves as avaluable tool for helping Librarian, Students,faculties etc. deal effectively with the challengesof the field. It emphasizes articles and reportsthat are directly relevant to practice.

General InformationManuscript should be prepared in accordance

with the uniform requirements for manuscriptssubmitted to the biomedical journals compiledby the International Committee of MedicalJournal Editors (ann. Intern. Med. 1992; 96: 766-767).

As per policy of the journal editorial committeeit disapproves the submission of the same articlessimultaneously to different journals forconsideration as well as duplicate publicationof the same article.

Submission of ManuscriptManuscript should be forwarded via email to

the Editor ([email protected]). The length of apaper is typically in the order of 15–30 journalpages. Manuscripts should use 12 point Timesor Times New Roman fonts, double line spacingand in MS Word format. The manuscript shouldarrange as follow: Covering letter, Checklist, titlepage, abstract, keywords, introduction, methods,results, discussion, references, tables, legends tofigures and figures. All pages should benumbered consecutively beginning with the titlepage. Signed declaration that the theme is ofhis own, and paper has not been publishedanywhere or not under consideration for

publication.Title pageIt should contain the title, short title (if any),

names of all authors (without degrees ordiplomas), names and full address of institutionswhere the work was performed,acknowledgement, abbreviations (if any used),name and address of corresponding author alongwith email, and contact phone number.

AbstractStructured abstract not more than 150 to 200

words. It must convey the essential features ofthe paper.

Key WordsAuthor should include 3-5 Key Words.IntroductionIt should contain the state why study was

carried out and what were its specific aims andobjectives.

Materials and MethodsThese should describe the nature of materials

and specific methods/procedures used toconduct the study. It also contains the statisticalmethods used for presentation and analysis ofdata and results.

ResultsThese should be concise and include only the

tables and figures necessary to enhance theunderstanding the text.

DiscussionIt should consist of a review of the literature

and relate the major findings of the study toother publications on the subjects along withsupporting references.

ReferencesAuthors are required to use the Vancouver

style to cite/quote the references. The referencesshould be numbered in the order in which theyappear in the texts and these numbers shouldbe inserted above the lines on each occasion theauthor is cited.

Indian Journal of Forensic OdontologyPaper Submission Instructions


36

Examples of common forms of referencesare

Journal articleAnsari Mehtab Alam, Kamal Mohd. Researchon “Meningitis’: a Bibliographic Study. Ind JLib & Info Sci, 2008; 2(1): 5-12 ( name ofjournal, year of publication, volume (issue)and pages).

MagazineGakhar Isha. Eco-friendly Bags in Fashion.

Women on the Earth, 2008; 2: 28-28.NewspaperParmar Vijaysinh. All this family got was their

son’s head, Times of India. 2008; July 29.BookBenjamin Lewin. Genes VI. New York; Oxford

University Press, 1997Bookchapter

Fisher M. Nosocomial. Infection and InfectionControl. In Jenson H, Baltimore R. PediatricInfectious Diseases. 2nd Ed, W.B. SoundersCompany; 2002: 1221.

World Wide WebJutta M. Joesch et al. Does Your Child Have

Asthma? Filled Prescriptions and Household Reportof Child Asthma. Elsevier. http://www.jpedhc.org/article/S0891-5245(06)00129-5/abstract (August 21, 2008).

Guidelines for presentation of Tables andFigures

TablesTables should be typed in double spaced on

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be followed in order for electronic images to beof sufficient quality to be published in the Journal.The photographs and figures should be sent assaved with their links.

Photographs (halftones) and radiographs(either color or black and white) will be acceptedin electronic form if the image is a minimum of4 inches wide (any height) and a minimumresolution of 300 ppi/dpi. We can accept

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Illustrations (black and white line art), charts,and graphs are often recreated in the Journaloffice. Digital images must be a minimum of 4inches wide (any height), and the resolution mustbe 1200 ppi/dpi. We can accept electronic filesfor illustrations in the following file formats: TIFF,EPS, JPEG, and PDF. The output software mustbe either Adobe PhotoShop or Adobe Illustrator,or Adobe Acrobat (for PDF images). For hard-copy submissions, we can accept laser and inkjetprints (600 ppi or higher print resolution ispreferred).

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14-18 September 2009Basic Crime Scene Reconstruction CourseCONTACT: E-mail: [email protected]

14 - 18 September 2009Basic Facial Reconstruction SculptureWorkshopCONTACT: www.skullpturelab.com

15-17 September 2009IMF 2009http://imf-conference.org/

21 - 25 September 2009Advanced Facial Reconstruction SculptureWorkshopCONTACT: www.skullpturelab.com

21-25 September 2009Forensic Soil ExaminationCONTACT: Website information: http://www.collegeofmicroscopy.com/

21-25 September 2009The Northwest Association of ForensicScientists and the Rocky Mountain Divisionof the International Association ofIdentification Fall 2009 Training ConferenceCONTACT: http://www.nwafs.org/

meetings.htm.

5-9 October 2009Basic SANE TrainingCONTACT: www.gnesa.org5-9 October 2009Scanning Electron MicroscopyCONTACT: Website information: http://www.collegeofmicroscopy.com/

12-14 October 2009Particle Isolation, Manipulation andMountingCONTACT: Website information: http://www.collegeofmicroscopy.com/

August 8 – 9, 2009Second National Conference of ISPRP,Kochi, IndiaContact: Dr George Jacob, OrganizingSecretary.Tel: 092494 49490, 094472 21596E-mail:[email protected]

September 2-5, 2009FDI Annual World Dental CongressSingapore 2009, SingaporeContact: Heather ShepphardTel: +33450 40 50 50E-mail:[email protected]

5-9 September 201020th International Symposium on theForensic Sciences (ANZFSS)CONTACT: www.anzfss2010.com

September 11-13, 2009Expodent Mumbai 2009, MumbaiContact: Mr. Firoz MerchantTel: + 91 22 40175522E-mail:[email protected]

4-8 October 20102010 Midwestern Association of ForensicScientists 39th Annual Meetingwww.mafs.net


40 Indian Journal of Forensic Odontology, January-March 2009; Volume 2 Number 1

October 9-11, 2009World Dental Show, MumbaiContact: Ranjita KunduTel: 09833923446, 022-23643344E-mail: [email protected]

October 23-25, 2009IDEM India, MumbaiContact: Mr Krunal Goda, Project ManagerTel: +91 22 42 10 78 02E-mail: [email protected]

October 30-November 1 , 200917th Annual conference of the IAACD, NewDelhiContact: SecretariatTel: + 91 11 26863388E-mail: [email protected]

November 5-8, 200944th India Orthodontic Conference, NewDelhiContact: Dr. Vikram GandhiTel: 011-26252398E-mail: [email protected]

12-15 October 200920th International Symposium on HumanIdentificationCONTACT: www.promega.com/geneticsymp20/

18 - 23 October 2009MAAFS, MAFS, SWAFS, SAFS JointMeeting & Call for Papers

4-8 January 2010Medicolegal Death Investigator TrainingCourseCONTACT: http://medschool.slu.edu/mldi

25-26 January 2010National Conference on Recent Advances inForensic Medicine & ToxicologyCONTACT:www.intelmedicon.com

26-27 January 2010American Board of Forensic OdontologyDental Identification WorkshopCONTACT: http://www.abfo.org

26-30 April 2010Medicolegal Death Investigator TrainingCourseCONTACT: (314) 977-5970 9-13 August 2010Medicolegal Death Investigator TrainingCourseCONTACT: (314) 977-5970

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