Combining wrist age and third molars in forensic age estimation: how to calculate the joint age estimate and its error rate in age diagnostics

Abstract

Background: Forensic age estimation in living adolescents is based on several methods, e.g. the assessment of skeletal and dental maturation. Combination of several methods is mandatory, since age estimates from a single method are too imprecise due to biological variability. The correlation of the errors of the methods being combined must be known to calculate the precision of combined age estimates.

Aim: To examine the correlation of the errors of the hand and the third molar method and to demonstrate how to calculate the combined age estimate.

Subjects and methods: Clinical routine radiographs of the hand and dental panoramic images of 383 patients (aged 7.8-19.1 years, 56% female) were assessed.

Results: Lack of correlation (r = -0.024, 95% CI = -0.124 to + 0.076, p = 0.64) allows calculating the combined age estimate as the weighted average of the estimates from hand bones and third molars. Combination improved the standard deviations of errors (hand = 0.97, teeth = 1.35 years) to 0.79 years.

Conclusion: Uncorrelated errors of the age estimates obtained from both methods allow straightforward determination of the common estimate and its variance. This is also possible when reference data for the hand and the third molar method are established independently from each other, using different samples.

Keywords: Age estimation error; combined methods; dental panoramic radiograph; forensic age estimation; hand radiograph.