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. 2025 Jan;139(1):143-155.
doi: 10.1007/s00414-024-03312-1. Epub 2024 Aug 22.

Insights into dental age estimation: introducing multiple regression data from a Black South African population on modified gustafson's criteria

Fabian Rudolphi  1 , Laurin Steffens  1 , Denys Shay  1   2 , Chané Smit  3 , Liam Robinson  3 , Herman Bernitz  3 , Andreas Schmeling  1 , Maximilian Timme  4
Affiliations

Insights into dental age estimation: introducing multiple regression data from a Black South African population on modified gustafson's criteria

Fabian Rudolphi et al. Int J Legal Med. 2025 Jan.

Abstract

Dental Age Estimation (DAE) is an effective instrument of the rule of law for verifying dubious age claims in living individuals. Once tooth development is complete, only degenerative dental characteristics can be used for this purpose. The influence of ethnicity on these degenerative dental characteristics has not been clarified.Degenerative changes were examined using modified Gustafson's criteria including secondary dentin formation, cementum apposition, periodontal recession and attrition using the Olze et al. (2012) staging scales. Orthopantomograms of 1882 black South Africans, consisting of 934 females and 948 males, from 12.00 to 40.96 years of chronological age were utilized. Two independent examiners performed the evaluations, with one of the two evaluating all radiographs twice.The relationship between individual characteristics and chronological age was analyzed using multiple regression analysis with chronological age as the dependent variable. The resulting R2 values ranged from 0.22 to 0.35, and the standard error of estimate were between 6.6 and 7.3 years. The correlation with age was consistently lower for females compared to males. The characteristic of cementum apposition emerged as critical in this population, due to a particularly low correlation with age and observer agreements partly in the "slight" range. The formula's values for the correlation with age were in general below the literature values for other populations. Overall, the limited precision of the age estimation by the formulae presented, especially for females, must be emphasized. The question of whether ethnicity per se exerts an influence on the characteristics in question, or whether the different socio-economic status, which encompasses factors such as nutrition and healthcare, is the determining factor, needs to be assessed in future studies.

Keywords: Age assessment; Chronological age; Demirjian; Legal medicine; Orthopantomogram; Premolars.

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Conflict of interest statement

Declarations. Compliance with ethical standards: All examinations were performed with the approval of the responsible ethics committee of the Medical Association Westfalen-Lippe and the University of Münster (AZ 2020-038-f-S), and in accordance with national law. This study was also approved by the University of Pretoria, Faculty of Health Sciences Research Ethics Committee (Reference no.: 587/2021). All procedures followed the ethical standards of the Helsinki Declaration of 1975, as revised in 2008. Conflict of interest: The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Stage classification to determine degree of secondary dentin formation [31]
Fig. 2
Fig. 2
Stage classification to determine degree of periodontal recession [31]
Fig. 3
Fig. 3
Stage classification to determine degree of attrition [31]
Fig. 4
Fig. 4
Stage classification to determine degree of cementum apposition [31]
See this image and copyright information in PMC

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