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. 2025 Sep;139(5):2313-2322.
doi: 10.1007/s00414-025-03505-2. Epub 2025 May 19.

Assessing the accuracy of the third molar eruption as an indicator of adulthood: findings from a black South African sample using the Gambier method

Nikolaos Angelakopoulos  1 , Shatakshi Sharma  2 , Sudheer Babu Balla #  3 , Galina Zolotenkova #  4 , Stefano De Luca #  5
Affiliations

Assessing the accuracy of the third molar eruption as an indicator of adulthood: findings from a black South African sample using the Gambier method

Nikolaos Angelakopoulos et al. Int J Legal Med. 2025 Sep.

Abstract

Background: Age estimation is a critical aspect of forensic practice, often requiring straightforward, accurate, and precise dental methods employed by experts in various contexts where their expertise is needed. The third molar eruption analysis presents a practical approach. This study evaluates the Gambier et al. scoring system for assessing legal adulthood (18 years) through third molar observations in black South African subadults.

Materials and methods: A retrospective analysis was conducted on 877 orthopantomograms (357 males and 520 females) of individuals aged 14 to 24 years.

Results: The mean chronological age increased with the progression of stages (1 to 3) and phases (A to D) of the third molar eruption for both sexes. Our study revealed a strong association between advanced eruption phases and the likelihood of being 18 years or older. For instance, phase D (complete emergence in the occlusal plane) showed a high likelihood of individuals being 18 years or older, with 76% of males (32 out of 42) and 80.5% of females (66 out of 82) in this phase aged above 18.

Conclusion: This technique, due to its ease of use, can provide useful preliminary information regarding the probable age of alleged minor asylum seekers. However, the results indicate that, in line with the minimum age principle, this method should be applied cautiously when determining adulthood, as the minimum age for both stage 3 of eruption and phase D is clearly below 18 years. Therefore, it should always be used alongside other validated methods recommended by international protocols and good practice guidelines to ensure reliability across different populations.

Keywords: Age of majority; Dental age estimation; Gambier et al. scoring system; South Africa; Third molar eruption.

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Conflict of interest statement

Declarations. Ethical approval: The outlined investigation protocol received approval from the Ethics Committee of Sechenov First Moscow State Medical University, Moscow, Russia (approval number No 21–24, dated 05/09/2024). Research involving human participants and/or animals: Not applicable. Informed consent: Not applicable. Compliance with ethical standards: The study was carried out following the ethical standards of the Declaration of Helsinki (Finland). Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Box-plot graphical representation of age distribution for each third molar for males and females
See this image and copyright information in PMC

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