Bone age and dental age to assess criminal responsibility: Part I

Age estimation in forensic science plays a crucial role in determining legal and criminal responsibilities for living individuals. When the age of an individual is uncertain, a forensic age estimation examination is required, typically involving radiographic evaluation of bone and dental development. This study aimed to estimate and classify bone and dental ages in a Portuguese population aged 6 to 21 years, using the Baccetti and Moorrees, Fanning, and Hunt methods. The results were compared to chronological age and between methods for medico-legal purposes, utilizing lateral cephalograms and orthopantomograms.

A total of 466 lateral cephalograms and 767 orthopantomograms were analyzed. Baccetti stages were assigned to the lateral cephalograms, and cephalometric analysis was performed using ImageJ® software. For orthopantomograms, each tooth in the third quadrant was assigned a stage based on the MFH method.

Cohen's weighted kappa coefficients were 0.987 (intra-observer) and 0.977 (inter-observer) for the Baccetti method. Moorrees, Fanning, and Hunt method validations ranged from 0.655 to 1.00. Correlation coefficients for dental and bone regressions were 0.894 and 0.907, with adjusted determination coefficients of 0.798 and 0.822, respectively. The dental regression underestimated age, unlike the bone regression. The methods' accuracy and reliability varied based on the age being classified.

Both regressions accurately estimated age, but the dental method was more appropriate due to its tendency to underestimate, high precision and consistency of results. No significant differences were found between males and females, and both methods, dental and bone, may be used together to classify legal ages.