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Comparative Age Estimation Using 2D and 3D Imaging of Maxillary and Mandibular Molars: A Prospective Study
Ayushi P Mangulkar1, Prajakta C Khelkar1, Bharathi S1
1Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, IND.
Cureus
|April 7, 2025
Summary
3D imaging of tooth pulp-to-enamel volume ratios offers a more accurate method for forensic age estimation than traditional 2D radiographic techniques. This advanced approach shows significant potential for reliable identification in legal and investigative contexts.
Area of Science:
- Forensic Odontology
- Anthropology
- Radiology
Background:
- Accurate age estimation is crucial in forensic odontology for identification and legal proceedings.
- Teeth are reliable biological indicators of maturity due to their resistance to external factors.
- Existing methods like the Tooth Coronal Index (TCI) using panoramic radiographs have limitations in accuracy.
Purpose of the Study:
- To compare the accuracy of age estimation using pulp-to-enamel volume ratios from 3D imaging versus the TCI method from 2D radiographs.
- To assess the reliability of these methods for forensic age determination.
Main Methods:
- Prospective analysis of 620 radiographs from individuals aged 16-65.
- Evaluation of 320 images each using TCI from panoramic radiographs and pulp-to-enamel volume (PV/EV) ratio from cone-beam computed tomography (CBCT) 3D reconstructions.
- Statistical analysis including t-tests, ANOVA, and regression analysis to determine correlations with age.
Main Results:
- TCI method showed a statistically significant correlation with age only for maxillary second molars (MX2) with poor predictive power (R² ≈ 0) and high standard error (14.57 years).
- PV/EV analysis from CBCT demonstrated a strong correlation with age (R² > 0.8) and a significantly lower standard error (4.34 years).
- Maxillary first (MX1), maxillary second (MX2), and mandibular second (MND2) molars' PV/EV ratios showed significant positive correlations with age (p < 0.01), with R² values nearing 1.
Conclusions:
- Three-dimensional imaging of pulp-to-enamel volume ratios in maxillary and mandibular molars provides a highly accurate and reliable method for age estimation.
- This 3D imaging technique significantly outperforms traditional 2D radiographic methods like TCI for forensic age assessment.
- The study highlights the substantial potential of 3D imaging for improving accuracy in forensic odontology age determination.
