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Age assessment using the second molar maturation index (I2M): A systematic review
Clarice de Araújo Oliveira1, Beatriz Alves Furtado1, Paulo Henrique Viana Pinto2
1Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, USP - University of São Paulo, Ribeirão Preto, Brazil.
Forensic Science International
|December 25, 2025
Summary
The Second Molar Maturation Index (I2M) method effectively estimates legal age thresholds in forensic science. This systematic review confirms its applicability across diverse populations for individuals aged 12-16 years.
Area of Science:
- Forensic Anthropology
- Odontology
- Human Identification
Background:
- Age estimation is critical in forensic science for both living and deceased individuals.
- Adolescent age estimation is vital for determining legal age thresholds, which differ globally.
- The Second Molar Maturation Index (I2M) was introduced in 2018 to estimate age relative to 14 or 16 years.
Purpose of the Study:
- To systematically review and assess the applicability of the I2M method.
- To evaluate the I2M method for estimating age thresholds of 12, 14, 15, and 16 years.
- To determine the reliability of the I2M method in forensic contexts across various populations.
Main Methods:
- Systematic literature search across six major databases (PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS, SciELO).
- Inclusion and exclusion criteria applied to select relevant studies.
- Methodological quality and risk of bias assessment of eligible studies.
Main Results:
- Seven eligible studies were included, all utilizing orthopantomographs of individuals aged 7-22 years.
- Validation studies were conducted in seven countries, demonstrating consistent applicability.
- All included studies exhibited a low risk of bias, indicating robust methodology.
Conclusions:
- The I2M method demonstrates applicability for estimating age thresholds of 12, 14, 15, and 16 years in forensic practice.
- Satisfactory results were observed across diverse populations, suggesting broad utility.
- Further primary research is recommended to enhance the method's evidence base and reliability.
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