Dental Age Estimation (DAE): Data management for tooth development stages including the third molar. Appropriate censoring of Stage H, the final stage of tooth development. (November 2015)

• Record Type: Journal Article
• Authors: Roberts, Graham J.; McDonald, Fraser; Andiappan, Manoharan; Lucas, Victoria S.
• Is Part Of: Journal of forensic and legal medicine. Volume 36(2015)
• Page Start: 177
• Page End: 184
• Publication Date: 2015-11
• Subjects: Third molars -- Dental age estimation -- Censored data -- Three standard deviations; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Electronic journals; 614.1
• DOI: 10.1016/j.jflm.2015.08.013
• Languages: English
• ISSNs: 1752-928X

Abstract

Abstract: Introduction: The final stage of dental development of third molars is usually helpful to indicate whether or not a subject is aged over 18 years. A complexity is that the final stage of development is unlimited in its upper border. Investigators usually select an inappropriate upper age limit or censor point for this tooth development stage. Materials and methods: The literature was searched for appropriate data sets for dental age estimation and those that provided the count (n), the mean ( x ¯ ), and the standard deviation (sd) for each of the tooth development stages. The Demirjian G and Demirjian H were used for this study. Upper and lower limits of the Stage G and Stage H data were calculated limiting the data to plus or minus three standard deviations from the mean. The upper border of Stage H was limited by appropriate censoring at the maximum value for Stage G. Results: The maximum age at attainment from published data, for Stage H, ranged from 22.60 years to 34.50 years. These data were explored to demonstrate how censoring provides an estimate for the correct maximum age for the final stage of Stage H as 21.64 years for UK Caucasians. Conclusion: This study shows that confining the data array of individual tooth developments stages to ± 3sd provides a reliable and logical way of censoring the data for tooth development stages with a Normal distribution of data. For Stage H this is inappropriate as it is unbounded in its upper limit. The use of a censored data array for Stage H using Percentile values is appropriate. This increases the reliability of using third molar Stage H alone to determine whether or not an individual is over 18 years old. For Stage H, individual ancestral groups should be censored using the same technique. Graphical abstract: Highlights: Censoring tooth development stages to ±3sd excludes extreme values. The data prepared in this way are Normally distributed. Stage H is non-Normally distributed. It is asymmetric and left skewed. It is necessary to report the data using percentile summary methods. Censoring Stage H gives a lower median value compared to uncensored data.