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AGE DETERMINATION BY
PHYSICAL & DENTAL
EXAMINATION
DR.S.SYLVIA
SENIOR ASSISTANT PROFESSOR
INSTITUTE OF FORENSIC MEDICINE
MMC.
WHY DO WE WANT TO KNOW THE
AGE??
• CRIMINAL CLAIMS
• UNKNOWN DEAD BODY
• UNKNOWN SKELETAL REMAINS
• MASS DISASTER
• CIVIL
- INSURANCE
- SPORTS
- NO BIRTH CERTIFICATE
- JOINING JOB
- MARRIAGE
- MILITARY RECRUITMENT
- REFUGEES
PHYSICAL EXAMINATION
• SECONDARY SEXUAL CHARATERS
ARCUS SENILIS
DENTAL EXAMINATION
• LIVE AND DEAD
Dr. Oscar Ameodo
• Father of Forensic Odontology
TEMPORARY DENTITION 6MONTHS - 6YEARS
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU LU
RL LL
CENTRAL
INCISOR
LATERAL
INCISOR
CANINE 1ST MOLAR 2ND MOLAR
CENTRAL
INCISOR
LATERAL
INCISOR
CANINE 1ST MOLAR 2ND MOLAR
UPPER
LOWER
6M
7M 8M
10M
1Y
1.5 Y 2Y
• SUCCESSIONAL TEETH
- With precursors
• SUPERADDED PERMANENT TEETH
- Without precursors
SUPERNUMERARY TEETH
PERMANENT DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1PM
1PM
1PM
1PM
2PM
2PM
2PM
2PM
RU LU
RL LL
1M 2M 3M
1M 2M 3M
1M
1M
2M
2M
3M
3M
CI LI C 1PM 2PM 1M 2M 3M
CI LI C 1PM 2PM 1M 2M 3M
7 8 11 9 10 6
12-14
14-25
UPPER
LOWER
• SPACING OF JAW
• IMPACTED TOOTH
MIXED DENTITION
• FIRST PERMANENT TOOTH?
• ERUPTION ?
• LAST TEMPORARY TO BE REPLACED?
• WHEN?
6 - 12YEARS
NUMBER OF PERMANENT TEETH =
(AGE IN YEARS - 5) X 4
DIFFERENCE BETWEEN TEMPORARY AND PERMANT TEETH
• Size
• Direction
• Crown
• neck
• Root
FDI- PERMANANT
11 21
CI CI
12
LI
22
LI
13
C
23
C
24
1PM
14
1PM
15
2PM
25
2PM
RU-1 LU-2
RL-4 LL-3
26 27 28
1M 2M 3M
16
1M
17
2M
18
3M
TEMPORARY DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU-5 LU-6
RL-8 LL-7
51
52
53
54
55
MODIFIED FDI - PERMANANT
11 21
CI CI
12
LI
22
LI
13
C
23
C
24
1PM
14
1PM
15
2PM
25
2PM
RU-1 LU-2
RL-3 LL-4
26 27 28
1M 2M 3M
16
1M
17
2M
18
3M
TEMPORARY DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU-5 LU-6
RL-7 LL-8
51
52
53
54
55
SIGMOID- PERMANANT
1 1
CI CI
2
LI
2
LI
3
C
3
C
4
1PM
4
1PM
5
2PM
5
2PM
RU LU
RL LL
6 7 8
1M 2M 3M
6
1M
7
2M
8
3M
TEMPORARY DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU LU
RL LL
I
II
III
IV
V
I
II
III
IV
V
PALMAR- PERMANANT
1 1
CI CI
2
LI
2
LI
3
C
3
C
4
1PM
4
1PM
5
2PM
5
2PM
RU LU
RL LL
6 7 8
1M 2M 3M
6
1M
7
2M
8
3M
TEMPORARY DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU LU
RL LL
A
B
C
D
E
A
B
C
D
E
CUNINGHAM / UNIVERSAL-
PERMANANT
8 9
CI CI
7
LI
10
LI
6
C
11
C
12
1PM
5
1PM
4
2PM
13
2PM
RU LU
RL LL
14 15 16
1M 2M 3M
3
1M
2
2M
1
3M
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
TEMPORARY DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU LU
RL LL
E
D
C
B
A
P
Q
R
S
T
F G H I J
K
L
M
N
O
NAVY- PERMANANT
8 9
CI CI
7
LI
10
LI
6
C
11
C
12
1PM
5
1PM
4
2PM
13
2PM
RU LU
RL LL
14 15 16
1M 2M 3M
3
1M
2
2M
1
3M
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
TEMPORARY DENTITION
CI CI
CI CI
LI
LI
LI
LI
C
C
C
C
1M
1M
1M
1M
2M
2M
2M
2M
RU LU
RL LL
E
D
C
B
A
O
N
M
L
K
F G H I J
T
S
R
Q
P
• Most Common Points for Comparison Include
1. The no. of teeth – Missing, impacted,
supernumerary
2. Restorations & Prosthesis – Tooth no., surfaces
involved, dental materials used - type of material,
no. of replaced teeth.
3. Dental Caries – Surface & configuration
4. Malposition & Rotation
5. Anomalous tooth formation – extra cusps, peg-
shaped incisors, fused teeth – imp. Characteristics
6. Root canal therapy – Type of filling material used,
imperfections of the canal
7. Bone pattern – Medullary bone, max. sinus
configurations
8. Occlusion – Overbite, overjet
9. Oral Pathology – enamel hypoplasia, drug induced gingival
hyperplasia etc.
10. Occupational Changes & Socioeconomic Pattern of the
Dentition
- Notching of the incisal edges of the incisors –
hair dressers, carpenters, shoe-makers, tailors, electrician, etc
- Generalised attrition of teeth – workers in sand blasters
- Socioeconomic status – multiple crowns, gold
restoration, RCT, Fixed partial dentures etc.
NOTCHING
• TEETH LOST BEFORE AND AFTER DEATH
If margins of empty sockets are unresorbed and
sharp means lost after death
• DETERMINATION OF RACE
CHINESE:
1.Wide arch
2.Enamel extension
between roots of molars
3.Five cusped third molars
EUROPEANS:
1. Narrow arch & crowding
SOUTH AFRICANS: Tall pulp chambers
MONGOLOID:
1.Occlusal enamel pearls in
premolars
2.Missing mand. incisors
3.Shovel-shaped incisors
AMERICAN INDIANS:
1. Marked attrition
2. Shovel-shaped
incisors
3. Large teeth
Metric [ Tooth size ]
Measurements
Non Metric [ Tooth Shape ]
Presence or absence of a particular
feature eg:- Cusp of carabelli- EXTRA
CUSP-MAXILLARY MOLAR
Influenced by local environmental
factors eg:-
missing lat. Incisors causes
compensatory increase in central
incisors,
Lack of space result in compression
of third molars.
heritable, more dependable
BROADLY CATEGORIZED AS
SEX DIFFERENCES IN TOOTH SIZE
Generally teeth are smaller in females
Teeth – used for differentiating sex by measuring
mesiodistal & buccolingual dimensions
Canines – show max. sex difference
Mandibular Canines show greatest dimensional
difference, being larger in males
AGE ESTIMATION IN IN ADULT
• Gustafson’s method
• Boyde’s method
• Stacks method
GUSTAFSON’S METHOD
1. ATTRITION – OCCUSAL SURFACE
2. SECONDARY DENTINE – INSIDE PULP
3. PERIODENTOSIS – GUM
4. CEMENTUM APPOSITION
5. ROOT RESORPTION – (LEAST RELIABLE)
6. TRANSPARENCY OF ROOT – (MINERAL) MOST
RELIABLE METHOD
• INCISORS – MOST SUITABLE
• MOLAR – NOT SUITABLE
1 TOOTH
EXTRACT
WASH
2 3% H2O2 RESIN GROUND
3 1MM-
TRANSPARENCY
100 MICRO
METER
ALREADY PLOTTED REGRESSION CHART
AGE ESTIMATION IN PRENATAL, NEONATAL
AND EARLY POST NATAL CHILD
1. Primary tooth germ begins to form at seven
weeks in utero(IU) & enamel formation of all
deciduous teeth complete by first year.
2. Permanent tooth germ begins to form at 3.5 to 4
months IU
3. Prenatal age estimation uses histological
techniques, enables observation of tooth
mineralization upto 12 weeks before it is apparent
on radiographs
BOYDE’S METHOD
• AMELOBLASTS- ENAMEL
• 4 µ / DAY
• INCRIMENTAL LINES- STRIAE OF RETZIUS
Neonatal line – DARKEST
Indicator of birth slowing down of enamel prism
growth rate, thus creating an apparent line of
demarcation.
STACK’S METHOD
• SIZE AND WEIGHT OF ANTERIOR TEETH.
IDENTIFICATION IN MASS DISASTERS
• Disasters: refers to natural calamities such as
earthquakes, floods and tsunami and accidental
or man-made events such as airplane crashes or
terrorist attacks-that result in multiple human
fatalities. Such incidents require identification of
the postmortem remains due to severe
mutilation
Almost 50% of identifications in
disasters are from dental evidence.
estimating age by dentition forensic medicine
estimating age by dentition forensic medicine
estimating age by dentition forensic medicine
estimating age by dentition forensic medicine

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estimating age by dentition forensic medicine

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  • 3. AGE DETERMINATION BY PHYSICAL & DENTAL EXAMINATION DR.S.SYLVIA SENIOR ASSISTANT PROFESSOR INSTITUTE OF FORENSIC MEDICINE MMC.
  • 4. WHY DO WE WANT TO KNOW THE AGE?? • CRIMINAL CLAIMS
  • 5. • UNKNOWN DEAD BODY • UNKNOWN SKELETAL REMAINS • MASS DISASTER
  • 6. • CIVIL - INSURANCE - SPORTS - NO BIRTH CERTIFICATE - JOINING JOB - MARRIAGE - MILITARY RECRUITMENT - REFUGEES
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  • 13. Dr. Oscar Ameodo • Father of Forensic Odontology
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  • 22. TEMPORARY DENTITION 6MONTHS - 6YEARS CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU LU RL LL
  • 23. CENTRAL INCISOR LATERAL INCISOR CANINE 1ST MOLAR 2ND MOLAR CENTRAL INCISOR LATERAL INCISOR CANINE 1ST MOLAR 2ND MOLAR UPPER LOWER 6M 7M 8M 10M 1Y 1.5 Y 2Y
  • 24. • SUCCESSIONAL TEETH - With precursors • SUPERADDED PERMANENT TEETH - Without precursors
  • 26. PERMANENT DENTITION CI CI CI CI LI LI LI LI C C C C 1PM 1PM 1PM 1PM 2PM 2PM 2PM 2PM RU LU RL LL 1M 2M 3M 1M 2M 3M 1M 1M 2M 2M 3M 3M
  • 27. CI LI C 1PM 2PM 1M 2M 3M CI LI C 1PM 2PM 1M 2M 3M 7 8 11 9 10 6 12-14 14-25 UPPER LOWER
  • 28. • SPACING OF JAW • IMPACTED TOOTH
  • 29. MIXED DENTITION • FIRST PERMANENT TOOTH? • ERUPTION ? • LAST TEMPORARY TO BE REPLACED? • WHEN?
  • 30. 6 - 12YEARS NUMBER OF PERMANENT TEETH = (AGE IN YEARS - 5) X 4
  • 31. DIFFERENCE BETWEEN TEMPORARY AND PERMANT TEETH
  • 32. • Size • Direction • Crown • neck • Root
  • 33.
  • 34.
  • 35. FDI- PERMANANT 11 21 CI CI 12 LI 22 LI 13 C 23 C 24 1PM 14 1PM 15 2PM 25 2PM RU-1 LU-2 RL-4 LL-3 26 27 28 1M 2M 3M 16 1M 17 2M 18 3M
  • 36. TEMPORARY DENTITION CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU-5 LU-6 RL-8 LL-7 51 52 53 54 55
  • 37. MODIFIED FDI - PERMANANT 11 21 CI CI 12 LI 22 LI 13 C 23 C 24 1PM 14 1PM 15 2PM 25 2PM RU-1 LU-2 RL-3 LL-4 26 27 28 1M 2M 3M 16 1M 17 2M 18 3M
  • 38. TEMPORARY DENTITION CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU-5 LU-6 RL-7 LL-8 51 52 53 54 55
  • 39. SIGMOID- PERMANANT 1 1 CI CI 2 LI 2 LI 3 C 3 C 4 1PM 4 1PM 5 2PM 5 2PM RU LU RL LL 6 7 8 1M 2M 3M 6 1M 7 2M 8 3M
  • 40. TEMPORARY DENTITION CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU LU RL LL I II III IV V I II III IV V
  • 41. PALMAR- PERMANANT 1 1 CI CI 2 LI 2 LI 3 C 3 C 4 1PM 4 1PM 5 2PM 5 2PM RU LU RL LL 6 7 8 1M 2M 3M 6 1M 7 2M 8 3M
  • 42. TEMPORARY DENTITION CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU LU RL LL A B C D E A B C D E
  • 43. CUNINGHAM / UNIVERSAL- PERMANANT 8 9 CI CI 7 LI 10 LI 6 C 11 C 12 1PM 5 1PM 4 2PM 13 2PM RU LU RL LL 14 15 16 1M 2M 3M 3 1M 2 2M 1 3M 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
  • 44. TEMPORARY DENTITION CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU LU RL LL E D C B A P Q R S T F G H I J K L M N O
  • 45. NAVY- PERMANANT 8 9 CI CI 7 LI 10 LI 6 C 11 C 12 1PM 5 1PM 4 2PM 13 2PM RU LU RL LL 14 15 16 1M 2M 3M 3 1M 2 2M 1 3M 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
  • 46. TEMPORARY DENTITION CI CI CI CI LI LI LI LI C C C C 1M 1M 1M 1M 2M 2M 2M 2M RU LU RL LL E D C B A O N M L K F G H I J T S R Q P
  • 47. • Most Common Points for Comparison Include 1. The no. of teeth – Missing, impacted, supernumerary 2. Restorations & Prosthesis – Tooth no., surfaces involved, dental materials used - type of material, no. of replaced teeth. 3. Dental Caries – Surface & configuration 4. Malposition & Rotation 5. Anomalous tooth formation – extra cusps, peg- shaped incisors, fused teeth – imp. Characteristics
  • 48. 6. Root canal therapy – Type of filling material used, imperfections of the canal 7. Bone pattern – Medullary bone, max. sinus configurations 8. Occlusion – Overbite, overjet 9. Oral Pathology – enamel hypoplasia, drug induced gingival hyperplasia etc. 10. Occupational Changes & Socioeconomic Pattern of the Dentition - Notching of the incisal edges of the incisors – hair dressers, carpenters, shoe-makers, tailors, electrician, etc - Generalised attrition of teeth – workers in sand blasters - Socioeconomic status – multiple crowns, gold restoration, RCT, Fixed partial dentures etc.
  • 50. • TEETH LOST BEFORE AND AFTER DEATH If margins of empty sockets are unresorbed and sharp means lost after death
  • 51. • DETERMINATION OF RACE CHINESE: 1.Wide arch 2.Enamel extension between roots of molars 3.Five cusped third molars EUROPEANS: 1. Narrow arch & crowding SOUTH AFRICANS: Tall pulp chambers
  • 52. MONGOLOID: 1.Occlusal enamel pearls in premolars 2.Missing mand. incisors 3.Shovel-shaped incisors AMERICAN INDIANS: 1. Marked attrition 2. Shovel-shaped incisors 3. Large teeth
  • 53. Metric [ Tooth size ] Measurements Non Metric [ Tooth Shape ] Presence or absence of a particular feature eg:- Cusp of carabelli- EXTRA CUSP-MAXILLARY MOLAR Influenced by local environmental factors eg:- missing lat. Incisors causes compensatory increase in central incisors, Lack of space result in compression of third molars. heritable, more dependable BROADLY CATEGORIZED AS
  • 54. SEX DIFFERENCES IN TOOTH SIZE Generally teeth are smaller in females Teeth – used for differentiating sex by measuring mesiodistal & buccolingual dimensions Canines – show max. sex difference Mandibular Canines show greatest dimensional difference, being larger in males
  • 55. AGE ESTIMATION IN IN ADULT • Gustafson’s method • Boyde’s method • Stacks method
  • 56. GUSTAFSON’S METHOD 1. ATTRITION – OCCUSAL SURFACE 2. SECONDARY DENTINE – INSIDE PULP 3. PERIODENTOSIS – GUM 4. CEMENTUM APPOSITION 5. ROOT RESORPTION – (LEAST RELIABLE) 6. TRANSPARENCY OF ROOT – (MINERAL) MOST RELIABLE METHOD
  • 57. • INCISORS – MOST SUITABLE • MOLAR – NOT SUITABLE 1 TOOTH EXTRACT WASH 2 3% H2O2 RESIN GROUND 3 1MM- TRANSPARENCY 100 MICRO METER ALREADY PLOTTED REGRESSION CHART
  • 58. AGE ESTIMATION IN PRENATAL, NEONATAL AND EARLY POST NATAL CHILD 1. Primary tooth germ begins to form at seven weeks in utero(IU) & enamel formation of all deciduous teeth complete by first year. 2. Permanent tooth germ begins to form at 3.5 to 4 months IU 3. Prenatal age estimation uses histological techniques, enables observation of tooth mineralization upto 12 weeks before it is apparent on radiographs
  • 59.
  • 60. BOYDE’S METHOD • AMELOBLASTS- ENAMEL • 4 µ / DAY • INCRIMENTAL LINES- STRIAE OF RETZIUS
  • 61. Neonatal line – DARKEST Indicator of birth slowing down of enamel prism growth rate, thus creating an apparent line of demarcation.
  • 62. STACK’S METHOD • SIZE AND WEIGHT OF ANTERIOR TEETH.
  • 63. IDENTIFICATION IN MASS DISASTERS • Disasters: refers to natural calamities such as earthquakes, floods and tsunami and accidental or man-made events such as airplane crashes or terrorist attacks-that result in multiple human fatalities. Such incidents require identification of the postmortem remains due to severe mutilation
  • 64. Almost 50% of identifications in disasters are from dental evidence.