age estimation in living and dead

1. Identification
Part -2
Dr Nikita Prabhakaran
Junior Resident
Department of Forensic Medicine
Thiruvananthapuram

3. • Gaurav Mukhi case
• “Youngest best player in ISL”
• “ Emerging player of the match” Award
• Alleged to be of over age
• ???????

4. Identification - 2

5. • Race
• Sex
•Age
• Stature

6. •Not the duty of other doctors !!!!!!!!!

7. • How to estimate age in the living and the dead?????

8. Major things to look for:
• (1) TEETH
• (2) BONE-ossification of bones
• (3)Secondary Sexual Characters
• (4) General Development- stature + psychomotor

9. Note:
• Infants- in utero features
• Children- general developmental milestones

10. Teeth
Temporary
teeth
Permanent
teeth
Physiological
changes

11. Alveolar cavity in mandible
3-4 month IU life
Cellular tooth germ
(crown)
Root grows
Lifting the
crown outside
Temporary
tooth eruption
At birth
Rudiments of all temporary
teeth + 1st permanent
molars
• Root reabsorbs
• Unsupported crown
falls off
• Permanent teeth
erupts

12. • Temporary Teeth = 2 incisors + 1 canine + 0 premolars + 2 molars
(5 * 4 = 20 teeth) 2102
2102
• Permanent Teeth = 2 incisors + 1 canine + 2 premolars + 3 molars
(8 * 4 = 32 teeth)
2123
2123

13. Temporary teeth Permanent Teeth
• Smaller, lighter, narrower (exception
temporary molars >>> permanent
premolars)
• Heavier, stronger, broader
• Anterior teeth - vertical • Inclined a little forward
• Milk white in colour • Ivory white in colour
• Quick attrition – less mineralisation • Less attrition
• Enamel- thinner • Thicker ( less constant)
• Marked constriction between
crown and root
• No such constriction

16. Temporary teeth Permanent Teeth
Anterior teeth-
Labial surface
Smoother Perikymata (depressions)
Incisal edges No mamelons Mamelons present
(wear away quickly)
Posterior teeth- Molars Buccal and lingual
surfaces-flatter
Less flat
Roots of molars Smaller + more divergent Larger+ less divergent

17. (8-12m)
8
10 18 14 24
6
(6-8m)
12
(12-14 m)
18
(18-20m)
14 24
(20-24m)
Upper
Lower
Medial Lateral

18. 6
8 10
12
18
18
14
14
24
24

19. 7
(7-8)
8
(8-9)
11
(11-12)
9
(9-11)
10
(10-12)
6
(6-7)
12
(12-14)
18
(>17)
Central
Incisor
Lateral
Incisor
Canine PM-1 PM-2 M-1 M-2 M-3

20. 7 8
9
10
11
6
12
18

21. Mixed Dentition
Age= (No: of permanent teeth – 5) * 4
Between the age of 6-11 years

22. Successional & Superadded teeth
• Successional- those permanent teeth that replace other teeth
• Super added- those added to the existing set of teeth, do not
replace any teeth ( eruption increases the number of teeth )

23. Gustafson’s Method
•>21 years old
• Physiological changes of age in dental tissues
•6 characteristics

24. • (1) Attrition- due to wear and tear from mastication
• (2) Periodontosis - regression of the gums
• (3) Secondary dentin – develop from the walls within the cavity
• (4) Cementum apposition- secondary cementum incremental lines
• (5) Root Resorption- starts at the apex
• (6) Root Transparency- >30 years – canals in the dentine (deposition)

25. Take the sum of
scores formula
AGE

26. Bone

28. CLAVICLE
Medial end
18-20 Yrs
22-23 Yrs

29. 6 m IU
7 m IU
9 m IU
60 Yrs
40 Yrs
STERNUM

30. acromion
coracoid
14 Yr
18 Yr
SCAPULA

31. head
greater
lesser
tuberosity
1 Yr
3 Yr
5 Yr
6 Yr
(16-18Yr)
capitulum
trochlea
Lateral epicondyle
13 Yr
11 Yr
2 Yr
14Yr
(14-17Yr)
Medial epicondyle
8 Yr

32. Upper end -radius
Lower end -radius
6 Yr
2 Yr 6 Yr
10 Yr
Upper end -ulna
Lower end -ulna
RADIUS AND ULNA
(14-17Yr)
(14-18Yr)

33. P
TQ
LS
CTM
H
TD
1- capitate
2-hamate
3-triquetral
4-lunate
5-trapezoid
5-scaphoid
6-trapezium
11-12-pisciform
CARPAL BONES
2
2-4
2-4
2-4
2-4 14-17 Yr

34. 14 yr (18 yr)
(11-14 yr)
(7-8 yr)
16 yr
(19 yr-F)
(21 yr -M)
PELVIS
Triradiate cartliage
Ilia crest
Ischial tuberosity
Ischiopubic ramus

36. 4-5 m IU
6-7 m IU
I
II
III
IV
V 8m IU (14 Yr)
(20-25) Yr
SACRUM

37. Head
Lower end of femur
1 yr
4 yr
11 yr
9 m IU
(15 yr)
(14- 17 yr)
(14- 17 yr)
(14- 17 yr)
FEMUR
Greater trochanter
Lesser trochanter

38. Upper end -Tibia
Lower end -Tibia
Just after birth
(14-17 yr)
2 yr
(14-17 yr)
4 yr
Upper end -Fibula
Lower end -Fibula
TIBIA AND FIBULA

39. (14-17 Yr)
TARSAL BONES
Calcaneum
5 m IU
Talus
7 m IU
Cuboid
9 m IU

40. 40-50 50
30-40
40-50
50-60
50-60
60-70
40-50
80
Cranial Sutures

41. Case
• A school student has won long jump in district level in the sub-junior
category
(sub-junior << 14 )
• Allegations came that she was above 16 years
????

43. Sexual development
•Tanners staging

44. General development

45. Age determination of foetus

46. Rule of Hasse
• First 5 months of IU life 
Crown-heel length=square of the months of gestation
• After that Age in lunar months * 5

47. 1st month/ 4 weeks
• I cm in length
• 2.5 g grey coloured oval mass= pigeons egg
• attached to the chorion with a very short cord
• limb buds nodules

49. 2nd month/ 8 weeks
• 4 cm
• Sex is indistinct
• Webbed hands and feet P

50. 3rd month/12 weeks
• 9 cm long
• Eyes are closed, pupillary memb++
• Sex – rarely indistinguishable

51. 4th month/ 16 weeks
• 13 to 16 cm long
• Sex distinguishable
• Convolutions of brain+
• Breast buds seen as dots
1/4th

52. 5th month/20 weeks
• 25 cm length
• Vernix caseosa ++
• Light hair in the head
• Lanugo on the body

55. 6th month/24 weeks
• 30 cm length
• Wrinkled appearance
• Eyebrows, eyelashes+
• Testicles –close to kidneys

56. 7th month/ 28 weeks
• Length:35 cm
• Thick finger nails( not reaching the tip)
• Eyelids partly open.
• Testes- ext inguinal ring
• Caecum in RIF+
• Period of viability

57. 8th month/32 weeks
• Length 40 cm
• Lanugo disappears from the face,
• Scalp hair thickens-1.5 cm length
• Nails have reached the tips
• Left testis descended

58. 9th month/36 weeks
• 45 - 47 cm
• Lanugo hair has complete disappeared
• Vernix caseosa at the flexures of joints

59. 10th month/40 weeks
• Full term
• Lanugo – absent except in shoulders
• Nails – project beyond, toenails reach tip
• Umbilicus-central part between xiphoid and
pubis
• Rectum : Dark brown meconium +

60. Medicolegal Importance of Age
• 3 months First trimester- one doctor is enough for MTP
• 4 months Quickening – quick unborn child Culpable
Homicide
• > 5 months- illegal MTP
• 7 months period of viability
• 1 year  Infant ( Infanticide)

61. • 5 years < 5 years in the custody of the mother
• (The Hindu minority and guardianship)
• 7 years Criminal responsibility
“ any act done by a child less than 7 years is not an offence (s 82 IPC)”
7-12 years: if he proves he did not attain such understanding-not
punishable
Exception: 5 years Railway act : child above 5 years should be held
responsible for wrecking a train

63. • 10 years
• Child < 10 years - kidnapped/ abducted punishment
10years  property is stolen Kidnapping
16 years (males) from local
guardianship
Kidnapping
18 years (females) from
local guardianship
Kidnapping
21 years female- imported for
illicit intercourse
Kidnapping

64. Kidnapping Abduction
Even with will
by illegal means
By decietfulness

65. • 12 years
• Age of consent ( S 89 IPC)
• Age of consent for general physical examination
• No consent is valid if age <12 years( S 90 IPC)
• < 12 years- gives his evidence in the court of Law
without oath

66. •14 years <14 years not allowed to work in any factory
cannot be employed for any work
•16 years : child- < 16 years (old juvenile act)
Now > 18 years ( JJA,2000 + POCSO)
16-18 years  rape / murder tried as adults
No death penalty/life term imprisonment

67. •18 years:
• Age of majority
• Right to vote
• Marriage for girls
• Consent for undergoing surgery
• Consent for sexual Intercourse
• Consent for acts intended to cause grievous hurt (boxing, fencing)
• Age for donating organs

68. • 21 years
• Age for marriage in adult males
• 60 years
• Senior Citizen- males
• (females- 56/58 years)

69. Discussion
• A child of age 6 years gave a rat poison ( offering it as a sweet) to his
grandmother and the grandmother dies… will he be responsible????

70. • A male of 21 years marries a female of 15 years … is it offence????

71. • A child of 12 years is diagnosed with umbilical hernia.
•Should we take a consent????
•From whom????

72. AGE in The LIVING
• General development
• Teeth Eruption
• Radiological
Any disparity Radiological
Age in The Dead
• External features
• Teeth- Gustafson’s
• Ossification- reddish brown
centre surrounded by bluish
white cartilage
• Fusion- sutures+ sternum
• Others-Rib phase analysis
• Pubic symphysis

73. Important questions
• Temporary and permanent teeth
• Successional and superadded teeth
• Gustafson’s technique
• Age estimation in the living/dead
• MLI of age
• Practical  X-rays

74. THANK YOU