Forensic age assessment of living adolescents and young adults at the Institute of Legal Medicine, Münster, from 2009 to 2018.

Due to high migration inflows to Europe, forensic age assessment of living persons has clearly gained importance. If there is a legal justification for X-ray examinations without a medical indication, the Study Group on Forensic Age Diagnostics (AGFAD) recommends the combination of a physical examination with anamnesis, an X-ray examination of the hand and a dental examination with evaluation of an orthopantomogram for age assessments of adolescents and young adults. If the development of the hand skeleton has been completed, an additional CT examination of the clavicles is to be performed. To demonstrate the outcome of forensic age assessments according to AGFAD recommendations with regard to migrants of doubtful minority declaration, this study analyzes the expert reports carried out at the Institute of Legal Medicine, Münster, from 2009 to 2018. A total of 597 age assessments were performed during the study period. A total of 227 age assessments were issued on behalf of youth welfare offices in the legal area of social law, 282 in family law proceedings, 76 in criminal proceedings, and 12 age assessments in immigration law proceedings. In 211 out of 597 cases, the stated age was compatible with the findings of the age assessment. In the remaining 386 cases, the average difference between the stated age and the minimum age was 1.9 years. The average difference between stated age and most probable age was 5.1 years. Of the 521 age assessments carried out outside criminal proceedings, 197 unaccompanied minors with questionable age minority (37.8%) have reached the age of majority beyond doubt. A total of 388 unaccompanied minors (74.5%) have most probably reached the age of majority. Forensic age assessments with the AGFAD methodology make an important contribution to legal certainty, the welfare of the child, and the fair distribution of resources.

Examination of regressive features of third molars for the purpose of age assessment in the living by means of rescaled regression analyses.

The main criterion of dental age assessment in living adolescents and young adults is the evaluation of third molars' mineralization. Concerning forensic age assessment after the completion of third molars' mineralization, apposition of secondary dentine and narrowing of the periodontal membrane as seen as decreasing radiolucent areas in the radiographs for mandibular third molars have already been described as regressive features. The present study examines the combination of both these features for the purpose of age assessment in regression analyses after rescaling the data to make it on the interval scale. To this end, a total of 1245 orthopantomograms was evaluated, taken from 606 females and 639 males in the age group of 15-40 years. The apposition of secondary dentine and narrowing of the periodontal membrane as seen as decreasing radiolucent areas in the radiographs were determined for the lower third molars. The correlation of the features with the chronological age was assessed by means of rescaled regression analyses. Furthermore, regression formulas for age assessment were established. The values of the standard error of estimate ranged between 3.55 and 4.52 years. In general, the rescaled regression of the examined features appears to be suited for forensic age assessment. A limitation of the present study is the comparatively low number of evaluable teeth in the examined age group. Due to an incomplete development or a lack of the mandibular third molars, only a mere half of the respective teeth could be included in the statistical analysis.

Dental age estimation in the living after completion of third molar mineralization: new data for Gustafson's criteria.

There is a need for dental age estimation methods after completion of the third molar mineralization. Degenerative dental characteristics appear to be suitable for forensic age diagnostics beyond the 18th year of life. In 2012, Olze et al. investigated the criteria studied by Gustafson using orthopantomograms. The objective of this study was to prove the applicability and reliability of this method with a large cohort and a wide age range, including older individuals. For this purpose, 2346 orthopantomograms of 1167 female and 1179 male Germans aged 15 to 70 years were reviewed. The characteristics of secondary dentin formation, cementum apposition, periodontal recession and attrition were evaluated in all the mandibular premolars. The correlation of the individual characteristics with the chronological age was examined by means of a stepwise multiple regression analysis, in which the chronological age formed the dependent variable. Following those results, R 2 values amounted to 0.73 to 0.8; the standard error of estimate was 6.8 to 8.2 years. Fundamentally, the recommendation for conducting age estimations in the living by these methods can be shared. The values for the quality of the regression are, however, not precise enough for a reliable age estimation around regular retirement date ages. More precise regression formulae for the age group of 15 to 40 years of life are separately presented in this study. Further research should investigate the influence of ethnicity, dietary habits and modern health care on the degenerative characteristics in question.

The chronology of the radiographic visibility of the periodontal ligament and the root pulp in the lower third molars.

Eruption and mineralization of third molars are the main criteria for dental age estimation in living adolescents. As the validation of completion of the 18th year of life appears not to be possible with the forensically necessary probability even if all the third molars of a person are completely mineralized, degenerative dental characteristics might be used for this purpose. In previous publications by Olze et al. (2010a,b) the radiographic visibility of the periodontal ligament and the root pulp in lower third molars were suggested as methods for this purpose. The aim of this study was to validate these characteristics in a large study population with a wide age range. In a material of 2346 orthopantomograms of 1167 female and 1179 male Germans aged from 15 to 70years the radiographic visibility of the root pulp in the lower third molars with completed mineralization were studied according to stage classifications proposed by Olze et al. (2010a,b). 1541 orthopantomograms of 705 females and 836 males with a sufficient quality of the radiograph showed at least one third molar. The suitability of the studied characteristics for age estimation in living individuals could be confirmed. Males and females presenting stage 1 of both characteristics were older than 18years of life. Males and females presenting stage 2 of both characteristics were older than 21years of life. The high number of missing third molars in the studied age group (46-60%) must be considered as a limitation of the methods. In further studies the influence of ethnicity, dietary habits and modern dental health care on the characteristics in question should be investigated.

Age estimation.

While age estimation of unidentified corpses and skeletons for identification purposes has a long tradition in forensic sciences, age estimation of living persons has formed a relatively recent area of forensic research which is becoming increasingly important. The international interdisciplinary Study Group on Forensic Age Diagnostics (AGFAD) issued recommendations for age estimation of living persons for the purpose of criminal, civil, asylum and old-age pension procedures as well as for determining the sex and age of skeletons. In the present work, the authors set out state-of-the art age estimation methods for specific case groups, define minimum requirements for reference studies and specify the need for further research. In addition, ethical and medico-legal aspects as well as issues relating to quality assurance are discussed.

Age estimation of unaccompanied minors. Part II. Dental aspects.

Recent years have brought a worldwide increase in cross-border migration due to a globalized economy and ongoing belligerent conflicts. As a result, the percentage of foreigners among the general population has steadily increased not only in Germany, but also in other countries. This trend has triggered a growing demand for forensic medicine to assess the age of adolescents and young adults. The individuals examined here are unaccompanied minors without valid identification documents who do not know their age or else are suspected of not giving their correct age. The mineralization of third molars is the main criterion for dental age estimation of living subjects in the relevant age group. To date insufficient knowledge has been obtained about how ethnic origin can influence tooth mineralization. This, however, constitutes a restraint on the reliability of age estimates and hence on the forensic value of information essential to legal security. A comparative study was conducted to present comparative data on third molar mineralization in a Caucasoid, Mongoloid and African sample. In conclusion, forensic age estimates of living subjects would be more powerful tools if population-specific standards were applied to evaluations of wisdom tooth mineralization. Since the mineralization of third molars is usually completed by the age of 19 or 20 years, this feature cannot be used to ascertain whether a person has attained the forensically relevant age of 21 years. The question was whether determination based on an orthopantomogram of a combination of features relevant to dental age estimation of adults supplies forensically useful information for ascertaining whether a person has attained 21 years of age. The features considered include the DMFT index of all permanent teeth, the DMFT index of all permanent teeth excluding third molars and the DFT index of third molars projecting beyond the occlusal plane. It can be concluded that an evaluation of the variations of the DMFT index does not by itself yield sufficient data to determine with the accuracy required in criminal proceedings whether a person has attained 21 years of age. An additional X-ray examination of the medial clavicular epiphyseal cartilage is, therefore, strongly recommended when assessing whether a person is over 21.

Age estimation of unaccompanied minors. Part I. General considerations.

In recent years many countries have experienced a sharp increase in the demand for forensic age estimates of unaccompanied minors. In many countries the age thresholds of relevance to criminal prosecution lie between 16 and 22 years. In line with recommendations issued by the Study Group on Forensic Age Diagnostics, for determining the age of live subjects a forensic age estimate should combine the results of a physical examination, an X-ray of the hand and a dental examination which records dentition status and evaluates an orthopantomogram. To assess the age of persons who are assumed to be at least 18 years old, an additional radiographic or CT examination of the collar bones is recommended. Forensic age estimates should take account of the ethnic origin and socio-economic status of the person under examination.

Studies on the progress of third-molar mineralisation in a Black African population.

The forensic determination of the age of living people has become increasingly important in recent years. With regard to the relevant age group, the radiographic assessment of third-molar mineralisation is of particular importance. So far, the influence of geographic origin on the mineralisation rate has been insufficiently analysed. The paper is based on a total of 595 conventional orthopantomograms of 474 male and 121 female Black Africans aged between 10 and 26 years for whom dates of birth were known. The mineralisation status of third molars was evaluated based on Demirjian's classification of stages [Demirjian et al., 1973. A new system of dental age assessment. Hum. Biol. 45, 221-227]. This study presents the means and standard deviations, median values and the lower and upper quartiles separately for both sexes for the mineralisation stages D-H. Statistically significant differences between the upper and lower jaws were observed in males examined with regard to their attaining the stage F. Mandibular teeth developed 0.8 years earlier than maxillary teeth. Significant sex-specific differences were found with regard to the age at which tooth 38 reached the stage G. In females, tooth 38 reached stage G 1.5 years earlier than in males. In comparison to White probands, the Black African sample showed a tendency to achieve the mineralisation stages earlier. We would recommend using population-specific standards for age determination purposes.

Combined determination of selected radiological and morphological variables relevant for dental age estimation of young adults.

The mineralisation of third molars is one of the main criteria for dental age estimation of living subjects in criminal proceedings. Since the mineralisation of third molars is usually completed by the age of 19 or 20 years, this feature cannot be used to ascertain whether a person has attained the forensically relevant age of 21 years. This study examined whether determination based on an orthopantomogram of a combination of features relevant to dental age estimation of adults, supplies forensically useful information for ascertaining whether a person has attained 21 years of age. The features considered include the DMFT index of all permanent teeth, the DMFT index of all permanent teeth excluding third molars, the DFT index of third molars projecting beyond the occlusal plane, the eruption of third molars and the periodontal recession of second molars. A total of 650 conventional orthopantomograms of German subjects aged 18-30 years were evaluated. The statistical evaluation of our results was based on a discriminant analysis. It was carried out with two classes defined by two age groups: < or = 21 years and > 21 years. The probability of correct classification was 69.7% for males and 71.4% for females. It can be concluded that an evaluation of the variables reviewed in this paper does not by itself yield sufficient data to determine with the accuracy required in criminal proceedings whether a person has attained 21 years of age. The additional radiographic examination of the medial clavicular epiphyseal cartilage is recommended.

Forensic age diagnostics of living people undergoing criminal proceedings.

In the German-speaking area, recent years have seen a rapid growth of the need for forensic age estimations. Such need arises, for example, if no verified information on the age of a person suspected of a criminal offence is available; the issue at question in terms of criminal law is whether the person concerned has reached the age of criminal responsibility and whether general criminal law in force for adults is to be applied. The relevant age tresholds in criminal proceedings are 14, 18 and 21 years of age. According to recommendations of the Study Group on Forensic Age Diagnostics, a forensic age estimate should consist of a physical examination, an X-ray of the hand, and a dental examination which records dentition status and evaluates an orthopantomogram. In addition, a radiological or CT examination of the clavicles is recommended to establish whether a person has attained 21 years of age. The present article addresses the influence of ethnic origin on the examined developmental systems.

Age estimation of unidentified corpses by measurement of root translucency.

To evaluate the root dentine translucency technique for age analysis, age estimates carried out at the Institute of Legal Medicine at the Charité University Hospital in Berlin between 1998 and 2002 of unidentified corpses were subjected to retrospective review. Teeth suitable for evaluation were obtained from 33 corpses of undisputed identity. Root translucency was measured at intervals of half a millimetre. Appropriate reference studies were used to translate the measurements obtained into estimated age. In 18 cases these estimates proved correct. In 14 cases the deviation lay within +/-10 years. In one case of known drug abuse combined with diabetic metabolism, two factors which promote the advance of root translucency, the deviation was 12 years. It was concluded that the described technique, which requires little time and money and is easy to apply, can produce sound results in the middle age group (30-60). To avoid seriously inaccurate estimates in individual cases, the result should always be verified critically against an assessment of the overall stomatognathic system and other post-mortem findings of relevance to age.

Forensic age diagnostics of living individuals in criminal proceedings.

Age estimations of living individuals are increasingly important in criminal matters. If doubts arise regarding the age of a person suspected of a criminal offense, forensic age estimation is prompted by the need to ascertain whether the person concerned has reached the age of criminal responsibility and whether general criminal law in force for older juveniles or adults is to be applied. According to the recommendations of the Arbeitsgemeinschaft für Forensische Altersdiagnostik (study group for forensic age diagnostics), age estimates in criminal proceedings should be based on the general physical examination, the X-ray examination of the hand and the odontological examination by a dentist, including dental status and orthopantomogram. In order to improve diagnostic reliability, these methods should always be used in combination, ensuring that each part is performed by forensically trained and experienced experts of the relevant disciplines. In order to demonstrate that the proband has reached the age of 21, an additional X-ray examination or CT scan of the clavicles is recommended. Future research projects should assess the variation for a combination of the above methods, quantify the impact of socio-economic status and ethnicity on the examined development systems and review the suitability of non-ionizing imaging methods of age estimation.

Dental age estimation based on third molar eruption in First Nation people of Canada.

Forensic age estimation of living subjects has become an increasing focus of interest in modern society. One main criterion for dental age estimation in the relevant age group is the evaluation of third molar eruption. The importance of ethnic variation in dental development requires population specific data for dental age evaluation. In the present study, we determined the stages of third molar eruption in 347 female and 258 male First Nations people of Canada aged 11 to 29 years based on radiological evidence from 605 conventional orthopantomograms. The results presented here provide data on the age of alveolar, gingival, and complete eruption of the third molars in the occlusal plane that can be used for forensic estimation of the minimum and most probable ages of investigated individuals.

Studies of the chronological course of wisdom tooth eruption in a German population.

Forensic age estimation in living subjects has gained increasing significance in recent years. In dental age estimation, tooth eruption is a parameter of developmental morphology that can be analyzed by either clinical examination or by evaluation of dental X-rays. In the present study, we determined the stage of wisdom tooth eruption in 144 male and 522 female German subjects aged 12-26 years based on radiological evidence from 666 conventional orthopantomograms. The results presented here provide useful data on the age of alveolar, gingival, and complete emergence of the third molars in the occlusal plane that can be utilized for the forensic estimation of the minimum and most probable ages of individuals under investigation.

Studies of the chronological course of wisdom tooth eruption in a Japanese population.

The importance of forensic age estimation in living subjects has grown over the last few years. In dental age estimation, tooth eruption is a parameter of developmental morphology that can be analyzed by either clinical examination or by evaluation of dental X-rays. In the present study, we determined the stage of wisdom tooth eruption in 549 male and 751 female Japanese subjects aged 14-26 years based on radiological evidence from 1300 conventional orthopantomograms. The results presented here provide useful data on the age of alveolar, gingival, and complete emergence of the third molars in the occlusal plane that can be utilized for forensic estimation of the minimum and most probable ages of investigated persons.

Comparative study on the effect of ethnicity on wisdom tooth eruption.

The current knowledge base for evaluating the influence of ethnic origin on wisdom tooth eruption is still inadequate. We therefore analyzed and compared the chronology of wisdom tooth eruption in three ethnic populations-German, Japanese, and black South African-based on evidence from 2,482 conventional orthopantomograms. The investigated German population ranked in the middle in terms of the age of wisdom tooth eruption. The black South African population was the fastest and the Japanese population the slowest in terms of reaching the respective eruption stages. Population-specific reference data should be used when evaluating wisdom tooth eruption for the purpose of forensic age estimation.