Tooth Cementum Annulation Method: Accuracy and Applicability

Abstract

Tooth cementum annulation (TCA) technique has been a frequently discussed method for the individual age estimation. Conflicting statements on its accuracy and applicability in previous publications have provoked our research. The accuracy and bias of the TCA age estimates were examined in a sample of 116 teeth from 65 individuals of known age and sex from the anatomical collection of the University of Tubingen (Germany). Incremental lines were counted on enhanced digital images of undecalcified, unstained, 60-80 microm thick cross-sections from the middle third of the root of single-rooted teeth. Maximal line counts resulted in age estimates that correlated best with the real age of the specimens. In this sample, this argument is supported by the observation that the mean number of lines increased significantly from the most cervical to the most apical section. Reasonably accurate age estimates based on TCA counts were only obtained in young adults. Both accuracy and bias continuously decreased with the increasing age of the individuals. A considerable underestimation of age occurred in individuals older than 40 years. Due to the conflicting results on the accuracy of the TCA technique this method should be used for age estimation only in association with the macroscopic examination.