Kvaal's Method Research Articles

Application of the Kvaal method to CBCT reconstructed panoramic images for age estimation

As the teeth are more durable than other parts of the skeleton, they provide valuable data for age estimation. Age estimation from adult teeth is mainly based on secondary dentin production. The present study aimed to devise a regression formula for age estimation specific to the Anatolian population using the Kvaal method on CBCT reconstructed panoramic images. In total, 201 individuals aged between 20 and 69 were divided into two groups: data from the study group (n = 101) were used to create the regression formulae, and data from the control group (n = 100) were used to test the formulae. Pearson’s correlation coefficients and linear regression analyses were performed. Maxillary teeth provided more accurate age estimates than mandibular teeth. The regression formulae derived in this study are found to be statistically applicable and reasonably accurate. However, these results should be interpreted with caution.

Age determination on panoramic radiographs using the Kvaal method with the aid of artificial intelligence.

This study aimed to assess and compare age estimation on panoramic radiography using the Kvaal method and machine learning (ML). 554 panoramic radiographs were selected from a Brazilian practice. To estimate age using the Kvaal method, the following measurements were performed on the upper left central incisors and canines: tooth, pulp and root length; root and pulp width at three different levels: at the enamel-cementum junction (ECJ); midpoint between the enamel-cementum junction and; at the mid root level. For ML age estimation, radiomic, semantic and the radiomic-semantic attribute extractions were assessed. Nineteen semantic and 14 radiomic attributes and a single set of 33 semantic-radiomic attributes were extracted. Logistic Regression, Linear Regression, KNN, SVR, Decision Tree Reg, Random Forest Reg, Gradient Boost Reg e XG Boosting Reg were used for ML classification. For the Kvaal method, Mann-Whitney test, Spearman correlation coefficient, Student's t-test and linear regression with its respective coefficient of determination were used to estimate age and to assess data variability. Mean absolute error (MAE) and standard error estimate (SEE) were assessed. For the Kvaal method, upper incisors presented higher precision than canines (R²: 0.335, SSE: 7.108). Males presented better MAE and SEE values (5.29,6.96) than females (5.69,7.37). The radiomic-semantic attributes presented superior precision (MAE: 4.77) than the radiomic and semantic (MAE: 5.23) attributes. The XG Boosting Reg classifier performed better than the other six assessed classifiers (MAE: 4.65). ML (MAE: 4.77 presented higher age estimation precision than the Kvaal method (MAE: 5.68). The use of ML on panoramic radiographs can improve age estimation.

Combining the third molar mineralization to further improve the accuracy of the Kvaal's method in dental age estimation of subadults in northern China.

The decrease in the dental pulp cavity based on deposition of secondary dentin is a useful variable for assessing age.A total of 340 orthopantomographs were used in this research, including 278 in training groups and 62 in testing groups.Original Kvaal's method underestimated the dental age for subadults in northern China.The equation of combined specific method constructed in our study was proved more suitable to calculate dental age for subadults in northern China.

Sex and age determination of human mandible using anthropological parameters and TCI and Kvaal methods: study of a Serbian medieval sample.

The aim of the study was to test the efficacy, reliability, and applicability of the Kvaal and Tooth Coronal Index (TCI) age determination techniques, and then to compare them with each other, as well as with the conventional anthropological age and sex determination techniques. The analyzed material originates from the medieval necropolis of the Vinča-Belo brdo site. During the research, 60 periapical (PA) and 30 orthopantomographic (OPT) images were analyzed. On each analyzed tooth, age assessment was performed using both TCI and Kvaal techniques. The obtained values of dental estimated age were compared with age estimated by anthropological analysis, and the deviations between the estimated and chronological age were analyzed in relation to the assessment technique, type of dental radiograph, tooth group, sex, and age. The mean error between TCI and the osteological method was 8.44 (SD = 7.56, Min = 0.169, Max = 36.4) and between Kvaal and the osteological method was 7.71 (SD = 5.57, Min = 0.133, Max = 26.7). The average value of age recorded by TCI method was 32.5years and by Kvaal method was 34.7years. There was no statistically significant difference based on the two radiographic methods, gender, individual teeth, or tooth group pairs. There was a statistically significant positive correlation between age and the error present. Gender determination based only on the mandible has a high correlation with the anthropological gender determination. The Kvaal method and the TCI method have proven their efficiency, reliability, and applicability. Significant correlation has been observed between dental and anthropological age and sex determination methods.

Estimation of Dental Age Using the Kvaal Method with Digital Panoramic Radiographs in Peruvian Adults

To determine the accuracy of the Kvaal method in the estimation of dental age through the analysis of digital panoramic radiographs of patients between 20 and 47 years of age who attended the stomatological clinic of the Universidad Científica del Sur, (2018 to 2019), Lima-Perú. 289 digital panoramic radiographs belonging to individuals of both sexes, aged 20 to 47 years were analyzed. Length and width measurements were obtained in the dental and pulp chamber in the upper central incisors. These data were subsequently evaluated by calculating the proportions between the pulp and root length of the upper central incisor by applying the formula of the method of Kvaal et al. to obtain the accuracy of the method in estimating dental age. Applying the formula of Kvaal et al. indicates that the relationship between the width of the pulp and the length of the root has a higher level of significance in relation to others proportions: M mean value of all ratios except T (-0.659) and W-L difference between W and L (-0.643). The coefficient of determination (r²) and standard error of estimation (SEE) using the original Kvaal formula is r²: 0.70, SEE: 4.90 years, then a modified Kvaal formula was proposed for the Peruvian population. The Method of Kvaal et al. has an accuracy of 1.24 in estimating the dental age of individuals, using the upper central incisor in digital panoramic radiographs.

Application of the Kvaal Method in Age Estimation of the Serbian Population Based on Dental Radiographs.

This study aimed to evaluate the applicability of the Kvaal method in determining the age of a Serbian population. In this retrospective descriptive study, 170 dental patients (age range 16–77 years) were included. The measurements of six types of teeth were performed on digital orthopantomography radiographs according to the Kvaal method. Statistical inter-observer and intra-observer reliabilities were calculated to evaluate the reproducibility of the measurements, as well as to examine the correlation between chronological age and measured values. The evaluation revealed a substantial difference (over 12 years) between chronological and estimated age. The P ratio had the strongest correlation with chronological age for the maxillary central (r = ±0.293) and lateral incisors (r = ±0.240), whereas the pulp/root width ratio at level A had the strongest correlation for the mandibular first premolars (r = ±0.270). The lowest SD values, for measurements on teeth 15/25 (SD = 125,787), had the most accurate correlation with age. Thus, we can conclude that the original Kvaal method is not applicable in the age estimation of the Serbian population. For future research, we suggest using cone beam computer tomography as a precise technology to evaluate the applicability of Kvaal and other methods for age estimation.

Age Estimation by Kvaal's Method Using Digital Panoramic Radiographs in the Saudi Population.

IntroductionIn forensic literature, estimating an individual's age has garnered a lot of attention. With increasing age, the size of the dental pulp cavity shrinks as a result of secondary dentin deposits. This could be used as a measure of age. Aside from morphological approaches, radiological approaches might be used to analyze this regression shift. Kvaal's method calculates the chronological age of individuals based on the age-pulp size relationship on periapical dental radiographs.PurposeThis study aims to use Kvaal's method to estimate the chronological age of patients using digital panoramic radiographs and verify the validity of regression equations proposed by Kvaal et al. in the Saudi population.Material and methodsA total of 74 digital orthopantomograms were randomly selected from Qassim University Dental Clinic in Saudi Arabia, ranging in age from 18 to 64 years (mean age 32 years). The radiographs were taken between 2018 and 2021 according to inclusion and exclusion criteria.ResultsWhen the Kvaal technique was applied to Saudi members, there was no statistically significant discrepancy between the estimated and chronological ages. The coefficient of determination R2 was highest when three mandibular teeth were evaluated together (0.752).ConclusionThe most accurate indicator for age assessment was "M" (mean worth, all things considered) and "W L" (contrast among "Width" and "Length").

Study of forensic age assessment using Kvaal's method with digital orthopantomographs (OPG)

Age is one of the important factor in making the identity of a person. Anthropologists, Archaeologists and Forensic scientists determine the age for identity of a person. Kvaal and Solheim given a method used on adults for calculation of age with the help of morphological and radiological methods, but extraction was still required. Present study was an observational study under taken for forensic age assessment using Kvaal's method with digital orthopantomographs. In the present study out of 100 subjects, maximum number of subjects from age group of 20–29 (61), 43 were females and 57 were males. Coefficient of determination was highest for lower first premolar (0.517) followed by upper central incisor (0.178), lower canine (0.134), lower lateral incisors, upper second premolar and upper lateral incisors. M & W-Lwere found significant predictors for lower first premolar, lower canine and upper central incisors. Regression equation derived for combined upper three teeth & lower three teeth revealed that coefficient of determination (R2) was significant higher for lower three teeth (0.478) than upper three teeth (0.069) with M & W-L were significant predictor. Regression equation derived for all six teeth together shows significant coefficient ofdetermination R2 (0.430) with M, W-L both are significant predictors. When all the six teeth taken together & compared for actual age & estimated age, mean difference was found to be (0.007). Kvaal's method for estimating age using digital orthopantomographs can be used for near accurate age estimation in 20–60 years age population with out removal of tooth.

Estimation of Biological Ages with Kvaal Method Using Panoramic Radiography in Semarang City

Introduction: Forensic odontology is a branch of dentistry that has disciplines learn about the examination of evidence derived from teeth, and how to deal with the evidence for legal concerns. Purpose: The aim of the study was to describe biological age estimates by using Kvaal method in Semarang, and the difference between biological and chronological age by using the Kvaal method in Semarang. This study was descriptive with crosssectional design. Materials and Methods: One of the methods in determining the estimated age by using teeth is the Kvaal method. Kvaal method determines the estimated age based on the pulp size using radiography. Result: The results showed the difference between biological and chronological age was ±4,57 years. This result is lower than Kvaal’s previous study result which was ±9,5 years. Conclusion: Based in the findings above, it can be concluded that the difference of chronological and biological age using Kvaal method in Semarang was ±4,57 years within 15-60 years old individuals in Semarang.

The impact of age mimicry bias on the accuracy of methods for age estimation based on Kvaal's pulp/tooth ratios: a bootstrap study.

Methods based on pulp/tooth ratios proposed by Kvaal et al. (1995) have been widely used for age estimation in adults. The tendency of age estimates to mimic the age structure of the reference population, i.e. age mimicry bias, is a possible source of controversy in the results of studies. The primary objective of the present study was to evaluate the effect of age mimicry bias on the accuracy of the original Kvaal's method and its recent modification proposed by Roh et al. (2018). The study sample comprised 240 cone-beam computed tomography scans of an Iranian population. The bootstrap procedure was used to study the impact of age mimicry bias on age estimates by constructing reference populations with different age structures. The accuracy of Kvaal's and Roh's variables for age estimation was assessed using a twofold cross-validation technique and principal component analysis. The application of original equations resulted in SEE values highly greater than the acceptable threshold for forensic purposes (10 years). The population-specific equations obtained SEE values of 9.18, 11.03, and 9.22 years using Kvaal's variables and 9.19, 11.13, and 9.14 years using Roh's variable for the maxillary, mandibular, and all teeth, respectively. The bootstrap procedure revealed that using uneven reference populations to formulate the equation resulted in significantly greater SEEs (almost all >10 years) that were not acceptable for forensic purposes. Moreover, using an older (a younger) reference population contributed to a sharp rise in the amount of over- (under-) estimation for younger (older) age groups. Age mimicry bias had an undesirable impact on the accuracy of dental age estimation based on Kvaal's and Roh's methods. The accuracy of the original equations was low for age estimation in the Iranian sample. However, the performance of the population-specific equations was reasonably acceptable for the maxillary and all six teeth.

Comparison of Two Methods in Estimating the Relation Between Dental Age and Chronological Age

Introduction: Personal identification is becoming increasingly important not only in legal medicine but also in criminal investigation, identification, and genetic research. Dental age (DA) estimation has gained acceptance because it is less variable when compared to other age indicators. Aim: This study aims to determine DA by radiographic methods in digital orthopantamogram using Willem's method and in intraoral periapical radiograph using Kvaal's method and also to find out the accuracy of two methods in determining the relation between DA and chronological age. Materials and Methods: The study sample consisted of 75 randomly selected subjects who referred to the Oral Medicine and Radiology department for the purpose to undergo orthodontic treatment, were selected. Orthopantmograph and one intraoral periapical radiograph of right mandibular first molar using paralleling cone technique were taken for each patient The DA was determined using orthopantamography by Willem's method and intraoral periapical radiograph by Kvaal's method. Results: The student's t-test was used to analyze the significance between the two different age estimation methods. In Demirjian's method, the overall mean difference between estimated DA and CA for males was 15.10 years, while for females was 11.88 years. Estimated DA assessment by Willem's method appeared to underestimate chronological age both in males and females. Conclusion: In this study, a significant relation was found between estimated DA and CA in the Willem method (p-0.00) and Kvaal's method (p-0.05). Both the methods seem to be applicable in estimating the age of both genders.

Differences in Age Estimated by the Kvaal Method on Right and Left Mandibular Canines

Background: The radiographic method for deter­mining the estimated age has the advantage of being non-invasive and the orthopantomogram images are digitally processed. Canines have a strong corre­la­tion with chronological age and have good resistance and large pulp space. This study aimed to determine the difference in age estimates using the Kvaal method on the right and left mandibular canines. Subjects and Method: There were 80 ortho­pantomogram samples from dental and oral clinic patients who had undergone orthopantomography at the Radiology Installation of Dr. Moewardi Hos­pital, from January 2019 to December 2020. The estimated age of right and left canines was calcu­lated based on the Kvaal method and performed a T-test. Results: At the estimated age of the right and left mandibular canines determined by the Kvaal formula, the T-test was performed showing a mean of 38.3 years for the right mandibular canine (Mean= 38.3; SD= 6.7) and 38.2 year the left mandi­bular canine (Mean= 38.2; SD= 8.9), with p = 0.910. Data analysis showed that there was no difference in age estimation using the Kvaal method on the right and left mandibular canines. Conclusion: There was no difference in age estimates by the Kvaal method on the right and left mandibular canines. Keyword s : Oratopantomogram, Metoday Qual, Kaninus Mandibula Correspondence: Sulistyani Kusumaningrum. Department of Radiology Dr. Moewardi Hospital / Faculty of Medicine Universitas Sebelas Maret, Surakarta. Email: kusumasulis1@gmail.com. Indonesian Journal of Medicine (2021), 06(02): 206-211 https://doi.org/10.26911/theijmed.2021.06.02.09

Application of Kvaal's radiological method for dental age estimation of Ajnala skeletal remains: A cross-validation study

Abstract Human remains retrieved from disguised locations like roadside trenches, potholes, sewage pits, and waterways are generally found badly damaged and discourageously commingled. Radiological examinations of such skeletal remains may provide crucial inputs towards their identification strategies, particularly for age estimations and paleo-pathological reconstructions. Teeth are the hardest and well-preserved human structures that are resilient to almost all sorts of mechanical, chemical, and biological degradations and thus, have prolonged post-mortem longevity and durability. In the present study, Kvaal's method was applied to peri-apical radiographs of canines to estimate the probable age thresholds of the unknown human skeletal remains excavated from an abandoned well at Ajnala (Amritsar, India). The underlying aim of the present study was to scrutinize the authenticity of written accounts about adulthood of Ajnala skeletal remains. Kvaal's radiometric method has been tested globally for age estimation of individuals of different ethnic groups and hence was chosen for age-at-death estimations of these remains. The radiolucent pulp area and entire tooth surface area on periapical radiographs of the anatomically intact canines (either dislodged or fitted in alveoli of both jaw fragments) were delineated using a computer-aided drafting software 'GIMP' version 2.10. Nine measurements were recorded on the length and width of tooth pulp at three different levels i.e., at the cemento-enamel junction (CEJ), at the mid-point between the CEJ and the mid-root level, and at the mid-root level following Kvaal et al., (1995) technique. The previously generated customized regression equations for teeth of known credentials and those showing a maximum degree of determination were utilized to estimate the age-at-death thresholds of present study Ajnala teeth. The best regression fit was obtained with Mittal et al., (2016) study to show that 98.6% Ajnala teeth belonged to adult individuals within age ranges of 18 to 60 years; with an average age of 31.6 years. Present study observations further substantiated the age estimates obtained from other methods, which endorsed the written accounts that the deceased (to whom Ajnala skeletal remains belonged to) were adult males at the time of their death.

Can canines alone be used for age estimation in Chinese individuals when applying the Kvaal method?

Due to the secondary dentin formation, the dental pulp undergoes changes in shape throughout life. Based on this phenomenon, the Kvaal method has been applied to various populations for age estimation, and its usefulness has been verified. When applying the Kvaal method to Chinese subjects, we observed a relatively strong correlation between mandibular canines and age. This study notes the correlation between canines and chronological age and is the first to identify which canine is most closely related to chronological age. In addition, a new, simpler formula is determined based on canines according to Kvaal’s methodology. The radiographs of 360 individuals from northern China were selected, from which the widths and lengths of the pulp from four canines were measured according to the Kvaal method. Next, inter- and intra-observer reliabilities were analyzed in order to assess the repeatability of these measurements. The correlation between measurements and age was examined, and Chinese-specific age estimation formulae were derived. The results revealed that the ratios from the left maxillary canine exhibited the strongest correlation with age compared to the other canines, whereas the left mandibular canine showed the weakest correlation, which may contribute to the overall poor correlation of mandibular canines with age. What’s more, the formula derived from the left maxillary canine in this study displayed the highest coefficients of determination, and the formula derived from all canines showed the lowest residuals. Both of these formulae performed better than the Chinese-specific formula derived from six different types of teeth in our previous study, which had formerly possessed the highest coefficients of determination and the lowest residuals. Thus, we concluded that canines do play an important role in age estimation in the Chinese population, and the correlation between maxillary canines and chronological age is stronger than that of mandibular canines, although no distinct trend as to which side is better correlated with age was established. Going forward, we recommend the analysis of additional samples from different geographical regions and populations to further verify the importance of canines in age estimation.

Assessment of validity and reliability of Kvaal's method for age estimation among a population sample - A retrospective study.

The present research was carried out with an aim to estimate and correlate chronological age and estimated age by Kvaal's Method in North Indian population using digital panoramic radiography. Further, the study was an attempt to evaluate the reliability of Kvaal's method for age estimation and to arrive at a population-specific regression equation. One hundred digital orthopantomograms of participants aged between 20 and 70 years of age were selected. The evaluation of 6 teeth according to Kvaal's method was carried out using measure tool of Sidexis Software (provided by the manufacturer). Correlation coefficient was carried out between chronological age and estimated age and further regression analysis was carried out for obtaining a population specific regression equation. It was observed that coefficient of determination (R2) is highest (0.223) for mandibular canine which indicates that age can be better estimated with this particular tooth. It was observed that large variations between the chronological and estimated age were not found. Also, Kvaal's formula proved accurate for estimating age using all the six selected teeth. Thus, it was concluded that mandibular canine would be the better tooth for age estimation, followed by maxillary second premolar and maxillary three teeth taken together.

Age estimation in Brazilian adults by Kvaal's and Cameriere's methods.

The aim of this study was to verify the precision and applicability of two methods of age estimation, Kvaal's and Cameriere's methods, among Brazilian adults. A sample composed of periapical radiographs of canine teeth belonging to 320 Brazilian adults was analyzed, divided into groups according to sex (male and female) and age group (20-29 years, 30-39 years, 40-49 years and 50-59 years). Kvaal's method presented better results when compared to the results of Cameriere's method in the general evaluation of each canine tooth, except for the upper left canine (tooth 23), which presented a mean error (ME) with no statistically significant difference between the methods (Kvaal: ME = 7.43, p = 0.4991, Cameriere: ME = 7.55, p = 0.6982). In the evaluation by age groups, Kvaal's method presented a lower variation between the real age and estimated age when applied to the age groups of 20-29 years and 30-39 years compared to the results provided by Cameriere's method. With respect to the groups aged 40 to 49 years and 50 to 59 years, Cameriere's method presented better performance than the results provided by Kvaal's method. The methods of estimating age proposed by Kvaal and Cameriere are simple and nondestructive and have demonstrated reproducibility and reliability. The Kvaal method was more accurate for the age groups of 20-29 and 30-39 years, and for those over 40 years, the Cameriere method was the most accurate.

Application of the Kvaal method for age estimation using digital panoramic radiography of Chinese individuals

The Kvaal method as a non-invasive method for age estimation based on the changes of pulpal size caused by secondary dentin deposition has been applied to different ethnics. However, its results are often conflicting and its accuracy is relatively poor. This study aimed to verify the applicability of the Kvaal method to estimate the ages of the Chinese population using digital panoramic radiographs and to formulate specific regression equations for use in Chinese subjects. A sample of 360 digital panoramic radiographs from northern Chinese population were selected, from which the pulpal size and width of six tooth types (maxillary central incisor, lateral incisor, second premolar, mandibular lateral incisor, canine, and first premolar) were measured using Kvaal’s method. Then, inter- and intra-observer reliabilities were calculated to evaluate the reproducibility of those measurements. The correlation between chronological age and measurements was also examined and the Chinese-specific equations for age estimation were conducted. After comparing the accuracy of the Chinese-specific equation with the original Kvaal equation, the age of the Chinese population was clearly overestimated by Kvaal’s equation, and a Chinese-specific equation could ameliorate age prediction accuracy. In addition, the residuals of the Chinese-specific equation were significantly lower than that of the original Kvaal’s method. Thus, we concluded that the original Kvaal equation cannot accurately estimate age in the Chinese population. Although accuracy improved using the Chinese-specific equation that was based on Kvaal’s methodology, the standard deviation remained large. In view of the lack of accurate age estimation methods for adults, we propose finding more correlated variables or combining other age estimation methods to increase the accuracy for adult age estimation.

Quantification of secondary dentin formation using dental orthopantomographs in a contemporary Malaysian population

ABSTRACTThe Kvaal method is recommended for age estimation in adults and is based on the analysis of the pulp chamber. Importantly, however, subsequent research has empirically demonstrated that the accuracy of this method varies across global populations. The aim of the current study is, therefore, to examine the relationship between secondary dentin formation and chronological age to establish forensic age estimation standards for a Malaysian population. A total of 300 anonymized dental orthopantomographs of Malaysian individuals, aged between 16 to 69 years were analysed following the Kvaal method. Length and width measurements of the tooth and pulp chamber were acquired in six teeth. Kvaal’s dental ratios were calculated and subsequently used to formulate multiple linear regression models. Intra-observer error was found to be within acceptable standards for all measurements (TEM<1.0, rTEM<5%, R>0.75). A significant negative correlation between chronological age and the Kvaal dental ratios was demonstrated (0.14–0.42). The most accurate model was for maxillary central incisor (SEE ±10.46 years). This study reaffirms the reproducibility of Kvaal’s method in dental radiographs and demonstrates its applicability amongst Malaysians.

Comparative analyses of three radiographic dental age estimation methods amongst Nigerians

Background: Age estimation is a critical step in constructing biological profiles from human skeletal remains. This study aimed to compare three radiographic methods of age estimation with tested validity in different populations for accuracy and applicability in forensic investigations amongst Nigerians.Methods: This was a retrospective study of panoramic radiographs (Planmeca Romexis®) captured from 46 young Nigerian patients between ages 6 to 21 years in a Federal Tertiary Health Institution in Southwest Nigeria between July and December, 2017. Parameters on the panoramic radiographs were measured and scored based on Demirjian, Cameriere and Kvaal radiographic dental age estimation methods. Data were analysed using SPSS version 20 at p 0.5). Demirjian method was found to be strongly correlated with chronological age (rs = 0.763); Cameriere method moderately correlated (rs = 0.684) and Kvaal method weakly correlated (rs = 0.476). Demirjian method showed the strongest direct relationship (R² = 0.56) followed by Cameriere (R² = 0.44) and Kvaal method (R² = 0.22). Demirjian system was the only significant predictor of the chronological age of Nigerian subjects using multiple linear regression.Keyword: Age estimation, Demirjian, Kvaal, Cameriere, Nigeria

Predicting age in the age group of 16–21 years using tooth–coronal index-Benindra method: a comparison with Kvaal and Schour and Massler methods

Age estimation is critical for the identification of human trafficking practices or struggles for the rights of legal heirs in justice cases in the age group of 16–21 years. This study aims to test the tooth–coronal index (TCI) by Benindra (TCI-Benindra) method and compare the results to those obtained with Kvaal as well as Schour and Massler methods. TCI-Benindra method was used to estimate age and then compared the results to those obtained with Kvaal as well as Schour and Massler methods. The results obtained with TCI-Benindra method exhibited a significant difference with those obtained with Kvaal method (P < 0.05), but exhibited no significant difference with those obtained with Schour and Massler method (P > 0.05). In conclusion, age estimation using TCI-Benindra and Schour and Massler methods gave results that were closest to the actual age; furthermore, significant differences were observed between TCI-Benindra and Kvaal method in these results.