Secondary Dentin Deposition Research Articles

Study of secondary dentine deposition in central incisors as an age estimation method for adults

AbstractThis work aimed to assess the pulp/tooth area ratio’s utility in the upper central incisors using orthopantomograms. A convenience sample of 801 adult patient orthopantomograms was studied. Image J® software was used to measure the pulp/tooth area ratio, and a regression model was developed. Our results conclude that the methodology assessing upper incisors’ pulp/tooth area ratio using orthopantomograms can lead to age overestimation and statistically significant differences between chronological and estimated age. For those over 50, no correlation between pulp/tooth area ratio and chronological age was found, suggesting that this may be the upper limit of this technique in this population. This methodology may not be suitable for age estimation, particularly in older adults.

Kvaal’s dental age estimation method applied to Brazilian adults—a cross-sectional test of validity

BackgroundDental age estimation of adults is a challenging procedure in forensic odontology. Radiographic techniques have enabled non-invasive age estimation of adults since the 90’s. Kvaal’s method based on the deposition of secondary dentin has demonstrated broad applicability in several populations. Population-specific studies with this method, however, are scarce in South America. This study tested the validity of Kvaal’s method in a sample of radiographs of Brazilian adults. The sample consisted of 192 periapical radiographs of 106 females (55.2%) and 86 males (44.8%) with ages between 20 and 80 years old. The permanent maxillary right (n = 84, 43.8%) and left (n = 108, 56.2%) central incisors were assessed based on Kvaal’s method.ResultsLin’s coefficient of concordance between estimated (EA) and chronological (CA) ages was 0.800 (IC95% = 0.753; 0.847) (p < 0.001). The mean difference between EA and CA was − 2.84 years (p < 0.001). For females and males, separately, the mean differences between EA and CA were − 3.82 years (CI95% = − 5.38; − 2.25) (p < 0.001) and − 1.86 years (CI95% = − 3.56; − 0.17) (p = 0.031), respectively. Underestimations were predominant and increased with time.ConclusionAfter 28 years of the original publication, Kvaal’s method remains reliable for non-invasive dental age estimation of adults, especially for the analysis of the permanent maxillary central incisors of Brazilian individuals.

Clinical case of viability in root canal treatment in an elderly patient with dental attrition

In root canal treatment, attention to atrial canals is crucial for the restructuring of dental health, especially in elderly patients with dental attrition. Atrial canals, characterized by low internal luminosity due to secondary dentin deposition, pose a challenge for the endodontist. This study reviews the literature on the preparation of these canals, focusing on foraminal permeability and glide path through biomechanical preparation. Instrumentation procedures and the importance of achieving patency or glide path, attained with appropriate instruments before canal preparation, are highlighted. A detailed evaluation and the use of TCHC computed tomography are essential for correctly diagnosing anatomical limitations in the root canal system. The application of internal anatomy and pathophysiology knowledge is vital to achieve favorable outcomes in endodontic treatments

Clinical case of viability in root canal treatment in an elderly patient with dental attrition

In root canal treatment, attention to atrial canals is crucial for the restructuring of dental health, especially in elderly patients with dental attrition. Atrial canals, characterized by low internal luminosity due to secondary dentin deposition, pose a challenge for the endodontist. This study reviews the literature on the preparation of these canals, focusing on foraminal permeability and glide path through biomechanical preparation. Instrumentation procedures and the importance of achieving patency or glide path, attained with appropriate instruments before canal preparation, are highlighted. A detailed evaluation and the use of TCHC computed tomography are essential for correctly diagnosing anatomical limitations in the root canal system. The application of internal anatomy and pathophysiology knowledge is vital to achieve favorable outcomes in endodontic treatments

Pulp volume quantification methods in cone-beam computed tomography for age estimation: A critical review and meta-analysis.

The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone-beam computed tomography (CBCT) with chronological age approximation. A subobjective was to investigate which methodology and CBCT technical parameters would be most appropriate to evaluate this correlation. This critical review followed the PRISMA guidelines, and it was conducted by a search through PubMed, Embase, SciELO, Scopus, Web of Science, Cochrane Library databases, as well as gray literature. Primary studies that used pulp volume, or pulp chamber to tooth volume ratio measured using CBCT were included. Seven hundred and eight indexed and 31 non-indexed records were identified. A qualitative analysis was performed including 25 selected studies with a total of 5100 individuals, age ranging from 8 to 87 years without sex predilection. The most used method was pulp volume/tooth volume. CBCT voxel size ranged between 0.09 and 0.5. Manual segmentation associated with threshold algorithms was used in most of the studies. Correlation between the pulp volume/tooth volume ratio was moderate: -0.66 for the upper central incisors, -0.59 for upper canines and -0.56 for lower canines. High heterogeneity was observed among the studies. It is concluded that pulp volume should be used with caution in age estimation. Evidence supports the preferable use of upper incisors with pulp volume/tooth volume ratio for age estimation. There is not enough evidence that voxel size interferes in age estimation by pulp volume.

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.

Chronological Age Estimation by Physiological Changes in the Teeth Among Deceased Human Adults

Background: Age can be estimated from the teeth by various methods like eruption of teeth which is known tobe a good indicator of the age of the person.Aims &amp; Objectives: The current study aimed to estimate the chronological age by physiological changes(Modified Gustafson’s method) occurring in teeth and also to find out the effect of the diet, other habits andsocio demographic factors on physiological changes in the teeth.Materials and Method: Present study was done by using the teeth extracted from the deceased bodies sent forpost mortem examination to the Department of Forensic Medicine, Sri Venkateswara Medical College, Tirupati,during the period of January 2016 to December 2016. A total of 70 cases were studied in the age group between25 to 60 years. Six physiological changes were studied in each case that were Attrition, Periodontosis, Secondarydentin deposition, Root resorption, Transparency of the root and Cementum opposition using modifiedGustafson’s formula.Results: The mean score of these physiological changes was directly proportional to age. Male to female ratioand non-vegetarian to vegetarian ratio was 3:1. The mean total score was high among males, urban residents,belonged to upper middle-class socio-economic status and alcoholics. However, means total score was lowamong smokersConclusion: Thus, in our study we found that when all the six physiological age factors were scored and usedtogether collectively, we will get better results, rather than using a single physiological factor for estimation ofage. Socio demographic factors, diet and habits have no effect on age estimation.

Role of Pulp Volume Method in Assessment of Age and Gender: An Observational Study from Lucknow, India

Introduction: In forensics, age and gender determination are required for victim identification. Secondary dentine deposition occurs throughout life, resulting in decreased pulp volume and size. Evaluation of pulp volume using Cone Beam Computed Tomography (CBCT) is a non invasive method used to evaluate age and gender. Aim: To evaluate the efficacy of the pulp volume method in determining age and gender. Materials and Methods: An observational study was conducted in the Oral Medicine and Radiology Department of King George’s Medical University, Lucknow, Uttar Pradesh, India from July 2019 to August 2020. Pulp volume measurements were obtained from CBCT data of randomly selected individuals (n=90) aged 18-70 years, focusing on maxillary Central Incisors (CI) and maxillary Canine (C). Statistical analyses, including Chisquare test, Pearson’s correlation, linear regression, and logistic regression, were performed on the data. Results: The CBCT data from 90 individuals, aged 18-70 years, were evaluated for pulp volume of maxillary CI and C. The Pearson correlation coefficient indicated a decrease in pulp volume with age. The validation of the equations for sex determination revealed higher prediction accuracy for CI (56.70%) compared to C (53.30%). Conclusion: Pulp volume obtained from CBCT can serve as a reliable indicator for age estimation and gender prediction.

&lt;strong&gt;Correlation between human chronological age and dentin volume of maxillary canine&lt;/strong&gt;

ABSTRACTIntroduction: One of the identification methods in forensic odontology is to estimate age through tooth characteristics. With age, odontoblast cells that line the pulp cavity will continue the process of secondary dentin deposition at a lower rate. Generally, maxillary canines are teeth that can survive in the oral cavity until old age and are less likely to wear out. This study aimed to determine the correlation between human chronological age and the dentin volume of the maxillary canines using CBCT radiographs. Methods: An analytic study of the Pearson correlation test was conducted on 114 samples of CBCT radiographs of the maxillary canines from the Radiology Unit of the Rumah Sakit Gigi dan Mulut, Faculty of Dentistry, Universitas Padjadjaran. The inclusion criteria for this study were canines with closed apex, no caries, no attrition, no restorations, no orthodontic treatment, and generally good health. Maxillary canine dentin volume was measured using the application ITK-SNAP version 3.8.0. The results of dentin volume were analyzed using the Pearson correlation test using SPSS IBM Statistics 25. Results: Pearson correlation analysis showed the correlation coefficient value (r= 0.270 and (r = 0.427) for the male and female samples, respectively. Conclusion: The correlation between chronological age and maxillary canine dentin volume in this study was not strong enough to be used as a single parameter in the age estimation method. Future research is expected to expand the sample size with a homogenous age distribution to obtain more consistent and accurate results.Keywords: age estimation; dentin volume; maxillary canines; ITK-SNAP; CBCT.

Age Estimation Using Maxillary Central Incisor Analysis on Cone Beam Computed Tomography Human Images.

Forensic dentistry plays an important role in human identification, and dental age estimation is an important part of the process. Secondary dentin deposition throughout an individual’s lifetime and consequent modification in teeth anatomy is an important parameter for age estimation procedures. The aim of the present study was to develop regression equations to determine age in adults by means of linear measurements and ratios on sagittal, coronal and axial slices of maxillary central incisors using cone bean computed tomography (CBCT). Multiplanar measurements of upper central incisors were taken for a sample of 373 CBCTs. Subsequently, one-way analysis of variance (ANOVA) and multivariate linear regressions were performed for age estimation. The equations obtained from axial linear measurements and ratios presented a standard error of the estimate (SEE) of ±10.9 years (R2 = 0.49), and a SEE of ±10.8 years (R2 = 0.50), respectively. The equation obtained for multiplanar linear measurements presented a SEE of ±10.9 years (R2 = 0.52), while the equation for multiplanar ratios presented a SEE of ±10.7 years (R2 = 0.51). Thus, CBCT measurements on upper central incisors were found to be an acceptable method for age estimation. Horizontal measurements, especially pulp measurements, improve the accuracy of age estimate equations.

Assessment of Accuracy of Two Different Radiographic Methods for Age Estimation to Chronological Age – A Comparative CBCT Study

Introduction: Assessment of age in adults is a difficult task in forensic medicine. In craniofacial structures, the mental, mandibular foramina and teeth are useful in age estimation. Because the pulp-to-tooth area ratio (PTR) based on secondary dentin deposition and the distance between the inferior border of the mental foramen and lower border of the mandible stays largely consistent over the course of a person's life, PTR and position of mental foramen are sensitive age markers. Aim: This study aims to assess an accurate method for age estimation, by comparing the results of the two different age estimation techniques such as mandibular canine's PTR and vertical position of the mental foramen using cone beam computed tomographic (CBCT) images. Materials and Methods: In 80 mandibular CBCT images, the pulp area and tooth area of the canine were measured from the axial section and a ratio was obtained. The same process was used for the sagittal sectional image. Another method involved measuring the mental foramen's four variables (X1, X2, X3, and X4) using a panoramic sectional image. The procured data were subjected to statistical analysis. Results: A negative linear relationship was acquired among the pulp cavity width, the height of the mandible (X1), and the age. Cubic regression analysis was performed, and the regression formulae were acquired. A mean difference of 2.11 years in axial section, 3.93 years in sagittal section, and 11.23 years in the mental foramen vertical position was acquired among the age estimated and chronological age. Conclusion: The sagittal sectional image of the mandibular canine's PTR is more accurate for determining age when compared with the vertical position of the mental foramen.

Age estimation from pulp tooth area ratio of mandibular canine using an orthopantomogram: A cross-sectional study

Background: Age estimation of living adult individuals can be accomplished with limited methods. Radiographic dental methods based on secondary dentin deposition have been described as one of them. In the present study, the relationship between chronological age and the ratio of pulp to tooth area using available panoramic images of mandibular canine by Kvaal’s technique was carried out for the age estimation in the study population. Materials and Methods: 24 orthopantomogram images (OPG) of mandibular canines between 16-56 years were collected from the archives and pulp tooth area ratios were measured. Age was estimated using the regression equation obtained. Results: It was observed that variables M’, ‘L’, and ‘r’ correlated highly with age and were included in the regression model. Statistical analysis indicated that the regression equation with selected variables explained 94.4% of the total variance. There was no significant difference between chronological and estimated age (p&gt;0.05) signifying that the derived formula is appropriate for all the selected age groups. Conclusion: The derived population-specific regression equation can be potentially used for the estimation of the chronological age of the study population.

Volumetric Analysis of Teeth using Cone Beam Computed Tomography for Age Estimation among the Indian Residents: A Pilot Study

Background: In forensic odontology, dental age estimation is important. Deposition of secondary dentin is a more significant method in dental age predicton. This secondary dentin decreases the size of the pulp cavity. Thus, pulp size is reduced with advancing age. Therefore, the tooth to pulp size area ratio goes on increasing as age increases. Aim: To assess the ratio of “pulp/tooth volume” in single and multi- rooted teeth by Cone Beam Computed Tomography (CBCT) and correlate with the age. Objective: 1. To analyse ratio of pulp/ tooth volume in single and multi-rooted teeth, 2. To evaluate accuracy of the Yang’s formula available for age estimation, 3. To generate the formula for multi rooted teeth and correlate with the age. Methodology: 150 extracted teeth of which 50 permanent maxillary canines, 50 maxillary first premolars and 50 permanent maxillary first molars were collected and subjected to CBCT scanning for volumetric analysis. ‘Pulp Volume (PV)’, ‘Tooth Volume (TV)’ and ‘Pulp/Tooth Volume Ratio (PTVR)’ were calculated. Result: Linear regression analyses established that the chronological age and PTVR correlated with each other. Pearson correlation coefficient showed TV, PV and PTVR were inversely proportional to age. Conclusion: This study revealed that permanent maxillary canine has the best correlation with age followed by First molar and First premolar.

Age Estimation Using Monoradicular Teeth by comparing Pulp/Tooth Area Ratios between Bucco-lingual and Mesio-distal Periapical Radiographs

Age estimation is an integral tool in identification of the victims when visual identification is not possible. Secondary dentin deposition is a regular ageing process and can be utilized in dental age estimation when development and eruption parameters cannot be utilized. In total, 38 monoradicular teeth of Nepalese subjects were assessed for tooth pulp ratio. Intraoral periapical radiographs of these teeth were taken, and pulp tooth ratio was calculated and dental age was estimated. The mean chronological age was 46.79 years and the mean estimated age was 44.32 years. The pulp/tooth area ratios calculated were in the range of 0.012 to 0.195, and 0.052 to 0.256 for mesio-distal and bucco-lingual planes respectively. Pulp tooth ratio of maxillary lateral incisors and mandibular lateral incisors showed the highest correlation with values of 90% and 76% respectively. Mesio-distal assessment was more accurate in dental age estimation than bucco-lingual view.

Radiographic Evaluation of Dental Age in Adults Using Digital Orthopantomograph

Introduction: Age estimation isimportant for administrative and ethical reasons and because of legal consequences. Dental pulp undergoes regression in size with increasing age due to secondary dentin deposition and can be used as a parameter of age estimation even beyond 25 years of age.Aims and Objectives: The purpose of the present study was to evaluate the feasibility of applying kvaal et al method of age estimation on maxillary second premolar &amp; mandibular first premolar on OPG. Materials and Methods: It is a retrospective study, which involved 100 sample of OPG on KODAK 9000 IMAGING. Measurements were performed on the standardized digital panoramic radiographs based on Kvaal’s method. Different regression formulae were derived and the age was assessed. The assessed age was then correlated to the actual age of the patient using Student’s t-test.Results: In this study, there were no significant difference in estimated &amp; actualage for both males and females.Conclusion: The study was an attempt to use KVAAL et al method of radiographic dental age estimation using OPG with minimal number of teeth.

Digitilized Radiographic Analysis of Coronal Pulp for Age Estimation in Adults using Tooth Coronal Index Method – A Pilot Study

Background: Teeth have become a valuable index to estimate age of an individual in forensic odontology. Although various methods have been reported in forensic literature for age estimation, radiographic methods are simple and require less expertise. Digitalization of panoramic radiographs and intraoral periapical radiographs helps in obtaining the more precise images and accurate measurements. Secondary dentin continuously gets deposited on pulpal surface throughout the life thus reducing the size of the pulp cavity. The Tooth Coronal Index (TCI) method is the indirect assessment of secondary dentin deposition for age estimation. Aim: This study aims to estimate the Tooth Coronal Index of mandibular first molar and its correlation with chronological age to derive a regression equation. Materials and Methods: A total of 50 adults above 20 years of age were selected from the outpatient department of our college. Digital intraoral periapical radiographs were taken by using Radiovisiography (RVG) for mandibular first molar. The crown height and Coronal Pulp Cavity Height were measured and then TCI was calculated. Further the data were subjected to statistical analysis. Results: Statistically significant difference was observed between age and TCI (p&lt;0.05*) and statistically insignificant difference observed between gender and TCI (p&gt;0.05). Conclusion: The Tooth Coronal Index provides more accurate estimation of age and it is a simple, non invasive and cost-effective method that could be easily applied for both living and dead individuals without any highly specialized equipment.

Estimasi usia prajurit TNI AL berdasarkan Tooth Coronal Index pada digital radiograf panoramik

Objectives: The purpose was to determine the estimated chronological age difference between Indonesian Navy soldiers (TNI-AL) and dental age based on the Tooth Coronal Index on panoramic digital radiographs, which are used as antemortem data for the purposes of identifying Indonesian Navy soldiers if they have an accident while on duty or on the battlefield where only tooth remains.&#x0D; Material and Methods: The method used was a cross-sectional observational survey with the sampling technique using purposive sampling. This study used 86 digital panoramic radiographs of Indonesian Navy soldiers who were assigned abroad from 2015-2017 at the Dental Radiology Installation of Ladokgi TNI AL R.E. Martadinata. The teeth measured were mandibular first molars with the Tooth Coronal Index (TCI) method, which is a method of estimating age based on secondary dentin deposition and tooth pulp size on dental radiographs. &#x0D; Results: The results of the chronological age difference with the dental age of Indonesian Navy soldiers using the Tooth Coronal Index (TCI) method on a panoramic digital radiograph performed on mandibular first molars were an average of 6.3 years. &#x0D; Conclusion: The dental age of Navy soldier is higher than chronological age.

The accuracy of age estimation from pulp chamber/crown volume ratio of canines obtained by cone beam computed tomography images: an Egyptian study

BackgroundGlobally, the need for an accurate and valid method for age estimation in adults still exists. The aging process is associated with secondary dentine deposition that reduces the volume of teeth pulp. Therefore, dental age could be recognized from the volume of pulp cavity. The aim of this study was to assess the accuracy and validity of pulp chamber/crown volume ratio of maxillary and mandibular canines in estimating age using cone beam computed tomography (CBCT) images in a sample of the Egyptian population.ResultsThere were significant strong negative correlations between age and each of the maxillary pulp chamber volume (PCV), mandibular PCV, maxillary pulp chamber/crown volume (PCV/CV) ratio, and mandibular PCV/CV ratio (p < 0.001). Furthermore, no significant differences were detected between both sexes regarding the mean maxillary and mandibular PCV and PCV/CV ratios (p > 0.05). The best fit regression model for age prediction was as follows: age (years) = 70.21 − 784.0x maxillary PCV/CV ratio − 1.66x maxillary PCV. The proposed model showed good power of prediction (R2 adjusted = 0.951). Additionally, the model was validated on an independent sample of 100 CBCT images with a root mean squared error (RMSE) of 2.86 years.ConclusionThe obtained valid regression formula in this study can serve as a reliable tool for age estimation in Egyptians. This formula should be further validated on a larger sample size of the Egyptian population that considers more steady age distribution.

Evaluation of secondary dentin deposition in lower first molars to indicate a legal age threshold of 14 years using receiver operating characteristic curves.

The age threshold of 14 years has become vital in proving legal violations involving children, particularly in cases of suspected child labour, child pornography and the minimum age of criminal responsibility. In recent years, there has been great interest in the evaluation of age in children and sub-adults using analysis of regressive changes in teeth, with a particular focus on age thresholds that are of medico-legal importance. This research aimed to compare the sensitivity and specificity of stages of root pulp visibility by Olze etal. in a sample of South Indian children aged between 12 and 16 years, with an age threshold of 14 years, using receiver operating characteristic curves and the area under the curve (AUC). Among the four stages of root pulp visibility, stage 2 showed the highest AUC in both female and male cohorts. For stage 2, lower sensitivity and higher specificity values were recorded, indicating the possibility of type II errors (i.e. false negatives). In both sexes, stage 2 had a higher AUC (i.e. 0.696 in females and 0.706 in males, respectively). Based on our findings, it can be concluded that this staging method in lower first molars is of limited value in indicating the legal age threshold of 14 years. Future research should validate the proposed approach in a larger sample and consider how to improve predictions in this area.

Age estimation using canine pulp volumes in adults: a CBCT image analysis

Secondary dentine deposition is responsible for the decrease in the volume of the pulp cavity with age. Therefore, the volume of the pulp cavity can be considered as a predictor for estimating age. The aims of this study were to investigate the relationship strength between canine pulp volumes and chronological age from homogenous (approximately equal numbers of individuals in each age range) age distribution and to assess the effect of sex as predictor in age estimation. This study was performed on 719 subjects of Pakistani origin. Cone beam computed tomography images of 521 left maxillary and 681 left mandibular canines were collected from 368 females and 349 males aged from 15 to 65 years. Planmeca Romexis® software was used to trace the outline of the pulp cavity and to calculate pulp volumes. Regression analysis was performed to assess the correlation between pulp volumes considering with and without sex as a predictor with chronological age. The obtained results showed that mandibular canine pulp volume and sex have the highest predictive power (R2 = 0.33). The relationship between mandibular canine pulp volume and sex with chronological age demonstrates an odd S-shaped non-linear relationship. A statistically significant difference in volumes of pulp was found (p = 0.000) between males and females. The conclusion was that predictions using the pulp volume of the mandibular canine and sex produced the best estimates of chronological age.