Forensic Odontology: Application in the Mediterranean Area

The use of dentition for identification and age estimation has been well established in the field of forensics, however, the accuracy and validity of various methods has not been systematically investigated in a variety of ethnic groups. Dental analysis has been widely employed for personal identification and age estimation due to teeth durability and being resilient to change. The aim of this thesis is to evaluate the applicability and reliability of three major dental methods for age estimation, focusing on Libyan population. Three principal dental approaches (dental wear and on shading, third molar maturity index (I3M), and linear regression formula) are explored. Furthermore, cervical vertebrae analysis, which concomitantly used with I3M for age estimation of young people, is also applied in this study. In the study of age estimation, dental wear and shading are two separate indicators that have to be combined together for best results. Herein, the score and shading data of 412 participants of known age and sex from North Africa (majority from Libya) and England were studied. The participants were classified into 14 age groups of 5-year intervals. A new table has been made for age estimation using shading wear. The results show a good agreement with real age of most participants with minimal errors associated with data analysis. The results also indicate the superiority of tooth wear level investigation over shading method in actual age estimation; 71% of the estimated ages are in agreement with the real age of the participants. New samples were gathered for the purpose of validation of age estimates; a sample of 918 healthy living Libyan subjects (521 females and 397 males), aged between 14 and 23, was used to analyse the third molar development by assessment of the I3M. The obtained results highlighted the significance of the I3M-based approach to adult age estimation, as 86.4% of the females and 89% of the males were correctly classified. It was also shown that, by using an I3M cut-off value of 0.09 instead of 0.08, an increase of around 3% was achieved in the numbers of individuals correctly identified using the method of Cameriere et al. (2006), when estimating the age of children by measurements of open apices in their teeth. The authors provided a first formula for the Italian population and in 2007, a formula for the European population. In this study, a new formula has been produced for the Libyan populations. According to the results, Libyan formula is the most accurate method compared with two methods tested in the present study, i.e. Italian and European formulae in Libyan population. The performance of the age estimation formula developed in thesis for the Libyan population has been compared against two other formulae previously presented in literature for the Italian and the European populations. No statistically significant difference was found between the European and Libyan formula proposed in this thesis, however, a difference was found between when compared with the Italian formula. Nevertheless, the linear regression formula developed in this thesis performed exceptionally well in estimating the age of Libyan population

Third molar maturity index by measurements of open apices in a Libyan sample of living subjects

In most countries, forensic age estimation in living subjects has become increasingly important in the last few years. In addition, as the age of legal majority ranges from 14 to 18 in many countries, and in Libya it is 18 years, radiographic assessment of the degree of third molar development is essential for forensic age estimation of adolescents and young adults. The aim of this paper is to assess the accuracy of the cut-off value of 0.08, by measurements of third molar index (I3M), in determining if a subject is adult or not in Libyan population. Digital panoramic radiographs of 307 healthy subjects (163 girls, 144 boys), aged between 14 and 22, were analysed. The I3M, the age and the sex of the subjects were used as predictive variable for age estimation. Using a cut-off of 0.08, the sensitivity of the test for boys was 90.9% and the specificity 100%. The proportion of correctly classified individuals was 95.1% (95% CI: 91.5–98.7%). The sensitivity for girls was 90.6% and the specificity 100%. The proportion of correctly classified individuals was 94.5% (95% CI: 90.9–98.1%). Estimated post-test probability in boys and girls was 100%. Further analyses, performed using a cut-off of 0.09, do not affect the specificity (100%) while they improve the sensitivity for both boys and girls