Accuracy of Identifying Juvenile/Adult Status from Third Molar Development using Prediction Probabilities Derived from Logistic Regression Analysis

Abstract

The use of third molars in predicting juvenile/adult status (</≥ 18 years) has important legal ramifications. Third molar development was assessed using Köhler's grading on 268 orthopantomograms of Indian subjects. Logistic regression analysis was applied to determine allocation accuracy of juvenile/adult status and the level of probability that is "reliable" in predicting juvenile/adult status. Allocation accuracies ranged between 75.8% and 78.2% for the sexes combined, with minimal male-female differences. Adults were categorized more accurately than juveniles, suggesting that Köhler's grading puts Indian juveniles at greater risk of unwarranted punishment. In both sexes, juvenile/adult status was "reliably" predicted when the probability was >80% using individual third molars (excepting the lower right third molar in males); combining upper and lower third molars on the left/right sides, "reliable" predictions were possible when the probability was >80% and >90% for females and males, respectively. Overall, "reliable" juvenile/adult status prediction was achieved in c. 36% of subjects.

Accuracy of the cutoff value of the third molar maturity index: an Egyptian study

“…Different sensitivity and specificity in these populations may be either due to actual differences between them or differences in the age distribution and sample size, as well as dissimilarity among observers. However, the examination of the third molars may provide reasonable accuracy for the likelihood that a person is at least 18 years old (Acharya et al 2014).…”

Validation of third molar maturity index (I 3M ) for discrimination of juvenile/adult status in South Indian population

“…Later, Acharya et al 63 applied the grading system of Köhler et al 64 to assess the ability of third molars in determining the age of majority, and summarized that only 35-37% of the sample examined falls into "reliable" prediction of juvenile/adult status, which is just over one in three cases. Based on the allocation accuracies, the author also suggested that Köhler's grading of third molars in Indians may be disadvantageous to individuals <18 years old, because of its tendency in the wrongful prediction of a juvenile as an adult.…”

Application of Third Molar Maturity Index (I3M) for Assessing Adult Age of 18 Years in a Southern Italian Population Sample

“…[16][17][18] However, considering all the possible limitations, I3M proved to be able to provide a good accuracy in discerning the individuals under the age of 18 years from the older ones. 11,[19][20][21] It should be remembered also that there are recommendations for age estimation as those of AGFAD (Study Group on Forensic Age Diagnostics) or those of the Forensic Anthropology Society of Europe (FASE); they state that age should be estimated by a forensic expert and that the examination should include a physical examination, a radiography of the no dominant side hand, a dental exam (dental condition and ortopantomographs), and a radiography of medial epiphysis of the clavicle. 11,12,[22][23][24] There is a discordance in the literature regarding the sex difference, in fact, according to some authors it should be considered, since dental mineralization would be premature for men, 25 whereas according to other authors, there are not any particular differences between the two sexes.…”