Relationship of the Pulp-to-Enamel Volume Ratio of Impacted Mandibular Third Molars with Chronological Age in an Iranian Population
Abstract
Objectives: This study aimed to examine the relationship of pulp-to-enamel volume ratio of third molars on cone-beam computed tomography (CBCT) images with chronological age, in order to create a regression equation that can be used to estimate age in both males and females.
Materials and Methods: A total of 122 impacted mandibular third molars of patients over the age of 18 years, who were referred to the dental clinic of Tehran University of Medical Sciences were analyzed in this cross-sectional study. CBCT images in DICOM format were imported into 3D Slicer software for calculation of pulp and enamel volumes. Data were analyzed by multiple linear regression (backward method) and Pearson's correlation coefficient (alpha=0.1 in regressions, and 0.05 in correlations).
Results: There was a significant inverse correlation between the pulp-to-enamel volume ratio and chronological age in both males (-0.55, P<0.001) and females (-0.517, P<0.001), as determined by the Pearson’s correlation coefficient. The mean absolute error (MAE) was lower in females (4.67 years) than in males (8.02 years) when using the pulp-to-enamel volume ratio as the sole independent variable. The regression formula that utilized the pulp-to-enamel volume ratio as a sole independent variable was able to estimate age in both sexes.
Conclusion: The results showed a statistically significant correlation between age and pulp-to-enamel volume ratio of impacted mandibular third molars, and this ratio may be applied as a useful index for age estimation.
1. Merdietio Boedi R, Shepherd S, Mânica S, Franco A. CBCT in dental age estimation: A systematic review and meta analysis. Dentomaxillofacial Radiology. 2022;51(4):20210335.
2. Ubelaker DH, Khosrowshahi H. Estimation of age in forensic anthropology: historical perspective and recent methodological advances. Forensic sciences research. 2019;4(1):1–9.
3. Arambawatta K, Peiris R, Hettiarachchi K, Dissanayake M, Ihalagedera D, Abeysundara A, et al. Age estimation using pulp/tooth area ratio of maxillary and mandibular canines on digital orthopantomographs in a sample of Sri Lankan population. International Journal of Forensic Odontology. 2021;6(2):106.
4. Solheim T, Vonen A. Dental age estimation, quality assurance and age estimation of asylum seekers in Norway. Forensic science international. 2006;159:S56–S60.
5. Sakuma A, Saitoh H, Suzuki Y, Makino Y, Inokuchi G, Hayakawa M, et al. Age estimation based on pulp cavity to tooth volume ratio using postmortem computed tomography images. Journal of forensic sciences. 2013;58(6):1531–5.
6. Uğur Aydın Z, Bayrak S. Relationship Between Pulp Tooth Area Ratio and Chronological Age Using Cone‐beam Computed Tomography Images. Journal of forensic sciences. 2019;64(4):1096–9.
7. Ge Z-p, Yang P, Li G, Zhang J-z, Ma X-c. Age estimation based on pulp cavity/chamber volume of 13 types of tooth from cone beam computed tomography images. International journal of legal medicine. 2016;130(4):1159–67.
8. Yazdanian M, Karami S, Tahmasebi E, Alam M, Abbasi K, Rahbar M, et al. Dental Radiographic/Digital Radiography Technology along with Biological Agents in Human Identification. Scanning. 2022;2022.
9. Asif MK, Nambiar P, Mani SA, Ibrahim NB, Khan IM, Sukumaran P. Dental age estimation employing CBCT scans enhanced with Mimics software: Comparison of two different approaches using pulp/tooth volumetric analysis. Journal of forensic and legal medicine. 2018;54:53–61.
10. Zhang Z-y, Yan C-x, Min Q-m, Li S-q, Yang J-s, Guo Y-c, et al. Age estimation using pulp/enamel volume ratio of impacted mandibular third molars measured on CBCT images in a northern Chinese population. International Journal of Legal Medicine. 2019;133(6):1925–33.
11. De Angelis D, Gaudio D, Guercini N, Cipriani F, Gibelli D, Caputi S, et al. Age estimation from canine volumes. La radiologia medica. 2015;120(8):731–6.
12. Pinchi V, Pradella F, Buti J, Baldinotti C, Focardi M, Norelli G-A. A new age estimation procedure based on the 3D CBCT study of the pulp cavity and hard tissues of the teeth for forensic purposes: A pilot study. Journal of forensic and legal medicine. 2015;36:150–7.
13. Farhadian M, Salemi F, Saati S, Nafisi N. Dental age estimation using the pulp-to-tooth ratio in canines by neural networks. Imaging science in dentistry. 2019;49(1):19–26.
14. Molina A, Bravo M, Fonseca GM, Márquez-Grant N, Martín-de-Las-Heras S. Dental age estimation based on pulp chamber/crown volume ratio measured on CBCT images in a Spanish population. International journal of legal medicine. 2021;135(1):359–64.
15. Ge Z-p, Ma R-h, Li G, Zhang J-z, Ma X-c. Age estimation based on pulp chamber volume of first molars from cone-beam computed tomography images. Forensic science international. 2015;253:133. e1–. e7.
16. Gulsahi A, Kulah CK, Bakirarar B, Gulen O, Kamburoglu K. Age estimation based on pulp/tooth volume ratio measured on cone-beam CT images. Dentomaxillofacial Radiology. 2018;47(1):20170239.
17. Star H, Thevissen P, Jacobs R, Fieuws S, Solheim T, Willems G. Human dental age estimation by calculation of pulp–tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth. Journal of forensic sciences. 2011;56:S77–S82.
18. Agematsu H, Someda H, Hashimoto M, Matsunaga S, Abe S, Kim H-J, et al. Three-dimensional observation of decrease in pulp cavity volume using micro-CT: age-related change. The Bulletin of Tokyo Dental College. 2010;51(1):1–6.
19. Dehghani M, Shadkam E, Ahrari F, Dehghani M. Age estimation by canines’ pulp/tooth ratio in an Iranian population using digital panoramic radiography. Forensic science international. 2018;285:44–9.
20. Zaher JF, Fawzy IA, Habib SR, Ali MM. Age estimation from pulp/tooth area ratio in maxillary incisors among Egyptians using dental radiographic images. Journal of Forensic and Legal Medicine. 2011;18(2):62–5.
21. Haghanifar S, Ghobadi F, Vahdani N, Bijani A. Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth. Journal of applied oral science : revista FOB. 2019;27:e20180722.
22. Aboshi H, Takahashi T, Komuro T. Age estimation using microfocus X-ray computed tomography of lower premolars. Forensic science international. 2010;200(1-3):35–40.
23. Andrade VM, Fontenele RC, de Souza AC, Almeida CAd, Vieira AC, Groppo FC, et al. Age and sex estimation based on pulp cavity volume using cone beam computed tomography: development and validation of formulas in a Brazilian sample. Dentomaxillofacial Radiology. 2019;48(7):20190053.
24. Porto LVMG, da Silva Neto JC, dos Anjos Pontual A, Catunda RQ. Evaluation of volumetric changes of teeth in a Brazilian population by using cone beam computed tomography. Journal of forensic and legal medicine. 2015;36:4–9.
25. Jagannathan N, Neelakantan P, Thiruvengadam C, Ramani P, Premkumar P, Natesan A, et al. Age estimation in an Indian population using pulp/tooth volume ratio of mandibular canines obtained from cone beam computed tomography. The Journal of forensic odonto-stomatology. 2011;29(1):1.
26. Biuki N, Razi T, Faramarzi M. Relationship between pulp-tooth volume ratios and chronological age in different anterior teeth on CBCT. Journal of clinical and experimental dentistry. 2017;9(5):e688.
27. Someda H, Saka H, Matsunaga S, Ide Y, Nakahara K, Hirata S, et al. Age estimation based on three-dimensional measurement of mandibular central incisors in Japanese. Forensic science international. 2009;185(1-3):110–4.
2. Ubelaker DH, Khosrowshahi H. Estimation of age in forensic anthropology: historical perspective and recent methodological advances. Forensic sciences research. 2019;4(1):1–9.
3. Arambawatta K, Peiris R, Hettiarachchi K, Dissanayake M, Ihalagedera D, Abeysundara A, et al. Age estimation using pulp/tooth area ratio of maxillary and mandibular canines on digital orthopantomographs in a sample of Sri Lankan population. International Journal of Forensic Odontology. 2021;6(2):106.
4. Solheim T, Vonen A. Dental age estimation, quality assurance and age estimation of asylum seekers in Norway. Forensic science international. 2006;159:S56–S60.
5. Sakuma A, Saitoh H, Suzuki Y, Makino Y, Inokuchi G, Hayakawa M, et al. Age estimation based on pulp cavity to tooth volume ratio using postmortem computed tomography images. Journal of forensic sciences. 2013;58(6):1531–5.
6. Uğur Aydın Z, Bayrak S. Relationship Between Pulp Tooth Area Ratio and Chronological Age Using Cone‐beam Computed Tomography Images. Journal of forensic sciences. 2019;64(4):1096–9.
7. Ge Z-p, Yang P, Li G, Zhang J-z, Ma X-c. Age estimation based on pulp cavity/chamber volume of 13 types of tooth from cone beam computed tomography images. International journal of legal medicine. 2016;130(4):1159–67.
8. Yazdanian M, Karami S, Tahmasebi E, Alam M, Abbasi K, Rahbar M, et al. Dental Radiographic/Digital Radiography Technology along with Biological Agents in Human Identification. Scanning. 2022;2022.
9. Asif MK, Nambiar P, Mani SA, Ibrahim NB, Khan IM, Sukumaran P. Dental age estimation employing CBCT scans enhanced with Mimics software: Comparison of two different approaches using pulp/tooth volumetric analysis. Journal of forensic and legal medicine. 2018;54:53–61.
10. Zhang Z-y, Yan C-x, Min Q-m, Li S-q, Yang J-s, Guo Y-c, et al. Age estimation using pulp/enamel volume ratio of impacted mandibular third molars measured on CBCT images in a northern Chinese population. International Journal of Legal Medicine. 2019;133(6):1925–33.
11. De Angelis D, Gaudio D, Guercini N, Cipriani F, Gibelli D, Caputi S, et al. Age estimation from canine volumes. La radiologia medica. 2015;120(8):731–6.
12. Pinchi V, Pradella F, Buti J, Baldinotti C, Focardi M, Norelli G-A. A new age estimation procedure based on the 3D CBCT study of the pulp cavity and hard tissues of the teeth for forensic purposes: A pilot study. Journal of forensic and legal medicine. 2015;36:150–7.
13. Farhadian M, Salemi F, Saati S, Nafisi N. Dental age estimation using the pulp-to-tooth ratio in canines by neural networks. Imaging science in dentistry. 2019;49(1):19–26.
14. Molina A, Bravo M, Fonseca GM, Márquez-Grant N, Martín-de-Las-Heras S. Dental age estimation based on pulp chamber/crown volume ratio measured on CBCT images in a Spanish population. International journal of legal medicine. 2021;135(1):359–64.
15. Ge Z-p, Ma R-h, Li G, Zhang J-z, Ma X-c. Age estimation based on pulp chamber volume of first molars from cone-beam computed tomography images. Forensic science international. 2015;253:133. e1–. e7.
16. Gulsahi A, Kulah CK, Bakirarar B, Gulen O, Kamburoglu K. Age estimation based on pulp/tooth volume ratio measured on cone-beam CT images. Dentomaxillofacial Radiology. 2018;47(1):20170239.
17. Star H, Thevissen P, Jacobs R, Fieuws S, Solheim T, Willems G. Human dental age estimation by calculation of pulp–tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth. Journal of forensic sciences. 2011;56:S77–S82.
18. Agematsu H, Someda H, Hashimoto M, Matsunaga S, Abe S, Kim H-J, et al. Three-dimensional observation of decrease in pulp cavity volume using micro-CT: age-related change. The Bulletin of Tokyo Dental College. 2010;51(1):1–6.
19. Dehghani M, Shadkam E, Ahrari F, Dehghani M. Age estimation by canines’ pulp/tooth ratio in an Iranian population using digital panoramic radiography. Forensic science international. 2018;285:44–9.
20. Zaher JF, Fawzy IA, Habib SR, Ali MM. Age estimation from pulp/tooth area ratio in maxillary incisors among Egyptians using dental radiographic images. Journal of Forensic and Legal Medicine. 2011;18(2):62–5.
21. Haghanifar S, Ghobadi F, Vahdani N, Bijani A. Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth. Journal of applied oral science : revista FOB. 2019;27:e20180722.
22. Aboshi H, Takahashi T, Komuro T. Age estimation using microfocus X-ray computed tomography of lower premolars. Forensic science international. 2010;200(1-3):35–40.
23. Andrade VM, Fontenele RC, de Souza AC, Almeida CAd, Vieira AC, Groppo FC, et al. Age and sex estimation based on pulp cavity volume using cone beam computed tomography: development and validation of formulas in a Brazilian sample. Dentomaxillofacial Radiology. 2019;48(7):20190053.
24. Porto LVMG, da Silva Neto JC, dos Anjos Pontual A, Catunda RQ. Evaluation of volumetric changes of teeth in a Brazilian population by using cone beam computed tomography. Journal of forensic and legal medicine. 2015;36:4–9.
25. Jagannathan N, Neelakantan P, Thiruvengadam C, Ramani P, Premkumar P, Natesan A, et al. Age estimation in an Indian population using pulp/tooth volume ratio of mandibular canines obtained from cone beam computed tomography. The Journal of forensic odonto-stomatology. 2011;29(1):1.
26. Biuki N, Razi T, Faramarzi M. Relationship between pulp-tooth volume ratios and chronological age in different anterior teeth on CBCT. Journal of clinical and experimental dentistry. 2017;9(5):e688.
27. Someda H, Saka H, Matsunaga S, Ide Y, Nakahara K, Hirata S, et al. Age estimation based on three-dimensional measurement of mandibular central incisors in Japanese. Forensic science international. 2009;185(1-3):110–4.
| Issue | Vol 23 (Continuously Published Article-Based) | |
| Section | Original Article | |
| Keywords | ||
| Age Determination by Teeth Cone-Beam Computed Tomography Dentin Secondary | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Niknami M, Mirhashemi A, Madani Z, Hasanpoor R, Kiani N. Relationship of the Pulp-to-Enamel Volume Ratio of Impacted Mandibular Third Molars with Chronological Age in an Iranian Population. Front Dent. 2026;23.
