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Published in: Forensic Science, Medicine and Pathology 1/2024

Open Access 11-02-2023 | Review

Dental age estimation using the Kvaal method—an evaluation of length and width ratios: a systematic review

Authors: S. Kazmi, Syed Jaffar Abbas Zaidi, Gowri Vijay Reesu, Simon Shepherd

Published in: Forensic Science, Medicine and Pathology | Issue 1/2024

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Abstract

This study aimed to systematically review the correlational accuracy between width ratios and length ratios based on the Kvaal methodology with chronological age. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The search strategy included ProQuest, PubMed, Science Direct, and Taylor and Francis and Willey online without time or language restriction using Kvaal method of age estimation as key words for the search up to December 2021. A team of two researchers independently selected the studies and extracted the data. The Covidence platform was used to systematically organize all titles. The full texts of eligible studies were analyzed. Risk of bias (RoB) was assessed using a modified (to the specific characteristics of this systematic review) checklist based on Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement checklist for observational studies. A total of 658 articles were initially reviewed, but 22 were selected for inclusion. The risk of bias was estimated to be unclear to low overall. Among the length ratios, ratio R showed a strong association with chronological age, followed by ratio P. For the width ratios, ratio B demonstrated a close association with chronological age, followed by ratio C. The results suggest that width ratios correlate better with chronological age than length ratios. This systematic review suggests the width ratios are more strongly associated with chronological age than the length ratios. Using a width ratio could serve as a convenient and rapid way to estimate dental age. Our results apply equally to all types of ethnic groups.
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Literature
1.
go back to reference Kvaal SI, Kolltveit KM, Thomsen IO, Solheim T. Age estimation of adults from dental radiographs. Forensic Sci Int. 1995;74(3):175–85.PubMedCrossRef Kvaal SI, Kolltveit KM, Thomsen IO, Solheim T. Age estimation of adults from dental radiographs. Forensic Sci Int. 1995;74(3):175–85.PubMedCrossRef
2.
go back to reference AlQahtani SJ, Hector MP, Liversidge HM. Accuracy of dental age estimation charts: Schour and Massler, Ubelaker and the London Atlas. Am J Phys Anthropol. 2014;154(1):70–8.PubMedCrossRef AlQahtani SJ, Hector MP, Liversidge HM. Accuracy of dental age estimation charts: Schour and Massler, Ubelaker and the London Atlas. Am J Phys Anthropol. 2014;154(1):70–8.PubMedCrossRef
3.
go back to reference Cameriere R, Ferrante L, Cingolani M. Variations in pulp/tooth area ratio as an indicator of age: a preliminary study. J Forensic Sci. 2004;49(2):317–9.PubMedCrossRef Cameriere R, Ferrante L, Cingolani M. Variations in pulp/tooth area ratio as an indicator of age: a preliminary study. J Forensic Sci. 2004;49(2):317–9.PubMedCrossRef
4.
go back to reference Bodecker CF. A consideration of some of the changes in the teeth from young to old age. Dental Cosmos. 1925;67(6):543–9. Bodecker CF. A consideration of some of the changes in the teeth from young to old age. Dental Cosmos. 1925;67(6):543–9.
5.
go back to reference Drusini AG, Toso O, Ranzato C. The coronal pulp cavity index: a biomarker for age determination in human adults. Am J Phys Anthropol. 1997;103(3):353–63.PubMedCrossRef Drusini AG, Toso O, Ranzato C. The coronal pulp cavity index: a biomarker for age determination in human adults. Am J Phys Anthropol. 1997;103(3):353–63.PubMedCrossRef
7.
go back to reference 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 Sci Int. 2009;185(1–3):110–4.PubMedCrossRef 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 Sci Int. 2009;185(1–3):110–4.PubMedCrossRef
8.
go back to reference Kazmi S, Mânica S, Revie G, Shepherd S, Hector M. Age estimation using canine pulp volumes in adults: a CBCT image analysis. Int J Legal Med. 2019;133(6):1967–76.PubMedPubMedCentralCrossRef Kazmi S, Mânica S, Revie G, Shepherd S, Hector M. Age estimation using canine pulp volumes in adults: a CBCT image analysis. Int J Legal Med. 2019;133(6):1967–76.PubMedPubMedCentralCrossRef
9.
go back to reference Li MJ, Chu G, Han MQ, Chen T, Zhou H, Guo YC. Application of the Kvaal method for age estimation using digital panoramic radiography of Chinese individuals. Forensic Sci Int. 2019;301:76–81.PubMedCrossRef Li MJ, Chu G, Han MQ, Chen T, Zhou H, Guo YC. Application of the Kvaal method for age estimation using digital panoramic radiography of Chinese individuals. Forensic Sci Int. 2019;301:76–81.PubMedCrossRef
10.
go back to reference Landa MI, Garamendi PM, Botella MC, Alemán I. Application of the method of Kvaal et al. to digital orthopantomograms. Int J Legal Med. 2009;123(2):123–8. Landa MI, Garamendi PM, Botella MC, Alemán I. Application of the method of Kvaal et al. to digital orthopantomograms. Int J Legal Med. 2009;123(2):123–8.
11.
go back to reference Akay G, Gungor K, Gurcan S. The applicability of Kvaal methods and pulp/tooth volume ratio for age estimation of the Turkish adult population on cone beam computed tomography images. Aust J Forensic Sci. 2019;51(3):251–65.CrossRef Akay G, Gungor K, Gurcan S. The applicability of Kvaal methods and pulp/tooth volume ratio for age estimation of the Turkish adult population on cone beam computed tomography images. Aust J Forensic Sci. 2019;51(3):251–65.CrossRef
12.
go back to reference Roh BY, Lee WJ, Ryu JW, Ahn JM, Yoon CL, Lee SS. The application of the Kvaal method to estimate the age of live Korean subjects using digital panoramic radiographs. Int J Legal Med. 2018;132(4):1161–6.PubMedCrossRef Roh BY, Lee WJ, Ryu JW, Ahn JM, Yoon CL, Lee SS. The application of the Kvaal method to estimate the age of live Korean subjects using digital panoramic radiographs. Int J Legal Med. 2018;132(4):1161–6.PubMedCrossRef
13.
go back to reference Paewinsky E, Pfeiffer H, Brinkmann B. Quantification of secondary dentine formation from orthopantomograms–a contribution to forensic age estimation methods in adults. Int J Legal Med. 2005;119(1):27–30.PubMedCrossRef Paewinsky E, Pfeiffer H, Brinkmann B. Quantification of secondary dentine formation from orthopantomograms–a contribution to forensic age estimation methods in adults. Int J Legal Med. 2005;119(1):27–30.PubMedCrossRef
14.
go back to reference Erbudak H, Ozbek M, Uysal S, Karabulut E. Application of Kvaal et al.'s age estimation method to panoramic radiographs from Turkish individuals. Forensic Sci Int. 2012;219(1–3):141–6. Erbudak H, Ozbek M, Uysal S, Karabulut E. Application of Kvaal et al.'s age estimation method to panoramic radiographs from Turkish individuals. Forensic Sci Int. 2012;219(1–3):141–6.
15.
go back to reference Patil SK, Mohankumar KP, Donoghue M. Estimation of age by Kvaal’s technique in sample Indian population to establish the need for local Indian-based formulae. J Forensic Dent Sci. 2014;6(3):166–70.PubMedPubMedCentral Patil SK, Mohankumar KP, Donoghue M. Estimation of age by Kvaal’s technique in sample Indian population to establish the need for local Indian-based formulae. J Forensic Dent Sci. 2014;6(3):166–70.PubMedPubMedCentral
16.
go back to reference Karkhanis S, Mack P, Franklin D.Age estimation standards for a Western Australian population using the dental age estimation technique developed by Kvaal, et al. Forensic Sci Int. 2014;235(104):e1-6. Karkhanis S, Mack P, Franklin D.Age estimation standards for a Western Australian population using the dental age estimation technique developed by Kvaal, et al. Forensic Sci Int. 2014;235(104):e1-6.
17.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339: b2535.PubMedPubMedCentralCrossRef Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339: b2535.PubMedPubMedCentralCrossRef
18.
go back to reference Marroquin TY, Karkhanis S, Kvaal SI, Vasudavan S, Kruger E, Tennant M. Age estimation in adults by dental imaging assessment systematic review. Forensic Sci Int. 2017;275:203–11.PubMedCrossRef Marroquin TY, Karkhanis S, Kvaal SI, Vasudavan S, Kruger E, Tennant M. Age estimation in adults by dental imaging assessment systematic review. Forensic Sci Int. 2017;275:203–11.PubMedCrossRef
19.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.CrossRef
20.
go back to reference Hostiuc S, Edison S-E, Diaconescu I, Negoi I, Isaila O-M. Accuracy of the Demirjian’s method for assessing the age in children, from 1973 to 2020. A meta-analysis. Legal Med. 2021;52: 101901.PubMedCrossRef Hostiuc S, Edison S-E, Diaconescu I, Negoi I, Isaila O-M. Accuracy of the Demirjian’s method for assessing the age in children, from 1973 to 2020. A meta-analysis. Legal Med. 2021;52: 101901.PubMedCrossRef
21.
go back to reference Bosmans N, Ann P, Aly M, Willems G. The application of Kvaal’s dental age calculation technique on panoramic dental radiographs. Forensic Sci Int. 2005;153(2–3):208–12.PubMedCrossRef Bosmans N, Ann P, Aly M, Willems G. The application of Kvaal’s dental age calculation technique on panoramic dental radiographs. Forensic Sci Int. 2005;153(2–3):208–12.PubMedCrossRef
23.
go back to reference Mittal S, Nagendrareddy SG, Sharma ML, Agnihotri P, Chaudhary S, Dhillon M. Age estimation based on Kvaal’s technique using digital panoramic radiographs. J Forensic Dent Sci. 2016;8(2):115.PubMedPubMedCentralCrossRef Mittal S, Nagendrareddy SG, Sharma ML, Agnihotri P, Chaudhary S, Dhillon M. Age estimation based on Kvaal’s technique using digital panoramic radiographs. J Forensic Dent Sci. 2016;8(2):115.PubMedPubMedCentralCrossRef
24.
go back to reference Saxena S, Tiwari S, Bhambal A. Variations in morphological variables of canine as indicators of age among Indian adults. Indian J Stomatol. 2011;2(1). Saxena S, Tiwari S, Bhambal A. Variations in morphological variables of canine as indicators of age among Indian adults. Indian J Stomatol. 2011;2(1).
26.
go back to reference Misirlioglu M, Nalcaci R, Adisen MZ, Yilmaz S, Yorubulut S. Age estimation using maxillary canine pulp/tooth area ratio, with an application of Kvaal’s methods on digital orthopantomographs in a Turkish sample. Aust J Forensic Sci. 2014;46(1):27–38.CrossRef Misirlioglu M, Nalcaci R, Adisen MZ, Yilmaz S, Yorubulut S. Age estimation using maxillary canine pulp/tooth area ratio, with an application of Kvaal’s methods on digital orthopantomographs in a Turkish sample. Aust J Forensic Sci. 2014;46(1):27–38.CrossRef
27.
go back to reference Chandan P, Arora K, Das M, Kaur P, Mohaptra S, Pareek S. Assessment of validity and reliability of Kvaal’s method for age estimation among a population sample & #8211; A retrospective study. Indian J Dent Res. 2020;31(2):186–90.PubMedCrossRef Chandan P, Arora K, Das M, Kaur P, Mohaptra S, Pareek S. Assessment of validity and reliability of Kvaal’s method for age estimation among a population sample & #8211; A retrospective study. Indian J Dent Res. 2020;31(2):186–90.PubMedCrossRef
28.
go back to reference Hisham S, Abdullah N, Mohamad Noor MH, Franklin D. Quantification of secondary dentin formation using dental orthopantomographs in a contemporary Malaysian population. Aust J Forensic Sci. 2019;51(sup1):S180–3.CrossRef Hisham S, Abdullah N, Mohamad Noor MH, Franklin D. Quantification of secondary dentin formation using dental orthopantomographs in a contemporary Malaysian population. Aust J Forensic Sci. 2019;51(sup1):S180–3.CrossRef
29.
go back to reference Li M, Zhao J, Chen W, Chen X, Chu G, Chen T, et al. Can canines alone be used for age estimation in Chinese individuals when applying the Kvaal method? Forensic Sci Res. 2022;7(2):132–7.PubMedCrossRef Li M, Zhao J, Chen W, Chen X, Chu G, Chen T, et al. Can canines alone be used for age estimation in Chinese individuals when applying the Kvaal method? Forensic Sci Res. 2022;7(2):132–7.PubMedCrossRef
30.
go back to reference Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Vasudavan S, Castelblanco E, Kruger E, et al. Orthodontic Treatment: Real Risk for Dental Age Estimation in Adults? J Forensic Sci. 2017;62(4):907–10.PubMedCrossRef Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Vasudavan S, Castelblanco E, Kruger E, et al. Orthodontic Treatment: Real Risk for Dental Age Estimation in Adults? J Forensic Sci. 2017;62(4):907–10.PubMedCrossRef
31.
go back to reference Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Nurul F, Kanagasingam S, Franklin D, et al. Application of the Kvaal method for adult dental age estimation using Cone Beam Computed Tomography (CBCT). J Forensic Leg Med. 2016;44:178–82.PubMedCrossRef Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Nurul F, Kanagasingam S, Franklin D, et al. Application of the Kvaal method for adult dental age estimation using Cone Beam Computed Tomography (CBCT). J Forensic Leg Med. 2016;44:178–82.PubMedCrossRef
32.
go back to reference Vossoughi M, Movahhedian N, Ghafoori A. The impact of age mimicry bias on the accuracy of methods for age estimation based on Kvaal’s pulp/tooth ratios: a bootstrap study. Int J Legal Med. 2022;136(1):269–78.PubMedCrossRef Vossoughi M, Movahhedian N, Ghafoori A. The impact of age mimicry bias on the accuracy of methods for age estimation based on Kvaal’s pulp/tooth ratios: a bootstrap study. Int J Legal Med. 2022;136(1):269–78.PubMedCrossRef
33.
go back to reference Hisham S, Abdullah N, Noor MHM, Franklin D. Quantification of secondary dentin formation based on the analysis of MDCT scans and dental OPGs in a contemporary Malaysian population. Leg Med (Tokyo). 2019;36:59–66.PubMedCrossRef Hisham S, Abdullah N, Noor MHM, Franklin D. Quantification of secondary dentin formation based on the analysis of MDCT scans and dental OPGs in a contemporary Malaysian population. Leg Med (Tokyo). 2019;36:59–66.PubMedCrossRef
34.
go back to reference Kolltveit KM, Solheim T, Kvaal SI. Methods of measuring morphological parameters in dental radiographs. Comparison between image analysis and manual measurements. Forensic Sci Int. 1998;94(1–2):87–95. Kolltveit KM, Solheim T, Kvaal SI. Methods of measuring morphological parameters in dental radiographs. Comparison between image analysis and manual measurements. Forensic Sci Int. 1998;94(1–2):87–95.
35.
go back to reference Philippas GG, Applebaum E. Age factor in secondary dentin formation. J Dent Res. 1966;45(3):778–89.PubMedCrossRef Philippas GG, Applebaum E. Age factor in secondary dentin formation. J Dent Res. 1966;45(3):778–89.PubMedCrossRef
36.
go back to reference Murray PE, Stanley HR, Matthews JB, Sloan AJ, Smith AJ. Age-related odontometric changes of human teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(4):474–82.PubMedCrossRef Murray PE, Stanley HR, Matthews JB, Sloan AJ, Smith AJ. Age-related odontometric changes of human teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(4):474–82.PubMedCrossRef
37.
go back to reference Oi T, Saka H, Ide Y. Three-dimensional observation of pulp cavities in the maxillary first premolar tooth using micro-CT. Int Endod J. 2004;37(1):46–51.PubMedCrossRef Oi T, Saka H, Ide Y. Three-dimensional observation of pulp cavities in the maxillary first premolar tooth using micro-CT. Int Endod J. 2004;37(1):46–51.PubMedCrossRef
38.
go back to reference Aboshi H, Takahashi T, Komuro T. Age estimation using microfocus X-ray computed tomography of lower premolars. Forensic Sci Int. 2010;200(1–3):35–40.PubMedCrossRef Aboshi H, Takahashi T, Komuro T. Age estimation using microfocus X-ray computed tomography of lower premolars. Forensic Sci Int. 2010;200(1–3):35–40.PubMedCrossRef
39.
go back to reference Ramli UIS, Muhd US, Mohd Yusof MYP. Accuracy of Kvaal’s radiographic and translucent dentinal root techniques of extracted teeth in Malay adults for dental age estimation. J Forensic Odontostomatol. 2021;2(39):38–44. Ramli UIS, Muhd US, Mohd Yusof MYP. Accuracy of Kvaal’s radiographic and translucent dentinal root techniques of extracted teeth in Malay adults for dental age estimation. J Forensic Odontostomatol. 2021;2(39):38–44.
40.
go back to reference Bang G. Age changes in teeth: developmental and regressive. Iscan MY Age Markers in the Human Skeleton. 1989;213. Bang G. Age changes in teeth: developmental and regressive. Iscan MY Age Markers in the Human Skeleton. 1989;213.
41.
go back to reference Hanihara T, Ishida H. Metric dental variation of major human populations. Am J Phys Anthropol. 2005;128(2):287–98.PubMedCrossRef Hanihara T, Ishida H. Metric dental variation of major human populations. Am J Phys Anthropol. 2005;128(2):287–98.PubMedCrossRef
42.
go back to reference Harris EF, Hicks JD, Barcroft BD. Tissue contributions to sex and race: differences in tooth crown size of deciduous molars. Am J Phys Anthropol. 2001;115(3):223–37.PubMedCrossRef Harris EF, Hicks JD, Barcroft BD. Tissue contributions to sex and race: differences in tooth crown size of deciduous molars. Am J Phys Anthropol. 2001;115(3):223–37.PubMedCrossRef
43.
go back to reference Kim E, Fallahrastegar A, Hur YY, Jung IY, Kim S, Lee SJ. Difference in root canal length between Asians and Caucasians. Int Endod J. 2005;38(3):149–51.PubMedCrossRef Kim E, Fallahrastegar A, Hur YY, Jung IY, Kim S, Lee SJ. Difference in root canal length between Asians and Caucasians. Int Endod J. 2005;38(3):149–51.PubMedCrossRef
44.
go back to reference Morse DR, Esposito JV, Schoor RS, Williams FL, Furst ML. A review of aging of dental components and a retrospective radiographic study of aging of the dental pulp and dentin in normal teeth. Quintessence Int. 1991;22(9):711–20.PubMed Morse DR, Esposito JV, Schoor RS, Williams FL, Furst ML. A review of aging of dental components and a retrospective radiographic study of aging of the dental pulp and dentin in normal teeth. Quintessence Int. 1991;22(9):711–20.PubMed
45.
go back to reference Sondang P, Kumagai H, Tanaka E, Ozaki H, Nikawa H, Tanne K, et al. Correlation between maximum bite force and craniofacial morphology of young adults in Indonesia. J Oral Rehabil. 2003;30(11):1109–17.PubMedCrossRef Sondang P, Kumagai H, Tanaka E, Ozaki H, Nikawa H, Tanne K, et al. Correlation between maximum bite force and craniofacial morphology of young adults in Indonesia. J Oral Rehabil. 2003;30(11):1109–17.PubMedCrossRef
46.
go back to reference Schulze R, Krummenauer F, Schalldach F, d’Hoedt B. Precision and accuracy of measurements in digital panoramic radiography. Dentomaxillofac Radiol. 2000;29(1):52–6.PubMedCrossRef Schulze R, Krummenauer F, Schalldach F, d’Hoedt B. Precision and accuracy of measurements in digital panoramic radiography. Dentomaxillofac Radiol. 2000;29(1):52–6.PubMedCrossRef
Metadata
Title
Dental age estimation using the Kvaal method—an evaluation of length and width ratios: a systematic review
Authors
S. Kazmi
Syed Jaffar Abbas Zaidi
Gowri Vijay Reesu
Simon Shepherd
Publication date
11-02-2023
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 1/2024
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-023-00575-9

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