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01-07-2018 | Original Article

The third molar maturity index in indicating the legal adult age in Kosovar population

Authors: Jeta Kelmendi, Roberto Cameriere, Ferit Koçani, Ivan Galić, Blerim Mehmeti, Marin Vodanović

Published in: International Journal of Legal Medicine | Issue 4/2018

Abstract

The third molar tooth, known as the “wisdom tooth,” is the only tooth that can be used to determine legal adult age. This study aimed to test the accuracy of Cameriere’s third molar maturity index (I_3M) in assessing the legal adult age of 18 years in the Kosovar population. Orthopantomographs (OPTs) of 1221 healthy living Kosovar individuals, aged between 12 and 23 years and with no congenital or developmental anomalies, were analyzed. Intra-class correlation coefficients were 0.858 (95% CI, 0.786 to 0.906) and 0.852 (95% CI, 0.779 to 0.903) for intra-rater and for inter-rater agreement, respectively. The sample was divided into training dataset (800 OPTs) and test dataset (421 OPTs). The training dataset was used to generate the logistic regression model, while the test dataset was used to study the performance of the model. I_3M and gender as independent variables and adult age (≥ 18 years) or minor age (< 18 years) as the dependent variable were used for logistic regression analysis. The receiver operating curve (ROC) analysis was used to determine the specific cut-off value of I_3M for predicting adult age. The results showed that only I_3M statistically significantly contributed to discriminating adults and minors. ROC analysis showed that the cut-off value of I_3M < 0.08 was the best in discriminating adults and minors. An analysis of the test dataset (421 OPTs) showed that as I_3M decreased the age gradually increased. The performance of the cut-off value of I_3M < 0.08, to discriminate between adults and minors, was analyzed by contingency tables for both sexes. In males, the accurate classification (Acc) was 0.968 (95% CI, 0.926 to 0.985), the sensitivity (Se) was 0.962 (95% CI, 0.925 to 0.978), and the specificity (Sp) was 0.976 (95% CI, 0.929 to 0.995). The Bayes post-test probability (Bayes PTP) was 0.975 (95% CI, 0.905 to 1.00). In females, Acc was 0.909 (95% CI, 0.870 to 0.917), Se and Sp were 0.826 (95% CI, 0.787 to 0.834) and 0.991 (95% CI, 0.953 to 1.00) respectively, while Bayes PTP was 0.989 (95% CI, 0.926 to 1.00). Our data support the usefulness of I_3M < 0.08 to indicate legal adult age in a Kosovar population.

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Title: The third molar maturity index in indicating the legal adult age in Kosovar population
Authors: Jeta Kelmendi
Roberto Cameriere
Ferit Koçani
Ivan Galić
Blerim Mehmeti
Marin Vodanović
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Legal Medicine / Issue 4/2018
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-017-1761-9

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The third molar maturity index in indicating the legal adult age in Kosovar population

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