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    Research Proposal For Final Year Project 2012/2013: Aiman Sabqi Ibrahim (0912877) Muhammad Faiz Mohamed (0916117)

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    Aiman Sabqi
    Nowadays the need for the estimation of age in living individuals is becoming increasingly important in forensic odontologysince there are increasing numbers of immigrants, asylum seekers who arrive in a country without acceptable identification papers or with missing or uncertain birth data. The usual anatomical areas used for age estimation are dental and the hand-wrist area. During the growth of a person, the application of skeletal, odontological, anthropological and psychological methods allows an approximate assessment of age. Among the methods most frequently used for skeletal maturity are those concerning the left hand-wrist area (Tanner et al 2001, Roche et al 1988) which can produce estimates up to the age of 16 years, at which time wrist maturation is complete in 90% of subjects. Other useful methods are based on radiographs of specific structures such as medial clavicular epiphysis cartilage. (Schmeling et al 2004 and Schulz et al 2005) However, these skeletal methods can have some drawbacks owing to the variability of bone maturation,which is influenced by environmental factors. Hence ,an alternative approach based on dental development was shown to be suitable for age determination in children because the calcification rate is controlled more by genes than by environmental factors, and this yields a lower variability in age estimation(Nolla 1960). Thus many age estimation methods by dental radiology found to have developed. Among the various methods, Demirjian’s method seems to be the simplest method as it categorizes the stages of dental development very well.Willem’s method is the modification of Demijian method and is known to be a useful tool. On the other hand Camerire’s method is also known to be useful in dental age estimation although it differs from Demrjian method.. it depends on the distances between the inner wall of open apices, number of roots with open apices,number of teeth with complete root closure, and finally the gender.

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    Research Proposal For Final Year Project 2012/2013: Aiman Sabqi Ibrahim (0912877) Muhammad Faiz Mohamed (0916117)

    Uploaded by

    Aiman Sabqi
    67 views23 pages
    Nowadays the need for the estimation of age in living individuals is becoming increasingly important in forensic odontologysince there are increasing numbers of immigrants, asylum seekers who arrive in a country without acceptable identification papers or with missing or uncertain birth data. The usual anatomical areas used for age estimation are dental and the hand-wrist area. During the growth of a person, the application of skeletal, odontological, anthropological and psychological methods allows an approximate assessment of age. Among the methods most frequently used for skeletal maturity are those concerning the left hand-wrist area (Tanner et al 2001, Roche et al 1988) which can produce estimates up to the age of 16 years, at which time wrist maturation is complete in 90% of subjects. Other useful methods are based on radiographs of specific structures such as medial clavicular epiphysis cartilage. (Schmeling et al 2004 and Schulz et al 2005) However, these skeletal methods can have some drawbacks owing to the variability of bone maturation,which is influenced by environmental factors. Hence ,an alternative approach based on dental development was shown to be suitable for age determination in children because the calcification rate is controlled more by genes than by environmental factors, and this yields a lower variability in age estimation(Nolla 1960). Thus many age estimation methods by dental radiology found to have developed. Among the various methods, Demirjian’s method seems to be the simplest method as it categorizes the stages of dental development very well.Willem’s method is the modification of Demijian method and is known to be a useful tool. On the other hand Camerire’s method is also known to be useful in dental age estimation although it differs from Demrjian method.. it depends on the distances between the inner wall of open apices, number of roots with open apices,number of teeth with complete root closure, and finally the gender.

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    Dental Age Estimation

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    Nowadays the need for the estimation of age in living individuals is becoming increasingly important in forensic odontologysince there are increasing numbers of immigrants, asylum seekers who arrive in a country without acceptable identification papers or with missing or uncertain birth data. The usual anatomical areas used for age estimation are dental and the hand-wrist area. During the growth of a person, the application of skeletal, odontological, anthropological and psychological methods allows an approximate assessment of age. Among the methods most frequently used for skeletal maturity are those concerning the left hand-wrist area (Tanner et al 2001, Roche et al 1988) which can produce estimates up to the age of 16 years, at which time wrist maturation is complete in 90% of subjects. Other useful methods are based on radiographs of specific structures such as medial clavicular epiphysis cartilage. (Schmeling et al 2004 and Schulz et al 2005) However, these skeletal methods can have some drawbacks owing to the variability of bone maturation,which is influenced by environmental factors. Hence ,an alternative approach based on dental development was shown to be suitable for age determination in children because the calcification rate is controlled more by genes than by environmental factors, and this yields a lower variability in age estimation(Nolla 1960). Thus many age estimation methods by dental radiology found to have developed. Among the various methods, Demirjian’s method seems to be the simplest method as it categorizes the stages of dental development very well.Willem’s method is the modification of Demijian method and is known to be a useful tool. On the other hand Camerire’s method is also known to be useful in dental age estimation although it differs from Demrjian method.. it depends on the distances between the inner wall of open apices, number of roots with open apices,number of teeth with complete root closure, and finally the gender.

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    67 views23 pages

    Research Proposal For Final Year Project 2012/2013: Aiman Sabqi Ibrahim (0912877) Muhammad Faiz Mohamed (0916117)

    Uploaded by

    Aiman Sabqi
    Nowadays the need for the estimation of age in living individuals is becoming increasingly important in forensic odontologysince there are increasing numbers of immigrants, asylum seekers who arrive in a country without acceptable identification papers or with missing or uncertain birth data. The usual anatomical areas used for age estimation are dental and the hand-wrist area. During the growth of a person, the application of skeletal, odontological, anthropological and psychological methods allows an approximate assessment of age. Among the methods most frequently used for skeletal maturity are those concerning the left hand-wrist area (Tanner et al 2001, Roche et al 1988) which can produce estimates up to the age of 16 years, at which time wrist maturation is complete in 90% of subjects. Other useful methods are based on radiographs of specific structures such as medial clavicular epiphysis cartilage. (Schmeling et al 2004 and Schulz et al 2005) However, these skeletal methods can have some drawbacks owing to the variability of bone maturation,which is influenced by environmental factors. Hence ,an alternative approach based on dental development was shown to be suitable for age determination in children because the calcification rate is controlled more by genes than by environmental factors, and this yields a lower variability in age estimation(Nolla 1960). Thus many age estimation methods by dental radiology found to have developed. Among the various methods, Demirjian’s method seems to be the simplest method as it categorizes the stages of dental development very well.Willem’s method is the modification of Demijian method and is known to be a useful tool. On the other hand Camerire’s method is also known to be useful in dental age estimation although it differs from Demrjian method.. it depends on the distances between the inner wall of open apices, number of roots with open apices,number of teeth with complete root closure, and finally the gender.

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    RESEARCH PROPOSAL for FINAL YEAR PROJECT 2012/2013

    Aiman Sabqi Ibrahim (0912877)


    Muhammad Faiz Mohamed (0916117)

    Supervisor
    Asst Prof Dr Bo Bo Ko
    Co-Supervisor
    Asst Prof Dr Susi Sukmasari
    The reliability of Camerieres age estimation
    method among Malay Malaysian children
    age groups 2-16 years old
    CURRENT ISSUE

    The need for age estimation of human is becoming an


    important in case of legal field such as:
    Recognizing the victim of catastrophe or disaster.
    Identifying unregistered immigrant which is increasing
    number.
    Investigation of crimes.

    Age estimation also becoming important in dental and medical


    field such as to identify any abnormality in endocrine system of
    an individual and also to aids in orthodontic treatment.
    During the growth of a person, the application of skeletal,
    odontological, anthropological and psychological methods
    allows an approximate assessment of age.

    The usual anatomical areas used for age estimation are dental

    and the hand-wrist area and teeth.


    However, these skeletal methods can have some weaknesses
    where bone maturation can be variable which is influenced by
    environmental factors.
    Hence, an alternative approach based on dental development
    was shown to be suitable for age determination in children
    because the:
    calcification rate is controlled more by genes than by
    environmental factors, and this yields a lower variability in
    age estimation (Nolla 1960).
    OPG are likely to be available compared to the hand wrist
    radiograph
    Thus many age estimation methods by dental radiology found to have developed

    Demirjians (1973) method seems to be the simplest method as it categorizes

    the stages of dental development very well into number of images.

    Willems (2001) method is the modification of Demirjians method using scoring

    system.

    In Malaysia, there are numbers of research about Demirjian and but only few research

    about Cameriere method have been conducted.


    Research question
    How is the reliability of Cameriere method on Malay
    Malaysian children.

    Hypothesis

    Cameriere method is reliable on Malay Malaysian

    children.

    Objectives
    To determine the reliability of Cameriere age estimation
    method among Malay children
    The study embarks the following objectives:

    To determine chronological age (CA) of Malay Malaysian

    children attended to dental clinic IIUM - Kuantan, Pahang

    To determine dental age (DA) of Malay Malaysian children

    attended to dental clinic IIUM - Kuantan, Pahang using

    Camerieres method.

    To determine the reliebility of DA using Cameriere method by

    comparing it to CA on Malay Malaysian children attended to

    dental clinic IIUM - Kuantan, Pahang.


    Significance for the discipline and the community
    Less evidence of age estimation work by Cameriere method
    among local Malay children has been found.
    This data can help students and clinician in applying Cameriere
    method among the Malay children in Kuantan, Pahang.
    The data could be of value to clinicians and dental students as
    evidence based data.
    Increased national data bank.
    It also can help data comparison between available data.
    Enable further investigation of age determination method using
    dental radiograph.
    To aid in orthodontic treatment.
    To detect any endocrine or development abnormalities in
    children.
    RESEARCH
    METHODOLOGY
    Study design
    It is a cross sectional study of panoramic radiographs of patients treated at the
    dental clinic IIUM Kuantan, from January 2009 to December 2012

    Selection of sample
    784 orthopantomographs taken from Malay children (382 boys, 402 girls) of healthy
    children aged between 2 and 16 years attending dental clinic IIUM Kuantan from
    January 2009 to December 2012.
    The seven permanent mandibular teeth (left or right quadrant) were evaluated.
    The inclusion criteria were
    healthy Malay children
    age between 2 and 16 years at the time of obtaining dental OPG
    good quality radiographs
    no agenesis or extractions in the lower quadrant (at site of examination).
    Exclusion criteria were hypodontia except permanent third molar, hyperdontia, unclear
    radiograph and gross anomalies.
    Data Collection:
    Radiographs were:
    digitalized by Ortopantomograph OP200

    which being stored in Planmeca Romexis software

    then images were transferred and recorded on computer files with the image format .jpg

    which then examined and measured by a computer-aided drafting program Adobe


    Photoshop CS3 on windows 7 operating system

    *Permanent developing mandibular teeth with exception of wisdom teeth were examined
    in radiographic picture. F.D.I. (Fede ration Dentaire Internationale) or a two-digit
    numbering system were used as nomenclature to classify the teeth.
    Briefly OPG Collected

    50 OPGs were tested for intra & Chronological age is obtain by the
    inter observer agreement using data from the OPG itself
    kappa test

    Dental age are calculated using


    Cameriere method

    Reliability test using paired T-test


    of CA and DA

    Significant / Not significant


    Intra- and inter-observer agreement

    As the possibility of replicating measurements reliably is an indispensable component of


    any metric study, intra- and inter-observer error was tested.

    All measurements were carried out by the same observer with sample experience of this
    technique.

    To test intra-observer reproducibility, a random sample of 50 panoramic radiographs was


    re-examined after an interval of at least 2 weeks and studied by concordance correlation
    coefficient, and k statistics (Cohens Kappa coefficient)
    Lastly, in order to evaluate inter-observer error, a new random sample of 50 individuals
    was selected and re-examined after a period of 3 weeks by the second author.

    This sample was also measured by another observer who had not worked with this
    method before.

    The subsample was composed of 25 males and 25 females, and the same procedure for
    all measurements was followed.

    After data collection, all measurements were entered into a computer database.

    The inter-observer reliability of the sum of normalized open apices (s) was studied by
    means of the concordance correlation coefficient, and k statistics (Cohens Kappa
    coefficient) were used to measure the inter-observer reliability of the number of the
    seven permanent mandibular teeth with root development complete.
    Kappa values are scaled between 0 and 1, 0 indicating the amount of
    agreement expected if scores were assigned randomly to specimens, and 1 for
    perfect agreement.
    Chronological age can be calculated by subtracting date of radiograph taken to date of
    birth.

    date of birth
    date of OPG
    taken

    CA = date of OPG taken date of birth


    Dental age estimation was performed according to the method of Cameriere et al. by using this
    formula:

    * g (variable) = 1 for boys/ 0 for girls * g (variable) = 1 for boys/ 0 for girls

    Age T = 8.387 + 0.282g 1.692 x 5 + 0.835N0 0.116s 0.139s x N0

    S = Sum of A/L ratio (normalized open apices) for every tooth with open apex or apices.
    A = radiographic distance of inner side of the open apex for single root. For
    teeth with two roots, sum of radiographic distance of inner side of the open
    apices were calculated (Ai, i = 1, . . ., 7)
    L = radiographic tooth length (Li, i = 1, . . ., 7)
    A/L = normalized measurement of seven left permanent developing mandibular
    teeth (xi = Ai/ Li, i = 1, . . ., 7). It need to be normalized as to exclude effect of
    difference due to angulations or magnification
    European linear regression formula was used, also available at the MS Excel template
    at website of the Istituto di Medicina Legale, Universita` degli Studi di Macerata (Italy)

    AgEstimation Project: http://agestimation.unimc.it.


    EXPECTED RESULT

    The expected result of this research will give us an idea about the reliability of
    Cameriere age estimation method among the Malay Malaysian children.

    It also gives us idea comparison between this method and the other methods
    done in other researches.

    This will be a valuable data as it can contribute to knowledge in forensic


    odontology field if it is published into journal.
    REFERENCES

    Amal, E.-B. A., Shaza, H. M., & Fatma, M. (2010). Dental age estimation in Egyptian
    children, comparison between two methods. Journal of Forensic and Legal Medicine, 363-
    367.

    Balogh, M. B., & Fehrenbach, M. J. (2006). Dental Embryology, Histology,and Anatomy. St.
    Loius, Missouri: Elsevier Inc.

    Cameriere, R., Ferrante, L., & Cingolani, M. (2006). Age estimation in children by
    measurement of open apices in teeth. Int. J. Legal Med. 120, 49-53.

    Cawson, R. A., & Odell, E. W. (2008). Cawson's Essential of Oral Pathology and Oral
    Medicine, Eighth Edition. Edinburgh, London, New York, Oxford, Philadelphia, St louis,
    Sydney, Toronto: Churchill Livingstone Elsevier.

    David R. Senn, P. G. (2010). Forensic Dentistry Second Edition. New York: CRC Press.
    Galic, I., Vodanovic, M., Cameriere, R., Nakas, E., Galic, E., Selimovic, E., et al. (2010).
    Accuracy of Cameriere, Haavikko, and Willems radiographic methods on age estimation
    on Bosnian-Herzegovian children age groups 6-13. Int J Legal Med (2011), 125:315 - 321.
    Holman, D. J., & Jones, R. E. (1998). Longitudinal analysis of deciduous tooth emergence
    ll: parametric survival analysis in Bangladeshi, Guatemalan, Japanese, and Javanese
    children. Am. J. Phys. Anthropol. 105, 209-230.

    Luca, S. D., Giorgio, S. D., Butti, A. C., Biagi, R., Cingolani, M., & Cameriere, R. (2012). Age
    estimation in children by measurement of open apices in tooth roots: Study of a Mexican
    sample. Forensic Science International.

    Welbury, R., Duggal, M. S., & Hosey, M. T. (2012). Paediatric Dentistry, Fourth edition.
    United Kingdom: Oxford University Press.

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