Nicolas Hennequin , MD; Maisy Lossois, MD; Valérie Maciocé, MSc; Eric Baccino, MD, PhD; Catherine Cyteval*, MD,PhD, Maxime Pastor, MD.
In forensic medicine, there has been a marked rise in demand for age estimation in recent years with the growing global migration trend. Forensic age estimation should be based on clinical examinations, hand radiography, as well as orthopantomography and clavicle CT scan if wrist bone fusion is in a late maturation stage. Orthopantomography is based on the mandibular third molar mineralization stage according to the Demirjian method. This study was carried out to validate the efficacity of CT scan with the Demirjian method to determine whether a single CT scan would be sufficient for mandible and clavicle examination. This exhaustive monocentric study included 201 living individuals up to 25 years old who had undergone orthopantomography and CT scan less than 2 months apart between 2007 and 2020. We compared mandibular third molar development stages that had been attributed via the two techniques. A concordance calculation to assess the findings of the two techniques revealed almost perfect agreement with a weighted kappa of 0.86 for the 128 left mandibular third molars and 0.88 for the 126 right mandibular third molars analyzed. Calculations of agreement in the CT findings also showed almost perfect agreement for intra-observer variability with a kappa of 0.97 and 1.0, and close agreement for inter-observer variability with kappas of 0.86 and 0.73. CT scan was found to be accurate for mandibular third molar development staging, with almost perfect agreement with regard to the Demirjian method using orthopantomography. CT scan could therefore be an effective alternative to orthopantomography.
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