Age Estimation from teeth

A study based for estimation of age from 2nd molar
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  JIAFM, 2005 : 27 (4). ISSN 0971-0973 231 AGE ESTIMATION FROM ERUPTION OF PERMANENTTEETH Dr. Kuldeep Singh,  Senior medical Officer, Bassi Pathana Dr. R.K.Gorea,  Professor and Head, Forensic Medicine, GMC, Patiala Dr.Vipin Bharti,  Professor and Head, Periodontology, GDC, Patiala  ABSTRACT This study was conducted on 578 individuals and eruption of various permanent teeth was noted in agegroup from 4 years to 25 years. Correlation of sex with the eruption of teeth was also noted and was foundstatistically that there was no significant difference in this. Eruption of teeth was compared between thetwo jaws and also the two sides of the jaws. Key Words : Molars, Age estimation, Teeth. INTRODUCTION The estimation of age is an important activity andis commonly carried in medico legal area.Assessment of age is often required whileadministering justice to an individual involved in civiland criminal litigation. The temporary teeth willguide from six months to thirty-three months whilethe permanent teeth will help from six years totwenty-five years in age determination. Eruption ofteeth is known to be affected by dietary, climatic,racial and geographical variations [1].The branch of Forensic Medicine, which dealswith the examination of teeth, is known as ForensicOdontology In a developing country like India, alarge number of people are illiterate and have noknowledge or records of their date of birth which isrequired by law enforcing agencies in matters like,criminal responsibilities, identification, judicialpunishment, consent, rape, criminal abortion,employment, attainment of majority, kidnapping andprostitution [2].There are two methods of dental ageassessment, radio- graphically and by clinicallyvisualization of eruption of teeth. By radiographicmethods it is possible to follow the formation ofcrowns and roots of teeth and their calcification. .In young age, this is possible to some extent bystudying the calcification of root, but as the childgrows, this is not possible. The clinical method toassess dental age is based on emergence of teethin the mouth. This method is more suitable since itdoes not require any special equipment, expertiseand is more economical. Tooth formation is the bestchoice for estimating the age as variations are lessas compared to other development factors.There are charts and tables for the assessment ofage during development period, which shows theformation, eruption, and calcification of teeth. Forthis purpose table of Krenfild and Logan furthermodified by Kronfild and Schour (1939) iscommonly used (Mc Donald and Avery, 1998)which has been accepted standard for many yearsSince population of India is very large and itsclimate are different in hence a cross-sectionalstudy was carried out in Patiala to estimate theeruption time of permanent teeth in the age groupof five years to twenty five yearsGonzales et al described that the teeth maygive, reliable information as to the age in childhoodand youth. The permanent teeth eruption starts atsixth year and by twelve to fourteen years, all thepermanent teeth except the third molars or wisdomteeth erupt [3].Polson described that when a tooth of thefirst dentition has erupted, the infant is in allprobability six to eight months old. An infant, whohas completed first dentition, has attained abouttwo years of age. The first permanent molar eruptsin boys at the age of 73 to 74 Months where as ingirls; it erupts at 70 to 72 months. The centralincisors showed a wide range in the time of  232 JIAFM, 2005 : 27 (4). ISSN 0971-0973 eruption, which were 72 to 84 months in boys and69 to 79 months in girls. The eruption of third molaris variable, and these teeth are prone to impaction.When present, one is more than seventeen years[4].Smith described the earlier eruption of teethin the lower jaw than in the upper jaw. Temporarydentition begins at 6-8 months off age by eruptionof lower central incisors and is completed at 24months by eruption of second molars. Permanentdentition begins at 6 years of age by eruption of1st molar behind the 2nd maxillary temporary teethand is completed at 17-21 years by eruption of 3rdmolar teeth (wisdom teeth).The eruption of wisdomteeth is very variable and is never before seventeenyears of age [5].Grewal described eruption of temporary teethin children at six months for lower central Incisors,seven months for upper central incisors, upperlateral incisors, seven to nine months for lowerlateral incisors, tenth to twelfth month. First molarat one year, canine eighteenth month, secondmolar twenty fourth month .The appearance ofpermanent teeth is at seventh to eighth year forcentral Incisor, eleventh to twelfth year for canine,ninth to tenth year for central premolar, tenth totwelfth year for post premolar, sixth to seventh yearfor first molar, twelfth year for second molar, thirdmolar at seventeen to twenty five year or any ageafter this [6].Billewicz et al studied on 635 West African(Gambian) children with in the range of 4.5 to 14.0years .They found no difference between eruptionages of homologous permanent teeth on the leftand the right side of the same jaw. Teeth eruptedin the lower jaw with the exception of 1st and 2ndpremolars. The eruption in females was earlier thanmales. One can estimate the calendar age frompermanent dentition with an error of 0.5 years forone to teeth and over one year for twelve teeth ormore [7].Sharma and Mittal studied patterns ofsecondary tooth eruption in Gujjars in a cross-sectional sample of 483 between 6 to13 years ofage. They observed female tooth emergenceadvancement over males but in the sequence ofemergence, there were no sex differences.Emergence time difference between median rightand left sides was only 14.29% namely centralincisors, mandibular 1st molars, in males and lateralmaxillary incisors in females. In general mandibularteeth except premolar tend to emerge earlier thantheir maxillary counterparts [8].Ilieva, Veleganova and Belcheva conductedstudy on 928 children from four to eight years ofage in Plovdiv for the eruption of first permanentmolars from randomly selected kindergartens andschools and found no statistically significantdifference in the eruption age of first permanentmolars between the two genders, as well asbetween the upper and lower jaw. They also foundthe initial eruption age of first permanent molars isfive to six years, the mean age is six to seven yearsand the latest age is seven to eight years [9].  Aims and Objectives 1.To find out average age from eruption of teethin general.2.To find out age separately in both sexes fromeruption of teeth.3.To find out the difference in age of eruptionof teeth in upper and lower jaw.Material and MethodsIn this study 578 children of age group 4years to 25 years were studied for the eruption ofpermanent teeth. Their teeth were examinedvisually in good light using probe, spatula andmouth mirror for eruption. The teeth were examinedeither in good daylight or by using a torch having avery fine focusing of light. A tooth was considerederupted, if it has pierced through gums andunerupted if not present in oral cavity.Only those cases were considered whoserecords were available for date of birth from schoolrecords, ration cards, horoscope, birth certificates,identity cards, driving licence and immunisationcard.After examination of teeth, statically tablesare prepared for mean age, range and S.D. foreruption of each tooth in the upper and lower jawand also for right and left sides of the same jaw.The statically analysis also done for comparisonof both sexes. OBSERVATIONS The study was conducted during the periodof September 2002 to September 2004 and 578cases were studied which were taken randomly  JIAFM, 2005 : 27 (4). ISSN 0971-0973 233 from various schools, colleges and OPDs of DentalHospital and Rajindra Hospital, Patiala.  Table 1showing distribution of group according to agegroups and Sex Age groupMaleFemaleTotal no. of cases4.1- 9 years81681499.1-14 years719016114.1-19 years645912319.1-25 years7471145Total290288578 Type of Tooth Jaw Side No.of cases Range Mean ± S.D. R 28 6.08 – 8.71 7.28 ± 0.54 UJ L 27 6.08 – 8.71 7.30 ± 0.55 R 38 6.08 – 8.71 7.20 ± 0.55 Central Incisor LJ L 38 6.08 – 8.71 7.20 ± 0.55 R 32 7.64 – 9.98 8.92 ± 0.56 UJ L 32 7.64 – 9.98 8.92 ± 0.56 R 37 7.64 – 9.98 8.88 ± 0.57 Lateral Incisor LJ L 37 7.64 – 9.98 8.88 ± 0.57 R 17 10.61– 11.96 11.23 ± 0.35 UJ L 18 10.61– 11.96 11.26 ± 0.37 R 23 10.61– 11.96 11.32 ± 0.44 Canine LJ L 23 10.61– 11.96 11.32 ± 0.44 R 40 9.38 – 11.20 10.16 ± 0.44 UJ L 39 9.38 – 11.20 10.17 ± 0.44 R 40 9.25 – 11.20 10.14 ± 0.46 PM 1   LJ L 40 9.25 – 11.20 10.14 ± 0.46 R 19 10.01 – 11.36 10.69 ± 0.39 UJ L 19 10.01 – 11.36 10.69 ± 0.39 R 19 10.01 – 11.36 10.63 ± 0.37 PM 2   LJ L 19 10.01 – 11.36 10.63 ± 0.37 R 24 5.81 – 7.91 6.60 ± 0.50 UJ L 24 5.81 – 7.91 6.60 ± 0.50 R 27 5.81 – 7.91 6.58 ± 0.59 M 1   LJ L 27 5.81 – 7.91 6.58 ± 0.59 R 212 12.01 – 14.15 13.32 ± 0.60 UJ L 211 12.01 – 14.14 13.30 ± 0.59 R 226 12.01 – 14.14 13.19 ± 0.63 M 2   LJ L 226 12.01 – 14.14 13.19 ± 0.63 R 75 17.02 -24.96 21.56 ± 2.28 UJ L 78 17.00 -24.96 21.39 ± 2.35 R 89 17.02 -24.96 21.39 ± 2.35 M 3 LJ L 91 17.00 -24.96 21.29 ± 2.35 Table 2showing eruption of Permanent Teeth in both jaws and sides Eruption of various permanent teeth werenoted in both jaws and and both sides and meaneruption was calculated and is tabulated below. DISCUSSION We took 578 random cases from differentschools and colleges and OPDs of RajindraHospital and Government Dental College Patiala.Out of these 290 were males and 288 were females.We noted eruption of permanent teeth in thevarious age groups.In our study we found that first permanent  234 JIAFM, 2005 : 27 (4). ISSN 0971-0973 al in 2002 who also found no significant differencein eruption and sex of the person as well as nodifference in eruption in two jaws.In our study, we found mostly the permanentteeth erupted earlier in the females than malesand that the eruption teeth was earlier in mandible(lower jaw) than in maxilla (upper jaw), wereconsistent with the findings of Sharma and Mittal(2001) who also found that eruption is earlier infemales and that too in mandible.Wisdom teeth in females erupted earlier inlower jaw as compared to that in males with meanof eruption in females at 21.27 ± 2.32 years onright side and 21.19 ± 2.38 years on left side of thelower jaw while in males the mean age of eruptionwas 21.39 ± 2.30 years on the right side and 21.33± 2.37 years. These finding were corroborative withthe finding of Sharma and Mittal's study. It was seenthat third molar erupted later in maxilla than inmandible in both females and males, with meanage of eruption in males at 21.51 ± 2.22 years onright side and 21.38 ± 2.33 years on the left sidesimilarly in females these erupted at the mean ageof 21.63 ± 2.41 years on the right side and 21.41 ±2..42 years on the left side of the maxilla. Theseearlier eruptions of mandibular teeth from theirmaxillary counter part were the similar to the resultsof the study done by Sharma and Mittal in 2001. SUMMARY AND CONCLUSION 1.First permanent teeth to erupt were firstmolars at the age between 5.81 to 7.91 years inboth the jaws2. Permanent central incisors erupted betweenthe age of 6.08 to 8.71 years for both halves ofupper as well as lower jaw3. Permanent lateral incisors erupt at the ageof 7.64 to 9.98 years in both halves of both jaws.4. First permanent premolars erupts between9.28 to 11.2 years with mean age of 10.14 ± 0.46years5.Second permanent premolars eruptsbetween 10.01 to 11.36 years for the both halvesof upper and lower jaw6.Next permanent teeth to erupt is canines atthe age between 10.61 to 11.96 years for bothhalves of upper and lower jaw7.Second permanent molars erupts betweenmolars were first to erupt at the age between 5.81to 7.91 years in both jaws and on both right andleft sides with the mean age of eruption at 6.58 ±0.59 years in lower jaw and 6.60 ± 0.50 years inupper jaw.We found next permanent teeth to erupt werecentral incisors which erupted between 6.08 to 8.71years in both halves of upper and lower jaws. Nextteeth found to erupt was found to be secondpremolars at the age of 10.01 to 11.36 years inboth halves of upper and lower jaws with the meanage of eruption 10.63 ± 0.37 years for the lowerjaw and 10.69 ± 0.39 years for the upper jaw. Wefound that canines erupted at the age between10.61 to 11.96 years for both halves of the upperand lower jaws with the mean age of eruption 11.32± 0.44 years for the lower jaw and 11.26 ± 0.37years for the left half and 11.23 ± 0.35 years forthe right half of upper jaw.In our study, we found that M2 was next toerupt between 12.01 to 14.15 years for upper jawsand 11.94 to 14.14 years in both halves of lowerjaws with the mean age of eruption 13.19±0.63years for the lower jaw and 13.32 ± 0.60 yearsfor upper jaw.M3 was the last permanent teeth to erupt andwas found to erupt at the age between 17.02 to24.96 years for both upper and lower with the meanage of eruption 21.29 ± 2.35 years for the left and21.35 ± 2.28 for the right half of lower jaw whilemean age of eruption of left half of upper jaw was21.39 ± 2.35 years and for right half 21.56 ± 2.28years. These finding were similar to the finding ofGrewal who in his study found that first permanentteeth to erupt was M1 and erupts at the agebetween 6 to 7 years, central permanent incisorserupt between 7 to 8 years, lateral incisors inbetween 8 to 9 years, first premolars between 9 to10 years, second premolars between 10 to 12years, canine to erupt at the age between 11 to 12years, age of eruption of M2 as 12 to 14 years andthat third molar erupted mostly between 17 to 25years [6].We also studied the co-relation of eruption ofteeth with sex of the person. There was also nosignificant difference in eruption betweenmandibular and maxillary first molars. Thesefindings were similar to the study done by Illieva et


Jul 23, 2017
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