Two new oro-cervical radiographic indexes for chronological age estimation: a pilot study on an Italian population

Chronological age (CA) plays a fundamental role in forensic dentistry (i.e. personal identification and evaluation of imputability). Even though several studies outlined the association between biological and chronological age, there is still great variability in the estimates. The aim of this study was to determine the possible correlation between biological and CA age through the use of two new radiographic indexes (Oro-Cervical Radiographic Simplified Score - OCRSS and Oro-Cervical Radiographic Simplified Score Without Wisdom Teeth - OCRSSWWT) that are based on the oro-cervical area. Sixty Italian Caucasian individuals were divided into 3 groups according to their CA: Group 1: CAG 1 = 8-14 yr; Group 2: CAG 2 = 14-18 yr; Group 3: CAG 3 = 18-25 yr; panorexes and standardised cephalograms were evaluated according Demirjian's Method for dental age calculation (DM), Cervical Vertebral Maturation method for skeletal age calculation (CVMS) and Third Molar Development for age estimation (TMD). The stages of each method were simplified in order to generate OCRSS, which summarized the simplified scores of the three methods, and OCRSSWWT, which summarized the simplified DM and CVMS scores. There was a significant correlation between OCRSS and CAGs (Slope = 0.954, p < 0.001, R-squared = 0.79) and between OCRSSWWT and CAGs (Slope = 0.863, p < 0.001, R-squared = 0.776). Even though the indexes, especially OCRSS, appear to be highly reliable, growth variability among individuals can deeply influence the anatomical changes from childhood to adulthood. A multi-disciplinary approach that considers many different biomarkers could help make radiological age determination more reliable when it is used to predict CA.