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A systematic review and meta-analysis of the fully formed wisdom tooth as a radiological marker of adulthood

Haglund, Mattias LU and Mörnstad, Håkan (2019) In International Journal of Legal Medicine 133. p.231-239
Abstract

Assessment of third molar development on dental radiograms is one of the most commonly used methods of forensic age estimation. Despite widespread use and numerous studies, there is a paucity of aggregated data on how well a fully mature third molar identifies adulthood (> 18 years), the most important threshold in a medicolegal context. Therefore, a systematic review and meta-analysis was conducted. A total of 1229 studies were screened, and 82 studies were assessed for inclusion. Twenty-four studies, with a pooled cohort of 19,690 individuals, presented true positive (TP), true negative (TN), false positive (FP), and false negative (FN) outcomes, enabling meta-analysis. The outcomes were based on using the third molar in the fully... (More)

Assessment of third molar development on dental radiograms is one of the most commonly used methods of forensic age estimation. Despite widespread use and numerous studies, there is a paucity of aggregated data on how well a fully mature third molar identifies adulthood (> 18 years), the most important threshold in a medicolegal context. Therefore, a systematic review and meta-analysis was conducted. A total of 1229 studies were screened, and 82 studies were assessed for inclusion. Twenty-four studies, with a pooled cohort of 19,690 individuals, presented true positive (TP), true negative (TN), false positive (FP), and false negative (FN) outcomes, enabling meta-analysis. The outcomes were based on using the third molar in the fully mature stage as a diagnostic test to indicate age 18 years or above. The false positive rate (fall-out/1-specificity) was 3.1% (95% CI 2.1-4.6%), and the true positive rate (recall/sensitivity) was 51% (95% CI 44-58%). Diagnostic accuracy was 71%. These findings, while reassuring in terms of the low false positive rate, highlight the need for complementary age estimation methods to avoid a significant number of false negatives.

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author
and
publishing date
type
Contribution to journal
publication status
published
keywords
Adult, Age Determination by Skeleton, Age Determination by Teeth, Forensic Sciences/methods, Human Development, Humans, Molar, Third
in
International Journal of Legal Medicine
volume
133
pages
9 pages
publisher
Springer
external identifiers
  • pmid:29744586
  • scopus:85046626561
ISSN
0937-9827
DOI
10.1007/s00414-018-1842-4
language
English
LU publication?
no
id
132ae067-f4a8-4fd5-a7f8-cf017bead8e0
date added to LUP
2025-03-01 17:25:02
date last changed
2025-07-06 14:49:30
@article{132ae067-f4a8-4fd5-a7f8-cf017bead8e0,
  abstract     = {{<p>Assessment of third molar development on dental radiograms is one of the most commonly used methods of forensic age estimation. Despite widespread use and numerous studies, there is a paucity of aggregated data on how well a fully mature third molar identifies adulthood (&gt; 18 years), the most important threshold in a medicolegal context. Therefore, a systematic review and meta-analysis was conducted. A total of 1229 studies were screened, and 82 studies were assessed for inclusion. Twenty-four studies, with a pooled cohort of 19,690 individuals, presented true positive (TP), true negative (TN), false positive (FP), and false negative (FN) outcomes, enabling meta-analysis. The outcomes were based on using the third molar in the fully mature stage as a diagnostic test to indicate age 18 years or above. The false positive rate (fall-out/1-specificity) was 3.1% (95% CI 2.1-4.6%), and the true positive rate (recall/sensitivity) was 51% (95% CI 44-58%). Diagnostic accuracy was 71%. These findings, while reassuring in terms of the low false positive rate, highlight the need for complementary age estimation methods to avoid a significant number of false negatives.</p>}},
  author       = {{Haglund, Mattias and Mörnstad, Håkan}},
  issn         = {{0937-9827}},
  keywords     = {{Adult; Age Determination by Skeleton; Age Determination by Teeth; Forensic Sciences/methods; Human Development; Humans; Molar, Third}},
  language     = {{eng}},
  pages        = {{231--239}},
  publisher    = {{Springer}},
  series       = {{International Journal of Legal Medicine}},
  title        = {{A systematic review and meta-analysis of the fully formed wisdom tooth as a radiological marker of adulthood}},
  url          = {{http://dx.doi.org/10.1007/s00414-018-1842-4}},
  doi          = {{10.1007/s00414-018-1842-4}},
  volume       = {{133}},
  year         = {{2019}},
}