Legal Medicine 12 (2010) 17

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Legal Medicine
journal homepage: www.elsevier.com/locate/legalmed

Review Article

Forensic age estimation in human skeletal remains: Current concepts

and future directions
Daniel Franklin *
Centre for Forensic Science, The University of Western Australia, M420, 35 Stirling Highway, Crawley 6009, WA, Australia

a r t i c l e

i n f o

Article history:
Received 1 September 2009
Accepted 8 September 2009
Available online 22 October 2009
Keywords:
Forensics
Forensic anthropology
Age estimation
Osteobiography
Identication
Skeletal growth
Skeletal degeneration

a b s t r a c t
Skeletal identication has a long tradition in both physical and forensic anthropology. The process generally begins with formulation of a biological prole (osteobiography); specically, estimation of sex, age,
ethnicity and stature. The present paper briey reviews a selection of the principal methods used for one
aspect of the identication process; the estimation of personal age. It is well-documented that variability
in the morphological features used to assess age in the human skeleton progressively increases from birth
to old age. Thus choice of method is inherently related to whether unidentied remains are those of a
juvenile or an adult. This review, therefore, considers methods appropriate for age estimation in both
juvenile and adult remains; the former being primarily based on developmental, and the latter degenerative, morphological features. Such a review is timely as new methods are constantly being developed,
concurrent with renements to those already well established in mainstream anthropology.
2009 Elsevier Ireland Ltd. All rights reserved.

1. Introduction
Forensic anthropology is a discipline that is continually evolving
and expanding. Not only does the role of the forensic anthropologist include the traditional study of human skeletal remains for
the purpose of identication (e.g. building a biological prole, trauma analysis, facial reconstruction), but it now also frequently involves identifying the living (e.g. ascertaining whether a person
has reached the age of criminal responsibility). The expansion of
the discipline, combined with rapidly improving technology, has
seen a real increase in the development of new, and renement
of existing, methods. The historical development, current state,
and future direction of the discipline was recently comprehensively reviewed by Komar and Buikstra [1].
Forensic anthropologists generally apply their expertise to medicolegal investigations, from single homicide cases, through to
mass death scenarios resulting from violent activities (e.g. 9/11
[2]; Bali bombing [3]; war crimes [4]) and natural disasters
(south Asian tsunami [5]). When unknown remains are referred
to the forensic investigator, one of the rst stages of the identication process (after ascertaining that the remains are actually human and of forensic relevance) involves formulating the
biological prole (osteobiography); sex, age, ethnicity and stature.
With each of these factors a range of considerations ultimately
determine choice of method and accuracy. The present paper
* Tel.: +61 8 6488 1232; fax: +61 8 6488 7285.
E-mail address: daniel.franklin@uwa.edu.au
1344-6223/$ - see front matter 2009 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.legalmed.2009.09.001

briey reviews a selection of the principal methods used for one

aspect of the identication process, the estimation of personal
age in human skeletal remains, and discusses some of the factors
that underlie how an appropriate technique is selected.

2. Selecting an appropriate method

Age estimation depends in part on the skeletal elements available for analysis; different bones are inherently more resilient than
other to damaging taphonomic processes, resulting in some bias in
preservation [6,7]. The nature of the death(s) being investigated
also inuences this process; e.g. a high velocity impact usually results in increased fragmentation [8]. Subsequent considerations
are typically related to the actual method(s), which as outlined
by Ritz-Timme et al. [9], should fulll the following specic demands: (i) they must have been presented to the scientic community through peer-reviewed publication; (ii) their accuracy must be
tested using valid statistical procedures and described by clearly
dened terms; and (iii) the method must be accurate enough for
routine forensic application.
Sex and/or population specicity are also important. As male
and female growth trajectories diverge, particularly prior to adolescence under the inuence of various hormones [10,11], many
current aging standards, formulated using documented reference
samples, provide both separate and pooled sex data. In most
forensic cases, however, it is highly unlikely that sex would be
known, or able to be reliably estimated in the juvenile, especially

D. Franklin / Legal Medicine 12 (2010) 17

pre-pubertal, skeleton [12,13]. In this situation, pooled sex age

estimation standards should be applied.
Further, any disturbance of normal growth patterns, such as
nutritional deciency or chronic illness, introduces a potential
source of error in age estimation; clearly, not all populations are
equably insulated from such insults. In these situations, the sequence and timing of tooth eruption is less susceptible to environmental insults, compared to skeletal growth and maturation [14].
This is likely related to tooth development being under strict genetic control [15,16], though special care is necessary in cases with
known, or suspected, pathologies [17]. Population variation can
cause bias in age estimations (even including bone microscopic
and pubic symphysis standards), nevertheless this does not appear
to have a serious effect [18,19; and see below].
Martrille et al. [20] note another complex issue for the forensic
investigator; whether to use just one or a combination (multifactorial approach) of aging methods. There appears to be good evidence
showing that multifactorial techniques increase accuracy and help
control for variation that may occur in any one single age indicator
(especially important in older individuals) e.g. [2125]. There does
not yet, however, appear to be any general consensus as to which
methods should be combined, if they should be weighted, and how
this can be achieved [20,26].
The issue of what constitutes an appropriate statistical approach for the estimation of skeletal age-at-death, especially for
adults, has been the subject of considerable debate. One of the primary issues is related to variation in the statistical assumptions of
the different methods that are available, and also whether the distribution of data in the original reference sample from which a
standard is formulated is the same for an individual outside of that
reference group [27]. It has been suggested that likelihood ratios
[28] and transition analysis [29,30] are better suited for age estimation based on an ordinal categorical variable (such as the Suchey-Brooks pubic symphysis stages see below). Readers
wishing to learn more about this topic and the various statistical
approaches will nd the following sources to be a good starting
point [2730].

3. Age estimation juveniles

It is well-documented that age estimation is usually most accurate in individuals still growing. In mature individuals, most standards generally rely on the highly variable deterioration of
morphological markers (e.g. pubic symphysis; sacro-iliac joint;
sternal rib ends) that are more inuenced by environmental factors, as opposed to the more predictable and well-documented
developmental markers characteristic of the juvenile skeleton
(e.g. dental development; skeletal growth and maturation)
[31,32]. The inherent variability in the morphological features used
to assess biological age thus progressively increases from fetal life
to old age [33]. The following is a selection of methods for estimating age in the immature skeleton presented according to the developmental characteristics examined.

3.1. Dentition
As the dentition, especially in the earlier years, represents a key
developmental characteristic for age assessment, it is not surprising that there are many dental standards available in the literature.
The estimation of age from teeth can be performed using radiographic evaluation of root development and mineralization (preferred) and/or macroscopic observation of tooth emergence
patterns. Attritional wear of teeth is also used, although the technique is less reliable, largely because tooth wear depends upon

highly individualistic factors, especially the types of food consumed [34].

Amongst the more popular tooth formation standards are
Moorrees et al. ([35] permanent; and [36] deciduous teeth)
and Demirjian et al. [37]. Both systems utilize composite visual
images (macroscopic and radiographic) of developmental stages
for individual teeth, from which sex-specic age estimations are
formulated. These systems are mostly based on populations of
European derivation [38]; North American and French Canadian.
Although they have been widely applied to individuals other than
those of the original reference populations, a loss of accuracy has
generally been reported [3943]. The ideal situation would be to
formulate representative databases of world-wide populations.
This would be especially useful when the ethnic origin of unidentied juvenile remains is not reliably known; in such an instance
pooled population standards would offer the most accurate means
for dental age estimation [44].
Another widely applied dental aging standard is the composite
visual system of Ubelaker [45]. This method provides schematic
representations of tooth formation and eruption suitable for individuals aged 5 months in utero through to 35 years; standard error
rates range from 2 months to 3 years. The data for the timing of
formation and eruption of the permanent dentition is derived largely from previously published data on Native North Americans
(see Ref. [45] p. 63 for sources) and the earlier stages are compiled
from white North American groups, nevertheless these standards
are frequently applied outside of their reference populations [46].
A particular limitation of dental development standards is that
the reliability of age estimation is not uniform from birth to adulthood. At around 14 years most teeth are fully developed and age
estimation becomes increasingly difcult [47]. Generally at this
stage the third molars are the only teeth still developing; this particular tooth, however, is not always useful since it is not only characterized by considerable variation in the timing of formation and
growth, but is also frequently congenitally absent [4850]. In their
recent evaluation of classication systems commonly used to assess third molar mineralization, Olze et al. [51] demonstrated the
Demirjian et al. [37] method to be most accurate for forensic age
estimation. Potential limitations aside, the teeth are still an accurate developmental marker for age estimation and are routinely
used in forensic anthropological investigations.
The precise errors in estimating age, either from the developing
or fully adult dentition, are not always apparent. In order to evaluate the degree of error associated with dental age estimation,
Reppien et al. [47] reviewed 51 forensic case les involving
unidentied bodies for which positive identications were subsequently obtained. A total of seven different methods were assessed,
the most popular being the Gustafson macrostructural age related
technique [52], as revised by Johanson [53]. On the basis of their
assessment, Reppien et al. [47] concluded that In cases with a
developing dentition the estimated age range can be narrowed to
24 years. Depending on the degree of development the dentition
of a small child can be estimated within a range of 2 years and for
the subadults a range of 4 years is more appropriate (p. 87). For
cases involving adults, it was recommended that an estimated
age range of 1020 years be provided, and to use the calculated
age and matching standard deviations instead of approximate values [47].
3.2. Skeletal growth
Skeletal maturity is a developmental measurement of bone size,
shape and degree of ossication relative to full maturity and this
can, therefore, also be used to derive an estimate of skeletal age.
As progressive developmental changes in bone size and morphology occur at relatively predictable rates, there is a positive correla-

D. Franklin / Legal Medicine 12 (2010) 17

tion between skeletal and chronological (or actual) age. The most
common skeletal maturity methods used to estimate subadult
age-at-death are based on metrical analysis and the macroscopic
(including radiographic where required) assessment of the morphology of ossication centers, including their size and timing of
initial appearance, through to subsequent fusion.
Repositories of documented (known age and sex) subadult skeletons are relatively rare; this problem is further compounded by
the fact that the samples actually available are generally small.
Thus medical imaging of the living offers a useful complementary
source of data. There have been numerous such studies, mostly on
European, North American and South African populations, which
provide measurement data on a variety of bones that can be used
to derive age estimates within both the pre- and postnatal age
range (e.g. [19,5459]). With clear denition, precise skeletal measurements can be obtained, and accurate age estimates can then be
derived from the aforementioned sources; such data are inherently
less subjective than those based on visual scoring systems.
New approaches to quantifying size and shape variation offer
alternative methods for subadult age estimation. Procrustes-based
geometric morphometric methods are now widely applied in many
areas of skeletal biology. These offer a package of statistically robust tools for quantifying and analyzing biological forms described
in terms of landmark coordinates. Using such an approach, Braga
and Treil [58] recently demonstrated that the centroid size of the
juvenile (birth 18 years) facial skeleton can be used as an age prediction variable. The technique gave a standard error rate of
62.1 years across all sub-samples. Franklin et al. [59] showed that
three-dimensional multivariate descriptors of mandible size and
shape could predict juvenile age (118 years) with standard error
rates between 1.3 and 3.0 years. Other research using these
methods is already owing into forensic anthropology (see Refs.
[13,6067] for recent applications).
With regard to methods based on the morphology of ossication centers, the degree of preservation of the remains referred
for examination (e.g. intact, decomposing or skeletonized) often
determines whether they can be effectively applied. The relative
experience of the excavator(s) is also an important consideration
in whether all possible elements are recovered [68]. The most commonly applied of these involve the handwrist [1]. The handwrist
was the rst area of the skeleton for which atlases outlining developmental standards became available; this was largely because
there are many bones in a small region [69].
The Gruelich and Pyle [70] atlas of sex-specic radiographs of
the handwrist are particularly important. The reference sample,
including material assembled by Todd [71], was predominately
American born individuals of North European ancestry. In this atlas, radiographs are generally presented at successive 3 month
intervals to 3 years of age, every 6 months to 14 years of age, and
yearly thereafter until adult status is reached. Age is estimated
by selecting the developmental pattern that most closely resembles the individual being assessed. Naturally personal experience
will inuence demarcating between developmental intervals.
The Tanner-Whitehouse (TW) method (the most recent being
TW3 [72]), follows basically the same premise, although individual
bones are scored independently, from which a maturity score is derived, and this is then used to estimate skeletal age. The rst two
versions of the TW method are based on a British reference sample.
The latest revision now includes reference data from European,
Asian and American populations. There are reports in the literature
that the Tanner-Whitehouse method may be slightly more accurate than the GruelichPyle atlas, although there appears to be a
general consensus that the differences are small and that the GruelichPyle method requires less time to apply [7376].
Other common handwrist classication systems include the
Fels [69] and Thiemann-Nitz methods [77]; Gilsanz and Ratib

[78] recently published a digital atlas communication of independent testing by the wider anthropological community is sure
to follow. For bones other than those of the hand or wrist, there
is data available in the literature covering the timing of epiphyseal
appearance and fusion; e.g. clavicle [79,80]; elbow [81]; knee [82];
foot [83]. Amongst the most comprehensive of the single sources
covering practically the entire human skeleton are Fazekas and
Ksa [54] and Scheuer and Black [57].
3.3. Summary
Dental and skeletal methods are generally the primary means
used to estimate age in the juvenile skeleton. In the present paper
space constraints permit review of all but a small proportion of the
total available methods. Obviously there are others, and as such, it
is recommended that those readers seeking a review of alternative
subadult aging methods consult Saunders [68].
4. Age estimation adults
Age estimation in adults, in the absence of key developmental
markers, depends on the more highly variable degeneration of
bones. This is further complicated by the fact that individualistic
factors (e.g. lifestyle, health and nutrition) can inuence skeletal
remodeling throughout life, introducing an extra source of bias
into the nal assessment. Different parts of the skeleton can thus
age at different rates, both between and within individuals. In
their analysis of the Branch Davidian victims, Houck et al. [84]
found that a multifactorial approach (see above) was the best for
minimizing such errors.
The primary methods for estimating age in the adult skeleton
are either based on the non-invasive assessment of morphological
changes or the application of more destructive techniques, such as
histomorphometry. The latter method, however, is generally reserved for cases of extreme skeletal fragmentation [1]. The following section examines a selection of those methods.
4.1. Non-invasive morphological methods
4.1.1. Age estimation from the Os coxae
4.1.1.1. Pubic symphysis. Age estimation based on changes in the
pubic symphyseal face has long been a favored approach. Meindl
and Lovejoy [85] suggest its widespread use is related to its greater
reliability than other morphological attributes (e.g. cranial sutures)
and the distinctiveness of the characters used. Amongst the earliest
of the published systems for scoring degenerative changes in the
morphology of the pubic symphysis was the 10 phase system of
Todd [86]. Todds method was subsequently expanded during the
1920s to include both males and females of different ethnic backgrounds and to incorporate additional patterns of symphyseal
metamorphosis.
Todds standards remained largely unchanged until research by
Brooks [87] demonstrated that it tended to over-estimate age, particularly in the later phases of life; in collaboration with a statistician, improvements were made to the age phases corresponding to
the symphyseal surface of the pubis. The next development in
pubic symphysis aging methods was McKern and Stewart [88]
who formulated a three component (dorsal plateau; ventral rampart; and symphyseal rim) system using a large male sample. Their
reference sample was subsequently updated to include female
individuals [89], although subsequent testing by a large cohort of
experienced anthropologists yielded unfavorable results [90].
In response to the apparent limitations of these pubic symphysis age standards, Brooks and Suchey [91] spent two years assembling a large modern sample (male = 739; female = 273), for which

D. Franklin / Legal Medicine 12 (2010) 17

demographic information and medical history was documented for

all individuals. This resulted in a new series of pubic standards,
which rather than using the complicated three component system,
incorporated an approach focusing on the total pattern of the symphyseal face. Using this system requires comparison of the morphology of the symphysis of interest to six sex-specic reference
phases (both early and late), each of which has accompanying
descriptions and clear photographs. A reference table corresponding to the phase to which the unknown specimen appears to most
clearly t provides the necessary statistics, including a mean age
estimate, standard deviation and 95% range (albeit broad) [91].
High quality models for this system are made available at cost
through France Casting, which further assists in assessing the
key features distinguishing phases.
4.1.1.2. Auricular surface. Although metamorphosis in the auricular
surface is not as distinctive as in the pubic symphysis, the former
feature has been successfully used as an indicator of skeletal age.
On the basis of their examination of a largely documented sample,
Lovejoy et al. [21] formulated eight morphological phases (2024
through to 60+ years of age), mostly divided by ve year increments, and with accompanying descriptions and photographs serving as age modes of an idealized metamorphosis of the auricular
surface. The general nature of individual surface changes with
age are described, such as grain and density, macroporosity and
billowing; characteristics in the apex of the auricular surface are
also used to narrow down subdivisions.
Meindl and Lovejoy [85] suggest that there are several advantages to using the auricular surface for age estimation, the most
noteworthy being its resilience to potential post-mortem damage
and continued age related changes beyond the fth decade of life.
Subsequent testing showed that their method can be applied irrespective of sex and ethnic group (e.g. Refs. [9294]; although these
studies comprised primarily Caucasians and African Americans).
When tested on an Asian sample from Thailand, the method was
found to lose accuracy [95]; it is, however, no surprise that the
method is optimized for major population groupings within the
United States, given this is the source of the original reference
sample.
In a recent re-analysis of auricular surface age estimation,
Buckberry and Chamberlain [96] found that the age of onset for
each stage of different features of the auricular surface described
by Lovejoy et al. [21] appears to both vary and develop independently of each other, resulting in some overlap of the ve year
age categories. A revised system was therefore proposed, whereby
the different auricular features are combined to provide a composite score from which an age estimate is derived. Osborne et al. [94]
also examined the Lovejoy et al. [21] method and found that some
of the mean ages of the eight phases were not signicantly different. In their revision, a modied six phase system was presented,
providing more robust phase categories and . . .a more accurate
view of the variation associated with auricular surface morphology
and age [94 p. 910].
4.1.2. Age estimation from the rib(s)
The sternal extremity of the rib is a forensically useful age marker in the human skeleton. Iscan et al. [97,98] used a relatively
small documented sample to formulate a series of standards based
on assessing features of the costochondral junction of the right
fourth rib, including the shape and depth of pit formation, changes
in the walls and surrounding rim, and overall bone texture and
density. Based on these features, and in conjunction with reference
photographs (or commercial casts) of type ribs, an unknown specimen is classied into one of nine phases, each of which has associated statistics, including mean age and range, standard deviation
and error, and 95% condence interval.

Although testing of the Iscan et al. [97,98] method showed that

it is acceptably accurate in both recent mixed ancestry (Caucasian
and African American [99]) and archaeological samples [100],
some methodological issues have recently been raised. Yoder
et al. [101] note that the technique was only devised for use on
the left side and that in forensic applications there can be some difculty in identifying the fourth rib. In order to further explore the
utility of ribs as an age marker, Yoder et al. [101] examined the left
and right second, third and fth to ninth ribs inclusive, primarily
drawn from the Terry Collection. Their statistical analyses demonstrated that there was little bilateral variation in rib phase scores
(only ribs two and three were signicantly different), that most
ribs yield age estimates similar to those derived from the right
fourth rib, and that a composite score based on multiple ribs produces practically the same age estimate as does the single right
fourth rib [101].
4.1.3. Age estimation from the cranial sutures
As the brous joints between the bones of the skull fuse progressively with increasing age, various systems of scoring the degree of closure of both the ecto- and endocranial sutures have
been developed [102105]. Most systems involve macroscopically
rating the degree of suture closure into one of several categories,
ranging from completely open through to complete obliteration.
A composite score is then calculated and used to derive a mean
age estimate, although the range within closure groups for the
aforementioned systems is generally is in the order of 30+ years.
The usefulness of cranial sutures as an indicator of skeletal ageat-death has been considered many times before, with a number of
studies concluding that the technique is simply too imprecise to be
of practical use in forensic investigation (e.g. [106108]). This technique may be better suited to archaeological specimens; crania often survive relatively intact and there are no legal ramications
associated with the nal age determination. A more detailed treatment is given in Masset [109].
4.2. Other methods
Quantitative bone histology is a particularly useful means of
estimating skeletal age from bone fragments otherwise of little
diagnostic value. The technique involves quantifying histomorphological features, most commonly: osteon size, type and density;
size and number of Haversian canals; and cortical thickness
[110]. Standards for many bones have been developed, each with
varying degrees of prediction accuracy, for example: (standard error in years) femur, ulna and humerus, 7.18.6, 7.910.6 and 6.2
9.5, respectively [111]; tibia and bula, 6.6913.62 and 5.27
10.85, respectively [112]; fourth rib, 4.811.6 [113].
Although bone histology is generally destructive to some degree, there are methods that are minimally invasive. The multiple
linear regression technique devised by Thompson [111] requires
only 0.4 cm core samples and achieves relatively accurate results
(see above). With appropriate expertise and due consideration of
potential biological (and other) factors inuencing reliability and
accuracy (see [114]), this is one of the more accurate methods
for estimating age in the adult skeleton. An excellent summary of
the physiological basis for histomorphometric age techniques,
including a comprehensive appendix of published methods and
their accuracy, is presented by Robling and Stout [110].
Amino acid racemization in dentine (and other bone or cartilage
tissue) is another specialized age estimation method, based upon
the gradual, and temperature dependent, transformation (racemization) of amino acids that constitute biological proteins during life
[115,116]. In their analysis of teeth extracted from dental patients
of known age (560 years), Grifn et al. [116] were able to predict
age to 8.7 years with 95% condence. For individuals younger

D. Franklin / Legal Medicine 12 (2010) 17

than 35 years of age the error in age estimation fell to 6.2 years. In
addition to costs of specialized equipment and expertise, there are
other limitations to the applicability of this technique. It is not
effective where the post-mortem interval is greater than 20 years;
advanced degradation and/or burning may alter the racemization
process; and burial conditions (particularly temperature) must be
known [116,117].
4.3. Summary
Of the various bones appropriate for making estimates of adult
age, the hip appears to be a popular choice. This is largely because
it provides two independent sites (pubic symphysis and auricular
surface) that are amongst the most accurate markers available
[85]. The error involved in estimating age using any morphological
method is not consistent across the adult lifespan, typically
increasing throughout life and especially beyond the fth decade.
For specimens of advanced age, quantitative bone histology may
offer a viable alternative, especially if the skeleton is fragmented
or otherwise morphologically non-diagnostic. More detailed treatments of adult skeletal aging are given in Cox [118] and Baccino
and Schmitt [119].
5. So what does the future hold?
Anthropologists interested in the skeleton have traditionally relied on the direct examination of physical remains as a primary
source of research data. As repositories of documented skeletons
(both juvenile and adult) are becoming increasingly rare, and considering that many of the extant collections comprise individuals
dating from historic periods, alternative data for modern populations must be found. Clinical images, such as radiographs, computed
tomography scans and magnetic resonance images are already proving to be a promising complementary source of data (e.g. [120
124]), especially as many forensic institutes now routinely use
medical scanning devices for post-mortem examinations.
Recent geometric morphometric studies (e.g. [58,59]) also suggest that the more comprehensive measures of size, such as centroid size, surfaces and volumes, all of which are becoming
increasingly common and easy to obtain using CT scans, offer a
promising alternative to traditional morphological approaches for
the accurate estimation of age in forensic studies. Importantly,
the samples available will be larger, with less age and sex biases,
and more representative of modern populations from around the
world. New developments are not simply limited to the physical
anthropological discipline; cognate areas of complimentary research (e.g. molecular osteology; histomorphology) are also likely
to provide both novel approaches and renements to existing
methods for age estimation.
Ofcial disclaimer
The author discloses no nancial relationship with commercial
entities.
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