290 JIAOMR 2004, 16: 04, 00:94 Age Estimation from Morphometric Analysis of Dental Pulp - A Digital Radiographic Study ‘Age Estimation from Morphometric Avaya of Dental Pulp Digital Radiographic stay JHAOMR 2008, 16:08, 290-254 ‘Address conespondence& reprint request oA Kuna N The Journal of Indian Academy of Oral Medicine @ Radiology Research & Emerging Trends Pulpal Chronology Anil Kumar N.!, Shailesh Lele* S08, 94 tesuer RIBS: Sus weer Rts, Mover be Cte ant mesngenn nde 9 SONTAG HES, rane INTRODUCTION: ‘ging refers to the irreversible and inevitable changes that ccur with time in all aspects of human body.” Age estimation plays an important role in forensic identification. The dentition is one of the systems used in estimating physiologic age.% Gustafsont and Oayalt have categorized age estimation by teeth in diferent ways. Basically there are four methods used for age estimation; they Incluge * 1, Visual method Radiographic method Histological method and Physical and Chemical method Formation of secondary dentin reduces size of the pulp, as age increases the size of the pulp decreases.” These changes can be used as 2 biomarker for chronological age in anthropologie and forensic studies.* Changes in the pulp chamber can bbe observed radiographicaly** Prapanpoch, Dove ‘and Cottone tried 2 radiographic method of age estimation by morphometric analysis of the dental 2, 3 4 pulp chamber in adult human beings.* Kvaal et alt Aevised a radiographic method, which could be used to estimate the chronological age of an adult from measurements of the size of pulp on full mouth dental radiographs. ost ofthe studies use conventional ragiographic methods for age estimation from dental pulp. The isadvantages of conventional radiography include, aiffcuty in measurements, pracessing errors, storage for longer duration and image transfer, More advances dental digital radiography became available to the dental profession in the late 1980s. Software tools in the digital systems allow measurements to be made with ease and rapidity. Most of the studies indicated a reduction in size of the pulp chamber in relationship to age. However, one of these studies reviewed pulpal reduction as 8 means of age determination, The purpose of the resent study was to establish morphometric values ‘of dental pulp using digital raclography in premolars ‘and molars. of individuals of diferent ages. The objective was to determine correlation between chronologic age and morphometry of dental pulp,Age Estimation {ror Morphometric Analysis of Dental Pulp - MATERIALS AND METHODS The study was conducted in the Department of Oral Medicine and Radiology at College of Dental Sciences, Davangere. The present study comprised of 997 subjects, consisting of 509 males and 488 females. ‘They were in the age range of 15 years (180 months) to 62 years (744 months) divided into 16 age groups of 3 years (36 months). The subjects with known date of birth and no history of extraction oF restoration were selected for the study. The teeth selected for the study were second premolars and first molars of maxilla and mandible of any one side. The chronological age of the subjects was calculated from the date of birth ang was then converted into months, Clinical examination was done to confirm that the teeth under study were present or absent; if Dresent were they carious or restored. Next, patient ‘demographic data such as name, age, sex, address. and date of birth were recorded in the proforma, RADIOGRAPHIC PROCEDURE: The study subjects were briefed about the radiographic procedure, consent obtained, and subjected to standard digital bitewing radiographic procedure. The sensor along with the holder was put In a disposable polythene sleeve. X-rays were directed perpendicular to the sensor in both the vertical and horizontal plane so as to pass through the contact area between 2nd premolar and Ist molar at the level of the occlusal plane (Fig. 1). The positioning ring of the holder aided in directing the x-ray beam. Exposure parameter were 65kVp, SMA, 0.5/0.6 seconds exposure time, target to sensor distance of 20 cms. MORPHOMETRIC ANALYSIS: Morphometric analysis of teeth wes done using software tools of digital radiographic system. Software tools allowed linear as well as curvilinear measurements between any two points or multiple points. FIRST MOLARS: Using software tools, several points were marked beginning at the mesial pulp horn following the ‘shape of the pulp chamber. The last point coincided ‘with the first point (Fig, 2), This measurement provided the perimeter value of the pulp chamber in first molars. A Digital Radiographic Study ‘SECOND PREMOLARS: Measurements similar to those in first. molars were proposed to be made In 2nd premolars as wel. However, the demarcation between pulp chamber ‘and pulp canal was found dificult to locate. An ‘ternative measurement was decided upan. The pulp chamber is expected to recede from dentino-enamel Junction due to depostion of secondary dentin. Hence jn premolar teeth, distance between the deepest point on the occlusal dentino-enamel junction and the roof ef the pulp chamber was measured (Fig. 3). ‘Thus, a total number of 997 bitewing radiographs were measured and a total number of 3988 measurements were obtained. RESULTS ‘The results were sorted into observational and ‘comparative data. OBSERVATIONAL DATA Initially, 3 individual groups were combined. The data were subjected to multiple regression analysis. However, overlapping of the predicted age prevailed. Therefore, five or more individual groups were combined to eliminate overlapping of the predicted age (Tables 1 & II and Graphs/Figures A&B) Analysis of tables and graphs shows that changes in the size of the pulp are consistent in maxillary second premolar tooth. Mandibular 2nd premolar tooth also showed consistent reduction in the size of the pulp chamber, but the change is not remarkable, Consistent reduction in the size of the pulp chamber can be observed in both maxillary and mandibular Ast molar teeth. Further, change in the size of the pulp chamber is more evident ever increased span of ‘age, ie, about 15 years whereas changes in the size Of the pulp chamber was less evident in small age range of 3 years. COMPARATIVE DATA: Comparison between male and female pulp measurements was made. In majority of the groups, statistically significant difference could be noted. However, the percentage reduction in perimeter of Pulp from younger to older age groups was similar in males and females. The secondary dentin deposition ratio thus appears to be same in both sexes. CORRELATION AND REGRESSION ANALYSIS: The data were statistically investigated with SPSS/PC + package (SPSS Ine, Chieago, IL USA). Mean value,TABLET : MEAN AGE AND PULP MEASUREMENTS IN MALE GROUPS PULP MEASUREMENTS sora | neanae Hox. 204 Premaae] Hx, 1st Molor [and 3nd Pema HORTA: (years) wen {sof wean [3 [ mean $8] mean [ap pe ee 3529 (on157) : mu{iosel owl ow] owl sul aa] om | sel ve “30-44 (ani) | “ia | sto} az | os | soe! a58{ ase] oes | seal aos 4562 (99) i See eno au {ow | sz) tes} 240 | oa | sal aes Diferencebaween 27220 [09.03 [es92| peace | day 225.32] 0.008 298 90 2000 [pena | 26135) peo0f za z=4.85| p20.003 2 Teva [asses | rouse Fs | pass [ener] son] 2 test p< 005. agnteant, p> 605 “non spntians TABLE 1: MEAN AGE AND PULP MEASUREMENTS IN FEMALE GROUPS PULP MERSUREMENTE Age groups Nene 290 | Moe 2 Premotor] Wan ist Molar [Mand 3nd REGO] Hand (years) Mein [SO] Mean [$0 SO] mean | s0-| Wess] 30 1529 (on 1 i sese0 |_sveo} 216 | oss | sos] tee] 24 | oo | aol aa 20-8 (ers) wv Soo si} an { oe} se) inl 229] nas | azasl aan $582 (ais) it Sse tse} 2as| ows | rar] isn] 25{ 04s | aos] ann Oiference btocen suf zis [ os0as | 2x04 | peaon | aea6 [oor 256 soups +» tui 22220 [ 620.03 [201730 | peooos | zea Tpoaooe L Heit} 29333 | psoas | 72534 |re000:| 2000 | r-asr Tooioar|pcoonr ** 2 tes, p< 005. sgnfcant, B » 005 - non sipufeane FAB. Hon Pp iksturamies ma croupe 7G ©: Wan Pulp eonrenent on Fenale ‘eres ey =a wo] Sse bal fa ; Dew Fs: oo Bex pees te owl bi a) #-—e5 ee 9 al rs oo ea we | Amps nyene sereneFig. 1 Dita intra-oral bitewing radlooraphic procedure, Fig. 3: Morphometric analysis: Manlary second premolar tooth. standard deviation, correlation coefficient, regression Coefficient and constant were calculated for each independent variable. Variables were introduced into nn from Morphometric Analysis of Dental Pulp - ‘A Digital Radiographic Study 2 multiple regression model. Following regression ‘analysis, regression equations were generated for ‘morphometric values of pulp. The regression equations were generated only for those values, which significantly correlated with age. DISCUSSION ‘The results obtained in the present study were in agreement with study conducted by Prapanpoch, Dove and Cottones and they were not in agreement with studies conducted by Morse et al, Mors Esposito and Schoor* and Kvaal et alf, It can be inferred that, amount of secondary dentin formation Was less in young subjects, but greater in older subjects. Much of this variability may be associated with different environmental factors such as diet, Darafunctional habits. Errors in morphometry of pulp ‘may be also have contributed, herman and Smith! studied dentin thickness in adults. Results showed that dentin’ thickness measured on the roof of the pulp chamber was significantly greater with advancing age. In this study, too, distance between occlusal dentino-enamel Junction and roof of the pulp chamber showed increase with age. The increase however, was nelther Consistent, nor was it remarkable from lower age ‘groups to higher, In premolar teeth, distance could not be ‘measured accurately. Superimposition caused by two Pulp homs caused difficulties in locating roof of the pulp chamber precisely. This explains why consistent increase in secondary dentin thickness is not obtained from lower age groups to higher age groups. Changes in the size of the pulp chamber are more evident over Increased span of aye ie, about 410-15 years, whereas changes in the size of the pulp chamber were less evident in small age range of 3 Years. Age estimation has significance, when predicted ‘age has narrower age range. Though age estimation 's possible from our study, age range within which the estimated age lies Is very wide, Therefore, Dractical utlity of this study may be limited. CONCLUSION Maxillary second premolar tooth showed inconsistent eduction in the size of the pulp chamber with advancing age. Reduction in the size of the pulp chamber of mandibular second premolar tooth was Consistent, yet not remarkable. Pulp perimeter of both maxillary and mandibular first molar teeth showed consistent reduction in the size of pulp asage advanced. Significant correlation does not seem s,matted of ae, dteminaon in humans, The to exist between size of the pulp chamber ond eran Youre of Forest Medie and Pathoy, chronological age in most instances. Wherever some 41882, 10): a. 50°55 sign Je estimation is «Morse D. Ry 2. \. Esposito and R. S. Schoor: A significance could be demonstrated, age estimatic Mage D, Re 3... epante and RS Schoen, ‘not precise on account of wide age range. Probably, pulp Boo, dentin Th mortal teeth Guntessence Ine, {an analysis in an even larger sample size may yield 1993, 24 pg. 329-333. ‘more precise results. The digital radiographic system Kal S. 1, K. M. Kole, 1. O. Thomson and T. ‘appears to be 2 convenient method for such Solheim :age ‘estimation of adult trom Dental Sohonenie cncivas Radiographs, Forensic Selene Internationa, 1998; 74 torphome is a. 175-188. 7. FromhottP. : Aging from Psychological Perspective in REPERERCES "Geriatric Dentistry- A textbook of gerontology", 4. Gustafson . : Forensic Odontology, ist exon, Staple Pedersen P. H. and H. Loe (editors), pp. 125, Ist Press, London, 1966 edition, ‘Munksgeerd, Copenhagen, 1986 Medical 2. Morse DR, JV. Esposit, R. S. Schoor, FL. Willams, Pushers 1994 and M.L." Furst = A review of aging of dental 8, Dayal P. K.: Textbook of Forensic Odontology, 1st ‘Componenis and retrospective radiographic sty of eton, Paras Medical Publishers, 1998, ging. of dental pulp ana. dentin in normal teeth, Quintessence Int, 1991, 22: pg. 711-720. Subramanyam B. V. Mod's Medical Jurisprudence and “Toxicology, 22nd edton, Butterworth India, New Delhi, 13. Solheim t.: Amount of secondary dentin as an indicator 1999. ‘of age, Scand Dent Res, 1992, 10099. 193-189. 4, zaberman U. and P. Smith : Sex and age related 4. Prapanpoch $., $.8. Dove and 2.A, Cotton: ditferences in primary and secondary dentin formation, Morphometric sndlsis ofthe dental pulp chamber 35 ‘Adv Dent Res, 2001 August, 15 4245, Appeal l..... Appeal ! We at the editorial office of JIAOMR want to document all the ssclentific work done by our members and contributors and make back volumes for future reference. - We request all past editors, subscribers & contributors to send us copies of the past journals so that we can compile the same. Thank you. 204