Cone-beam computed tomography application in age estimation




Forensic sciences; Age determination by teeth; Age determination by skeleton; Forensic dentistry; Radiology; Cone-beam computed tomography.


Age estimation is a fundamental process in Forensic Science. Different methods of dental age assessment have been developed to estimate the chronological age of living and dead humans, including the use of 3D images obtained from Cone-beam Computed Tomography (CBCT). The aim of this study was to analyze, through a literature review, the use of CBCT for age estimation. For this purpose, complete scientific articles published in national and international journals were used. CBCT proved to be effective during age estimation, in dental and bone analyses. However, the chronological age, the level of dental development, as well as the different groups of teeth seem to influence the analyses, determining a higher or lower level of reliability in the presumption of age. CBCT exams are an excellent alternative for analyzing both dental and bone tissues, contributing significantly to age estimation.


Arai, Y., Tammisalo, E., Iwai, K., Hashimoto, K., & Shinoda, K. (1999). Development of a compact computed tomographic apparatus for dental use. Dentomaxillofac Radiol, 28(4), 245-248.

Asif, M. K., Ibrahim, N., Al-Amery, S. M., Muhammad, A., Khan, A. A., & Nambiar, P. (2020). A novel method of age estimation in children using three-dimensional surface area analyses of maxillary canine apices. Leg Med (Tokyo), 44, 101690.

Asif, M. K., Nambiar, P., Ibrahim, N., Al-Amery, S. M., & Khan, I. M. (2019a). Three-dimensional image analysis of developing mandibular third molars apices for age estimation: A study using CBCT data enhanced with Mimics & 3-Matics software. Leg Med (Tokyo), 39, 9-14.

Asif, M. K., Nambiar, P., Mani, S. A., Ibrahim, N. B., Khan, I. M., & Lokman, N. B. (2019b). Dental age estimation in Malaysian adults based on volumetric analysis of pulp/tooth ratio using CBCT data. Leg Med (Tokyo), 36, 50-58.

Aydin, Z. U., & Bayrak, S. (2019). Relationship Between Pulp Tooth Area Ratio and Chronological Age Using Cone-beam Computed Tomography Images. J Forensic Sci, 64(4), 1096-1099.

Aydin, Z. U., & Bayrak, S. (2019). Relationship Between Pulp Tooth Area Ratio and Chronological Age Using Cone-beam Computed Tomography Images. J Forensic Sci, 64(4), 1096-1099.

Bayrak, S., Halıcıoglu, S., Kose, G., & Halıcıoglu, K. (2018). Evaluation of the relationship between mandibular condyle cortication and chronologic age with cone beam computed tomography. J Forensic Leg Med, 55, 39-44.

Bjork, M. B., & Kvaal, S. I. (2018). CT and MR imaging used in age estimation: a systematic review. J Forensic Odontostomatol, 36(1), 14-25.

Bueno, M. R., Estrela, C., Azevedo, B. C., & Diogenes, A. (2018). Development of a New Cone-Beam Computed Tomography Software for Endodontic Diagnosis. Braz Dent J, 29(6), 517-529.

Cameriere, R., Ferrante, L., & Cingolani, M. (2006). Age estimation in children by measurement of open apices in teeth. Int J Legal Med, 120(1), 49-52.

Cameriere, R., Velandia Palacio, L. A., Pinares, J., Bestetti, F., Paba, R., Coccia, E., & Ferrante, L. (2018). Assessment of second (I2M) and third (I3M) molar indices for establishing 14 and 16 legal ages and validation of the Cameriere's I3M cut-off for 18 years old in Chilean population. Forensic Sci Int, 285, 205.e1-205.e5.

Cantekin, K., Sekerci, A. E., & Buyuk, S. K. (2013). Dental computed tomographic imaging as age estimation: morphological analysis of the third molar of a group of Turkish population. Am J Forensic Med Pathol, 34(4), 357-362.

Chun, K., Choi, H., & Lee, J. (2014). Comparison of mechanical property and role between enamel and dentin in the human teeth. J Dent Biomech, 5, 1758736014520809.

Dalessandri, D., Tonni, I., Laffranchi, L., Migliorati, M., Isola, G., Visconti, L., . . . Paganelli, C. (2020). 2D vs. 3D Radiological Methods for Dental Age Determination around 18 Years: A Systematic Review. Appl Sci, 10(9), 1-15.

Deitos, A. R., Costa, C., Michel-Crosato, E., Galic, I., Cameriere, R., & Biazevic, M. G. (2015). Age estimation among Brazilians: Younger or older than 18? J Forensic Leg Med, 33, 111-115.

Demirjian, A., & Goldstein, H. (1976). New systems for dental maturity based on seven and four teeth. Ann Hum Biol, 3(5), 411-421.

Demirjian, A., Goldstein, H., & Tanner, J. M. (1973). A new system of dental age assessment. Hum biol, 45(2), 211-227.

Gadelha, M., Lima, J., Lima Arrais Ribeiro, I., & Santiago, B. (2019). Aplicabilidade do volume da câmara pulpar para a estimativa de idade em adultos a partir de tomografias computadorizadas de feixe cônico: um estudo piloto. Rev Bras Odontol Leg, 30-39.

Ge, Z. P., Yang, P., Li, G., Zhang, J. Z., & Ma, X. C. (2016). Age estimation based on pulp cavity/chamber volume of 13 types of tooth from cone beam computed tomography images. Int J Legal Med, 130(4), 1159-1167.

Gelbrich, B., Carl, C., & Gelbrich, G. (2020). Comparison of three methods to estimate dental age in children. Clin Oral Investig, 24(7), 2469-2475.

Ginzelova, K., Dostalova, T., Eliasova, H., Bruna, R., & Vinsu, A. (2019). Comparison of dental and chronological age based on CBCT-generated panoramic images and reconstructed 3D images. Anthropol Anz, 76(1), 49-56.

Gioster-Ramos, M. L., Silva, E. C. A., Nascimento, C. R., Fernandes, C. M. S., & Serra, M. C. (2021). Técnicas de identificação humana em Odontologia Legal. Res Soc Dev, 10(3), e20310313200.

Gulsahi, A., Kulah, C. K., Bakirarar, B., Gulen, O., & Kamburoglu, K. (2018). Age estimation based on pulp/tooth volume ratio measured on cone-beam CT images. Dentomaxillofac Radiol, 47(1), 1-7.

Guo, Y. C., Yan, C. X., Lin, X. W., Zhou, H., Li, J. P., Pan, F., Zhang, Z. Y., Wei, L., Tang, Z., & Chen, T. (2015). Age estimation in northern Chinese children by measurement of open apices in tooth roots. Int J Legal Med, 129(1), 179-186.

Haghanifar, S., Ghobadi, F., Vahdani, N., & Bijani, A. (2019). Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth. J Appl Oral Sci, 27, e20180722.

Helmy, M. A., Osama, M., Elhindawy, M. M., & Mowafey, B. (2020). Volume analysis of second molar pulp chamber using cone beam computed tomography for age estimation in Egyptian adults. J Forensic Odontostomatol, 3(38), 25-34.

Hounsfield, G. N. (1973). Computerized transverse axial scanning (tomography). 1. Description of system. Br J Radiol, 46(552), 1016-1022.

Hunt, E. E., Jr, & Gleiser, I. (1955). The estimation of age and sex of preadolescent children from bones and teeth. Am J Phys Anthropol, 13(3), 479-487.

Jain, S., Choudhary, K., Nagi, R., Shukla, S., Kaur, N., & Grover, D. (2019). New evolution of cone-beam computed tomography in dentistry: Combining digital technologies. Imaging Sci Dent, 49(3), 179-190.

Kazmi, S., Mânica, S., Revie, G., Shepherd, S., & Hector, M. (2019). Age estimation using canine pulp volumes in adults: a CBCT image analysis. Int J Legal Med, 133(6), 1967-1976.

Kellinghaus, M., Schulz, R., Vieth, V., Schmidt, S., & Schmeling, A. (2010). Forensic age estimation in living subjects based on the ossification status of the medial clavicular epiphysis as revealed by thin-slice multidetector computed tomography. Int J Legal Med, 124(2), 149-154.

Kuhnen, B., Fernandes, C. M. S., Barros, F.., Andrade, J. M., Scarso Filho, J., Gonçalves, M., & Serra, M. C. (2021). Estimativa da idade por meio da análise da mineralização dentária e a sua contribuição forense. Res Soc Dev, 10(11), e598101119481.

Maret, D., Peters, O. A., Dedouit, F., Telmon, N., & Sixou, M. (2011). Cone-Beam Computed Tomography: a useful tool for dental age estimation? Med Hypotheses, 76(5), 700-702.

Motawei, S., Helaly, A., Aboelmaaty, W., Elmahdy, K., Shabka, O., & Liu, H. (2020). Length of the ramus of the mandible as an indicator of chronological age and sex: A study in a group of Egyptians. Forensic Sci Int: Reports, 2, 100066.

Nasseh, I., & Al-Rawi, W. (2018). Cone Beam Computed Tomography. Dent Clin North Am, 62(3), 361–391.

Nolla, C. M. (1960) The development of permanent teeth. J Dent Child, 27, 254-266.

Rivera, M., De Luca, S., Aguilar, L., Velandia Palacio, L. A., Galić, I., & Cameriere, R. (2017). Measurement of open apices in tooth roots in Colombian children as a tool for human identification in asylum and criminal proceedings. J Forensic Leg Med, 48, 9-14.

Różyło-Kalinowska, I., Kalinowski, P., Krasicka, E., Galić, I., Mehdi, F., & Cameriere, R. (2022). The Cameriere method using cone-beam computed tomography (CBCT) scans for dental age estimation in children. Aust J Forensic Sci, 54(3), 311-325.

Shekhawat, K. S., & Chauhan, A. (2016). Analysis of dental hard tissues exposed to high temperatures for forensic applications: An in vitro study. J Forensic Dent Sci, 8(2), 90-94.

Sinanoglu, A., Kocasarac, H. D., & Noujeim, M. (2016). Age estimation by an analysis of spheno-occipital synchondrosis using cone-beam computed tomography. Leg Med (Tokyo), 18, 13-19.

Tanner J. M. (1975). The measurement of maturity. Trans Eur Orthod Soc, 45-60.

Tavares, K. I. M. C. ., Fernandes, C. M. S., Santos-Junior, A. O. ., & Serra, M. C. (2022). O emprego da microtomografia computadorizada na estimativa da idade. Res Soc Dev, 11(7), e39711730010.

Terakado, M., Hashimoto, K., Arai, Y., Honda, M., Sekiwa, T., & Sato, H. (2000). Diagnostic imaging with newly developed ortho cubic super-high resolution computed tomography (Ortho-CT). Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 89(4), 509-518.

Ubelaker, D. H., & Parra, R. C. (2008). Application of three dental methods of adult age estimation from intact single rooted teeth to a Peruvian sample. J Forensic Sci, 53(3), 608-611.

Valluri, R., Jain, Y., Lalitha, C., Sajjan, P., Ealla, K., & Dantu, R. (2020). Age Estimation in Mixed-dentition Children, Using Cameriere's European Formula and Demirjian's Method: A Comparative Pilot Study. J Contemp Den Pract, 21(3), 310-316.

Veras, N. P., Abreu-Pereira, C. A., Kitagawa, P. L. V., Costa, M. A. ., Lima, L. N. C. ., Costa, J. F. ., & Casanovas, R. C. (2021). Avaliação de um método de estimativa de idade pela mineralização dentária dos terceiros molares. Res Soc Dev, 10(7), e19410716524.

Wanzeler, A. M. V., Montagner, F., Vieira, H. T., Dias da Silveira, H. L., Arús, N. A., & Vizzotto, M. B. (2020). Can Cone-beam Computed Tomography Change Endodontists' Level of Confidence in Diagnosis and Treatment Planning? A Before and After Study. J Endod, 46(2), 283-288.

Wolf, T. G., Briseño-Marroquín, B., Callaway, A., Patyna, M., Müller, V. T., Willershausen, I., Ehlers, V., & Willershausen, B. (2016). Dental age assessment in 6- to 14-year old German children: comparison of Cameriere and Demirjian methods. BMC Oral Health, 16(1), 120.

Yang, Z., Fan, L., Kwon, K., Pan, J., Shen, C., Tao, J., & Ji, F. (2020). Age estimation for children and young adults by volumetric analysis of upper anterior teeth using cone-beam computed tomography data. Folia Morphol (Warsz), 79(4), 851-859.

Zhang, Z. Y., Yan, C. X., Min, Q. M., Li, S. Q., Yang, J. S., Guo, Y. C., Jin, W. F., Li, L. J., Xing, P. F., & Li, J. (2019). Age estimation using pulp/enamel volume ratio of impacted mandibular third molars measured on CBCT images in a northern Chinese population. Int J Legal Med, 133(6), 1925–1933.

Zirk, M., Zoeller, J. E., Lentzen, M. P., Bergeest, L., Buller, J., & Zinser, M. (2021). Comparison of two established 2D staging techniques to their appliance in 3D cone beam computer-tomography for dental age estimation. Sci Rep, 11(1), 9024.



How to Cite

SANTOS-JUNIOR, A. O.; FERNANDES, C. M. da S.; TAVARES, K. I. M. C. .; SERRA, M. da C. Cone-beam computed tomography application in age estimation. Research, Society and Development, [S. l.], v. 11, n. 11, p. e112111132861, 2022. DOI: 10.33448/rsd-v11i11.32861. Disponível em: Acesso em: 28 sep. 2022.



Health Sciences