Use of developing teeth and hand-wrist films to determine the chronological age of children in the Turkish population

The aim of this study was to develop a new formula by measuring the developing teeth, carpal bones and epiphyses of the ulna and radius to determine the chronological age of Turkish children. The study sample consisted of 202 Turkish children with panoramic and hand-wrist radiographs in the digital archive that were taken at the same date. Seven left permanent mandibular teeth, except the third molar, were evaluated and the number of teeth with closed apex was recorded (N0). The distance between the inner side of open apex (Ai, i=1,…,7) was measured by using the Image J program and divided by the tooth length (Li, i=1,...,7) to minimize the magnification differences among x-rays (xi=Ai/Li, i=1,…,7). The sum of the normalized open apices (s) was also calculated. The carpal area (Ca), covering the epiphyses of ulna and radius and all carpal bones, was measured using x-rays of the left hand. The areas of each carpal bones and epiphyses of the ulna and radius were measured, and these measurements were added together to obtain the bone area (Bo). The Bo/Ca ratio between the total area of carpal bones and the carpal area was calculated to normalize the measurements. The accuracy of age estimation of the equations formulated by Cameriere et al. was evaluated. In addition, new formula of "Age THW=7.359 + 0.797g + 0.427N0 – 0.797s + 3.954Bo/Ca – 0.212N0s" was developed using the data of present study. There was no statistically significant difference between the chronological age and the estimated age for the total sample (p=0.987). Likewise, no significant difference was found between the chronological age and the estimated age in girls or boys (p=0.991 and p=0.990). The new formula obtained from the variables of the present study was more successful in predicting chronological age than the other adjusted age estimation methods, and the equation hit the age with 72.80% accuracy. The new regression model, created for the Turkish children by using both developing teeth and hand-wrist bones, was considerably successful in estimating the chronological age (mean difference=-0.001). Keywords: Forensic age estimation, Cameriere's method, hand-wrist bones, open apex, chronologic age Supporting Institutions: Hacettepe University BAP Coordination Unit (TKB-2020-18618)