FORENSIC ASSESSMENT OF AGE FROM PULP CAVITY USING CONE BEAM COMPUTED TOMOGRAPHIC IMAGES (AN OBSERVATIONAL CROSS- SECTIONAL STUDY)

Background: In human dentition, the size of pulp cavity decreases as deposition of secondary dentin increases with age which can be used as an age predictor. This study aims to investigate the correlation between chronological age with pulp to tooth volume ratio (PV/TV) and Kvaals’ morphological ratios, evaluate Kvaal's approach age estimation applicability, validate original regression models suggested by Kvaal et al. and create population specific regression equations for age prediction utilizing PV/TV and Kvaals’ variables. Materials and Methods: This study examined CBCT images of 75 teeth of individuals aged 18-60 years. Volumetric analysis of maxillary central incisor pulp cavity and tooth was performed using 3D Slicer software and PV/TV was calculated. Linear measurements of three sorts of teeth were conducted in sagittal sections utilizing Kvaal's approach. Correlation and multiple linear regression analysis were conducted. Kvaals’ original regression formulas were applied for age assessment. PV/TV and Kvaals’ ratios errors were measured across voxel sizes. Results: Regression models using PV/TV with varying voxel sizes were significant for age estimation with the best model with correlation coefficient of 0.775 and coefficient of determination of 0.601. Regression analysis utilizing stepwise method showed stronger correlation (R=0.613-0.646) and higher coefficient of determination (R²=0.3760.417) than utilizing Kvaals’ M and W-L variables with all predictors were found significant. No significant difference between voxel sizes regarding PV/TV error, likewise Kvaals’ ratios error except maxillary lateral incisor. Conclusions: PV/TV proved to be a reliable age estimation indicator. Kvaal's approach was applicable to Egyptian adult subjects. Original Kvaals’ formulae lacked precision. Population specific formulae using stepwise method had higher prediction ability than M & W-L predictors.