Imaging Sci Dent.  2014 Sep;44(3):185-191. 10.5624/isd.2014.44.3.185.

Radiographic evaluation of third molar development in 6- to 24-year-olds

• Jung YH
• Cho BH

• KMID: 1974481
• DOI: http://doi.org/10.5624/isd.2014.44.3.185

Abstract

PURPOSE
This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender.
MATERIALS AND METHODS
A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age.
RESULTS
The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively.
CONCLUSION
The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females.

Keyword

Radiography, Panoramic; Molar, Third; Development; Classification

MeSH Terms

Classification
Crowns
Female
Humans
Linear Models
Male
Molar, Third*
Radiography, Panoramic
Retrospective Studies
Young Adult*

Figure

• 

  Fig. 1 Cropped panoramic radiographs show developmental stages of the third molars. Stage 0: Radiolucent bud with no calcification. Stage A: Cusp tips mineralized but not yet coalesced. Stage B: United mineralized cusps and well-defined mature coronal morphology. Stage C: Crown about half formed, evident pulp chamber, and visible dentinal deposition. Stage D: Crown formation completed to the cementoenamel junction and pulp chamber with a trapezoidal form. Stage E: Commencement of formation of the inter-radicular bifurcation and root length less than the crown length. Stage F: Root length at least as great as the crown length and roots with funnel-shaped endings. Stage G: Root walls parallel, with apices remaining open. Stage H: Apical ends of the roots completely closed and uniform width of the periodontal membrane around the root.

Reference

1. Mincer HH, Harris EF, Berryman HE. The A.B.F.O. study of third molar development and its use as an estimator of chronological age. J Forensic Sci. 1993; 38:379–390.

2. Gunst K, Mesotten K, Carbonez A, Willems G. Third molar root development in relation to chronological age: a large sample sized retrospective study. Forensic Sci Int. 2003; 136:52–57.

3. Jafari A, Mohebbi S, Khami M, Shahabi MS, Naseh M, Elhami F, et al. Radiographic evaluation of third molar development in 5- to 25 year olds in Tehran, Iran. J Dent (Tehran). 2012; 9:107–115.

4. Lim HS, Lee SW. Roentgenographic studies on the growth & development of lower third molars in Korean female. J Korean Acad Oral Maxillofac Radiol. 1976; 6:59–66.

5. Harris EF. Mineralization of the mandibular third molar: a study of American blacks and whites. Am J Phys Anthropol. 2007; 132:98–109.

6. Thorson J, Hägg U. The accuracy and precision of the third mandibular molar as an indicator of chronological age. Swed Dent J. 1991; 15:15–22.

7. Bolaños MV, Moussa H, Manrique MC, Bolaños MJ. Radiographic evaluation of third molar development in Spanish children and young people. Forensic Sci Int. 2003; 133:212–219.

8. Almeida MS, Pontual AD, Beltrão RT, Beltrão RV, Pontual ML. The chronology of second molar development in Brazilians and its application to forensic age estimation. Imaging Sci Dent. 2013; 43:1–6.

9. Kurita LM, Menezes AV, Casanova MS, Haiter-Neto F. Dental maturity as an indicator of chronological age: radiographic assessment of dental age in a Brazilian population. J Appl Oral Sci. 2007; 15:99–104.

10. Olze A, Bilang D, Schmidt S, Wernecke KD, Geserick G, Schmeling A. Validation of common classification systems for assessing the mineralization of third molars. Int J Legal Med. 2005; 119:22–26.

11. Dhanjal KS, Bhardwaj MK, Liversidge HM. Reproducibility of radiographic stage assessment of third molars. Forensic Sci Int. 2006; 159:Suppl 1. S74–S77.

12. Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol. 1973; 45:211–227.

13. Olze A, van Niekerk P, Schmidt S, Wernecke KD, Rösing FW, Geserick G, et al. Studies on the progress of third-molar mineralisation in a Black African population. Homo. 2006; 57:209–217.

14. Thevissen PW, Pittayapat P, Fieuws S, Willems G. Estimating age of majority on third molars developmental stages in young adults from Thailand using a modified scoring technique. J Forensic Sci. 2009; 54:428–432.

15. Olze A, Taniguchi M, Schmeling A, Zhu BL, Yamada Y, Maeda H, et al. Comparative study on the chronology of third molar mineralization in a Japanese and a German population. Leg Med (Tokyo). 2003; 5:Suppl 1. S256–S260.

16. Olze A, Schmeling A, Taniguchi M, Maeda H, van Niekerk P, Wernecke KD, et al. Forensic age estimation in living subjects: the ethnic factor in wisdom tooth mineralization. Int J Legal Med. 2004; 118:170–173.

17. Thevissen PW, Alqerban A, Asaumi J, Kahveci F, Kaur J, Kim YK, et al. Human dental age estimation using third molar developmental stages: accuracy of age predictions not using country specific information. Forensic Sci Int. 2010; 201:106–111.

18. Liversidge HM. Timing of human mandibular third molar formation. Ann Hum Biol. 2008; 35:294–321.

19. Johan NA, Khamis MF, Abdul Jamal NS, Ahmad B, Mahanani ES. The variability of lower third molar development in Northeast Malaysian population with application to age estimation. J Forensic Odontostomatol. 2012; 30:45–54.

20. Lee SH, Lee JY, Park HK, Kim YK. Development of third molars in Korean juveniles and adolescents. Forensic Sci Int. 2009; 188:107–111.

21. Sisman Y, Uysal T, Yagmur F, Ramoglu SI. Third-molar development in relation to chronologic age in Turkish children and young adults. Angle Orthod. 2007; 77:1040–1045.

22. Arany S, Iino M, Yoshioka N. Radiographic survey of third molar development in relation to chronological age among Japanese juveniles. J Forensic Sci. 2004; 49:534–538.

23. Bassed RB, Briggs C, Drummer OH. Age estimation and the developing third molar tooth: an analysis of an Australian population using computed tomography. J Forensic Sci. 2011; 56:1185–1191.

24. Kasper KA, Austin D, Kvanli AH, Rios TR, Senn DR. Reliability of third molar development for age estimation in a Texas Hispanic population: a comparison study. J Forensic Sci. 2009; 54:651–657.

25. Solari AC, Abramovitch K. The accuracy and precision of third molar development as an indicator of chronological age in Hispanics. J Forensic Sci. 2002; 47:531–535.

26. Orhan K, Ozer L, Orhan AI, Dogan S, Paksoy CS. Radiographic evaluation of third molar development in relation to chronological age among Turkish children and youth. Forensic Sci Int. 2007; 165:46–51.

27. Martin-de las Heras S, García-Fortea P, Ortega A, Zodocovich S, Valenzuela A. Third molar development according to chronological age in populations from Spanish and Magrebian origin. Forensic Sci Int. 2008; 174:47–53.

28. Olze A, Taniguchi M, Schmeling A, Zhu BL, Yamada Y, Maeda H, et al. Studies on the chronology of third molar mineralization in a Japanese population. Leg Med (Tokyo). 2004; 6:73–79.

29. Levesque GY, Demirijian A, Tanguay R. Sexual dimorphism in the development, emergence, and agenesis of the mandibular third molar. J Dent Res. 1981; 60:1735–1741.

30. Kullman L. Accuracy of two dental and one skeletal age estimation method in Swedish adolescents. Forensic Sci Int. 1995; 75:225–236.

31. Willershausen B, Löffler N, Schulze R. Analysis of 1202 orthopantograms to evaluate the potential of forensic age determination based on third molar developmental stages. Eur J Med Res. 2001; 6:377–384.