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Applicability of tooth cementum thickness as an age marker: systematic review and meta-analysis

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Abstract

The age estimation by tooth cementum thickness is a method that has been discussed regarding its applicability. The aim of this study was to conduct a systematic review on the use of tooth cementum thickness as a biomarker for age estimation in adults, as well as a meta-analysis to assess the method’s reliability. The search was conducted on Embase, LILACS, PubMed/MEDLINE, SciELO, Scopus, and Web of Science databases. Two independent reviewers used inclusion and exclusion criteria to select and assess relevant studies. For bias risk assessment, a checklist proposed by the Joanna Briggs Institute was applied. Pearson and Spearman correlation coefficients were considered as effect measures for the meta-analysis between tooth cementum thickness and chronological age. Heterogeneity among studies was evaluated using Cochran’s \(\:Q\) test (\(\:p<0.05\)), I2 index, and Graphic Display of Heterogeneity plot. Meta-analysis robustness was assessed using Baujat plots, and publication bias was checked using DOI plots and the Luis Furuya-Kanamori index. Most selected studies showed low risk of bias. Although not all studies were included in the meta-analysis, moderate heterogeneity was found among those included. The synthesized result indicated that tooth cementum thickness has a moderate correlation with chronological age, both when the outlier study is included (\(\:r=0.59\:[0.48;0.69]\)) and when the outlier is removed (\(\:r=0.57\:[0.45;0.68]\)). It is concluded that tooth cementum thickness represents a potential age biomarker that can be useful in age estimation methods for adults. However, the presented results should be considered cautiously, emphasizing the need for further primary studies.

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Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

References

  1. Birimiša M, Dumančić J, Vodanović M et al (2021) Forensic determination of dental age by cementum thickness of human teeth. J Forensic Odontostomatol 39(3):41–48

    PubMed  PubMed Central  Google Scholar 

  2. Machado CEP, Deitos AR, Velho JA, Cunha E (2022) Tratado De Antropologia Forense - Fundamentos e metodologias aplicadas à prática Pericial, 1st edn. Millenium, São Paulo

    Google Scholar 

  3. Gustafson G (1950) Age determinations on teeth. J Am Dent Assoc 41(1):45–54

    Article  PubMed  Google Scholar 

  4. Bertrand B (2019) Age-at-death estimation by cementochronology – somewhere between indifference and overconfidence. Forensic Sci Int 302(1):109886. https://doi.org/10.1016/j.forsciint.2019.109886

    Article  PubMed  Google Scholar 

  5. Kvaal SI, Solheim T (1995) Incremental lines in human dental cementum in relation to age. Eur J Oral Sci 103(1):225–230. https://doi.org/10.1111/j.1600-0722.1995.tb00164.x

    Article  PubMed  Google Scholar 

  6. Kvaal SI, Solheim T, Bjerketvedt D (1996) Evaluation of preparation, staining and microscopic techniques for counting incremental lines in cementum of human teeth. Biotech Histochem 71(4):165–172. https://doi.org/10.3109/10520299609117155

    Article  PubMed  Google Scholar 

  7. Bertrand B, Cunha E, Bécart A, Gosset D, Hédouin V (2019) Age at death estimation by cementochronology: too precise to be true or too precise to be accurate? Am J Phys Anthropol 169(3):464–481. https://doi.org/10.1002/ajpa.23849

    Article  PubMed  Google Scholar 

  8. Bertrand B, Oliveira-Santos I, Cunha E (2019) Cementochronology: a validated but disregarded method for age at death estimation. In: Adserias-Garriga J (ed) Age estimation: a multidisciplinary approach. Academic Press is an imprint of Elsevier, London, United Kingdom, San Diego, CA, United States, pp 169–186. https://doi.org/10.1016/B978-0-12-814491-6.00012-1

    Chapter  Google Scholar 

  9. Lieberman DE, Meadow RH (1992) The biology of cementum increments (with an archaeological application). Mamm Rev 22(2):57–77. https://doi.org/10.1111/j.1365-2907.1992.tb00120.x

    Article  Google Scholar 

  10. Stott GG, Sis RF, Levy BM (1982) Cemental annulation as an age criterion in forensic dentistry. J Den Res 61(1):814–817. https://doi.org/10.1177/00220345820610063401

    Article  Google Scholar 

  11. Phulari RGS, Dave EJ (2021) Evolution of dental age estimation methods in adults over the years from occlusal wear to more sophisticated recent techniques. Egypt J Forensic Sci 11(36):1–14. https://doi.org/10.1186/s41935-021-00250-6

    Article  Google Scholar 

  12. Shylaja S, Manay SM, Ganji KK et al (2022) Dentinal translucency and width of cementum: predicting the age over 55 years in south Indian adults using extracted sectioned teeth. J Forensic Odontostomatol 40(2):10–20

    PubMed  PubMed Central  Google Scholar 

  13. Solheim T (1990) Dental Cementum apposition as an indicator of age. Eur J Oral Sci 98(6):510–551. https://doi.org/10.1111/j.1600-0722.1990.tb01006.x

    Article  Google Scholar 

  14. Pinchi V, Forestieri AL, Calvitti M (2007) Thickness of the dental (radicular) cementum: a parameter for estimating age. J Forensic Odontostomatol 25(1):1–6

    PubMed  Google Scholar 

  15. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71

    Article  PubMed  PubMed Central  Google Scholar 

  16. The Joanna Briggs Institute (2020) Checklist for analytical cross sectional studies. https://jbi.global/critical-appraisal-tools. Accessed 05 June 2023

  17. Harrer M, Cuijpers P, Furukawa T, Ebert D (2021) Doing Meta-analysis with R: a Hands-On Guide. Chapman & Hall/CRC, Boca Raton and London. https://doi.org/10.1201/9781003107347

    Book  Google Scholar 

  18. Olkin I, Dahabreh IJ, Trikalinos TA (2012) GOSH – a graphical display of study heterogeneity. Res Synth Methods 3(3):214–223. https://doi.org/10.1002/jrsm.1053

    Article  PubMed  Google Scholar 

  19. Furuya-Kanamori L, Barendregt JJ, Doi SAR (2018) A new improved graphical and quantitative method for detecting bias in meta-analysis. Int J Evid Based Healthc 16(4):195–203. https://doi.org/10.1097/xeb.0000000000000141

    Article  PubMed  Google Scholar 

  20. Dias PEM, Beaini TL, Melani RFH (2010) Age estimation from dental cementum incremental lines and periodontal disease. J Forensic Odontostomatol 28(1):13–21

    PubMed  Google Scholar 

  21. Amariti ML, Restori M, De Ferrari F et al (1999) Age determination by teeth examination: a comparison between different morphologic and quantitative analyses. J Clin Forensic Med 6(2):85–89. https://doi.org/10.1016/s1353-1131(99)90205-5

    Article  PubMed  Google Scholar 

  22. Kasetty S, Rammanohar M, Raju Ragavendra T (2010) Dental cementum in age estimation: a polarized light and stereomicroscopic study. J Forensic Sci 55(3):779–783. https://doi.org/10.1111/j.1556-4029.2010.01363.x

    Article  PubMed  Google Scholar 

  23. Zou KH, Tuncali K, Silverman SG (2003) Correlation and simple linear regression. Radiology 227(3):617–622. https://doi.org/10.1148/radiol.2273011499

    Article  PubMed  Google Scholar 

  24. Zander HA, Hürzeler B (1958) Continuous cementum apposition. J Dent Res 37(6):1035–1044. https://doi.org/10.1177/00220345580370060301

    Article  PubMed  Google Scholar 

  25. Smid JR, Rowland JE, Young WG et al (2004) Mouse cellular cementum is highly dependent on growth hormone status. J Dent Res 83(1):35–39. https://doi.org/10.1177/154405910408300107

    Article  PubMed  Google Scholar 

  26. Pinto PHV, Fares LC, Silva RHA (2022) Dental age estimation by cementum incremental lines counting: a systematic review and meta-analysis. Forensic Sci Int 341(1):111492. https://doi.org/10.1016/j.forsciint.2022.111492

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. We also thank Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) by the financial supporting provided.

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No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

    Mirela Cristina da Silva & Paulo Henrique Viana Pinto

  2. Department of Stomatology, Public Health and Forensic Odontology, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

    Ricardo Henrique Alves da Silva

  3. USP – Faculdade de Odontologia de Ribeirão Preto, Av. do Café, s/n, Ribeirão Preto, 14040-904, SP, Brazil

    Ricardo Henrique Alves da Silva

Authors
  1. Mirela Cristina da Silva
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  2. Paulo Henrique Viana Pinto
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  3. Ricardo Henrique Alves da Silva
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Contributions

PHVP and RHAS had the idea for the article. MCS and PHVP searched and selected the articles, extracted the data, and wrote the original draft. PHVP performed the data analysis. MCS and PHVP obtained and interpreted the results. RHAS supervised, wrote, and critically reviewed the article. All authors (MCS, PHVP, RHAS) approved the manuscript.

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Correspondence to Ricardo Henrique Alves da Silva.

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da Silva, M.C., Pinto, P.H.V. & da Silva, R.H.A. Applicability of tooth cementum thickness as an age marker: systematic review and meta-analysis. Int J Legal Med (2025). https://doi.org/10.1007/s00414-025-03426-0

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