Determination of Age

Age of a person can be estimated from

1) Physical or morphological features

2) Study of eruption of teeth

3) Secondary sexual characters

4) Study of appearance and fusion of ossifications centre.

Dental Examination

• a) Eruption data

• b) Root calcification,

• c) Other: Boyde’s Method Gustafsen’s

Method

Eruption of tooth 1) Root formation occurs after completion of crown. 2) As the root become longer the crown erupts through bone and finely comes out of the jaw. 3) The tooth calcifies from crown to neck and roots 4) The root of deciduous undergoes resorption until only crown remains, that falls off

Fairly accurate information of age can be made.In old age, either the tooth falls off, decayed or the

crown is worn away to the sockets.

Teeth Temporary Permanent

Lower central incisor

Upper central incisor

Upper lateral incisor

Lower lateral incisor

Canine

First premolar

Second premolar

First molar

Second molar

Third molar

5-6 month

6-7 month

7-8 month

8-9 month

11/2 year

XX

XX

1 years

2-21/2 year

XX

7-8 year 7-8 year 8-9 year 8-9 year 11-12 year 9-10 year 10-11 year 6-7 year 12-14 years

17-25 years

Temporary Teeth Eruption Calcification

Lower Central incisor 6 month. 1.5 - 2yr.

Upper Central incisor 7 month. 1.5 - 2yr.

Upper Lateral incisor 8 month. 1.5 - 2yr.

Lower Lateral incisor 9 month. 1.5 - 2yr.

1st Molar 1 yr. 2- 2.5 yrs.

Canine 1.5 yr. 2.5 - 3 yrs.

2nd Molar 2 yr. 3 yrs.

How to remember ?

Permanent Teeth Eruption Calcification

1st molar 6-7 yrs. 9-10 yrs.

Central incisor 7-8 yrs. 10-11 yrs.

Lateral incisor 8-9 yrs. 11-12 yrs.

1st premolar 9-10 yrs. 12-13 yrs.

2nd premolar 10-11 yrs. 13-14 yrs.

Canine 11-12 yrs. 14-15 yrs.

2nd molar 12-14 yrs. 14-16 yrs.

3rd molar 17-25 yrs. 20-23 yrs.

How to remember ?

Features Temporary teeth Permanent teeth

Size & weight Smaller, lighter Larger heavier

Colour China white Ivory white

Incisor vertical Projected forward

Neck More constricted Less constricted

Presence of ridge Between neck & body No ridge

Root of molars Smaller & More divergent Longer and less divergent

Replacement By permanent teeth Not replaced

Total No. Twenty Thirty two

Difference between Temporary and permanent teeth

Period of mixed dentition

• Period when both the temporary and permanent teeth are present ,period starts from 6th year when the first molar erupts and till the canine falls i.e. up to 11 yrs.

• Refer the chart

Permanent teeth eruption

Temporary Permanent Total

1st Molar 6-7 yrs. 20 + 4 24

Central Incisor 7-8 yrs. 16 + 8 24

Lateral Incisor 8-9 yrs. 12 +12 24

1st Premolar 9-10 yrs. 8 +16 24

2nd Premolar 10-11 yrs. 4 + 20 24

Canine 11-12 yrs. 0 + 24 24

2nd Molar 12-14 yrs. 0 + 28 28

3rd Molar 17-25 yrs. 0 + 32 32

• Wisdom Tooth-

• Body of jaw grows posteriorly and the ramus is • elongated after eruption of second molar and a • space is created for third molar that errupts • between 17-25 yrs. • The space of third molar should be examined for • it’s hardness.• •

•

• • Some time third molar never erupts as the jaw

• space is inadequate particularly in mandibular

• third molar that remains trapped called as a • impacted teeth.

•

Impacted tooth

• Success ional teeth : These are ten in each jaw. Permanent teeth replaces temporary except the permanent premolar that erupts in place of deciduous molars

• Superadded teeth : Do not have deciduous predecessors and erupt behind temporary teeth All permanent molars are superadded as the first permanent molar erupts while other deciduous teeth are present.

•

•

.Boyd’s method: Method of studying the cross striations which develop in the enamel of teeth till the enamel goes on depositing on the teeth these cross striations lines represent daily incremental lines of the enamel.Usefull to estimate the age of enamel.

Stack's Method: Estimation of age of infant from weight and height of erupting teeth of a child.

Gustafson’s method: In elderly, based on ageing & decaying in teeth. a) Attrition b) Paradentosis c) Secondary dentine d )Root resorption e) Cementom opposition f) Transparency of root

Point’s formula

Mile’s formula

Daliz’s modification of Gustafson’s formula

Determination of age after completion of eruption

Medico legal aspect of dental study both in living and dead

• Identification of Individual- Age Sex Race • Familial setting of the teeth• Identification for a longer period because it resists

decomposition.• Habit of chewing tobacco.• Evidence of any missing tooth or artificial denture help in

proving identity.• Occupation e.g. notch under tooth in Tailor.• Grievous hurt- Sec.320 IPC Fracture dislocation of tooth.• Poisoning cases- Amount of heavy metals can be detected

for a considerable period of time after death.• Chr. Phosphorous poisoning—Phossy jaw characteristic.• Bite marks Help in investigation.• Artificial denture.• Pink teeth- Teeth are pink in putrefied bodies due staining of

hemoglobin products• Blood group detection is possible.

Development of secondary sexual characters

Appearance/greying of hairs

Males yrs.

Female yrs.

Pubic hairs 14-15 13-14

Axillary hairs 15-16 14-15

Beard & Moustache 16-17 Absent

Other body parts 17-20 Absent

Graying of hairs 40 40

Graying of pubic hairs

55 55

Balding 45 Less common

Tanner’s stages of growth of Pubic hairs

Stages Growth of hairs Age

Stage 1 Prepubertal, no pubic hairs, fine brown vellus hairs

<12 yrs.

Stage 2 Sparse, not extending to mons pubis, light pigmented at base of penis

12-13 yrs.

Stage 3 Darker coarse extending on to mons pubis pigmented and start curling and spreading

13-14 yrs.

Stage 4 Covering most part but not going up to thigh

14-15 yrs.

Stage 5 Dense hairs extending to the inner thighs and dark mature pubic hairs

>15 yrs.

Hoarseness of voice occurs in boys between 15-17 yrs. of age.

Stature of person starts decreasing after 25 yrs. of age at the rate of 1mm.per year.

Menopause in woman comes between 41-45 yrs. of age.

Development of Breast

Elevated as a small mound and there is a enlargement of areolar diameter 11-12 yrs.

More elevation of breast and papillae and enlargement of areolar diameter

13 yrs.

Areola and papillae project over the level of breast

14 yrs.

Only papillae project over the level of breast

15 yrs.

Only papillae project over the surface and areola merges in to the breast

15-16 yrs.

Appearance of and fusion of ossification centres.

X-ray advised for determination of age,Below 10 years- a) Both elbow joint. b) Both wrists Joint.Between 10 to 20 years-a) Both elbow joints b) Both wrist joints c) Pelvis AP views. 3) Above 20 years a) Chest AP & Lat. View. Showing medial ends of clavicles Sternum with

xiphoid and manubrium and vertebral column. b) Skull ( AP & Oblique profileview ) Showing cranial sutures and calcification of root of teeth.

Wrist JointOssification centre Appearance (Yrs.) Fusion (Yrs.)

Pisiform bone 9-12 (12-17)

1st Metacarple 3 (4) 14-16 (16-18)

Lower end of Radius

1 (1) 16 ½ -18 (16-17)

Lower end of Ulna 8-10 (10-11) 17 (18)

No of Carpal bone(5)

No. of carpal bones = Age in years +1

Carpal Bones Appearance

S - Scaphoid 5 years

L - Lunate 4 years

T - Triquetrum 3 years

P - Pissiforem 9 –12 years

T - Trapizium 5 years

T - Trapizoid 6 years

C - Capitate 2 months

H - Hamate 2 years

Carpal Bones Appearance

S - Scaphoid 5 years

L - Lunate 4 years

T - Triquetrum 3 years

P - Pissiforem 9 –12 years

T - Trapizium 5 years

T - Trapizoid 6 years

C - Capitate 2 months

H - Hamate 2 years

Elbow joint

Lat.Epicondyle 10 (12) 10-12 yrs with Capitulum (11-16)

Med. Epicondyle 5 (7) 14 yrs with shaft

(16)

Head of Radius 6 (8) 14 yrs. (16)

Tip of Olecrenon process of ulna

9-12 (11-13) 15 yrs. (17)

Ossification centre Appearance (Yrs.) Fusion (Yrs.)

Head of Femur 1 14-15

App. Fusion yrs.

Grater Trochantor 15-17 Lesser Trochantor 14

Iliac crest 17-19

Ischial Tuberosity 14-16 20

Triradiate cartilage 14 - 15

3

1

14

Hip Joint(Female)

Appearance of Centers of ossification:

Lower end of femur :- 9th month of intrauterine life (IUF )

Upper end of tibia- just before birth

Diameter of centre is 2-5 mm at37-38 wks & 6-8 mm. in full term Foetus.

Knee Joint

Upper end of Tibia 14 - 15 (15-17)

Upper end of Fibula 14 - 16 (11-16)

Lower end of femur 14 – 17 (14-17)

Lower end of Tibia 1 14-15

Lower end of Fibula 1 14-15

Metatarsals 3 14-15

Tarsal phalanges 1-3 16-18

Calcaneum 5 IU

Cuboid 10 IU

Talus 7 IU

App. Fusion yrs.Ankle joint

Fontanalle: Posterior fontanelle closes between 1.5 to 2 months. Anterior fontanelle closes by 2nd year. Posteriolateral fontanelle closes within short period after birth. Anterolateral fontanelle closes within first 6 months after birth

Metopic suture: Closes between 2-4 years, some times may remain intact.Basi occiput suture: fuses with Basi sphenoid by about 18-20 yrs. in female, 20-22 yrs in male .

Coronal, sagittal & lambdoid suture starts to close on their inner side at about the age of 25 yrs

Closure of sutures begins on the inner side 5-10 yrs. earlier than on outer side.

Outer side of vault - - Posterior 1/3 of sagittal-- 30 years - Ant 1/3 sagittal & lower ½ of coronal -- 40-50 years - Middle 1/3 of sagittal + upper ½ coronal -- 50-60 yearsLambdoid suture Closure completes by -- 45 years.

Sqamous part of temporal fuses withneighbouring bones -- 60 years

For confirmation of age between 14-25 yrs.

14 yrs. Patella completely ossifies

14-25 yrs. Sternum fusion takes place below upwards.

15-16 yrs. Elbow joint

16-17 yrs. Ankle joint

17-18 yrs. Hip joint

18-19 yrs. Knee, shoulder, inner end of clavicle centre appears.

18-20 yrs iliac crest.

21 yrs Fusion of ischial tuberosity and inner side of clavicle.

22 yrs. Epiphyseal union of sternal end of clavicle

Other factors that are helpful for estimation of age:

Thyroid and cricoid cartilage tend to ossify by 45-50 yrs.

The fusion of cornua with the body of hyoid bone occurs after 40 yrs.

Lipping of the body of lumbar vertebra starts around 40-50 yrs.Atrophic changes in inter vertrible discs starts around 50-60 yrs.

Arcus senalis i.e. an opaque zone around the periphery of cornea may be noticed around 60 yrs.

Graying of pubic hairs are more reliable and usually starts after 60 yrs.

To,The------------------------------------Reference:Name:Age stated:---------- Sex:--------------- Occupation:--------------------Address:------------------------------------------------------------------------Brought by Police constable:---------------------No.----------,P.S.-----------Identified by:--------------------------------------------------------------------------Date and Time of examination:-------------------------------------------Place of examination:------------------------------------------------------Consent:----------------------------------------------------------------------- If minor below 12 yrs. consent by parents/GuardianExamined in presence of:-----------------------------------------------(If female) Signature of female attendentIdentification marks:1)------------------------------------------------------- 2)-------------------------------------------------------Birth Date:----------------------- Education:--------------------------------

Physical Examination:

1) Height: 2) Weight:3) Chest girth at the level of nipple------------- 4) Abdominal girth at the level of naval-------5) General built and appearance:-----------------------------------------------------------------------6) Hairs: Pubic:------------, Axillary:---------------, Facial:------------, Scalp:----------------7) Development of breast:----------------------------8) Development of genitals:--------------------------9) Onset Of Puberty: Voice:--------------- Adam’s apple:----------------- Date of menarche:----------------- Regularity of menses:---------10) Dental Status: Modified FDI Method

21 11

31 41

1) Any other findings: Skin: Eye: Others:

2) Advise ‘X-ray’: X-ray plate no.. Date:

Age Certificate

ToThe ----------------------------------------------Reference: Age estimation of ------------------------------------------------- dated

Sir,I, Dr. ------------------------------------------, after going through the findingsof -----------------------------------------------------------------------------------------physical examination report no.---------------------------,dated ---------------‘X ray plate No. -----------------------------------------------,dated ---------------Radiological examination report no.----------------------,dated---------------And the date of birth certificate no.-----------------------,dated ---------------Produced before me,

I am of the opinion that the individual's age is about --------------years.

Signature ( Dr. ) DesignationPlace:----------------- Regd. No.

Date: ------------------

Medico legal importance of Age

• 1) Criminal responsibility:- Liability for punishment,– 82 IPC—under 7yrs. Not an offence.– 83 IPC – 7 to 12 yrs. Capable of committing offence.– Railway Act:- Above 5yrs. Offence.( If destruction of

Railway Property)– 89 IPC:- Under 12 yrs.-Can not give a valid consent (Act

done in good faith & for it’s beneficiaries.• 87 IPC: - Above 18 yrs.-Can give valid consent.( to suffer any

harm which may result from act not intended or not known to cause death or grievous injury)

• 2) Judicial Punishment- Juvenile justice act 2000—Juvenile (Boys/Girls) below 18 yrs.“Juvenile in conflict with Law” Juvenile offender.

3) Kidnapping: It is removing a person from a lawful guardianship 1) Child less than 10 yrs- S.369 IPC

2) Less than 16yrs.of boy & less than 18 yrs of girl-S.361IPC.

a) With intension of taking any movable property

b) Kidnapping of minor for the purpose of begging. c) To procure a girl for prostitution if she is less than

18 yrs S366IPC d) To import a girl to India for illicit intercourse if she

is less than 21 yrs.

4) Rape: - 375 IPC Girl under 15 yrs.if she is his own wife. Girl under 16 yrs. even if she has given consent.

5) Child marriage Restraint Act.

Medico legal importance con-

6) Attainment of majority Indian majority act-On completion of 18 yrs. 7) Employment- Factory Act 1984 -below 14yrs. cannot be employed’ On completion of 15 yrs.certificate of fitness is

required. 8) Infanticide-9) Criminal abortion –Stages of development of product of conception.10) Competency as witness - No age limit.11) Impotence & Sterility-12) Identification.

Medico legal importance con.-

Provisional Age CertificateProvisional Age Certificate

On clinical examination of the individual, age is about -----------years.

However, the final opinion regarding the age should be collected from

This office after submission of the Radiological report and the birth

certificate. Signature Name (Dr. )Place:--------- Designation Regd. No.Date:-----------

Medico legal importance of Age:

Age MLE IPC Sec/ Act Remarks

> 7 months (IUL)

Infanticide Sec 300 IPC Viability is attained

> 5 yrs. Criminal responsibility

Railway act Punishable for offence

>7 yrs. Criminal responsibility

Sec.82 IPC No criminal intent & not guilty of the crime

7-12 yrs. Criminal responsibility

Sec 83 IPC Guilty of offence if sufficient maturity & understanding present

<12 yrs. Consent Sec 89 IPC Parents / guardians must give consent for physical examination

>14 yrs. Employment Factory Act Can not be employed in factory job.

14-15 yrs. Employment Factory Act Non hazardous jobs in factory during day time given

>15 yrs. Employment Factory Act Can be employed provided fitness certificate is given.

<15 yrs. Rape Sec. 375 IPC Sexual intercourse with his own wife with or without consent

<15 yrs.(girls) Statutory rape Sec. 375 IPC Sexual intercourse with a girl with or without consent

<16 yrs.(boys) Judicial punishment

Juvenile justice 1986

Sent to reformatory school.

<16 yrs.(boys) Kidnapping Sec.361 IPC Taking away without the consent of lawful guardian.

<18yrs.(girls) Kidnapping Sec.361 IPC 10 yrs. imprisonment with or without fine.

<18yrs.(girls) Kidnapping Sec. 366 IPC Procuring a girl for illicit intercourse 10 yrs. imprisonment with or without fine

>18yrs. Consent Sec. 87 IPC Can consent to suffer any harm not intended or known to cause death/grievous hirt.

>18 yrs. Attainment of majority

Sec.3 India majority act.1875

Except those under the guardianship of court can make a valid, will cast vote in election.

>18 yrs(girls) Marriage Child marriage restraint act 1978

> 18 yrs. Employment Minimum age to enter govt. services.

<21Yrs.(girls) Kidnapping Sec.366-B IPC Procuring girls from outside the country or from Jammu & Kashmir for illicit intercourse. Punishment -10 yrs. imprisonment with fine.

>21yrs. Attainment of majority

Sec. 3 Indian Majority Act 1875

For those under guardianship of court.

>21 yrs. Marriage Child marriage restraint act 1978

55-65 yrs. Employment Age of retirement