Pulp volume quantification methods in cone‐beam computed tomography for age estimation: A critical review and meta‐analysis

The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone‐beam computed tomography (CBCT) with chronological age approxi...

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Bibliographic Details
Published in:Journal of forensic sciences 2023-05, Vol.68 (3), p.743-756
Main Authors: Barbosa, Marcella Guedes, Franco, Ademir, Oliveira, Renata Dantas Barreto, Mamani, Mariela Peralta, Junqueira, José Luís Cintra, Soares, Mariana Quirino Silveira
Format: Article
Language:English
Subjects:
Adolescents
Age
Age Determination by Teeth - methods
age estimation by teeth
Algorithms
Chronology
Computed tomography
Cone-Beam Computed Tomography
Dental Pulp Cavity - diagnostic imaging
forensic dentistry
Heterogeneity
Imaging, Three-Dimensional
Incisor
Meta-analysis
Qualitative analysis
Teeth
Tomography
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Summary:The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone‐beam computed tomography (CBCT) with chronological age approximation. A subobjective was to investigate which methodology and CBCT technical parameters would be most appropriate to evaluate this correlation. This critical review followed the PRISMA guidelines, and it was conducted by a search through PubMed, Embase, SciELO, Scopus, Web of Science, Cochrane Library databases, as well as gray literature. Primary studies that used pulp volume, or pulp chamber to tooth volume ratio measured using CBCT were included. Seven hundred and eight indexed and 31 non‐indexed records were identified. A qualitative analysis was performed including 25 selected studies with a total of 5100 individuals, age ranging from 8 to 87 years without sex predilection. The most used method was pulp volume/tooth volume. CBCT voxel size ranged between 0.09 and 0.5. Manual segmentation associated with threshold algorithms was used in most of the studies. Correlation between the pulp volume/tooth volume ratio was moderate: −0.66 for the upper central incisors, −0.59 for upper canines and −0.56 for lower canines. High heterogeneity was observed among the studies. It is concluded that pulp volume should be used with caution in age estimation. Evidence supports the preferable use of upper incisors with pulp volume/tooth volume ratio for age estimation. There is not enough evidence that voxel size interferes in age estimation by pulp volume.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.15248