Paper 2: Age determination: In relation to specific demands of forensic practice : Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology
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Received: May 23, 2003
Accepted: October 16, 2003
Ref: Prasad BK, Kumar P and Tyagi YK.  Age determination: In relation to specific demands of forensic practice  Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology, 2003; Vol. 4, No. 2, (July - December 2003): ; Published: November 20, 2003, (Accessed: 

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Bijay Kumar Prasad Pankaj Kumar Yogesh Kumar Tyagi
Bijay Kumar Prasad
Pankaj Kumar
Yogesh Kumar Tyagi

Age determination: In relation to specific demands of forensic practice

Bijay Kumar Prasad,Department of Forensic Medicine, College of Medical Sciences, Nepal
Pankaj Kumar, Department of Respiratory Virology, VP Chest Institute, University of Delhi, Delhi-110007, India,
Yogesh Kumar Tyagi, Department of Biochemistry, VP Chest Institute, University of Delhi, Delhi-110007, India.


Age determination in cadavers, human remains and living individuals may clarify issues with significant legal and social ramification for individuals and in community. In cases of age estimation, medical ethics and legal rules are the important factors, which should be considered. The choice of method has to take account of the individual circumstances of each case. Most methods require either the consultation of specialized and trained scientist. The methods must be presented to the scientific community, as a rule by publication in review form and the methods should be scientific accurate and results should be reproducible .In this review we have described some important method of age determination and legal and social issue involved in age determination in forensic medicine..


Age Estimation, Clinical Forensic Medicine

Need of accurate methods for age determination in forensic practice

TThe need for accurate techniques for age estimation has never been grater than last two decades because of two main reasons related to current sociopolitical development. The first reason is increasing number of unidentified cadavers and human remains, the second reason is rise in cases requiring age estimation in living individuals with no valid proof of date of birth. These developments have greatly underlined the importance of aging both in human remains and living individuals.

The implications of " lack of identification" of a cadaver are not to be underestimated. Appropriate identification is important not only for administrative and ethical reasons, but also because of serious legal consequences. In civil law the death of person (which can only be proclaimed following correct identification of the deceased) changes the civil and juridical status not only of the deceased but also of the relatives. Death has major economic and financial ramification for the relatives arising from issues of inheritance and insurance. In criminal law, lack of identification seriously hampers murder enquiries. Finally false or unidentified cadavers offer an opportunity to illegally obtain identity documents and thereby switch identity.

When attempting to match unidentified remains against hundreds of missing individuals, age is a primary crucial factor for preliminary screening procedures. Age estimation is therefore one of the slandered request made be police and juridical authorities upon the discovery of dead body.

Estimation of age is also becoming crucial in living individuals. Many countries have registered in increase in the influx of individuals lacking valid identity documents (e.g. refugees, illegal immigrants). This is resulted in an increase in the prison population of foreign juvenile delinquents with no valid documents. Knowledge of age of living individuals without valid documents may be required to clarify legal questions concerning the imputability of juvenile or young adult delinquents. Pension claims of older individuals or requests for political asylum [1].

The demands of methods of age determination are dependent on circumstances of individual cases. In many cases an appropriate age estimation by trained and experienced persons based on anthropological / dental status, which can be performed quickly and immediately, is sufficient for example for confirmation of the identity of a deceased in connection with other findings. However, in other cases age estimation is has to be as accurate as possible- for example if the identity of a victim of a murder case is unclear or if legal questions concerning the imputability of young delinquents have to be clarified. In such cases age estimation may play a central role in clarification of questions, which have a major legal and social impact for individuals as well as for community; this is the peculiarity of age estimation in forensic practice. In such a framework, methods of age estimation have to fulfill specific demands.

The main question: Which methods can fulfill these specific demands

Numerous papers concerning age estimation have been summarized in different review articles and in books [2-5]. Most of the review gives indications as to the preferred methods according to the authors. But usually no statistically founded reasons for such a choice are given. Not infrequently methods which are commonly considered inaccurate (such as ectocranial suture closure) are still recommended. This may be mainly ascribed to the lack of consistent data concerning the accuracy of methods for age estimation. Studies that test various methods in an independent material are rare and as rule limited to special fields (e.g. dental and skeleton methods) [6-9]. A comparison of different methods with regard to their accuracy based on published original data can be performed only with severe limitations. The methods have been developed on the samples of differing or unknown size and age structure. In many cases there is lacking of details regarding the procedures used and in some cases there are even statistical inconsistencies [10].

This overview is an attempt to summarize relevant information about these methods and to give recommendations for their application. We have attempted to restrict cited literature to original, basic and/or recent literature which we believe will be of greatest value.

Methods for age determination

In childhood, age estimation can be performed by using morphological methods, because a great number of age dependent morphological features especially of dental and skeleton system can be evaluated. At the end of skeletal growth and development, only a few age dependent features like development of third molars and of bones of wrist and hand remain to be used for age estimation by morphological methods, resulting in decrease in accuracy with increasing age. In adulthood, the accuracy of most morphological methods is poor: In this age group a biochemical method based on aspartic acid racemization in dentine offers the most accurate results.

Table-1 shows the methods for age estimation in childhood and adolescence. Table 2 shows recommended method for age determination in adulthood. The detail method for age estimation can be obtained from the cited literature.

 Click here to download tables 1 and 2.

Final remarks

1. The choice of method has to be consider the specific circumstances of the individual cases. In details, the following questions must be clarified to enable an optimal choice: What accuracy is needed? Which age range is to be expected? Are sex, race, and ethnic origin known and to be considered? In cadavers: Which material can be analyzed (Elapsed time since death? Environmental factor? )? In living individuals: Which ethical and legal regulations have to be considered?

2. Published data should not be used uncritically for age determination. Special education and training is required for the application of all effective methods. An adequate calibration by each "user" is to be strongly recommended to avoid systemic errors.

3. Every recommended method is represented by several scientific groups, each of them using their very own methodological protocol and different procedures for evaluation of their method. This leads to several limitations in compatibility, reproducibility and verification. In a time in which quality control has achieved a great importance in all fields of the biomedical sciences it is surprising how few attempts have been made to find common standardization, calibration and evaluation procedures for methods for age determination. At the moment, there are no generally accepted guidelines concerning quality assurance in age estimation. Efforts in these directions are necessary in order to guarantee quality standards and adequate answers to the important legal and social issue of age estimation in forensic medicine.


1. Ritz S, Kaatsch H-J (1996) Methoden der Altersbestimmung an lebenden personen: Moglichkeiten, Grenzen, Zulassigkeit und ethische Vertretbarkeit : Rechsmedizin 6: 171-176.
2. Iscan MY, Loth SR (1989) Osteological manifestations of age in adult. In: Iscan MY, Kennedy KAR (eds) Reconstruction of life from the skeleton. Iley-Liess, New York, pp 23-40.
3. Kerley ER (1970) Estimation of skeleton age: after about age 30. In Stewart TD (ed) Personal identification in mass disasters. Smithsonian Institution. Washington DC, pp 57-70.
4. Ubelaker DH (1991) Human skeleton remains. Taraxacum press, Washington, pp 63-95.
5. Whittaker DK (1990) the principals of forensic dentistry: I. Identification procedures. Dent Update 17: 315-321.
6. Baccino E, Ubelaker DH, Hayek L-ac, Terilli A (1999) Evaluation of seven methods of estimation age at death from mature skeleton remains. J Forensic Sci [In press].
7. Bouvier M, Ubelaker DH (1977) A comparison of two methods for the microscopic determination of age at death. Am J Phy Anthropol 46: 391-394.
8. Dudar JC, Pfeiffer S, Saunder SR (1993) Evaluation of morphological and histological adult skeleton age-at-death estimation techniques using ribs. J Forensic Sci 38: 677-685.
9. Hagg U, Matsson L (1985) Dental maturity as an indicator of chronological age: the accuracy and precision of three methods. Eur J Orthod 7: 15-19.
10. Lucy D, Pollard AM (1995) Further comments on the estimation of error associated with the Gustafson dental age estimation method. J Forensic Sci 40: 222-227.
11. Demirjian A, Goldstein H (1976) New system of dental age maturity based on seven and fourth teeth. Ann Hum Biol 3: 411-421.
12. Demirjian A, Goldstein H, Tanner JM (1973) A new system of dental age assessment. Hum Biol 45: 211-227.
13. Gustafson G, Koch G (1974) Age estimation up to 16 years of age based on dental development . Odont Revy 25: 297-306.
14. Engstrom C, Engstrom H, Sagne S (1983) Lower third molar development in relation to skeleton maturity and chronological age. Angle Orthod 53: 97-106.
15. Kohlar S, Schmelzle R, Loitz C, Puschel K (1994) Die Entwicklung des Weisheitszahnes als Kriterium Der Lebensaltersbestimmung. Ann Anat 176: 339-345.
16. Mincer HH, Harris EF, Berryman HE (1993) The ABFO study of third molar developments and its use an estimator of chronological age. J Forensic Sci 38: 379-390.
17. Pfau RO, Sciulli PW (1994) A method for establishing the age of subadults. J Forensic Sci 39: 165-176.
18. Roche AF, Chumlea C (1988) Assessing the skeleton maturity of the hand wrist: FELS method. Charles C Thomas, Springfield, Illinois.
19. Tanner JM, Whitehouse RH, Cameron N (1988) Assessment of skeleton maturity and prediction of adult height (TW2 method). Academic Press, London, New York, Sen. Francisco.
20. Borrman H, Solheim T, Magnusson B, Kavaal SI, Stene-Johansen W (1995) Iner-examiner variation in the assessment of age-related factors in teeth. Int J Legal Med 107: 183-186.
21. Gustafson G (1950) Age determination on teeth. J Am Dent Assoc 41: 454-54.
22. Gustafson G (1955) Altersbestimmungen an Zahnen. Dtsch Zahnarztl Z 10: 1763-1768.
23. Charles DK, Condon K, Cheverud JM, Buikstra J (1986) Cementum annulation and age determination in homo sapiens. I. Tooth variability and observer error. Am J Phys Anthropol 71: 311-320.
24. Condon K, Charles DK, Cheverud JM, Buikstra J (1986) Cementum annulation and age determination in homo sapiens. II. Estimates and accuracy. Am J Phys Anthropol 71: 321-330.
25. Grobkopf B (1990) Individualaltersbestimmungen mit Hilfe von Zuwachsringen im Zement bodaengelagerter menschlicher Zahne. Z Rechtsmed 103: 351-359.
26. Fu S-J, Fan C-C , Song H-W, Wei F-Q (1995) Age estimation using a modified HPLC determination of Ratio of aspartic acid in dentin. Forensic Sci Int 73:35-40.
27. Helfman PM, Bada JL (1976) Aspartic acid racimization in dentine as a measure of aging. Nature 262:279-281.
28. Mornstad H, Pfeiffer H, Teivens A (1994) Estimation of dental age using HPLC- technique to determine the degree of aspartic acid racimization. J Forensic Sci 39: 1425-1431.
29. Brooks ST (1955) Skeleton age at death: reliability of cranial and public age indicators. Am J Phys Anthropol 13: 567-597.
30. Gilbert BM, McKern TW (1973) A method for aging the female pubis. Am J Phys Anthropol 38: 31-38.
31. Uytterschaut HT (1985) Determination of skeleton age by histological methods. Z Morphol Anthropol 75: 331-340.
32. Yoshino M, Imaizumi K, Miyasaka S, Seta S (1994) Histological estimation of age at death using microradiographs of humeral compact bone. Forensic Sci Int 64: 191-198.
33. Meindl RS, Lovejoy CO, Mensforth RP (1983) Skeleton age at death: Accuracy of determination and implications for human demography. Hum Biol 55: 73-87.
34. Saunders SR, Fitzgerald C, Rogers TL, Dudar C, McKillop H (1992) A test of several methods of skeleton age estimation using a documented archaeological sample. Can Soc Forensic Sci 25: 97-118.

*Corresponding author and requests for clarifications and further details:
Dr. Pankaj Kumar
Department of Respiratory Virology,
VP Chest Institute,
University of Delhi,
Delhi-110007, India.

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