Medicolegal and Physiological Age Estimation by Third Molar Development Using Demirjian Classification and Its Correlation with Physiological Markers of Growth and Puberty Among Students Aged 17–25 Years at Ayub Medical College, Abbottabad
DOI:
https://doi.org/10.65761/pjcr.2026.351Keywords:
Age estimation; Demirjian classification; Forensic odontology; Third molar development; Chronological age; Pubertal maturation; Medicolegal age assessmentAbstract
Background: Age estimation is essential in forensic dentistry, particularly for determining legal adulthood. Third molar development is a useful biological marker during late adolescence, although its relationship with physiological growth and pubertal maturation remains unclear.
Objective: To evaluate third molar development using Demirjian classification and its association with chronological age, anthropometric parameters, and pubertal maturation among students aged 17–25 years.
Methods: This analytical cross-sectional study was conducted at Ayub Medical College, Abbottabad, from April to August 2025 and included 100 students. Panoramic radiographs were assessed using Demirjian stages A–H. Chronological age, anthropometric measurements, and self-reported pubertal milestones were recorded. Statistical analyses included Spearman correlation, Mann–Whitney U, chi-square, and receiver operating characteristic (ROC) curve analyses. Statistical significance was set at p < 0.05.
Results: Participants had a mean age of 20.99 ± 2.33 years, with equal male and female representation. Demirjian stage H was observed in 72% of participants, increasing from 28% among those aged 17–18 years to 100% among those aged 23–25 years. Third molar development correlated significantly with chronological age (ρ = 0.629, p < 0.001), but not with height, weight, body mass index, or reported pubertal milestones (all p > 0.05). At the 18-year threshold, stage H showed 78.4% sensitivity, 75.0% specificity, 95.8% positive predictive value, and 78.0% classification accuracy. The ROC area under the curve was 0.810.
Conclusion: Third molar maturation may support forensic age estimation; however, individual developmental variability and the limitations of a single dental indicator must be considered when assessing legal adulthood.
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