Reliability of a forensic odontology method for age-at-death estimation in adults: a Mexican case study

This study aimed to evaluate the reliability of an age estimation method based on the pulp⁄tooth area ratio by assessing intra- and inter-examiner agreement across five observers at different intervals. Using the same X-ray device and technical parameters, 96 digital periapical X-ray images of upper and lower canines were obtained from 28 deceased people in Central America, whose age at death ranged from 19 to 49 years. Excellent and good agreement of results were achieved, and there were no statistically significant differences. The R2 value for upper teeth (54.0%) was higher than the R2 value for lower teeth (45.7%). The highest intraclass correlation coefficient value was 0.995 (0.993–0.997) and the lowest 0.798 (0.545–0.895). Inter-examiner agreement was high with values of 0.975 (0.965–0.983) and 0.927 (0.879–0.955). This method is adequate for assessing age in missing and unidentified people, including victims of mass disasters.