Third Molar Eruption in Dental Panoramic Radiographs as a Feature for Forensic Age Assessment—Presentation of a New Non-Staging Method Based on Measurements

SIMPLE SUMMARY: The aim of the study was to develop a method for assessing the eruption of mandibular wisdom teeth based on measurements, rather than using fixed stages within the framework of the forensic age assessment. A total of 423 dental panoramic radiographs (DPRs) from individuals aged 15 to 25 were examined, and measurements were taken by two independent examiners. It was possible to develop a method comparing the distances between certain dental landmarks and a simplified radiological occlusal plane. The results revealed moderate correlations between these measurements and individuals’ chronological ages. Intra- and inter-rater reliability for the new method were excellent. In conclusion, this study proposes a novel and promising method for assessing the eruption status of mandibular wisdom teeth in forensic age assessment using DPRs. Further research is needed to validate these findings through reference studies. ABSTRACT: The evaluation of third molar eruption in dental panoramic radiographs (DPRs) constitutes an evidence-based approach for forensic age assessment in living individuals. Existing methodologies involve staging morphological radiographic findings and comparing them to reference populations. Conversely, the existing literature presents an alternative method where the distance between third molars and the occlusal plane is measured on dental plaster models. The aim of this study was to adapt this measurement principle for DPRs and to determine correlation between eruption and chronological age. A total of 423 DPRs, encompassing 220 females and 203 males aged 15 to 25 years, were examined, including teeth 38 [FDI] and 48. Two independent examiners conducted the measurements, with one examiner providing dual assessments. Ultimately, a quotient was derived by comparing orthogonal distances from the mesial cementoenamel junctions of the second and third molars to a simplified radiological occlusal plane. This quotient was subsequently correlated with the individual’s age. We estimated correlations between age and quotients, as well as inter- and intra-rater reliability. Correlation coefficients (Spearman’s rho) between measurements and individuals’ ages ranged from 0.555 to 0.597, conditional on sex and tooth. Intra-rater agreement (Krippendorf’s alpha) ranged from 0.932 to 0.991, varying according to the tooth and sex. Inter-rater agreement ranged from 0.984 to 0.992, with distinctions drawn for different teeth and sex. Notably, all observer agreement values fell within the “very good” range. In summary, assessing the distance of third molars from a simplified occlusal plane in DPRs emerges as a new and promising method for evaluating eruption status in forensic age assessment. Subsequent reference studies should validate these findings.