Presentation on theme: " Legal Medicine Journal Club Alejandro Garcés Descovich Emily Rincón Álvarez Jorge Enrique Ruíz M Universidad de La Sabana Legal Medicine XI Semester."— Presentation transcript:
Legal Medicine Journal Club Alejandro Garcés Descovich Emily Rincón Álvarez Jorge Enrique Ruíz M Universidad de La Sabana Legal Medicine XI Semester April 24th of 2010
KEYWORDS: Forensic age estimation Criminal proceedings Dental age Skeletal maturity
CONTENT INDEX 1. Introduction 2. Materials and Methods 3. Results 4. Discussion 5. Conclusions 6. Questions time
INTRODUCTION Estimating the age of living subjects as a problem Difficult problems facing forensic medicine Criminal Proceedings Doubt (Authorities) Charging of a crime according to age
INTRODUCTION The need for accurate age estimation techniques has never been greater due to armed conflicts in many countries in our time Immigrants Asylum-seekers
INTRODUCTION Time consuming task that requires interdisciplinary approach. Physicians with forensic experience Knowledge of Auxology Radiology Dentistry Legal Medicine
INTRODUCTION Main objective Differences between Skeletal Dental age assesments Comparison of left hand/wrist radiographs and OPG’s
A = Calcification of oclusal points. B = Fusion of the calsification points C = End of formation of the enamel. D = Formation of the crown. E = The lenght of the root is shorter than the height of the crown. F = The lenght of the root is the same that the crown. G = the end of the formation of the root. H = Closing of the apical orifice. DERMIRJIAN METHOD
MATERIALS AND METHODS Originated from areas with major world conflict The Balkans (Slovenia, Serbia, Croatia) Albania Middle East (Palestine, Lebanon, Iran, Iraq, Egypt) (Algeria, Morocco, Nigeria).
MATERIALS AND METHODS Data: May 1989 to September 2007 Clinical assessment of the individuals Physical examination (Body Mass Index) Signs of sexual maturity (Tanner Staging System)
MATERIALS AND METHODS Data: Skeletal development Radiologic exam of Left hand/wrist (Greulich-Pyle method) Dental examination Inspection oral cavity OPG’s (Panorex) Pelvic X-ray (23 individuals)
RESULTS 26 of the 52 individuals Reported ages lower than the assessed ages. In 43 of all cases, the reported age was 18 years, but only 17 were confirmed by radiographic examinations OPGs Hand/wrist X-rays In 26 cases age estimation the individuals were older than had been reported.
Case no. 25: Reported age: 16 years and 8 months Estimated biological age: 22 years and 6 months Discrepancy in reported age was 5 years and 10 months
RESULTS Statistically significant difference between: Reported age and assessed biological age (t = 4.085; p < 0.001) No statistically significant difference between: Skeletal age and assessed dental age (t = 0.791; p = 0.431).
DISCUSSION Analysis of the data revealed: Significant correlation between: Results from: Left hand/wrist X-rays OPGs Almost every individual, indicating: Similar growth patterns: Skeletal Dental structures Younger than 16 years THE OLDER A SUBJECT BECOMES = THE LESS ACCURATE THE METHODS ARE
DISCUSSION Markers for: Bones Teeth Sexual development The only reliable indices for assessing a living individual’s age in forensic settings.
DISCUSSION Sexual development markers + BMI Is not appropriate for age estimation (Variability) Diseases (disproportionate growth) Result of malnutrition Congenital disorders Physical examination (Empirical)
DISCUSSION X-rays represent the most objective method Assessing dental and bone maturity. Immigrants in an attempt to avoid criminal prosecution Report their ages as younger than they actually are.
CONCLUSIONS Standardization of methods used in the age estimation of living individuals is imperative. All of the techniques employed to asses age in a living individual Estimates of Biological age Doesn’t certains chronological age
CONCLUSIONS Differences in the rate of ossification in various age-groups Primarily the result of: Socioeconomic factors A careful approach to age determination is necessary Few physicians are skilled in forensic age determination. Entrust expert pathologists with the task of performing age assessment
QUESTIONS??? 23rd of April “Day of the Language” WE APPRECIATE YOUR COMMENTS