ABSTRACT
En la última década, la odontología forense se ha enfocado en el desarrollo de metodologías para la estimación de edad (EE) debido a la gran demanda en procesos identificatorios. Entre esas técnicas, el conteo de anulaciones del cemento dental (TCA) ha ofrecido resultados promisorios, pero también contradictorios que han generado dudas sobre su precisión y confiabilidad. El objetivo de este trabajo fue caracterizar, establecer alcances, e identificar las limitaciones del conteo de TCA según los actuales estándares normativos y metodológicos. Se realizó una revisión con búsqueda sistemática del método de conteo de TCA para EE incluyendo estudios experimentales y notas técnicas en las bases PubMed/Medline, Scopus, Web of Science (WoS) y Embase. Se emplearon los términos "estimation", "age" y "cementum", con búsqueda manual complementaria en Google Scholar. Se excluyeron revisiones, estudios en colecciones arqueológicas, estudios radiológicos y cartas al editor. La búsqueda arrojó un total de 273 artículos, seleccionándose 27 que cumplieron con los criterios de inclusión. La mayoría de los estudios fueron publicados en Asia, particularmente en India (n=21). Sólo 6 artículos declararon el número total de individuos, tipos de diente y de cortes histológicos, siendo el premolar el más estudiado. Apenas dos artículos evaluaron la calidad de la muestra a analizar mediante legibilidad de los cortes obtenidos. El test más empleado para evaluar la precisión del método fue el coeficiente de correlación de Pearson (n=21). Estos hallazgos exponen la alta heterogeneidad reportada en las metodologías de EE mediante conteo por TCA, por lo que aún no existe un proceso estandarizado que abarque todas sus etapas y entregue resultados confiables siguiendo los estándares jurídicos actuales para la evidencia científica. Un mayor control de las limitaciones técnicas detectadas aumentará el valor como prueba en un contexto identificatorio legal o forense.
SUMMARY: In the last decade, forensic odontology has focused on the development of age estimation (AE) methodologies due to the great request in identification processes. Among these techniques, the tooth cementum annulation (TCA) count method has offered promising but also contradictory results, raising questions about its accuracy and reliability. The aim of this work was to characterize, establish the scope, and identify the limitations of the TCA count method according to the current normative and methodological standards. A scoping review was carried out for TCA count methods for AE, including experimental studies and technical notes in the PubMed/Medline, Scopus, Web of Science (WoS) and Embase databases. The terms "estimation", "age" and "cementum" were used, with a complementary manual search in Google Scholar. Reviews, studies in archaeological collections, radiological studies and letters to the editor were excluded. The search yielded a total of 273 articles, selecting 27 of them that met the inclusion criteria. Most of the studies were published in Asia, particularly India (n=21). Only 6 articles declared the total number of individuals, types of teeth, and histological sections, with the premolar being the most studied. Only two articles evaluated the quality of the sample to be analyzed through the legibility of the cuts obtained. The most widely used test to assess the precision of the method was the Pearson correlation coefficient (n=21). These findings expose the high heterogeneity reported in EE methodologies by counting TCA, so there is still no standardized process that covers in all its stages and delivers reliable results following current legal standards for scientific evidence. More control of the detected technical limitations will increase the value as evidence in a legal or forensic identification context.
Subject(s)
Humans , Age Determination by Teeth/methods , Dental Cementum/anatomy & histology , Forensic DentistryABSTRACT
Introduction: Periapical cemento-osseous dysplasia is a pathologic entity resulting from bone and cementum reactional process which affects the periapical region of the anterior mandible. Its etiology is not fully understood, but possibly it is related to an unusual bone and cementum response to some local factor. Objective: The aim of this study is to present a case of periapical cemento-osseous dysplasia. Case report: A 50 years-old female patient sought for dental care due to pain in the lower right premolar region. The panoramic radiography revealed the presence of an extensive radiolucent lesion with radiopaque areas located between the roots of the teeth #43 and #35. Teeth presented vitality and it was not observed any changes involving the periodontal ligament. Periapical cemento-osseous dysplasia diagnosis was established through clinical and radiographic features. Periapical cemento-osseous dysplasia does not require any treatment unless complications occur. Patient's complaint of discomfort was related to occlusal imbalance and was solved after the occlusion reestablishment. The patient was radiographically followed-up for 12 months and the lesion exhibits satisfactory signs of healing. Conclusion: The dentists need to be aware of asymptomatic intra-osseous lesions affecting the anterior region of mandible not to misconduct the diagnosis that could compromise the patient's oral health.