Medical age estimation through evaluation of wisdom teeth on panoramic radiographs, a literature study

Due to lack of identification documents or uncertainty in regard to past life stories asylum-seeking individuals in Sweden are offered medical age estimation by The Swedish Migration Agency to determine if the person is ≥18 years old. The age estimation process consists of two examinations; panoramic examinations of the lower wisdom teeth and magnetic resonance imaging (MR) of the thigh bone. Dentists and medical radiologist assess the radiographs according to a probability scale made by The Swedish National Board of Forensic Medicine and provide separate age assessment that are used to determine whether or not the person of interest is of legal age. The purpose of this review was to evaluate studies that have analyzed wisdom teeth development in panoramic radiographs for medical age estimations and assess if it is a reliable method. Searching the databases PubMed and Web of Science identified included articles. The search resulted in 97 findings. After abstract and full text review 25 studies were included. 13 studies present mean age and standard deviation at different root development stages. Based on this information the proportion of individuals <18 years old presenting fully and not fully developed lower wisdom teeth was compiled. As a mean, a relative small portion of individuals <18 years old presented fully developed roots, though with large spread. Given there are few alternatives, using fully developed lower wisdom teeth as an indicator of age ≥18 years is a reasonably reliable method due to a low risk of assessing someone as adult when minor