Bone age and dental age to assess criminal responsibility: Part II.

Introduction: Age estimation is vital in dentistry and legal contexts to determine minors' criminal responsibility. This study aimed to estimate and classify bone and dental age in a Portuguese population, using the Greulich-Pyle method and the Moorrees Fanning and Hunt method, comparing the accuracy of both methods.

Materials and methods: 597 left hand and wrist radiographs and 184 orthopantomographs were selected, and the methods were applied.

Results: Cohen's weighted kappa coefficient ranged between 0.890 and 1. Both methods underestimate age. The linear regression formulas showed strong correlations between estimated and real age (0.902 for bone age assessment and 0.894 for dental age assessment). For the bone assessment the accuracy is highest at 14 and 18 years, with similar values to those at 12 and 16. The AUC shows that the method is more reliable at 12 and 14 years. For the dental age assessment, a lower sensitivity value was observed for the age of 12 (73.91%) and a higher for 18 years (91.03%), increasing with age. The accuracy was higher at 12 years (89.62%) and lowest at 18 years (83.02%). Specificity values were higher for ages 12 and 14 (93.98% and 95.24%, respectively). The lowest AUC value was recorded for 18 years (0.889), while for ages 12, 14, and 16, the values were similar, indicating lower reliability for the legal age of 18.

Conclusion: For individuals under 12, 14, 16, and 18 years old, the bone method is the most effective. However, combining both methods allows greater accuracy and consistency in age estimation for medico-legal applications.