Determination of Age

Age of a person can be estimated from 1) Physical or morphological features 2) Study of eruption of teeth 3) Secondary sexual characters 4) Study of appearance and fusion of ossifications centre.

Dental Examination
a) Eruption data b) Root calcification, c) Other: Boydes Method Gustafsens Method

Eruption of tooth
1) Root formation occurs after completion of crown.
2) As the root become longer the crown erupts through bone and finely comes out of the jaw. 3) The tooth calcifies from crown to neck and roots 4) The root of deciduous undergoes resorption until only crown remains, that falls off Fairly accurate information of age can be made. In old age, either the tooth falls off, decayed or the crown is worn away to the sockets.

Teeth Lower central incisor Upper central incisor Upper lateral incisor

Temporary 5-6 month 6-7 month 7-8 month

Permanent 7-8 year 7-8 year 8-9 year

Lower lateral incisor

Canine First premolar Second premolar First molar Second molar Third molar

8-9 month
11/2 year XX XX 1 years 2-21/2 year XX

8-9 year
11-12 year 9-10 year 10-11 year 6-7 year 12-14 years
17-25 years

How to remember ?
Temporary Teeth Eruption Calcification

Lower Central incisor Upper Central incisor Upper Lateral incisor Lower Lateral incisor

6 month. 7 month. 8 month. 9 month.

1.5 - 2yr. 1.5 - 2yr. 1.5 - 2yr. 1.5 - 2yr.

1st Molar
Canine 2nd Molar

1 yr.
1.5 yr. 2 yr.

2- 2.5 yrs.
2.5 - 3 yrs. 3 yrs.

How to remember ?
Permanent Teeth Eruption Calcification

1st molar Central incisor Lateral incisor 1st premolar 2nd premolar Canine

6-7 yrs. 7-8 yrs. 8-9 yrs. 9-10 yrs. 10-11 yrs. 11-12 yrs.

9-10 yrs. 10-11 yrs. 11-12 yrs. 12-13 yrs. 13-14 yrs. 14-15 yrs.

2nd molar
3rd molar

12-14 yrs.
17-25 yrs.

14-16 yrs.
20-23 yrs.

Difference between Temporary and permanent teeth

Features Size & weight Colour Incisor Temporary teeth Smaller, lighter China white vertical Permanent teeth Larger heavier Ivory white Projected forward

Neck
Presence of ridge

More constricted
Between neck & body

Less constricted
No ridge

Root of molars

Smaller & More divergent Longer and less divergent By permanent teeth Twenty Not replaced Thirty two

Replacement Total No.

Period of mixed dentition

Period when both the temporary and permanent teeth are present ,period starts from 6th year when the first molar erupts and till the canine falls i.e. up to 11 yrs.

Refer the chart

Permanent teeth eruption 1st Molar Central Incisor Lateral Incisor 1st Premolar 2nd Premolar 6-7 yrs. 7-8 yrs. 8-9 yrs. 9-10 yrs. 10-11 yrs.

Temporary

Permanent

Total

20 16 12 8 4

+4 +8 +12 +16 + 20

24 24 24 24 24

Canine

11-12 yrs.

+ 24

24

2nd Molar

12-14 yrs.

+ 28

28

3rd Molar

17-25 yrs.

+ 32

32

Wisdom ToothBody of jaw grows posteriorly and the ramus is elongated after eruption of second molar and a space is created for third molar that errupts between 17-25 yrs. The space of third molar should be examined for its hardness.

Impacted tooth

Some time third molar never erupts as the jaw space is inadequate particularly in mandibular third molar that remains trapped called as a impacted teeth.

 Success ional teeth : These are ten in each jaw. Permanent teeth replaces temporary except the permanent premolar that erupts in place of deciduous molars Superadded teeth : Do not have deciduous predecessors and erupt behind temporary teeth All permanent molars are superadded as the first permanent molar erupts while other deciduous teeth are present.

Determination of age after completion of eruption

Boyds method: Method of studying the cross striations which develop in the enamel of teeth till the enamel goes on depositing on the teeth these cross striations lines represent daily incremental lines of the enamel.Usefull to estimate the age of enamel. Stack's Method: Estimation of age of infant from weight and height of erupting teeth of a child. Gustafsons method: In elderly, based on ageing & decaying in teeth. a) Attrition b) Paradentosis c) Secondary dentine d )Root resorption e) Cementom opposition f) Transparency of root Points formula Miles formula Dalizs modification of Gustafsons formula
.

Medico legal aspect of dental study both in living

and dead

Identification of Individual- Age Sex Race Familial setting of the teeth Identification for a longer period because it resists decomposition. Habit of chewing tobacco. Evidence of any missing tooth or artificial denture help in proving identity. Occupation e.g. notch under tooth in Tailor. Grievous hurt- Sec.320 IPC Fracture dislocation of tooth. Poisoning cases- Amount of heavy metals can be detected for a considerable period of time after death. Chr. Phosphorous poisoningPhossy jaw characteristic. Bite marks Help in investigation. Artificial denture. Pink teeth- Teeth are pink in putrefied bodies due staining of hemoglobin products Blood group detection is possible.

Development of secondary sexual characters

Appearance/greying Males Female yrs. of hairs yrs. Pubic hairs Axillary hairs 14-15 13-14 15-16 14-15

Beard & Moustache 16-17 Absent Other body parts Graying of hairs Graying of pubic hairs Balding 17-20 Absent 40 55 45 40 55 Less common

Tanners stages of growth of Pubic hairs

Stages Stage 1 Stage 2 Growth of hairs Prepubertal, no pubic hairs, fine brown vellus hairs Sparse, not extending to mons pubis, light pigmented at base of penis Darker coarse extending on to mons pubis pigmented and start curling and spreading Age <12 yrs. 12-13 yrs.

Stage 3

13-14 yrs.

Stage 4

Covering most part but not going 14-15 yrs. up to thigh

Stage 5

Dense hairs extending to the inner thighs and dark mature pubic hairs

>15 yrs.

Hoarseness of voice occurs in boys between 15-17 yrs. of age. Stature of person starts decreasing after 25 yrs. of age at the rate of 1mm.per year. Menopause in woman comes between 41-45 yrs. of age.

Development of Breast
Elevated as a small mound and there is a enlargement of areolar diameter 11-12 yrs.

More elevation of breast and papillae and enlargement of areolar diameter

Areola and papillae project over the level of breast Only papillae project over the level of breast Only papillae project over the surface and areola merges in to the breast

13 yrs.

14 yrs.

15 yrs.

15-16 yrs.

Appearance of and fusion of ossification centres.

X-ray advised for determination of age, Below 10 years- a) Both elbow joint. b) Both wrists Joint. Between 10 to 20 years-a) Both elbow joints b) Both wrist joints c) Pelvis AP views. 3) Above 20 years a) Chest AP & Lat. View. Showing medial ends of clavicles Sternum with xiphoid and manubrium and vertebral column. b) Skull ( AP & Oblique profileview ) Showing cranial sutures and calcification of root of teeth.

Wrist Joint
Ossification centre Appearance (Yrs.) Fusion (Yrs.)

Pisiform bone
1st Metacarple Lower end of Radius Lower end of Ulna No of Carpal bone(5)

9-12
3 1 8-10

(12-17)
(4) (1) (10-11) 14-16 16 -18 17 (16-18) (16-17) (18)

No. of carpal bones

= Age in years +1

Carpal Bones Appearance S - Scaphoid L - Lunate T - Triquetrum P - Pissiforem T - Trapizium 5 years 4 years 3 years 9 12 years 5 years

T - Trapizoid
C - Capitate H - Hamate

6 years
2 months 2 years

Carpal Bones Appearance

S - Scaphoid
L - Lunate T - Triquetrum P - Pissiforem T - Trapizium T - Trapizoid C - Capitate H - Hamate

5 years
4 years 3 years 9 12 years 5 years 6 years 2 months 2 years

Elbow joint
Ossification centre Appearance (Yrs.) Fusion (Yrs.)

Lat.Epicondyle

10

(12)

10-12 yrs with Capitulum (11-16)

Med. Epicondyle
Head of Radius Tip of Olecrenon process of ulna

5
6 9-12

(7)
(8)

14 yrs with shaft (16)

14 yrs. (16) (17)

(11-13) 15 yrs.

Hip Joint
(Female)
App. Head of Femur Grater Trochantor Lesser Trochantor Iliac crest Ischial Tuberosity 1 3 1 14 14-16 Fusion yrs. 14-15 15-17 14 17-19 20

Triradiate cartilage

14 - 15

Appearance of Centers of ossification:

Lower end of femur :- 9th month of intrauterine life (IUF )

Upper end of tibia- just before birth Diameter of centre is 2-5 mm at 37-38 wks & 6-8 mm. in full term Foetus.

Knee Joint

Upper end of Tibia

14 - 15

(15-17) (11-16) (14-17)

Upper end of Fibula 14 - 16 Lower end of femur 14 17

Ankle joint
App. Lower end of Tibia Lower end of Fibula 1 1 Fusion yrs. 14-15 14-15

Metatarsals Tarsal phalanges Calcaneum Cuboid Talus

3 1-3 5 IU 10 IU 7 IU

14-15 16-18

Fontanalle: Posterior fontanelle closes between 1.5 to 2 months. Anterior fontanelle closes by 2nd year. Posteriolateral fontanelle closes within short period after birth. Anterolateral fontanelle closes within first 6 months after birth Metopic suture: Closes between 2-4 years, some times may remain intact. Basi occiput suture: fuses with Basi sphenoid by about 18-20 yrs. in female, 20-22 yrs in male .

Coronal, sagittal & lambdoid suture starts to close on their inner side at about the age of 25 yrs

Closure of sutures begins on the inner side 5-10 yrs. earlier than on outer side.
Outer side of vault - - Posterior 1/3 of sagittal-- 30 years - Ant 1/3 sagittal & lower of coronal -- 40-50 years - Middle 1/3 of sagittal + upper coronal -- 50-60 years Lambdoid suture Closure completes by -- 45 years.
Sqamous part of temporal fuses with neighbouring bones

-- 60 years

For confirmation of age between 14-25 yrs. 14 yrs. Patella completely ossifies 14-25 yrs. Sternum fusion takes place below upwards. 15-16 yrs. Elbow joint 16-17 yrs. Ankle joint

17-18 yrs. Hip joint

18-19 yrs. Knee, shoulder, inner end of clavicle centre appears. 18-20 yrs iliac crest. 21 yrs 22 yrs. Fusion of ischial tuberosity and inner side of clavicle. Epiphyseal union of sternal end of clavicle

Other factors that are helpful for estimation of age: Thyroid and cricoid cartilage tend to ossify by 45-50 yrs. The fusion of cornua with the body of hyoid bone occurs after 40 yrs. Lipping of the body of lumbar vertebra starts around 4050 yrs. Atrophic changes in inter vertrible discs starts around 50-60 yrs. Arcus senalis i.e. an opaque zone around the periphery of cornea may be noticed around 60 yrs. Graying of pubic hairs are more reliable and usually starts after 60 yrs.

To, The-----------------------------------Reference: Name: Age stated:---------- Sex:--------------- Occupation:-------------------Address:-----------------------------------------------------------------------Brought by Police constable:---------------------No.----------,P.S.----------Identified by:-------------------------------------------------------------------------Date and Time of examination:------------------------------------------Place of examination:-----------------------------------------------------Consent:----------------------------------------------------------------------If minor below 12 yrs. consent by parents/Guardian Examined in presence of:----------------------------------------------(If female) Signature of female attendent Identification marks:1)------------------------------------------------------2)------------------------------------------------------Birth Date:----------------------- Education:--------------------------------

Physical Examination: 1) 3) 5) 6) 7) 8) 9)

Height: 2) Weight: Chest girth at the level of nipple------------- 4) Abdominal girth at the level of navalGeneral built and appearance:----------------------------------------------------------------------Hairs: Pubic:------------, Axillary:---------------, Facial:------------, Scalp:---------------Development of breast:---------------------------Development of genitals:-------------------------Onset Of Puberty: Voice:--------------Adams apple:----------------Date of menarche:----------------Regularity of menses:--------10) Dental Status: Modified FDI Method

21 11 31 41
1) Any other findings: Skin: Eye: Others:
2) Advise X-ray: X-ray plate no..

Date:

Age Certificate
To The ---------------------------------------------Reference: Age estimation of ------------------------------------------------- dated
Sir, I, Dr. ------------------------------------------, after going through the findings of ----------------------------------------------------------------------------------------physical examination report no.---------------------------,dated --------------X ray plate No. -----------------------------------------------,dated --------------Radiological examination report no.----------------------,dated--------------And the date of birth certificate no.-----------------------,dated --------------Produced before me, I am of the opinion that the individual's age is about --------------years. Signature ( Dr. Designation Regd. No.

Place:----------------Date: ------------------

Medico legal importance of Age

1) Criminal responsibility:- Liability for punishment, 82 IPCunder 7yrs. Not an offence. 83 IPC 7 to 12 yrs. Capable of committing offence. Railway Act:- Above 5yrs. Offence.( If destruction of Railway Property) 89 IPC:- Under 12 yrs.-Can not give a valid consent (Act done in good faith & for its beneficiaries. 87 IPC: - Above 18 yrs.-Can give valid consent.( to suffer any harm which may result from act not intended or not known to cause death or grievous injury) 2) Judicial Punishment- Juvenile justice act 2000Juvenile (Boys/Girls) below 18 yrs.Juvenile in conflict with Law Juvenile offender.

Medico legal importance con3) Kidnapping: It is removing a person from a lawful guardianship 1) Child less than 10 yrs- S.369 IPC 2) Less than 16yrs.of boy & less than 18 yrs of girlS.361IPC. a) With intension of taking any movable property b) Kidnapping of minor for the purpose of begging. c) To procure a girl for prostitution if she is less than 18 yrs S366IPC d) To import a girl to India for illicit intercourse if she is less than 21 yrs.

4) Rape: - 375 IPC Girl under 15 yrs.if she is his own wife. Girl under 16 yrs. even if she has given consent. 5) Child marriage Restraint Act.

Medico legal importance con.6) Attainment of majority Indian majority act-On completion of 18 yrs.

7) Employment- Factory Act 1984 -below 14yrs. cannot be employed On completion of 15 yrs.certificate of fitness is required. 8) Infanticide9) Criminal abortion Stages of development of product of conception. 10) Competency as witness - No age limit. 11) Impotence & Sterility12) Identification.

Provisional Age Certificate On clinical examination of the individual, age is about ----------years. However, the final opinion regarding the age should be collected from This office after submission of the Radiological report and the birth

certificate.
Place:---------

Signature Name (Dr. Designation Regd. No.

Date:-----------

Medico legal importance of Age:

Age > 7 months (IUL) > 5 yrs. MLE Infanticide IPC Sec/ Act Sec 300 IPC Remarks Viability is attained

Criminal responsibility Criminal responsibility Criminal responsibility Consent

Railway act

Punishable for offence

>7 yrs.

Sec.82 IPC

No criminal intent & not guilty of the crime Guilty of offence if sufficient maturity & understanding present Parents / guardians must give consent for physical examination

7-12 yrs.

Sec 83 IPC

<12 yrs.

Sec 89 IPC

>14 yrs.
14-15 yrs.

Employment
Employment

Factory Act
Factory Act

Can not be employed in factory job.

Non hazardous jobs in factory during day time given

>15 yrs.

Employment

Factory Act

Can be employed provided fitness certificate is given. Sexual intercourse with his own wife with or without consent Sexual intercourse with a girl with or without consent Sent to reformatory school.

<15 yrs.

Rape

Sec. 375 IPC

<15 yrs.(girls)

Statutory rape

Sec. 375 IPC

<16 yrs.(boys)

Judicial punishment Kidnapping

Juvenile justice 1986 Sec.361 IPC

<16 yrs.(boys)

Taking away without the consent of lawful guardian. 10 yrs. imprisonment with or without fine. Procuring a girl for illicit intercourse 10 yrs. imprisonment with or without fine Can consent to suffer any harm not intended or known to cause death/grievous hirt. Except those under the guardianship of court can make a valid, will cast vote in election.

<18yrs.(girls) <18yrs.(girls)

Kidnapping Kidnapping

Sec.361 IPC Sec. 366 IPC

>18yrs.

Consent

Sec. 87 IPC

>18 yrs.

Attainment of majority

Sec.3 India majority act.1875

>18 yrs(girls)

Marriage

Child marriage restraint act 1978

> 18 yrs.

Employment

Minimum age to enter govt. services.

<21Yrs.(girls)

Kidnapping

Sec.366-B IPC

Procuring girls from outside the country or from Jammu & Kashmir for illicit intercourse. Punishment -10 yrs. imprisonment with fine.

>21yrs.

Attainment of majority

Sec. 3 Indian Majority Act 1875

For those under guardianship of court.

>21 yrs.

Marriage

Child marriage restraint act 1978

55-65 yrs.

Employment

Age of retirement