EXAMINATION FOR

DETERMINATION OF AGE

DR. CHAITANYA V. TINGNE

MBBS; MD (FM)
ASSOCIATE PROFESSOR
DEPARTMENT OF FORENSIC MEDICINE
GMC, ALIBAG - RAIGAD
 IN CIVIL CASES
• Identification
• Employment
• Marriage
• Majority
• Management of property
• Testamentary capacity
 IN CRIMINAL CASES
• Rape
• Criminal abortion
• Infanticide
• Abduction
• Prostitution
• Juvenile offenders
• Criminal responsibility
• Competency as witness
PROFORMA FOR EXAMINATION
Preliminaries
• To,
Name of investigating officer
Name of police station
• Reference- letter no, date
• Name
• Age as stated
• Sex
 PROFORMA

• Occupation –
• Factories act1948
• Adult –who had completed their 18 years
• Adolescent – 15-18 years
• Children> 14yrs but<15 yrs
• Note - Child below 14yrs is not allowed to work in
factory, mines or any hazardous employment
 PROFORMA

• Address-
• Brought by police constable (name, no, police station)
• Identified by (name of person)
• Date and time of examination
• Place of examination
 Consent
• Question (in the language the person giving consent
understands):
• Are you willing to be/to have your son / daughter /ward /wife
physically examined by me, and to undergo radiological
examination/ to have him /her radiologically examined to
estimate your /his/her age for the purpose of________ Knowing
that you have right to refuse, but that such refusal may go
against you?
 Consent
• Answer given: Yes / No
• (If age is apparently less than 12 years, then consent of the
parent / guardian is mandatory)
• Signature / thumb impression of person giving consent:
• Name & signature of witness to consent:

• If person being examined is female, name & signature of

female attendant / Doctor present during examination.
 IDENTIFICATION MARK
• Identification mark (at least 2 ID marks) (complete description as to
shape, colour, nature, dimensions, and location with respect to 2 fixed
anatomical landmarks):
• 1] Mole- A black, circular, elevated, non hairy mole of size 0.3 cm in a
diameter was present over the right zygomatic region of the face 4 cm
above the right angle of mandible.
• 2] Tatoo mark- A green tattoo mark of design “lord hanuman” of size 8
cm x 5 cm, 4 cm below the left elbow joint was present on the flexor
aspect of upper part of left forearm.
 PROFORMA
• Date of birth:
• Any documentary evidence produced: Yes / No-
• If yes, nature:
• Documentary evidences are birth certificate, living
certificate, H.S.C. and S.S.C. certificate, passport, voting
card, driving licence

• Education
 AGE DETERMINATION
I. General physical examination.
II. Development of secondary sexual characters.
III. Development and eruption of teeth.
IV. Ossification of bones.
I. GENERAL PHYSICAL EXAMINATION

• Height
• Weight
• Chest girth at nipple level
• Abdominal girth at the level of navel
• General built and appearance
 Mean Height and Weight in Indian Girls
Age in Years Mean height in cm Average ± 2 SD in cm Mean weight in kg Average ± 2 SD in kg

6 118 107-128 20 15-28

7 120 109-131 22 16-30

8 126 114-138 24 16-36

9 132 119-145 28 20-42

10 138 124-152 37 22-50

11 144 130-158 39 25-56

12 151 137-165 41 27-63

13 159 145-172 46 31 –65

14 160 147-174 50 35-70

15 161 148-175 54 35-72

16 162 149-175 55 39-75

17 163 150-175 56 41 -80

18 163 –164 151-175 57 42-80

 Mean Height and Weight in Indian Boys
Age in Years Mean height in cm Average ± 2 SD in cm Mean weight in kg Average ± 2 SD in kg

6 116 106-125 21 16-26

7 121 112-132 23 18-30

8 127 116-138 26 19-35

9 132 120-143 28 21-40

10 138 125-150 31 22-46

11 146 132-161 35 23-49

12 150 135-160 40 27-60

13 157 140-173 45 30-67

14 163 146-180 51 35-75

15 169 152-185 57 40-82

16 174 160-188 62 45-88

17 176 163-189 66 49-95

18 177 164-190 69 51-97

 II. SECONDARY SEXUAL CHARACTERS IN
FEMALES
• Development of breast
• Axillary hair- (Absent/Downy/Sparse/Black/Rich/Bushy)
• Pubic hair- (Absent/Downy /Sparse/Black/Rich/Bushy)
• Menarche-
• If menarche attained yes /no
• Date of last menstrual period
• Mestrual cycle- Regular/ irregular/30 days cycle/ blood PV for
how many days
External genitalia- female look for the prominence of the labia and
mons pubis)
 SECONDARY SEXUAL CHARACTERS
MALES
• Moustache (Absent/Downy/rough/Sparse/dense/Black)
• Beard
• Axillary hair
• Pubic hair
 SECONDARY SEXUAL CHARACTERS
• Graying of scalp hairs starts at temporal region around 40yrs
followed by hairs of beard, moustache & chest. Baldness appears
around 50yrs.
• Graying of pubic hairs starts at 55 yrs.
• Voice - (Deep or soft)
• Adam's apple- (Prominent/not prominent)
• External genitalia - (In male, look for the development of penis
and pendulousness of scrotum;
• History of Ejaculation-
 TANNER STAGING OF PUBIC HAIRS
Stage 1 Pre-pubertal NO PUBIC HAIR, fine brown villous hair (<
12 years)
Stage 2 SPARSE not extending on to mons pubis, light pigmented
(12-13 years)
Stage 3 DARKER, COARSE extending on to mons pubis,
pigmented, start curling and spread (13-14 years)
Stage 4 COVERING MOST PARTS but not going up to thighs (14-
15 years)
Stage 5 Dense hair extending to the INNER THIGHS, Mature pubic
hair (> 15 years)
 TANNER STAGING OF BREAST DEVELOPMENT
Stage 1 Prepubertal – ELEVATED PAPILLA, small fat areola (not
seen before 9-10 years)
Stage 2 Papilla forms a PALPABLE NODULE (Breast bud) (10-11
years)
Stage 3 Breast DEVELOPMENT BEYOND THE AREOLA,
contour of breast not defined (by 13 years)
Stage 4 CONTOUR OF BREAST WELL DEFINED, more breast
(by 13 years development with elevation of the Areola
double mound
Stage 5 MATURE BREAST -more breast development with loss
(by 15-16 yrs) of double mound, papilla project as nipple
 PROFORMA
• Dental status
• Any other finding- skin, eyes, other
• Advised x-ray –
• X-ray plate no.
• Date
III. DEVELOPMENT & ERUPTION
OF TEETH
 DENTAL EXAMINATION
• The tooth eruption in oral cavity occurs when the root is
almost half formed. As the root becomes longer, the
crown erupts through the bone and is seen outside of the
jaw in an oral cavity.

• Degree of formation of root and crown structures, the

stage of eruption and the intermixture of temporary and
permanent teeth are helpful in estimating age from birth to
25 years.
 DENTAL EXAMINATION
• The x-ray of the jaw would show developmental
status of unerupted teeth and the degree of root
completion in erupted teeth.

• Crown and root development of the second molar,

and third molar- helpful for 8 - 21 years.
 TEMPORARY TEETH

10 TEMPORARY TEETH IN EACH JAW

4 incisors,
2 canines &
4 molars
(no premolars, no 3rd molar).
 TEMPORARY TEETH ERUPTION
Teeth Time of eruption
Central incisor (Lower) 6 - 8months
Central incisor (Upper) 7 – 9 months
Lateral incisor (Upper) 9 -10 months
Lateral incisor (Lower) 10 – 12 months
1st Temp. Molar 12 - 14 months
Canines 17 -18 months
2nd Temp. Molars 20 - 30 months
 PERMANENT TEETH

16 PERMANENT TEETH IN EACH JAW

4 incisors,
2 canines,
4 premolars &
6 molars.
 ERUPTION OF PERMANENT TEETH
Teeth Time of eruption
1st molar 6-7 years
Central incisor 6-8 years
Lateral incisor 7-9 years
1st bicuspid 9-11 years
2nd bicuspid 10-12 years
Canine 11-12 years
2nd molar 12-14 years
3rd molar 17-25 years
 SPACE FOR THIRD MOLAR
In females- 15-16 years. In males- after 16 years of age.
 RADIOLOGICAL ASSESSMENT OF TEETH
DEVELOPMENT
• Made by viewing X-ray films.
• Orthopantomogram- provided the facility is available.
• Otherwise, X-ray of the oral cavity- Oblique tangential view with
the mouth open.
• A tooth erupts in an oral cavity only when there is a half root
formation inside the jaw.
• Teeth develop earlier in females in comparison to males.
• The germination centre of the third molar appears between 7 and 9
years.
 CHARTING OF TEETH
● Universal system- Teeth are numbered 1to 16 from right
to left and 17 to 32 from lower left to lower right

RIGHT SIDE LEFT SIDE

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
 CHARTING OF TEETH
● PALMAR NOTATION

RIGHT SIDE LEFT SIDE

8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
 CHARTING OF TEETH
● HADERUP SYSTEM
● It is similar to Palmer notation except that it uses a (+)
sign for upper teeth and (-) lower teeth
RIGHT SIDE LEFT SIDE

+8 +7 +6 +5 +4 +3 +2 +1 +1 +2 +3 +4 +5 +6 +7 +8

-8 -7 -6 -5 -4 -3 -2 -1 -1 -2 -3 -4 -5 -6 -7 -8
 CHARTING OF TEETH
• FDI (Federation Dentaire Inetrnationale)-
• FDI system substitutes for permanent teeth
RIGHT SIDE LEFT SIDE

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28
48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38
2nd
temporary
molar
appeared
Mixed dentition-
first molar
appeared
2nd
Permanent
molar
appeared
 PROVISIONAL AGE CERTIFICATE
• On clinical examination of individual, age is ____ years. however,
the final opinion regarding the age should be collected from this
office after submission of radiological report.

Date and place Sign. name and designation of doctor

 (IV) OSSIFICATION OF BONES
• Bone ossification, or osteogenesis, is the process of bone
formation. This process begins between the sixth and
seventh weeks of embryonic development and continues
until about age twenty-five; although this varies slightly
based on the individual.
• There are two types of ossification centers - primary and
secondary.
 X-RAY FINDINGS IN BONES
• In long bones, the appearance and fusion of epiphyses can be
evaluated for the purpose of age estimation. The findings can be
described as:-
“no fusion”
“fusing”
“recently fused:
“fused”.

• X-ray of the hands, wrists, elbows, shoulders, feet, ankles, knees,

the pelvis, and hip joints are very useful.

• The fusion of bones takes place 1 year earlier in females than in

males.
SK
 HOW TO REMEMBER

SK 18
Pisiform 11 yrs (A)
Iliac crest 19 yrs
• Head and greater
tuberosity have
appeared but not
fused
• Age <18 years.
• Head fused
• Age >18 years.
Lower end of humerus, upper ends of radius and ulna not fused
Age <16 years
Lower end of humerus,
upper ends of radius and
ulna not fused
Age <16 years
 Lower end of
humerus, upper
ends of radius and
ulna fused
Age > 16 years
Pisiform appeared
(>11yr), Lower
ends of radius and
ulna not fused
Age < 18 years
Lower ends of
radius and
ulna not fused

Age > 18
years
Upper end of
femur not
fused
Age < 16
years
Upper end of femur
not fused
Age < 16 years
 Upper end of
femur fused
Age > 16 years
 Lower end of
femur, upper
ends of tibia
fibula not fused

Age < 18 years

 Lower end of
femur, upper
ends of tibia
fibula not fused

Age < 18 years

Lower end of
femur, upper
ends of tibia
fibula fused
Age > 18 years
 Lower tibia
fibula not fused

Age < 16 years

 Lower tibia
fibula fused
Age > 16 years
 STERNUM
• Sternum body has 4 centers since birth, which unite from below -> upwards
direction.
3rd and 4th parts unite at 15 years.
2nd and 3rd unite at 20 years.
1st and 2nd parts unite at 25 years.Manubrium unites with body of sternum at
60 years.
• Tip of Xyphoid process appears at 3 years and unites at 40 years with body of
sternum.
 OPINION OF AGE
• Provisional age certificate immediately
• Send for X-rays with id marks on requisition form
• Final report after radiologists opinion(3-4hrs)
• Range should be 6months to 1year and not more upto 25
years