Various age estimation methods in the living and

dead and importance of age estimation

Bruk .G

Feb 22 2025 GC
 Various age estimation mechanism in the
living and dead and importance of age
estimation
 Outline
 Introduction
 Methods of Age determination
 Medico legal Importance of Age
 Introduction

 Identification:- is determination of the individuality

of a person based on certain features or
characteristics.
 May classified as
i. complete- exact fixationof individuality
ii. Partial- to ascertain only some features
 Identification is necessary in

 In livings
 In recently dead
 In decomposed and mutilitated body
 In skeleton and fragments
 Age determination in different age category

 Age determination in fetus

 Age determination in infancy, childhood and dults
upto age 25
 Age determination in adults above 25
  Determination of Age in Fetus
 Gestational age
 Prenatal period
i. zygote – 0 to 14 days
ii. Embryo – 14 days to 8 weeks
iii. Fetus – 9 weeks to birth
 Perinatal period-28 wks of gestation to 7 days after birth
 Postnatal period-
i. New born (neonate)– first 4 weeks after birth
ii. Infant – up to one year
iii. Toddler – 1 to 3 year
 Age of a fetus assessed by various ways

i. CH/CR length
ii. Weight
iii. Physical features and morphology
iv. Appearance of ossification centers
v. Appearance of germination centers
vi. Length of hand and foot
vii. Miscellaneous methods like Assessment of serum placental
lactogen, Microscopic examination of body tissue
 Length and weight

 ideally age up to 30 days or 4 weeks - by no. of somites

 after 30 days up to 8 weeks CRL in mm.
 fetal period - crown-heel length is preferable.
 Haase’s Rule
Age in month Length in cm Weight in gm
1 1 2.75
2 3-4 10
3 9 30-35
6 30 700
7 35 1000
9 45 2000-2500
10 50 3000

Crown-heel length (CHL) in centimeters and weight

correlated with age of fetus in months
 Haase's Rule: age in months is determined by
taking crown to heel length

 up to 5th month- the square root of length of

the fetus will give the age of the fetus in lunar
months
 after 5th month- the length of the fetus devided
by 5 will give the age of the fetus in lunar months
 Morphological Features

 Eye appears as 2 dark spots and mouth as a cleft at 1st month

 Mouth and nose separated, feet and hand webbed in 2nd
month
 At third month, placenta developed.
 4th month, the sex can be differentiated, skin covered by
appearing downy lanugos' hairs
 Morphological Features

 5th month, Light hairs appear at scalp, the head is larger and
about 1/3rd of crown-rump length of fetus
 6th month, Brain –cerebral hemispheres cover the cerebellum,
Sylvan fissure formed
 7th month, Skin is dusky red, thick and fibrous and covered
with vernix
 Morphological Features

 8th month, The skin is rosy, not wrinkled, covered with soft
hairs
 By the ninth month, Both testes in scrotum. Meconium found
in rectum.
 10th month, Scalp covered with 3-5 cm hairs, lanugo absent
from body except at shoulders, face not wrinkled, skin pale
and covered with vernix caseosa
 Germination and Calcification of Teeth

 Development of dental lamina at 6th wks

 Dental papilla formed at 8th wks
 At 3 month, Bud or germination centers for permanent teeth
appears
 Calcification of temporary teeth occurs at 4-5 month.
 Length of Hand and Foot
From foot length
PG (wks)=8.8649 + 3.4863 × FL with
0.75 standard error of the estimate
From hand length
PG (wks) = 8.0514 + 4.8824 × HL With
Standard error = 1.04 of the estimate
 Ossification Centers

Appearanc Ossification center

e in wks

5 Two primary centers for clavicle fuse together

6 Center of mandible and maxilla
7 Primary center for shaft of tibia and femur
8 Primary center for shaft of humurs, radius, ulna and fibula
9 Center for lesser wing of sphenoid bone appears
11 Center for sphenoid body appears
12 Center for tympanic part of temporal bone appears
16 Primary center for pubis appears and Centers for ischium appears
20 Center for petrous part of temporal bone appears, Center for manubrium and first
and second segment of sternum and center of calcanium
28 Center for talus appears
36 Center for lower end of femur and Center for cuboid appears
AGE ESTIMATION IN INFANTS, CHILDREN AND
ADULTS LESS THAN 25 YEARS
 The age of individual can be determined from

 Physical examination
 Secondary sexual characters
 Teeth
 Ossification of bones
 Weight

 Few days loss of 10% bw,regains by 10 th day

 10 th day - 3 month :25-30 g/day
 at 5 month BW doubles, at1 year- 3x, at 2 year- 4x
 at 3year- 5x, at 5year-6x and at 10year- 10x of BW.
 3-7 years -2 kg/year, then 3 kg/year up to puberty
 Underweight  Overweight

 Malnutrition  Hypothyroidism
 Hyperthyroidism  Overeating
 Cushing’s syndrome
 Malabsorption syndrome
 Hypothalamic disorder
 Infection(HIV, tuberclosis)
 Malignancy
 Anorexia nervosa
 Height

 At birth -50 cm
 60cm at 3 month, 70 cm at 9 month and 75 cm at 1
year.
 At 2yrs-90cm and 100cm at 4 yrs
 Then 5 cm every year up to 10 yrs
 There is 20 cm net increment during the onset of
puberty.
 Short stature  Long stature

 Familial  Constitutional
 IUGR, Intrauterine  Familial
infection  Marfan syndrome
 Genetic disorders
 Nutritional deficiencies
 Acondroplasia
 Osteogenesis imperfecta
 Mucopolysaccharidosis
 Head circumference

 At birth the HC of the neonate is 35cm

months HC

3 month 40

1 year 45

2 year 48

7 year 50
10 year 52
 Secondary sexual characters
 Puberty
 SMR (Tanner stages)
 breast changes in females,
 pubic hair changes in both males and females and
 genital changes in males.
 breast bud vs testicular enlargement
 breast development → development of pubic hairs →menarche
 in males Moustache and beard arises , Hoarseness of voice , Adam’s apple
get prominent by 15-17 years.
Sexual maturity rating (Tanner stages) of secondary sexual characteristics

Boys - Development of external genitalia

Stage 1: <10, Prepubertal

Stage 2: 12-13, Enlargement of scrotum and testes; scrotum skin reddens and changes
in texture
Stage 3: 13-14, Enlargement of penis, further growth of testes
Stage 4: 14-15, Increased size of penis with growth in breadth and development of
glans; testes and scrotum larger, scrotum skin darker
Stage 5: >15, Adult genitalia
 Boys and girls - Pubic hair

Stage 1: <10, Prepubertal (can see values hair similar to abdominal wall)
Stage 2: 12-13, Sparse growth of long, slightly pigmented hair, straight or
curled, at base of penis or along labia
Stage 3: 13-14, Darker, coarser and more curled hair, spreading sparsely over
junction of pubes
Stage 4: 14-15, Hair adult in type, but covering smaller area than in adult; no
spread to medial surface of thighs
Stage 5: >15, Adult in type and quantity, with horizontal distribution
("feminine")
Girls - Breast development

Stage 1: 9-10, Prepubertal

Stage 2: 10-11, Breast bud stage with elevation of breast and papilla;
enlargement of areola
Stage 3: 12-13, Further enlargement of breast and areola; no separation of
their contour
Stage 4: 13-14,Areola and papilla form a secondary mound above level of
breast
Stage 5: 15-16Mature stage: projection of papilla only, related to recession of
areola
 precocious puberty  Delayed puberty
 Constitutional  Panhypopitutarism
 Disorders of posterior  Congenital absence of
hypothalamus organs
 Congenital virilizing  Turner’s syndrome
syndrome  Polycystic ovarian disorder
 Androgen-secreting tumors  Hypogonadism
Teeth
 Diphyodont

 A tooth consists of three parts

i. crown
ii. Root
iii. Neck
 Tooth is structurally
composed of
i. Pulp
ii. Dentine
iii. Enamel
iv. Cementum
v. Periodontal membrane
 Teeth are of following types:
i. Incisors
ii. Canine
iii. Premolars
iV. Molars

 They are also classified as

i. Temporary teeth
ii. Permanent teeth

 They are also called as

i. Unicuspid – incisors and canine
ii. Bicuspid – premolar
iii. Tricuspid – molars
 Age from teeth can be determined by noting
 Nature of teeth – temporary or permanent
 Number of teeth – whether 20, 24, 28 or 32
 Eruption of teeth
 Laboratory methods – like Boyde’s method,
Stack method etc
 Temporary Teeth
 deciduous teeth or milk teeth or primary dentition -20
 8 incisors,4 canines, 8 molars

 Eruption of Temporary Teeth

 lower central incisors- 6 month
 upper medial incisor at 7 month
 upper later incisor at 8month
 lower lateral incisor at 9 month
 first molar erupts at 1 year (12-14 mths)
 canine at 1.5 years (17-18 mths)
 second molar erupt at 2 year(20-30 mths) of age
 Permanent Teeth
 They are 32 in numbers
 8 incisors,4 canines, 8 premolar, 12 molars

 Eruption of Permanent Teeth

 first molar 6-7yr
 medial incisor 7-8
 lateral incisor 8-9
 first premolar bicuspid 9-10
 second premolar bicuspid 10-11
 canine 11-12
 second molar 12-14
 third molar 17-25
 Mixed dentition
starting from 6 year of life, due to eruption of
permanent first molar till 11 years of age
where temporary canine is replaced by
permanent canine
 Teeth are useful for age determination by
i. by the state of development
ii. by secondary changes
 Factors affecting eruption and calcification of teeth

 Ethinic, cultural, hereditary, environmental, endocrine

reactions, metabolic disorders, infectious diseases and
nutrition
 It is generally accepted that in a child, estimation of age from
teeth gives better results than skeleton.
 Teeth eruption is not always bilaterally symmetrical
 Important terms
sucessional teeth
superadded teeth
spacing of the jaw
Impacted tooth
 Delayed Dentition  Premature Dentition

 Malnutrition  Congenital syphilis

 Recurrent illness  Hyperpituitarism
 Rickets
 Ossification of bones

 Fusion the process of union of epiphysis and diaphysis

 Union is a process, not an event.
 As a general rule, the aging of bones is more accurate with
respect to the appearance of centers of ossification than it is
with respect to the union of epiphyses.
 Skeletal development in females can be in advance of males
up to one year but dental development may differ only from
one to four months.
 Areas X-Rayed to determine Age

Wrist and Hand-children

Elbow, shoulder, pelvis and knee-Adult
Skull, Vertebrae and sternum-old person
 Frontal x-ray of wrist, hand and elbow

 Humerus- medial and lateral epicondyles

 Radius- upper and lower ends
 Ulna- upper and lower ends
 Carpals
 Metacarpals
 Phalanges
 Appearance and fusion of epiphyses in humerus, radius and ulna

Bone part Appearance Fusion

Medial epicondyle 5-6 years 14-16 years

Lateral epicondyle 10-11 years 14-16 years

Upper end of radius 5-6 years 15-17 years

Lower end of radius 1- 2 years 17-19 years

Upper end of ulna 8- 9 years 15-17 years

Lower end of ulna 5-6 years 17-19 years

 Appearance of epiphyses in carpal bones

Carpal bone Appearance

Hamate 2 months
Capitate 3-5 months

triquetral 3 years
Lunate 4 years
Scaphoid 5 years

Trapezoid 5 years

trapezium 6 years

Pisiform 9 -12 years

 Appearance and fusion of epiphyses in metacarpals and phalanges

Bone part Appearance Fusion

Base of first 2-3 years 15-17 years

metacarpal

Metacarpal ends One and half to two and 15-19 years

half years
Phalangeal ends 2-4 years 15-18 years
 Appearance and fusion of epiphyses in femur, tibia and fibula

Bone part Appearance Fusion

Upper end of femur 1-2 years 17-18 years

Lower end of femur IU-1 years 18 -19 years

Upper end of tibia At birth 18 -19 years

Lower end of tibia 1- 2 years 16 -17 years

Upper end of fibula 4 - 5 years 18 -19 years

Lower end of fibula 1- 2 years 16 -17 years

 Ossification of human pelvis
 Risser scale of progressive ossification

i. Grade 1: ilium is calcified at level of 25%- early puberity

ii. Grade 2: ilium is calcified at level of 50%- growth sprut
iii. Grade 3: ilium is calcified at level of 75%- slowing of growth
iv. Grade 4: ilium is calcified at level of 100%-cessation of growth
v. Grade 5: ilium is calcified, iliac epiphyses is fused with the iliac
crust
i. Grade 1(12-14)
ii. Grade 2(15-16)
iii. Grade 3(17-18)
iv. Grade 4(19-20)
v. Grade 5(21-23)
 Ossification of sternum
 Describes fusion of segments of
sternal body with each other and
sternal body with manubrium and
xiphoid process

 fusion of 3rd and 4th segments- 15yr

 fusion of 2nd and 3rd segments- 20yr
 fusion of 1st and 2nd segments- 25yr
 fusion of sternal body and xiphoid
process- 40yr
 fusion of sternal body with
manubrium- 60yr
 Age determination in adults over 25 years

 Physical examination
 Secondary change in teeth
 Change in Skelton
 radiology
 Physical examination

 Graying of hair
 Baldness
 Skin change:-lax, dry, thin, wrinkled
 Eye change:-prysbiopia, cataract, arcus senilis
 presacusis
 Decreased lean body mass, muscle
 Decrease bone density
 Physical examination

 Prostate enlargement
 Vaginal/urethral mucosal atrophy
 Musculoskeletal disorders
 Postural hypotension
 Anemia
 Brain atrophy
 Stiff gait
  Estimation of age from teeth

 chemical method
 miles method
 Gustafson’s method
 GUSTAFSON’S METHOD

 The age determination of adult over 21 years

depends on the physiologic age changes in each of
the dental tissues.
 The formula is:-An + Pn + Sn + Rn + Cn + Tn = points
→ age in years
i. Attrition:These are the changes caused on masticating surface tooth
due to wearing & tearing.
ii. Paradentosis:tooth root may be exposed with deposition of debris.
iii. Secondary Dentin deposition of secondary dentine tissue in the pulp
cavity.
iv. Cementum Apposition:Cementum deposition increases
v. Transparency of Root: It occurs due to rarefaction of dentine tissue
vi. Root Resorption:It is a decaying process with resorption of root
  Estimation of age from bone

 Pubic symphisis
 Skull suture closure
 Other osteologic changes
 Suture closure in the skull

 Closure begins in inner table 5 -10 years earlier than

outer table
 Fusion occurs earlier in male
 less reliable, gives estimate in decades
 lapsed union, delayed ectocranial suture closure
 Order of suture closure

 30-40 yrs: posterior 1/3 of sagittal suture

 40-50 yrs: anterior 1/3 of sagittal suture and
lower half of coronal suture
 50-60 yrs: middle 1/3 of sagittal suture upper
half of coronal suture
 45-55 yrs: lamboid suture
 Additional Changes in Skeleton

 Calcification of thyroid and cricoid cartilage, hyoid bone-

around 40
 Calcification of laryngeal cartilage and epiglottis-40 yrs
 Lipping of body of lumbar vertebral body may start at around
40 to 50 years of age
 Additional Changes in Skeleton

 Atrophic changes in the intervertebral discs is observed in 50

to 60 years
 Fusion of xipiod with sternum occurs at about 40 years and
fusion of sternum with manubrium occurs at about 60 years
 Deposition of secondary dentin can be assessed using
periapical radiograph to estimate age in adults.
Medico legal Importance of Age
 Criminal responsibility
 Judicial punishment
 Rape
 Kidnapping
 Employment
 Attaining of majority
 Marriage contract
 Identification
 Impotence and sterility
 Criminal abortion
 Infanticide
 Reference
 The Essentials of Forensic Medicine and
Toxicology, Dr. Narayan Reddy 25edition, 2006th
 Best Principles of Forensic Medicine and
Toxicology
 Encyclopedia of Forensic Medicine and
Toxicology
THANK YOU!