A Test of Ubelaker’s Method of Estimating Subadult Age from the Dentition

Emilie L. Smith
B.A., University of Texas at Austin, 1999

A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of
Science in Human Biology in the Graduate School of the University of Indianapolis

May 2005

Copyright © 2005 Emilie L. Smith. All Rights Reserved

 FORM B

Accepted by the faculty of the Graduate School, University of Indianapolis, in the partial
fulfillment of the requirements for the Master of Science degree in

HUMAN BIOLOGY

Stephen P. Nawrocki
__________________________________

Thesis Advisor – Dr. Stephen P. Nawrocki, D.A.B.F.A

Christopher W. Schmidt
__________________________________

Reader – Dr. Christopher W. Schmidt

Jeffrey A. Dean
__________________________________

Reader – Dr. Jeffrey A. Dean

5-15-05
_______________________

Date

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 DEDICATION

This thesis is dedicated with love and gratitude to my family for their extraordinary

commitment to my education. Without your constant encouragement and support, I would not

have had the courage to pursue my education to this level.

This thesis is also dedicated to my best friend of eighteen years, Meredith M. McQuiston,

who stood beside me and urged me at every step of the way.

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 ACKNOWLEDGMENTS

This project would not have been possible without the enthusiasm, support,

encouragement, and creative insight of many people. First and foremost, I would like to thank

my advisor Dr. Stephen Nawrocki, whose assistance and guidance was instrumental in the

completion of this thesis. Additionally, I would like to thank the faculty members of the

Department of Biology at the University of Indianapolis.

I would like to express a special thanks to this study’s Principal Investigator, Dr. Edwin

T. Parks with the Department of Oral Pathology, Medicine, and Radiology at the Indiana School

of Dentistry for generously offering his time to be the P.I for this study and for his assistance in

gaining access to the charts at the Riley Hospital for Children Pediatric Dental Clinic.

I would also like to thank the proofreaders of the early drafts of my thesis, particularly

Dr. Jeffrey A. Dean, whose extensive efforts to accommodate my needs during the accumulation

of my research at the dental clinic will never be forgotten and Dr. Chris W. Schmidt, for his

many contributions and limitless knowledge of the teeth.

I would like to express my gratitude to everyone at the Riley Hospital for Children

Pediatric Dental Clinic for all their help, assistance, and guidance, with special thanks to Dr.

Richard D. Jackson, Dr. Brian J. Sanders, Marsha Thomas, Donna Bumgardner, and Rachel

Boruff.

Additional thanks to Dr. Douglas Ubelaker and Taraxacum Inc. Publishers for granting

permission to reprint a copy of the1989 Dental Aging Chart and Julia Mead for giving her

official permission to include the American Dental Association-copyrighted Development of

Human Dentition Chart within the body of my thesis.

I am quite fortunate to have been surrounded by smart, funny, and caring friends and

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colleagues who made substantial contributions to my thesis, in addition to my well-being!

Thanks to Jill Masters, Denver Gray, and Nancy Masters for helping me to keep my sanity and a

smile on my face - I will always remember and cherish our time as roommates. I would also like

to thank Krista Latham, Nicolette ‘Chick’ Parr, and Janene Curtis, who offered their friendship,

listened to my numerous concerns, dissipated them with great ease, and provided knowledgeable

advice.

Lastly, I would like to thank my best friend (Meredith), my sisters (Gina Marie, Melissa,

and Suzanne) and my parents (Ernest and Marie), who provided me with endless supplies of

support and encouragement.

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 ABSTRACT

In forensic anthropology and dentistry, the age at death of an unknown individual must

sometimes be estimated from the teeth. Various charts are utilized to age subadult human

remains by comparing the teeth present with the standardized pictures to obtain a target age

estimate. The two main charts used today were published by Schour and Massler (1944) and

Ubelaker (1978; 1989). Each of these charts includes pictures of the teeth at different ages and

are very similar in their illustrations, primarily because the latter is derived from the former.

The purpose of this study is to determine whether Schour and Massler’s and Ubelaker’s

charts are appropriate for estimating the ages of modern children, to ascertain which one is more

accurate, and to see if their target age and associated error ranges are still applicable. Since these

charts are used regularly by osteologists, it seems appropriate to subject them to rigorous testing

with a known-age sample. Unfortunately, no such tests have been conducted, so the present

study fills a void in the literature. In addition, with the increased use of DNA techniques, it has

become easier to determine sex from subadult remains. Therefore, it may no longer be justified

to combine males and females if indeed there are significant sex differences in dental

development. Failure to separate the sexes would result in greater aging errors for both. Thus, a

secondary purpose of this study is to determine if dividing the sample by sex would increase the

overall accuracy of the charts.

The study sample is composed of 419 modern European American children aged 5-15

years. These children were randomly selected and approximately equal numbers of males and

females were chosen for each year of age. Panoramic radiographs were examined to assign a

stage of formation and eruption to the teeth as a whole. The target age given by each chart for a

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particular dental stage became the predicted age for each child, which was then compared with

the known chronological age.

Various summary statistics were calculated for each chart, including mean age and

observed age range per stage. Measures of mean error (bias and inaccuracy) were calculated for

each stage and for each chart as a whole. The percentage of individuals correctly falling within

the predicted +/-2 standard deviation interval for each stage was also calculated. The data were

then evaluated for sex differences using t-tests and analysis of covariance (ANCOVA). New

target ages and 95% prediction intervals were calculated for each stage for each chart.

This study found that Schour and Massler’s and Ubelaker’s charts are equally effective at

determining age when the new target ages and associated error ranges are applied. Mean ages

per stage are about half a year higher than the whole years provided on both charts, meaning that

the charts tend to underestimate age at death. Ubelaker’s chart is slightly better with respect to

the robusticity of its error ranges, but Schour and Massler’s chart has slightly lower inaccuracy

and bias values. Not surprisingly, the narrow error ranges originally provided by Schour and

Massler do not work. Additionally, there are small but significant sex differences in age for

some of the later dental stages, which can affect the overall accuracy of age estimation.

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 TABLE OF CONTENTS

Signature Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i

Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

Chapter 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Chapter 2: Dental Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Chapter 3: Development of the Dental Aging Charts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Chapter 4: Materials and Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Chapter 5: Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Chapter 6: Discussion and Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Literature Cited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

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 CHAPTER 1: INTRODUCTION

Comprehensive knowledge of growth and development is fundamental in gaining an

understanding of morphological variation in children. An assessment of the state of an individual’s

dental development can be important in the evaluation of his or her overall maturity and can be used

to compare growth and health between individuals and populations. In addition, the state of dental

development can be used to ascertain the age of an unidentified child.

To determine age, one compares information obtained from the skeleton, in this case the

teeth, and then translates this morphology into an approximate chronological age. Dental age is

therefore a predictor of actual age. Analysis of subadult dentition for aging purposes seems to be

fairly robust, especially since it has been determined that the formation of the teeth is reasonably

resistant to environmental influences. Tooth formation is generally viewed as a “progressive,

continuous, and cumulative process” (Prahl-Anderson and Van der Linden, 1972:535).

In forensic anthropology and dentistry, age at death is estimated by comparing the

decedent’s teeth with a series of standardized images of dentitions at different ages presented on

comprehensive charts. A target estimate is then assigned to the unknown individual. The two main

charts utilized by anthropologists were prepared by Schour and Massler (1944) and Ubelaker (1978;

1989). These charts are similar and provide line drawings of the teeth in 21 different developmental

stages from just prior to birth to early adulthood. However, there are some differences between

these charts in their depiction of the development and eruption of specific teeth and in their

designated error intervals. These charts are not sex-specific even though many authors have noted a

distinct sexual dimorphism in the formation and eruption of the teeth (Schour and Massler, 1941;

Steggerda and Hill, 1942; Gleiser and Hunt, 1955; Lewis and Garn, 1960; Glister et al., 1964;

1
Ubelaker, 1978; Smith, 1991).

Morphological vs. Chronological Age

The term ‘chronological age’ is used throughout this thesis to refer to the actual age of an

individual. Krogman (1968a:175) defines chronological age as the “birthday - or calendric age of

the child. It is based on sidereal time and is constant” (1968a:175). “Dental age,” on the other

hand, refers to the morphological state of an individual’s dentition without reference to their actual

age. Moorrees et al. (1963a) describe dental age as involving both the formation and the emergence

of the teeth. Krogman (1968a:175-6) defines dental age as “the variable to moderately variable

registry of biologic time in the developing dentition,” which he divided into two subtypes:

calcification age and eruption age. Calcification age is defined as the “stage-sequence of tooth

development from first appearance of cusp(s) to root apical closure,” a concept that is similar to

Moorrees et al.’s ‘tooth formation’ (Krogman, 1968a:175-6; 1968b:335). Eruption age is defined as

“the progressive emergence of the tooth from its alveolus into functional occlusion,” which is

similar to Moorrees et al.’s (1963a) ‘emergence’ (Krogman, 1968a:175-6).

The term ‘dental development’ is not always defined in the literature and often seems to be

(incorrectly) used as a synonym for dental formation. In this particular thesis, use of ‘development’

will follow Garn et al. (1958), who assert that dental development is composed specifically of

calcification (including crown completion and root formation) and eruption. Similarly, Smith

(1991) describes dental development as the combined processes of formation and eruption. She

defines formation as the “formation of an organic matrix and its subsequent calcification or

mineralization” (1991:144). In this study, formation, mineralization, and calcification will all be

used interchangeably to refer to the development of the crown and roots.

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 Moorrees et al. (1963a:1490) define physiological age as an estimation of “maturation of

one or more tissue systems, and . . . is best expressed in terms of each system studied. Maturation is

scaled by the occurrence of one or the sequence of multiple events that are irreversible.” The

authors state that ‘physiologic age’ and other commonly-substituted words for terms such as

‘biologic’ and ‘developmental’ age are merely intended to describe the morphological status or state

of a child, whereas chronological age suggests an approximation of status due to the range in

observed development for any age. Shumaker (1974:55) suggests that “chronologic age norms deal

with the mean and the physiologic age norms deal more closely with individual development.”

Various authors have compared ‘dental age’ with ‘chronological age’ and ‘skeletal age.’ A

common definition of ‘skeletal age’ can be derived from Krogman and is “the registry of biologic

time in the developing skeleton” (1968a:175). Scheuer and Black identified three phases that

comprise skeletal development including: (1) formation of the centers of ossification, (2) the

growth of the centers of ossification, and (3) the time during which fusion of the center with a

separate center of ossification occurs (2000:6). Green (1961) examined a sample of 56 European

American males ages 8 to 12 and found that dental age is more correlated with chronological age

than with skeletal age. This finding is similar to those of Holz et al. (1959), who noted a closer

association between chronological age and dental age than between skeletal age and dental age.

Krogman (1968a,b) and Demirjian (1986) determined that dental development has a close

association with chronological age. Lewis and Garn (1960) also found that the stages of tooth

formation are less variable than the stages of skeletal development. Kullman (1995), however,

found that a determination of dental age was not as accurate as skeletal age when studying children

between the ages of 14 to 18. Bambha and Van Natta (1959) found no evidence of an association

between skeletal age and dental eruption. Grøn (1962) determined that tooth emergence was

3
closely related to the stage of root formation rather than to chronological or skeletal age. Feasby

(1981), however, found a low correlation between the dental eruption rate and root formation.

Various problems in age estimation arise from a lack of rigorous testing, a lack of proper

statistical methods, and because of differences in secular and population trends. It has also been

noted by various authors that many studies do not include important information on methodology,

ages of subjects, sample sizes, and statistical methods used (Smith, 1991; Scheuer and Black, 2000).

Therefore, many studies are not comparable because of the inherent difference between the

underlying variables. This problem can lead to conclusions that any differences between samples

are due to true population differences, when in reality they are more likely a result of sampling

effects or the misuse of statistical procedures.

Anthropological and Forensic Significance

Norms of dental development provide a means for aging subadult human skeletal remains by

giving anthropologists a method of estimating the unknown chronological age from known

morphology. Estimation is possible because the “growth of the deciduous and permanent teeth

takes place over the entire range of the juvenile life span, starting during the embryonic period and

nearing completion during the late adolescent . . . period” (Scheuer and Black, 2000:12). After this

period, the teeth are in full articulation and begin to undergo attrition and other structural changes.

Dental maturation is, therefore, of “particular significance for … aging skeletal specimens when

only jaws remain” (Moorrees et al. 1963a:1490) and is important even with a complete skeleton.

The purpose of this study is to determine whether the use of Schour and Massler’s or

Ubelaker’s dental age charts are appropriate for age estimation in modern American children. Since

these charts are both used regularly by anthropologists to estimate age at death from skeletonized

4
subadult remains, it would seem appropriate to subject them to rigorous tests with a known-age

sample. Unfortunately, few such tests have been conducted, so the present study will fill a void

present within the literature. In addition, with the increased utilization of DNA techniques, it has

become easier to determine sex from subadult remains. Therefore, it may no longer be justified to

combine males and females if indeed there are significant sex differences in dental development.

Failure to separate the sexes would result in greater aging errors for both sexes. A secondary

purpose of this study is to determine whether dividing the sample by sex will increase the overall

accuracy of the charts.

Chapter 2 gives a general discussion of the dental development of subadults, including rates

of formation and eruption, sex differences, ancestral differences, environmental and genetic

influences, and methodological concerns. Chapter 3 outlines in detail the evolution and

development of the Schour and Massler and Ubelaker dental aging charts and examines the results

from previous tests of these charts. Chapter 4 describes the materials and methods used in this

study, with emphasis on the selection of the clinical sample, scoring systems, and statistical

methods. Chapter 5 presents detailed results for both charts. The study will conclude with Chapter

6, which will give a summary of the findings and a discussion of future research possibilities.

5
 CHAPTER 2: DENTAL DEVELOPMENT

In their method of formation, structure, and basic functioning, teeth record and retain a

history of their development and the events to which they have been subjected. For these reasons,

normal tooth development has long formed the primary basis for age determination of children of

unknown age. Investigation of the literature reveals numerous studies of dental aging, including

formation and eruption. Garn et al. (1959), Lewis and Garn (1960), and Krogman (1968a,b)

established that tooth formation was less variable than skeletal maturation, making the former

potentially more accurate for age estimation.

For these reasons, it is important to understand the development of the human dentition,

including patterns and timing of formation and eruption. These factors are discussed in detail in this

chapter, and factors that potentially influence dental eruption (such as sex and ancestry) will be

examined. Various dental aging methods are also addressed, producing a comprehensive view of

previous research attempting to approximate chronological age from the development of the teeth.

Dental Development

Tooth formation. The development of the dentition occurs in a predictable pattern. At

approximately thirteen weeks of intrauterine life, the first deciduous central incisors begin to form,

followed by the deciduous first premolars at approximately fifteen weeks. These teeth are followed

two weeks later by the lateral incisors and approximately two weeks later by the canines and

deciduous second premolars (Kraus, 1959; Kraus and Jordan, 1965; Hillson, 1996). The first

permanent molars begin calcification after about 28 to 32 weeks in utero (Kraus and Jordan, 1965).

Among the molars, the mesiobuccal cusp is always the first to begin developing, followed by the

6
mesiolingual, distobuccal, and distolingual cusps, respectively. Lastly, a fifth, distal cusp generally

develops on the lower molars (Schour and Massler, 1941; Gleiser and Hunt, 1955; Kraus and

Jordan, 1965; Hillson 1996). At birth, the state of development of the teeth is dependent upon the

duration of gestation and the overall extent of tooth development while in the uterus (Hillson,

1996).

Postnatal development of the human dentition occurs with the initiation of the permanent

incisors (excluding the upper lateral incisors, which follow slightly behind) at around three to four

months after birth (Hillson, 1996). At this point in time, the germs of the deciduous premolars

occupy the majority of the vertical space of the maxilla, with the total height of the upper jaw being

almost double the size at birth (Logan, 1935).

The canine crowns begin to form at about one month after the initiation of the permanent

incisors. At six months of age, calcification has advanced in the upper and the lower central

incisors with the enamel and dentin cap reaching 1 to 1.5 mm in height (Kronfeld, 1935b). At the

end of the first year, the upper permanent second incisors initiate formation, which are then

followed consecutively by the first and second permanent premolars and second molars through the

end of the second year and into the third year of age (Hillson, 1996).

The completion of the tooth crowns is much more variable than their initiation. According

to Schour and Massler (1940b), the tooth crown is completed when the production of enamel stops,

and the overall time until completion is dependent on the general size of the crown and the rate of

apposition. In deciduous teeth, crown completion takes from 7 to 14 months, and in permanent

teeth, completion requires 4 to 6½ years (Schour and Massler, 1940b). The permanent first molar

crowns are completed at approximately 3 years of age, incisors at 4 or 5 years, canines and first

premolars at about 6 years, and second premolars and second molars from 7 to 9 years of age

7
(Fanning and Brown, 1971; Hillson, 1996).

The completion of root formation has been deemed more variable than crown completion

and depends on the root’s overall length and the rate of dentin apposition (Schour and Massler,

1940b). However, Lauterstein (1961), in an effort to compare bone age with chronologic age,

decided that root formation may be as good of an indicator of age as bones. In general, the

deciduous roots require 1½ to 2 years for completion and the permanent roots require 5 to 7 years

(Schour and Massler, 1940b). Churchill (1932) found that the absorption of the root of the first

deciduous incisors begins before the roots of the second deciduous incisors are completely formed.

Additionally, the deciduous second premolar is completely erupted with roots fully formed before

the permanent first molar erupts (Cheyne, 1947). Among the permanent teeth, first molars and

incisors usually complete their roots first, at about 9 and 12 years respectively, and the rest close

after the age of 12.

The permanent third molar is highly variable and usually does not begin formation until the

other crowns have completed their development, with initiation beginning anywhere from 7 to 15

years of age (Demisch and Wartmann, 1956; Hillson, 1996). The completion of the third molar

crown occurs sometime between the ages of 12 and 15, and the roots generally do not close until

between 17 and the early twenties (Fanning and Brown, 1971; Hillson, 1996).

Dental eruption. El-Nofely and İşcan (1989:239) define dental eruption as the “tooth

breaking through the alveolar tissue until it reaches an antagonist or an obstacle.” The term

eruption is used interchangeably throughout the literature with emergence (Miles, 1963). Steggerda

and Hill (1942), Gustafson and Koch (1974), and Filipsson (1975) collectively agree that a tooth is

erupted when it makes its first appearance through the gums. Hillson (1996:138) defines dental

eruption as “the process by which teeth, in their bony crypts, migrate through the jaws and emerge

8
into the mouth. It continues as each tooth moves into occlusion and beyond to compensate for the

effects of wear, so that eruption is a continuous process that never completely ceases.” Demirjian

(1986:270) believes that eruption is applied erroneously when used to denote the appearance of a

tooth in the oral cavity. He claims the correct term for the piercing of the gum is “clinical

emergence,” and the piercing of the alveolar bone should be called “alveolar emergence.” Gleiser

and Hunt (1955:265-6) had previously defined alveolar emergence as the occasion when “the tips of

one or more cusps are at or just above the superior margin of the alveolar process.” Garn et al.

(1958) and Lewis and Garn (1960) later defined alveolar eruption as the time when there is no

apparent alveolar bone located above the tooth and the subsequent elevation of the crown above the

alveolar margin. According to Hurme (1948), these differing definitions could make comparisons

between different studies difficult.

The permanent dentition is much more variable than that of the deciduous in both the

sequence and the timing of eruption. According to Hillson (1996), eruption times can be broken

into three phases: Phase One includes the emergence of permanent first molars and incisors (5 to 8

years of age); Phase Two consists of the emergence of the canines, premolars, and second molars

(9.5 to 12.5 years); and Phase Three consists of the emergence of the third molars (late teens to

early twenties). Bradley (1961) found that the canines and premolars begin to erupt when their

crowns are entirely complete and that these teeth reach the occlusal plane before completion of their

roots. He also noted that the canine and first premolar began and completed eruption at

approximately the same times, followed by the second premolar. Fanning and Moorrees (1969)

found that the permanent teeth tend to emerge approximately after 50 to 75% of their root length

has been attained and concluded that eruption is more closely related to the stages of root formation

than with chronological or skeletal age.

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 In various studies it has often been noted that eruption of the teeth usually occurs in pairs.

Lo and Moyers (1953) and later Prahl-Anderson and Van der Linden (1972) both determined that

the order of dental eruption was bilaterally symmetrical. However, Steggerda and Hill (1942) noted

that while eruption generally does occurs in pairs, many examples of eruption on the one side

occurring in a different year than that of its antimere can be found. Their study showed sixteen

instances in which the eruption times of the left and the right sides were outside the limit of one

standard error. The authors concluded that the differences in eruption of the left and right sides

were due to chance variation.

Brauer and Bahador (1942) and Adler (1963) also discovered a lack of symmetry among the

right and left sides of the arch. Lauterstein et al.’s (1962) findings supported this disparity and they

noted a high incidence of occurrence among the buccal teeth and their antimeres. Lauterstein et al.

(1967) found instances of asymmetries in eruption among the mandibular permanent canines and

premolars in 54% of the 242 children studied.

Inconsistencies in eruption between the upper and lower teeth have also been observed.

Schour and Massler (1940b) found that maxillary teeth begin to form before the mandibular teeth,

with the exception of the upper permanent lateral incisor. Interestingly, however, they found that

the lower teeth generally erupt before the corresponding upper teeth. Brauer and Bahador (1942)

and Adler and Gödény (1952) also noted this trend.

Factors Influencing Dental Eruption

There are many theories as to the processes that cause a tooth to emerge from its crypt and

erupt through the gums. Brauer and Bahador (1942) explain that the same biological principles that

can be applied to the body also control the development of the teeth. Therefore, variation will exist

10
in the calcification and eruption of the teeth. Steggerda and Hill (1942) proposed that there are not

only biologic forces at hand, but also local factors, such as nutrition and the environment, that

influence the time of eruption of individual teeth. The biologic factors that can contribute to the

general development of the teeth include genetic factors and endocrine reactions (Steggerda and

Hill, 1942; Garn et al., 1965a; Prahl-Anderson and Van der Linden, 1972; Davidson and Rodd,

2001). Additionally, sex and ancestry are important factors that can influence the eruption of the

teeth and will be discussed in detail.

Genetic factors. Genetic factors are very important in the development of each individual

tooth. Wise et al. (2002) state that there are 25 known human syndromes that involve disruptions in

the process of dental eruption, with the most frequent disruption being delayed eruption. Some of

these genetic disorders include Trisomy 21 Syndrome, cleidocranial dysplasia, achondroplastic

dwarfism, and chondroectodermal dysplasia (McDonald et al., 2004). Wise et al. (2002) found that

the modes of inheritance of these syndromes were equally distributed between autosomal

dominant/recessive and X-linked dominant/recessive forms.

Some additional genetically determined dental traits include teeth that have been modified

or reduced in size and an absence of the tooth within the mouth. Modified teeth include peg or

barrel-shaped incisors, diminutive teeth, and absent cusps (Dahlberg, 1957).

Lewis and Garn (1960) and Garn et al. (1965a) theorized that tooth formation is genetically

determined and in an analysis of monozygotic twin pairings found correlations of tooth formation

ranging from 0.75 to better than 0.90. Correlations found among dizygotic pairs from triplet sets

were approximately 0.30, the same as for non-triplet siblings (Lewis and Garn, 1960). Garn et al.

(1960) found that among monozygotic triplet pairings, there is a correlation of 0.91 for both sexes.

Garn et al. (1965a) also found strong sibling correlations in tooth development. The findings by

11
these authors are consistent with the assumption that the timing of tooth formation is largely, but not

absolutely, genetically determined. Twins and siblings generally share the same fetal and postnatal

environments, thus it is difficult to distinguish any environmental factors that may play a role in

tooth formation. Kraus and Jordan (1965:213) concluded that since twin studies have shown that

many morphological traits of the teeth are genetically determined, the “crown morphology of the

primary dentition, particularly of the mandibular first molars and lateral incisors, is under the

control of genes throughout the period of odontogenesis.”

Endocrine factors. Recent investigations of how hormonal growth affects dental eruption

have reported on individuals with various endocrinopathies. One endocrine condition that effects

the development of the teeth is hypothyroidism. In congenital hypothyroidism, without hormonal

therapy, the eruption and loss of the deciduous teeth and the eruption of the permanent teeth can be

significantly delayed. In addition, while the sizes of the teeth are normal, they are crowded into

jaws that are overly small (McDonald et al., 2004). In juvenile hypothyroidism, an untreated case

can also lead to delayed loss of the deciduous dentition and delayed eruption of the permanent

dentition. This situation can cause a child with a chronological age of 14 to have the dental stage of

a 9 or 10 year old (McDonald et al., 2004).

Individuals affected by hypopituitarism, hypoparathyrodism, and autoimmune

polyendocrinopathy are much less affected by dental growth retardation (El-Nofely and İşcan,

1989). In hypopituitarism, individuals have teeth that are normal in size, however, approximately

25 percent have delayed eruption (McDonald et al., 2004; Garn et al., 1965b). In severe instances

the deciduous dentition is retained throughout the person’s life with developed, but unerupted,

permanent teeth underneath (McDonald et al., 2004).

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 Environmental factors. While some authors have concluded that environmental factors

may play a role in the development of the dentition, Smith (1992) and Konigsberg and Holman

(1999) believe that deciduous tooth eruption is well buffered against these influences. Some

environmental factors that have been found to influence the emergence of the permanent teeth

include early or late extraction of the deciduous teeth, supernumerary teeth, odontoma, crowding,

osteogenic tumors, cysts, and trauma (Prahl-Anderson and Van der Linden, 1972; El-Nofely and

İşcan, 1989; Wise et al., 2002; McDonald et al., 2004). Adler (1963) and El-Nofely and İşcan

(1989) concluded that these various factors could lead to premature loss of deciduous teeth, which

can affect the timing of the emergence of their successors. For example, loss of the deciduous teeth

too early while the permanent successor is still in the jaw may result in developmental retardation.

Lauterstein et al. (1962), however, found an accelerated rate of eruption among extracted deciduous

premolars.

Bradley (1961) examined the mandibular permanent canine and premolars to determine

whether there was a relationship between eruption and crowding of the mandibular permanent

dentition. He found that increased crowding in the mandibular permanent dentition had a small but

significant correlation with a retardation of the early phases of eruption of the mandibular canine.

Crowding was also correlated with delayed calcification of the second premolar, followed by an

increased rate of eruption during the early phases.

Nutritional factors. Nutrition and socioeconomic factors may also affect the emergence of

the permanent dentition. Malnourished children among low socioeconomic environments show

retardation in the eruption of the teeth relative to other children in a given population (El-Nofely

and İşcan, 1989). However, other studies imply that nutritional and social stresses do not have as

significant an effect on dental formation as they do on other physical growth criteria such as height,

13
weight, skeletal, and sexual maturation (Demirjian, 1986). Garn et al. (1965a) studied the effects of

nutrition on dental development by analyzing the degree of fatness in children. They found that

fatter children are more advanced in their dental development, however, the effect is small. They

found that the teeth were “one-third as responsive to nutritional status as ossification timing or

epiphyseal fusion” (Garn et al., 1965a:231).

Sex Differences

Gleiser and Hunt (1955) and Miles (1963) found that the sex differences in the development

of the teeth are far less than those found in the skeleton. Gleiser and Hunt (1955) determined that at

equivalent stages of permanent dental development, the average age of girls is about 95% of that of

boys. Gleiser and Hunt (1955) also found that absolute sex difference in eruption gradually

increased with respect to chronological age, with girls becoming increasingly advanced.

Glister et al. (1964) found that females at 10 months of age tend to be about 2 months

advanced over males. Konigsberg and Holman (1999) note that such small differences in the

eruption of the deciduous teeth are not likely to create serious inaccuracy in age estimates. Hurme

(1949) suggests that the differences in sex are so slight that the ranges of normalcy for boys and

girls are approximately equivalent. Hurme (1949) also points out that the actual amount of female

advancement generally depends on the tooth in question.

Black (1978) found that sexual dimorphism of the deciduous dentition was small in

comparison to the permanent dentition. Lauterstein (1961) found a slight tendency among the

deciduous teeth of two-year-old boys to erupt earlier than those of girls the same age.

Lo and Moyers (1953) and Hurme (1957) are in agreement that in girls, the sequence of

emergence of the first premolars and the mandibular canines are in the order of mandibular canine,

14
maxillary first premolar, and mandibular first premolar. However, in boys, the maxillary first

premolar consistently precedes the other two. Carr (1962) and Carlos and Gittelsohn (1965)

obtained similar results. Smith and Garn (1987) found that the sequence of eruption among the

mandibular permanent canine and first molar may be sexually dimorphic and may differ between

populations. Lo and Moyers (1953) justify these differences in eruption as being a result of the

earlier onset of puberty in females. Nanda (1960), however, found no correlation between dental

eruption and puberty.

Hurme (1957) suggested that sex could be determined by examining the sequence of

emergence of the permanent canine and first premolar. He states that the greatest time difference in

the emergence of teeth among boys and girls is the mandibular canine, which appears about eleven

months earlier in girls than in boys. Ferembach et al. (1980) agree that the canines show the

greatest sexual dimorphism among the teeth. Hurme (1957) also notes that the sex difference in the

eruption of the permanent maxillary canine is significant and suggests that if subadult remains

exhibit this tooth close to or ahead of the eruption of the maxillary second premolar, the remains are

likely to be female.

Studies of sex differences in dental development generally agree that the early stages of

tooth development are similar in males and female, with differences in development beginning at

the crown completion stage and increasing during development of the root. However, there are

some discrepancies among the studies. Demirjian and Levesque (1980) attributed this inconsistency

to the limited sample sizes used by the researchers. They attempted to reinvestigate the sex

difference in dental calcification on a larger scale with an ethnically homogeneous population.

They used a large sample size of 5,437 radiographs from a homogeneous French-Canadian

population to examine the differences between males and females in the development of the

15
mandibular permanent teeth from the beginning stages of calcification to the closure of the root

apex. They noted that there was not a discernable sex difference until the completion of the

development of the crown, with girls being more advanced by a mean of 0.35 years for four teeth.

For the subsequent stages of root development, the average difference between sexes is 0.54 years,

with the canine having the largest difference of 0.90 years. These results support the earlier

findings of Garn et al. (1958) and Nolla (1960) that sexual dimorphism is more important during the

later stages of dental development, especially during root development, than during the period of

crown development.

Garn et al. (1958) investigated the formation and eruption of the mandibular molar and

premolar teeth and noted that girls preceded the boys in almost all teeth. The found that during the

eruption stage (which includes alveolar eruption and attainment of the occlusal level) the average

sex difference was 0.52 years. During the calcification stage (from follicle to beginning root) the

average sex difference was only 0.16 years. Lewis and Garn (1960) found that girls’ dental

development was, on average, 0.32 years and in extreme cases up to 0.92 years ahead of boys.

Nolla (1960) found that for all teeth at every stage, girls were more advanced. Lauterstein (1961)

also found that girls’ permanent teeth erupted earlier and their root formation was more advanced

than boys.

Garn et al. (1956) found evidence that the timing and order of dental calcification was, in

fact, influenced by sex. They noted that cases where the second permanent premolar calcified prior

to the second molar were more frequent in girls, whereas the calcification of these two teeth

simultaneously is primarily a male characteristic.

Sex and ancestral differences. Steggerda and Hill (1942) determined that between

different ancestral groups there are sex differences in the eruption time of teeth. They found that of

16
the four ancestral groups analyzed, the average eruption time of female European Americans and

Maya is five to six months ahead of that of males, with sexual dimorphism in eruption being

slightly greater among African Americans and less in Native Americans. Dimorphism is greatest in

the canines. In the four populations they studied, in females the maxillary canines erupted 9.6

months and mandibular canines 10.2 months before males. The canines of African American

females erupt more than a year before those of males and as a result, the greatest difference between

the sexes occurs during the tenth and eleventh years. At this age, females may have one or more

teeth than males. The canines of females were found to erupt before the second premolar in the

maxilla in all populations, which is the same eruption order as the corresponding mandibular teeth

in males. Female mandibular canines erupt before both the first and second premolars. Among

European Americans, the maxillary second premolar of both males and females erupts before the

corresponding tooth in the mandible. This condition was also found among Navajo males and

females and in Mayan males. In the Navajo, the maxillary first premolar erupts before the

mandibular in females. In all of the other ancestral groups tested, the mandibular teeth erupted

before the maxillary, or the differences are not significant

Ancestry

It has been noted in various studies that there are different rates of permanent tooth eruption

among the various ancestral groups. El-Nofely and İşcan (1989) note that between populations,

differences can only be considered in the context of socioeconomic conditions, nutritional status,

and other environmental factors. However, in spite of the difficulty in separating genetic factors

from external influences, many studies have found that the sequence of tooth eruption varies

between ancestral groups in different geographic locations.

Steggerda and Hill (1942) studied the influence of ancestry upon the mean time of eruption,

17
including comparisons of sex and the order of eruption. The subjects analyzed within this study are

of ancestral groups from significantly different environments. They ranked the ancestral groups

studied by their rate of dental eruption. These rages ranged from fast (Navajo, African American)

to slow (Mayan, European American). They found that there is no significant ancestral difference

in the mandibular first molar. However, this tooth in the Navajo does erupt earlier than in any of

the other ancestral groups. Among the Maya, the central incisors erupt later than in the other

ancestral groups. This difference occurs in both the maxillary and mandibular teeth, involves both

sexes, and occurs about six months after the eruption of the same teeth among European Americans.

All other Mayan teeth except the canines erupt before those of European Americans, with the first

premolar and second molar being most pronounced in their early eruption. All the teeth of African

Americans also erupt before those of the European Americans, except for the maxillary second

premolar. The teeth of the Navajos have the earliest eruption times of all the groups studied. Their

teeth erupt at a significantly earlier age than in European Americans in all instances, except the

maxillary and mandibular central incisors and maxillary first molars.

It has been suggested that eruption in African American and Eskimo children may occur

from ½ to 1½ years earlier than in European Americans (Bang, 1989; Hurme, 1957). However,

Hurme (1957) also claims that there is not a significant difference between the “Mongolian” groups

versus the Europeans and Japanese. El-Nofely and İşcan (1989) use flawed logic in attributing this

delay in European and Japanese to the fact that they are from industrialized populations and thus

have improved nutritional status and medical care, which results in a later emergence of the teeth.

Nyström et al. (1986; 2001) examined Finnish children and determined that they were more

advanced in dental maturity when compared to the research by Demirijian et al. (1973) on French

Canadian children. Accelerated dental development was also shown in a South Indian population

18
(Koshy and Tandon, 1998). However, Speechly and Liversidge (1998) did not find any population

differences in dental maturation for British and Bangladeshi children.

Dental Aging Methods

In 1958, Garn et al. devised five stages of calcification and eruption including: (1) stage of

full follicle, immediately preceding first evidence of cusp calcification; (2) crown completion and

beginning of root formation; (3) alveolar eruption; (4) attainment of occlusal level; and (5) apical

closure. They distinguished calcification as involving stages 1, 2, and 5 and equated eruption with

stages 3 and 4. Lewis and Garn (1960) later eliminated the two eruption stages and devised a

system of three stages for dental development including: (1) calcification of the crown; (2)

completion of crown formation; and (3) closure of the root apices. Gustafson and Koch (1974) also

described stages of tooth development, which involved four phases: (1) commencement of

mineralization; (2) completion of crown; (3) eruption of the tooth (where the cusp penetrates the

gingiva); and (4) completion of the root. These stages were used to construct a simple diagram for

age estimation.

A method of aging using dental microstructure was developed by Boyde (1963; quoted in

Bang, 1989) and is based on the fact that the formation of enamel in humans originates at the dentin

surface and moves outward at a speed of two to eight microns every twenty-four hours. These lines

of enamel deposition are discernible on the surface as “Lines of Retzius.” The “neonatal line”

within the teeth forms the border between the prenatal and the postnatal enamel and is found where

enamel is forming at the time of birth. Counting the lines of Retzius up from the neonatal line to the

surface of the enamel allows for age determination of a young individual (Bang, 1989). This

quantitative method, while accurate, is very elaborate. Huda and Bowman (1995) applied Boyde’s

19
technique to unknown, commingled juvenile European skeletons recovered from Saint Bride’s

Church in London. They managed to confidently age eight of the ten individuals by analyzing the

dental microstructure after unsuccessful attempts to use known skeletal aging methods.

Moorrees et al. (1963a) feel that tooth formation is superior to tooth eruption for the

assessment of dental age. They studied radiographs of maxillary incisors and eight mandibular

teeth in order to provide norms for their formation. The authors identified several stages in the

formation of the crown and root in deciduous and permanent mandibular canines and molars, and

root resorption in deciduous teeth. They found that the range of variation is least for crown

development and greatest for root apex closure. There were also significant differences between

males and females.

Bailit and Hunt (1964) used the Moorrees et al. (1963a) chart to assess sexual dimorphism

and the developmental age of twenty-five girls and twenty-five boys using a mandibular canine.

The authors examined radiographs and scored them based on the methods determined by Moorrees

et al. (1963a) and compared their results to the known chronological age of the child. The

developmental age of the canine for both sexes was determined and compared to the known

chronological age. Sex was correctly determined in 70% of the cases. However, Bailit and Hunt

(1964) question this method’s usefulness in medico-legal applications due to the sexual dimorphism

of the radiographs being too slight.

Demirjian and Tanner (1973) developed an aging system using an approach used earlier by

Tanner et al. (1962). Their method used a 7-tooth system that was based on eight stages of

calcification, and each tooth was given a score based in its phase of calcification. These evaluations

were totaled for all teeth, which gave a maturity score measuring from 0 to 100. This maturity age

could then be converted into a dental age. The 1973 method for estimating dental maturity was

20
later reevaluated and updated by Demirjian and Goldstein (1976). They developed a new system

that extended the age range and the number of stages and created a 4-tooth system of analysis. The

authors noted in their discussion that their sample was entirely of French-Canadian origin and may

not be applicable to other populations. They conjecture that while the scores for the stages will

likely not change very much, the maturity standards might change considerably.

Nykänen et al. (1998) used the Demirjian et al. (1973) method for dental age estimation and

applied their standards to Norwegian children. They found that their children were somewhat more

advanced in dental development than the French-Canadian children. This finding is in accordance

with the studies of Swedish and Finnish children that have been analyzed utilizing the Demirjian

method (Hägg and Matsson, 1985; Nyström et al., 1986; Staaf et al., 1991). Although the mean

differences between estimated and chronological ages were comparatively small, indicating a good

correlation between dental maturity and actual age among the Norwegian and French-Canadian

children, individual estimates varied considerably, particularly in the older children. This

observation of increased variability with age was also found in other studies using various methods

for age estimation from dental development (Hägg and Matsson, 1985; Nyström et al., 1986;

Reventlid et al., 1996).

Davis and Hägg (1994), in an effort to estimate chronological age based on tooth formation

in Chinese children, used the methods of Demirjian et al. (1973) along with the updated standards

by Demirjian and Goldstein (1976) and Demirjian (1986). While they found the precision to be

high, the accuracy was low, with the mean difference between dental age and chronological age of

the Chinese children being eleven months for boys and seven months for the girls. Davis and Hägg

(1994) believe that their results indicate that Demirjian’s method cannot be accurately used to

estimate the chronologic age of Chinese children.

21
 Loevy (1983) used the methods of Demirjian et al. (1973) to analyze and compare the dental

development of European American, African American, and Latin American children from the

Chicago area. He found that each of the populations tested displayed faster development than

Demirjian’s French-Canadian children. Loevy (1983) also determined that Latin American males

were not significantly different from European American males and that African American males

were significantly different from European American males. For the females, a significant

difference was found between European Americans and the other two groups (Loevy, 1983).

Several studies have tested systems of dental aging using children of known age, however,

some do not report the actual differences in predicted versus actual ages (e.g., Haavikko, 1974).

Staaf et al. (1991) tested the methods for age determination from dental development and compared

the methods of Demirjian et al. (1973), Haavikko (1974), and Liliequist and Lundberg (1971).

Their sample consisted of 541 Swedish children aged 5.5 to 14.5 years. Staaf et al. (1991) found

that when Demirjian’s method was used, the age was consistently overestimated by approximately

ten months for both sexes. These results were similar to those of Hägg and Matsson (1985), who

obtained an overestimate of four to six months for Demirjian’s method. An analysis of Haavikko’s

(1974) method found an underestimate ranging from four to six months, with lower errors attributed

to the younger individuals and higher errors for those above approximately ten years of age (Staaf et

al., 1991). Liliequist and Lundberg’s (1971) system of assessing dental age displayed a correct

estimate for girls and an overestimate of roughly seven months for boys (Staaf et al., 1991). Staaf et

al. (1991) explain the differences between Haavikko’s (1974) and Liliequist and Lundberg’s (1971)

studies as resulting from the differences of about one year or more between each of their stages.

Hägg and Matsson (1985) compared the methods of Liliequist and Lundberg (1971),

Gustafson and Koch (1974), and Demirjian et al. (1973) to determine which one more accurately

22
predicts the age of 150 Swedish children 3.5 to 12.5 years of age. Each case was independently

assessed by each researcher. Unlike Staaf et al. (1991), Hägg and Matsson found that the method of

Liliequist and Lundberg (1971) consistently underestimated the age by two to six months, with

lower errors for the boys. In addition, they found that this test had, overall, the lowest accuracy

despite the fact that it represents standards set from analyses of Swedish children. Hägg and

Matsson (1985) also found that the methods of Gustafson and Koch (1974) were difficult to

replicate and the age predictions were poor for females but acceptable for males. Of the three tests,

the stages of the development of maturity determined by Demirjian et al. (1973) when used on

French-Canadian subjects gave the most precise age estimates. They determined that the subject’s

age could be accurately estimated to within 15 to 25 months with 95% confidence.

Methodological Considerations

Hurme (1948) blames much of the discrepancy in the various dental aging methods on

authors’ differing definitions of dental eruption. There also seems to be some confusion among

researchers in the use of the terms development, formation, and calcification, which are used

interchangeably. There is disagreement as to whether calcification or eruption data is better for

dental aging. Some researchers consider dental eruption to be limiting in that it can only be

examined for a short period of time compared to formation. In a living individual, a tooth may be

lacking at the time of oral examination but may be visible one or two weeks later (Demirjian and

Levesque, 1980; Ferembach et al., 1980; El-Nofely and İşcan, 1989; Smith, 1991; Haavikko, 1974).

Formation of the crowns and roots is said to be more accurate in that the process can be followed

longitudinally and assessed radiographically, permitting continuous scoring over several years

(Demirjian and Levesque, 1980; Smith, 1991). Formation also allows for the analysis of dental

23
maturation in periods where no emergence takes place. Smith (1991) believes that tooth formation

is more resistant to environmental influences, whereas dental eruption can be influenced easily by

caries, tooth loss, and severe malnutrition. For skeletonized individuals, a cross-sectional approach

is the only one available. In these cases, a radiological analysis gives an internal view of the teeth,

enabling examination of formation and development at a single point in time.

El-Nofely and İşcan (1989) believe that clinical examination of the oral cavity in living

subjects is the most common and best manner for studying tooth emergence. Clinical oral data

permits an observation of the tooth’s initial appearance in the mouth, including its penetration

through the oral mucosa. Additionally, an oral examination involves simple, rapid, and convenient

data, does not require expensive tools or equipment, has less intra- and interobserver error, enables

a large sample size, and allows intra- and interpopulation epidemiological studies of dental growth

and maturation. However, for forensic purposes, these oral data may have limited utility.

The variation in mean eruption times of teeth presented in the literature is noted by

Steggerda and Hill (1942), who believe that some differences between studies could be due to the

method of tabulation of the material. They note that in some cases, the researcher’s averages are

based upon the nearest birthday, some upon the actual month and year, and others consider the year

group to include all individuals up to their next birthday.

Steggerda and Hill (1942) also note that part of the discrepancy between studies could be

due to the fact that not all authors take into consideration the uneven distribution of sex in their

study samples, which becomes a problem when female dentitions consistently erupt earlier than

those of males. An additional source of error could be that researchers often base their studies on

relatively small sample sizes, so the real variation in the population may, in actuality, be greater

than what is stated (Bang, 1989).

24
 Numerous studies also have found discrepancies when attempting to use a recognized

method of determining dental age on a different population than was originally tested. This

disagreement could be due to differences in calcification and eruption patterns between and among

various populations. However, it would be interesting to determine if some of these differences

were due more to improper application than due to true population differences.

Additionally, there is generally an underlying assumption that the error ranges were properly

constructed for the reference population and that the error ranges were then correctly applied to the

new population. However, the methods in these studies are rarely questioned and many obtain

impressive results from incomplete data, non-random samples, and small sample sizes, and many do

not take into consideration differences in sex or ancestry. They rarely give methods or reasons

behind their statistical analyses and frequently fail to give enough summary statistics to allow for

critical comparison and assessment.

Summary

The importance of the human dentition as a “measure of maturity” and the association of

dental age with chronologic age are of interest to both the forensic anthropologist and the

orthodontist. An investigation of the literature reveals numerous studies of dental development,

including formation and eruption. Various methodologies have been used to establish standards for

estimating age at death in medicolegal cases. If the standards determined for dental aging are

applied to unknown skeletal remains without questioning the origin or validity of these standards,

scientists may be introducing unrecognized error into their predictions. It is important to question

these older, but accepted methods of age determination to determine their applicability in modern

usage.

25
 CHAPTER 3: DEVELOPMENT OF THE DENTAL AGING CHARTS

The first chronologies of dental formation can be attributed to Legros and Magitot (1880,

1881; quoted from Smith, 1991:145). These authors developed tables that displayed the appearance

of dental tissues and structures for both the deciduous and permanent teeth, with emphasis on

prenatal formation. In 1933, Logan and Kronfeld examined children with various dental

abnormalities, including cleft palate and linear enamel hypoplasias, and discussed the errors found

in Legros and Magitot’s chart of calcification. The authors found that within the table, all

permanent teeth, from central incisor to second premolar in both upper and lower jaws, are shown

as beginning calcification at one month after birth, whereas “in reality there are differences of

almost two years between formation of the dentin of the central incisor and that of the second

bicuspid” (1933:392). Logan and Kronfeld also found that although the chart contains many

inaccuracies, “the table has for four decades been copied, without modification, by accepted

authorities on histology” (p. 392). Smith (1991) cites the errors found in Legros and Magitot’s

chart as a result of their data being poorly translated into English and their table of development

being partially misprinted. Later developmental charts appeared in American dental journals in

1883 (Black) and 1884 (Peirce) without any description of the methods or sample subjects. Smith

(1991:146), however, believes that these charts were a product of each author’s analyses of

hypoplastic banding and found that when “measured against modern studies, all are quite

inaccurate.”

Later, in 1924, W.J. Brady printed a chart that pictographically depicts stages of dental

development, eruption, and absorption that he developed after more than 25 years of study. He

believed that it was a dentist’s duty to know the average time of loss of the deciduous teeth, much

26
as they know their multiplication tables, in order to properly care for children’s teeth. Brady laments

“both live-stock and automobiles usually receive better care than children’s teeth. Surely children

are as important as pigs or flivvers!” (Brady, 1924:3). His chart displays both the upper and lower

dentition beginning at the 17th week of embryonic life and follows prenatal development through

the 20th, 25th, 30th, and 40th (birth) weeks. The postnatal stages begin at 5 months and are also

recorded at 7, 9, 14, 18, 24, and 30 months and then continue consecutively from 3 to 15 years of

age.

In 1940 (b), Schour and Massler researched the incremental growth of the teeth and likened

their development to tree rings. Their study included a table modifying data from Logan and

Kronfeld (1933) and Kronfeld (1935a, b) on the initiation of calcification of the permanent teeth.

The authors also included a ‘diagrammatic representation of the chronology and mode of

development of human upper teeth’ (1940b:1929), which appears to apply some of the Logan and

Kronfeld data as well as their own data (Schour and Hoffman, 1939; Schour and Kronfeld, 1938;

Schour and Massler, 1940a, 1940b). There are some critiques against Schour and Massler using

these data because they were based on a very small sample and many of these individuals had died

from illnesses, which could, potentially, have had an effect on their dental development (Garn et al.,

1959; Miles, 1963; Lunt and Law, 1974a; Ubelaker, 1987). Additionally, they seem to ignore

previous findings that the Logan and Kronfeld ranges (1933; Kronfeld, 1935a,b) were too narrow

and that many children “fell outside of the published ranges, occasionally by as much as 3 to 4 years

(Garn et al., 1959; Lewis and Garn, 1960).

Despite using the same manner of presentation, Schour and Massler do not reference

Brady’s (1924) previous diagram representing a pictorial development of the dentition. There are

many noticeable discrepancies between the two charts. Most conspicuously, Brady does not

27
indicate that the permanent teeth begin their formation until 14 months of age, with the calcification

of the medial permanent incisor crown. Schour and Massler, however, show in their chart that the

permanent teeth begin their formation at the age of 6 months with calcification of the crowns of

both the medial incisor and canine. Schour and Massler’s developmental chart more closely depicts

published data for these rates of formation. Schour and Massler’s chart (1940b) shows 21

developmental stages of the upper dentition from 5 to 8 months in utero, birth, 6 months, 9 months,

and then chronologically 1 to 14 years of age.

Schour and Massler later modified their pictorial chart in 1941, with 22 developmental

stages for the first 35 years of life. They eliminated the 13 and 14-year age stages and included new

stages at ages 15, 21, and 35. The authors do not list any prior references used, however, these data

are probably extensions of their 1940’s data (a, b). Differences between the 1940b and the 1941

charts are minor, with dissimilarities beginning at the 2 year stage. Their older chart (1940b) shows

the second permanent premolar beginning cusp formation at age 2; however, this is not seen in the

new chart until age 3. Additionally, the third molar at age 15 in the 1941 chart shows the same

stage of root development as eliminated age 13 in the older version. Schour and Massler describe

their chart as having six overall phases of development, including Prenatal, Birth/Neonatal, Infancy,

Childhood, Grade-School, and Adulthood. Within these phases are further distinctions. The

authors describe the Prenatal period as the time when the crowns of the deciduous teeth begin to

grow and calcify. The Birth/Neonatal period is defined as the time during which root formation has

not begun and the deciduous teeth are unerupted. It is at this time that the crowns of the deciduous

incisors are five-sixths complete, the canine crowns are one-half complete, the cusps of the first

premolar are completed and coalesced, and the cusps of the second premolar are one-half formed

and still isolated. The Infancy period is designated by an Early Infancy period (Birth to 6 months)

28
and a Late Infancy Period (6 months to 1 year). The Early Infancy period is characterized by the

growth and calcification of the canines. The Late Infancy period includes the eruption of the

deciduous incisors. The Childhood period is also known as the “preschool age” and includes

children from ages 2 to 6. It involves the complete presence of the deciduous dentition in the mouth

by the end of the second year, the gradual resorption of the deciduous roots, and continued growth

and calcification of the permanent first molars and anterior teeth. Schour and Massler also note that

during this period, at around 4 to 5 years of age, the deciduous anterior teeth begin to spread apart to

accommodate the eruption of the larger permanent teeth. The Grade-School period is characterized

by grade-school aged children from 6 to 12 years of age. This stage features a time of mixed

dentition and is divided into the Early Grade-School period (ages 6 to 10) and the Prepubertal

period (ages 10-12). The Early Grade-School period begins with the eruption of the first permanent

molar at 6 years and also features the appearance of the permanent incisors at 7 to 8 years. The

Prepubertal period begins with the eruption of the first and second permanent premolars, the

canines, and the eruption of the permanent second molars (at approximately 12 years of age). This

stage is characterized by the completion of the permanent dentition, with the exception of the third

molar. The Adulthood period of this chart includes the Adolescent period (ages 12 to 15), which

features the completion of all the permanent dentition, and the Young Adult period (ages 15 to 21),

which is the period when the third molar erupts.

The Schour and Massler chart appears in a slightly modified version in 1944 as a wall-sized

chart entitled ‘Development of the Human Dentition’ distributed by the American Dental

Association (see Figure 3.1). This chart notes at the bottom that it is the second edition; however, it

is uncertain which version of the previous two charts are considered to be the ‘first.’

29
30
FIGURE 3.1. Schour and Massler’s 1944 Chart entitled ‘Development of the Human Dentition.’ Reprinted with permission
of the American Dental Association.
31
FIGURE 3.2. Ubelaker’s 1989 Dental Aging Chart from Human Skeletal Remains (Fig. 71). Reprinted with permission of
Taraxacum Inc. Publishing Company and Douglas H. Ubelaker.
The library at the American Dental Association in Chicago was unable to locate an earlier edition of

the wall-sized chart and the only other versions of the Schour and Massler chart were published by

the Journal of the American Dental Association in 1940 and 1941. The newer 1944 chart is similar

to the 1941 version; however, one noticeable difference is the addition of error ranges. There are no

data accompanying this new chart in the form of published research in a journal, thus it is not

certain how the error ranges were derived. Other differences include the elimination of postnatal

ages of 6 and 8 months and the addition of an 18-month age stage (1.5 years). The newly added 18-

month age group most closely resembles the 1941 stage at 2 years. Beginning with 6 months of

age, there are apparent differences in the formation of the dentition, with root development in the

later Schour and Massler chart being more advanced at almost every stage. Despite this

progression, the ages for loss and eruption are still the same for both charts. The phases mentioned

by Schour and Massler in 1941 are now partially visualized in their 1944 chart. This chart is

grouped by Deciduous Dentition, Mixed Dentition, and Permanent Dentition categories. The

Deciduous Dentition includes two subgroups, Infancy (5 months to 18 months) and Early

Childhood/Pre-School Age (2 to 6 years). The Mixed Dentition includes Late Childhood/School

Age children ages 7 to 10 years, and the Permanent Dentition grouping includes ‘Adolescence and

Adulthood’ individuals aged 11 to 35 years.

The 1944 Schour and Massler chart was printed in their “Atlas of the Mouth and Adjacent

Parts in Health and Disease” (1958) published by the American Dental Association, and includes

the same error ranges. This version of their chart is very similar to their 1944 chart with the first

difference being seen at age 6, with development of the permanent upper and lower canines

beginning root initiation. Root initiation has not begun in the previous chart at this age and does not

reach the same stage in the 1958 chart until 8 years of age. At 7 years in the 1958 chart, the

32
development of the permanent lower canine is shown with the development of the root half shaded.

This seems to be the authors’ way of displaying the high variability in the formation of this

particular tooth. At age 8, the stages again become similar in their formation to the 1944 chart.

In 1978, and again in 1989, Ubelaker expanded and changed many of the error ranges

originally given by Schour and Massler in 1944 (see Figure 3.2). This change seems to be primarily

due to the fact that Ubelaker’s chart was developed for analysis of Native American Indians and

other non-white dentitions after determining that Schour and Massler’s chart consistently

overestimated the ages at death of these individuals and underestimates their actual growth rate

(Merchant and Ubelaker, 1977). Despite the modifications made for Native American individuals,

Ubelaker’s chart has now become a recognized world standard for all ancestral groups. Ubelaker

also made minor adjustments to the original pictorial depictions of the rates of formation and

eruption of the teeth, with the most distinct visual difference being in the development of the canine

from the age of 18 months to 2 years. The changes made by Ubelaker are associated with various

author’s findings of earlier formation and development of Native American individuals. However,

the chart derived and modified from these data should not be a substitute for these original

publications (Ubelaker, 1987).

There seem to be spontaneously generated or tacitly modified differences among all of the

dental aging charts with no mention as where these differences were generated. For example,

Ubelaker’s 1989 chart was reproduced in a text by Buikstra and Ubelaker (1994:51), and while

Ubelaker’s 1989 text gave a target age with error range as 12 years ± 30 months, the 1994 text gave

an error range for the same age of ±36 months with no mention as to why this change was made.

Additionally, Ubelaker’s newer 1999 edition of his 1989 book replicates the chart again with the

error age at 12 years ± 30 months, and he notes that his ranges express variability within the

33
literature; the error intervals may be inexact by as much as 5 years, especially among the older ages.

Some errors in using these charts are incorrect citations; for example, some say they use the 1941

Schour and Massler chart, however, they have actually examined the 1940 chart (Trodden, 1982:5).

Brauer and Bahador (1942) tested Schour and Massler’s 1940 chart on 315 patients and

found that only 45-49% of the patients tested exactly matched the picture given for the appropriate

year. The investigators noted difficulties in reconciling anterior versus posterior tooth development.

They determined that “calcification age and eruption age do not necessarily correspond with

chronologic age” (Brauer and Bahador 1942:1386).

Miles (1958) tested Schour and Massler’s 1941 chart and found that on individuals up to the

age of 12, most were close to their actual estimates, few exceeding their true age by more than one

year. After 12 years, Miles found an increasing tendency for the individuals to be scored 2 or more

years above or below the actual age. The age estimates found with Schour and Massler’s 1941

chart for individuals over 16 years of age were consistently too low, and the author suggests

modifying the chart to correct the development of the third molar.

Miles (1963) again critiques Schour and Massler’s 1941 chart, citing that it is limited to

individuals below 15 years because no stages of growth for the third molar are recorded for the

critical formation ages between 15 and 21 years. Miles claims that “where material of unknown sex

is concerned, estimates of age based on the dentition are more likely to be correct than those based

on osseous development” because sex differences in the skeleton are about three times greater than

those for tooth development (p. 258). Scheuer and Black (2000) recommend that Schour and

Massler’s 1941 chart is best used when examining infancy and early childhood subjects.

There do not appear to be any tests of Ubelaker’s chart. There was a modification made by

WEA (1980) that can be viewed in Scheuer and Black (2000) that was based on Ubelaker’s 1978

34
chart. The only major differences in this newer chart is that the error interval at 15 years has been

narrowed from 15 ± 36 months, as was previously found in Ubelaker’s chart, to 15 ± 30 months.

Additionally, in the WEA chart, at 6 months of age the permanent cusps are beginning in the

mandible, which is not present in Ubelaker.

The history of these dental charts is long and complex, but it seems that they each lack

vigorous testing. Those tests that have been performed do not recommend any major changes.

35
 CHAPTER 4: MATERIALS AND METHODS

Clinical Sample

The sample for this study was used upon receiving approval from the Indiana University-

Purdue University at Indianapolis (IUPUI) and Clarian Institutional Review Boards and

Subcommittees Reviews, as well as the University of Indianapolis Committee on Research

Involving Human Participants. The subjects for this longitudinal study were located by examining

existing records located at the Riley Hospital Dental Clinic in Indianapolis, Indiana. The sample

consists of 419 randomly selected European children from 5 to 15 years of age and includes

approximately equal numbers of males and females for each year of age. Research was conducted

until approximately twenty males and twenty females were obtained for each age or until the

existing supply of records for that age was exhausted (see Table 4.1). The age ranges from 5 to 15

were selected because of the available data and because children tended to have their first dental

visit at Riley Hospital at around five years of age. By the age of fifteen, permanent teeth (excluding

the third molar) are nearing full occlusion (Harris and McKee, 1990; Nanda, 1960).

Individuals not of European-American ancestry were excluded from this study in order to

concentrate on variation within one ancestral group and to maximize homogenous sample sizes.

Ancestral information was obtained from the patient’s charts and was based on notations made by

the residing dentist. Within these charts, the general notes for ‘race’ were abbreviated with ‘W’ for

white, ‘H’ for hispanic and ‘B’ for black. Only those individuals with a ‘W’ notation were included

in this study. Additionally, any chart with mention of biracial ancestry (Bi) was eliminated from

this study.

36
 TABLE 4.1. Comparison of total number of male and female European subjects per age
range.

AGE MALES FEMALES TOTAL

5.00-5.99 14 9 23
6.00-6.99 25 17 42
7.00-7.99 25 25 50
8.00-8.99 27 20 47
9.00-9.99 22 21 43
10.00-10.99 21 19 40
11.00-11.99 23 21 44
12.00-12.99 18 19 37
13.00-13.99 21 15 36
14.00-14.99 19 8 27
15.00-15.99 13 17 30
TOTAL 228 191 419

Other charts that were eliminated included all patients with considerable orthodontia (such

as braces) or more than one absent tooth. Also excluded were any panoramic radiographs that were

blurry, washed out, or that had an unlisted date of exam which could not be determined from the file

information. In addition, any siblings of a subject previously selected were excluded. Sibling status

was determined by a common surname and street address. Some patients’ charts had discrepancies

between the date of birth on the radiograph and the one located within the chart. If a discrepancy

was found, the birth date used was the one recorded by the parent on the patient information sheet.

The panoramic radiographs used to assess the stages of formation and eruption of the teeth

were taken by trained technicians using a Planmeca Proline PM2002 CC panoramic unit before the

beginning of this study. Panoramic radiographs were chosen because they provide comprehensive

coverage of all teeth, and the film includes the “maxillary region extending to the superior third of

the orbit, and the entire mandible including the temporomandibular joint region” (Miles and Parks,

37
2004:72). The use of bitewings was discarded early in the study due to the limited number of teeth

represented on them and the lack of notation of which side of the jaw each bitewing film represents.

The only information taken from the patients’ charts was the child’s sex, date of birth, and

the date of the radiograph. Radiographs were placed on a lighted mount in a room with subdued

lighting to allow for accurate interpretation and ideal digital images. Two digital pictures were

taken of each radiograph with a Fuji FinePix 2650 digital camera at one megapixel of resolution to

allow for analysis at a different time. All potentially identifying information was blocked out of the

pictures with black electrical tape. Consecutive numbering was assigned by the researcher for each

individual and a sticker with this number was placed on the radiograph for the purpose of the

picture and then removed. This number was recorded, along with the data for that particular

individual, on a self-designed Data Recording Form (which is appended at the end of this chapter).

Scoring Systems

Specific dental stage numbers were assigned to Ubelaker’s (1978) and Schour and Massler’s

(1944) dental charts, beginning with 1 for the ‘birth’ stage and ending with 18 at the age 21 stage.

Since the ages in the study range from 5 to 15, stages 9 through 17 were generally assigned for

those ages (Nawrocki et al., 1998).

The best digital image for each individual was professionally printed onto Fuji Film Printpix

paper. Each picture was then visually compared to Ubelaker’s (1978) dental aging charts and given

a dental stage number according to which Ubelaker stage the radiograph most closely matched.

Then all pictures were reexamined using Schour and Massler’s (1944) chart. The left side of the

mouth (including both the mandible and the maxilla) was used in all cases to make comparison with

the published charts easier. In addition, any developmental abnormalities (e.g., congenitally absent

38
teeth) were noted.

The target age for each dental stage was the predicted age given by each chart, which was

then compared with the actual chronological age. The chronological age was calculated as a

decimal age using the website http://www.simd.org/Tools/age.asp by entering the date of birth and

the date that the panoramic radiograph was taken.

All data were entered into a Microsoft Excel 2000 spreadsheet for calculating general

statistics and developing tables.

Statistical Methods

Various summary statistics were calculated for each chart, including mean age per stage,

standard deviation, and observed ranges. Bias and inaccuracy statistics (measures of mean error)

were calculated for each stage and for each chart as a whole. Bias was calculated as

∑expected age – observed age

/n

and inaccuracy was calculated as

∑(expected age – observed age)/n

The percentage of individuals correctly falling within the predicted +/-2 standard deviation interval

for each stage was also calculated. The data were then evaluated for sex differences using t-tests

and analysis of covariance (ANCOVA) with SYSTAT v. 5.2.1 for the MacIntosh (Wilkinson,

1992). In the analysis of covariance (ANCOVA), the recorded stage is the semi-continuous

39
dependent variable, sex is a categorical independent variable, and age is a continuous covariate

independent variable, resulting in the following model:

Dental Stage = Sex + Actual Age + error

The 95% prediction intervals were calculated for each stage using the formula:

Target age ± t(0.05) (1 + 1/n)1/2 (s)

where ‘n’ is the number of individuals within a stage and ‘s’ is the standard deviation of that

particular stage being tested. The percentage of individuals correctly falling within the 95%

prediction intervals was calculated for each stage and for each chart overall.

40
 University of Indianapolis

Department of Biology

Emilie L. Smith – M.S. Thesis Research

SAMPLE NUMBER: __________ SEX: __________

BIRTHDATE: __________ DATE OF EXAM: __________

Date of Radiographs Years Months Decimal Age

Orthopantograms

Bitewings

Other

UBELAKER DENTAL STAGE: _______________

TARGET AGE: __________ ERROR RANGE: __________

S & M (1944) DENTAL STAGE: _______________

TARGET AGE: __________ ERROR RANGE: __________

NOTES: Left side of mouth examined for all stages.

41
 CHAPTER 5: RESULTS

Qualitative Results

When analyzing each radiograph and assigning each individual a stage (9-17), certain

nuances were observed that influenced how individuals were scored using the Ubelaker (1989)

and the Schour and Massler (1944) charts. For example, in stage 9, the first molars have begun

root formation in Ubelaker’s chart; however, in Schour and Massler’s chart, they have only just

completed crown formation (see Figure 5.1). This difference caused some individuals to be

classified as one stage later when using Schour and Massler’s chart. Stages 10 and 11 were very

similar between the two charts and no problems were noted in these stages.

Beginning with stage 12, additional differences can be observed between the charts. At

this stage in Ubelaker’s chart, the first and second permanent incisors are at stage 13 in Schour

and Massler’s. This led to some differences when scoring the study sample. In addition, in

Schour and Massler’s stage 12, the canine is underdeveloped relative to Ubelaker’s chart (the

root should be developed at approximately ½ its full length but it is shown at ¼). This difference

led to some individuals being placed into Schour and Massler’s stage 13 when the root was

further developed (see Figure 5.2).

At stage 13, the second molar in Ubelaker’s chart is shown with roots developing,

however, in Schour and Massler, root formation has not yet begun. It was found that Ubelaker’s

chart more accurately depicted the state of tooth development in the study sample in this respect.

In Ubelaker’s chart the development of the roots of the first and second incisors at stage 13 were

at stage 14 in Schour and Massler’s chart. However, while these differences were noticeable,

they did not affect the stage placement because the overall eruption pattern had not advanced to

42
 Schour and Massler (1944) Ubelaker (1989)

FIGURE 5.1. Comparison of Schour and Massler’s and Ubelaker’s Stage 9.

Ubelaker (1989)

Schour and Massler (1944)

STAGE 12 STAGE 13

FIGURE 5.2. Comparison of Schour and Massler’s and Ubelaker’s Stages 12 and 13.

43
Schour and Massler’s stage 14.

It should be noted that in evaluations of Schour and Massler’s stage 13, in most cases the

mandibular teeth were more advanced than they should be (especially the roots of the 1st and 2nd

permanent premolars) while the maxillary teeth tended to match the picture very well. Another

general irregularity in both charts involves the formation of the permanent second premolar,

shown as being developmentally the same as the first premolar. However, the P2 was found to

be less developed than the P1 in most cases. This difference was especially noted in stages 13

and 14.

Another scoring difficulty for both Schour and Massler’s and Ubelaker’s charts was

distinguishing between stages 14 and 15. The major difference between these stages is the

transition from mixed dentition to permanent dentition. Thus, for both charts, even if most of the

teeth were in stage 15, if any deciduous teeth were present, they were placed into stage 14. The

unintended effect of this strategy was to dramatically reduce the number of individuals in stage

15 (Tables 5.1 & 5.2).

For both charts, the difference between stages 16 and 17 is slight. If root formation for

the M2 and the P2 was incomplete, the specimen was classified as stage 16, and if all of the

apices were closed, the specimen was placed into stage 17. Differences in the development of

the third molar between stages 16 and 17 were observed, but these differences were highly

variable and did not appear to be stage-specific.

Overall, it seemed that the Ubelaker chart performed better than the Schour and Massler

chart in both placing individuals correctly in the stage that they should have belonged in and in

the correct phase of development for each tooth in the diagrams.

44
Quantitative Results

The first method used to compare the two charts evaluates the range of ages obtained per

stage. The second method compares the means obtained for the study sample with the predicted

means from the original charts. Third, bias and inaccuracy statistics were calculated to assess

mean error. The fourth method of comparison evaluated the predicted error ranges as given in

each original chart. After these comparisons, I checked for differences between the sexes, and

lastly I constructed new target ages and 95% prediction intervals for each stage.

Method 1: Range of ages per stage. The first method used to assess the Ubelaker and

Schour and Massler charts was a comparison of the distribution of individuals by age per

observed stage (Tables 5.1 and 5.2). The largest numerical grouping for each stage is marked

with a bold font. As seen by the positions of the bolded values, Table 5.1 shows a fairly linear

progression from stages 9-13 for Ubelaker’s chart with some disparity for ages 10, 11, 13, and

14. The trend for Schour and Massler’s chart is also fairly linear. Both tables lack a strong

grouping of individuals for stages 12 and 15. Overall, both charts seem to track the age of

individuals fairly well. A total of 37% (139/375) of the kids up to and including stage 16 scored

with Ubelaker’s chart fell in the predicted “best” stage, while a total of 36% (137/377) of the

children scored with Schour and Massler’s chart fall in their predicted “best” stage.

Method 2: Comparing the means. The second method used to assess the two charts is

to compare the mean ages obtained from the study sample with the predicted ages for each stage

for the published charts. Summary statistics, including the mean, standard deviation, sample

variance, minimum and maximum, and sample size for each of these stages are given in Tables

5.3 and 5.4. The data for these tables are calculated using combined sexes.

45
TABLE 5.1. Comparison of number of individuals by age per observed Ubelaker stage
(sexes combined).

Observed Ubelaker Stage

Decimal Age 8 9 10 11 12 13 14 15 16 17 Totals
5.00-5.99 1 13 9 23
6.00-6.99 6 24 11 1 42
7.00-7.99 7 25 15 3 50
8.00-8.99 1 16 17 11 2 47
9.00-9.99 2 4 8 20 9 43
10.00-10.99 2 4 15 14 3 2 40
11.00-11.99 2 23 7 12 44
12.00-12.99 1 7 6 19 4 37
13.00-13.99 4 25 7 36
14.00-14.99 13 14 27
15.00-15.99 12 18 30
Totals 1 19 43 58 45 52 59 16 83 43 419

TABLE 5.2. Comparison of number of individuals by age per observed Schour and
Massler stage (sexes combined).

Observed Schour & Massler Stage

Decimal Age 8 9 10 11 12 13 14 15 16 17 Totals
5.00-5.99 12 11 23
6.00-6.99 3 27 10 2 42
7.00-7.99 8 21 17 4 50
8.00-8.99 1 15 11 17 4 47
9.00-9.99 2 4 5 23 9 43
10.00-10.99 2 3 14 16 3 2 40
11.00-11.99 2 23 7 12 44
12.00-12.99 1 7 6 20 3 37
13.00-13.99 4 25 7 36
14.00-14.99 13 14 27
15.00-15.99 12 18 30
Totals 0 15 49 52 38 61 92 16 84 42 419

46
 TABLE 5.3. Summary statistics for age for each Ubelaker stage (sexes combined).

Stage 9 Stage 10 Stage 11

Mean 5.75 Mean 6.57 Mean 7.80
Standard Deviation 0.529 Standard Deviation 0.942 Standard Deviation 0.908
Sample Variance 0.280 Sample Variance 0.887 Sample Variance 0.824
Minimum 5.02 Minimum 5 Minimum 6.3
Maximum 6.6 Maximum 9.29 Maximum 10.44
n 19 n 43 n 58

Stage 12 Stage 13 Stage 14

Mean 8.43 Mean 9.59 Mean 11.14
Standard Deviation 0.940 Standard Deviation 1.046 Standard Deviation 1.156
Sample Variance 0.884 Sample Variance 1.093 Sample Variance 1.335
Minimum 6.97 Minimum 7.15 Minimum 8.84
Maximum 10.49 Maximum 12.04 Maximum 13.85
n 45 n 52 n 59

Stage 15 Stage 16 Stage 17

Mean 11.64 Mean 13.34 Mean 14.53
Standard Deviation 0.844 Standard Deviation 1.316 Standard Deviation 1.047
Sample Variance 0.712 Sample Variance 1.733 Sample Variance 1.097
Minimum 10.12 Minimum 10.5 Minimum 12.1
Maximum 12.96 Maximum 15.84 Maximum 15.96
n 16 n 83 n 43

47
 TABLE 5.4. Summary statistics for age for each Schour & Massler stage
(sexes combined).

Stage 9 Stage 10 Stage 11

Mean 5.69 Mean 6.51 Mean 7.81
Standard Deviation 0.520 Standard Deviation 0.947 Standard Deviation 0.952
Sample Variance 0.270 Sample Variance 0.898 Sample Variance 0.906
Minimum 5.07 Minimum 5 Minimum 6.3
Maximum 6.6 Maximum 9.29 Maximum 10.44
n 15 n 49 n 52

Stage 12 Stage 13 Stage 14

Mean 8.22 Mean 9.42 Mean 11.07
Standard Deviation 0.973 Standard Deviation 1.012 Standard Deviation 1.195
Sample Variance 0.947 Sample Variance 1.025 Sample Variance 1.429
Minimum 6.97 Minimum 7.15 Minimum 8.09
Maximum 10.49 Maximum 12.04 Maximum 13.85
n 38 n 61 n 62

Stage 15 Stage 16 Stage 17

Mean 11.64 Mean 13.33 Mean 14.58
Standard Deviation 0.844 Standard Deviation 1.314 Standard Deviation 0.996
Sample Variance 0.712 Sample Variance 1.726 Sample Variance 0.993
Minimum 10.12 Minimum 10.5 Minimum 12.1
Maximum 12.96 Maximum 15.84 Maximum 15.96
n 16 n 84 n 42

48
 The mean ages for each chart are summarized in Table 5.5, and it can be seen that the

study sample tracks the predicted ages on the charts fairly well but are mostly overestimated.

Much of this overestimation, however, is due to the authors of these charts rounding down their

age designations in each category to obtain whole numbers. In both charts, it was observed that

stages 14 and 15 appear to have similar mean ages, and t-tests indicate that the mean ages for

these stages are not statistically different (Ubelaker: t = 1.34, p = 0.18, df = 64; Schour and

Massler: t = 1.32, p = 0.19, df = 63). Therefore, in order for these charts to be used in a rigorous

fashion, stages 14 and 15 may need to be combined into a single stage. However, the similarity

may simply be a result of the small sample size for stage 15 (n = 16). The mean age for stage 16

for the study sample shows the greatest difference from the chart means, probably because at this

age, juvenile dental formation and eruption has slowed and both Ubelaker and Schour and

Massler combined 12, 13, and 14 year age groups, so the use of age 12 as the predicted age for

stage 16 is misleading. Stage 17 is underestimated when comparing the obtained mean age with

TABLE 5.5. Obtained mean ages for Ubelaker and Schour and Massler stages
(sexes combined).

Ubelaker Schour & Massler

Obtained Ubelaker Obtained S&M
Actual Actual
Mean (n) Predicted Mean (n) Predicted
Stage Stage
Age Age Age Age
9 5.75 19 5 9 5.69 15 5
10 6.57 43 6 10 6.51 49 6
11 7.80 58 7 11 7.81 52 7
12 8.43 45 8 12 8.22 38 8
13 9.59 52 9 13 9.42 61 9
14 11.14 59 10 14 11.07 62 10
15 11.64 16 11 15 11.64 16 11
16 13.34 83 12 16 13.33 84 12
17 14.53 43 15 17 14.58 42 15

49
the charts’ predicted ages probably because the study sample was restricted to individuals under

the age of 16, resulting in artificial truncation.

Method 3: Assessing mean error. The mean error for each chart was determined by

calculating bias and inaccuracy statistics for the study sample for each stage, using Ubelaker’s

and Schour and Massler’s predicted ages. The bias for both charts was negative across all stages

(see Table 5.6), indicating a systematic underestimation of the true ages by about seven-tenths of

a year. This underestimation is largely a result of the target ages for each stage on the original

charts being rounded to the nearest whole year. Therefore, any juvenile age estimate based on

these charts will always underestimate the actual age of the subject unless the radiograph was

taken on their birth date. For example, for a random sample of 5-year-old children, it would be

expected that the mean age would be approximately 5.5 years of age. Consequently, for each

dental stage given in whole years, the expected baseline bias should be -0.5 years. When the

rounding error on both charts is taken into account, the obtained bias values in Table 5 are

reasonable and not much more than the predicted 0.5 years, indicating that overall, the chart

diagrams perform well. The only exceptions that are readily observed are stages 14 and 16 in

both charts, which seem to underestimate the ages of the study sample more than would be

predicted by the rounding errors.

Inaccuracy values are predictably higher than the bias values, ranging from about 0.7 to

1.5 years. Again, 0.5 years of this error is due to the rounding of the chart ages to the nearest

year. As before, stages 14 and 16 performed less well than the others. Overall, Schour and

Massler’s chart performs slightly better than Ubelaker’s with both lower inaccuracy and bias

values for nearly every stage.

50
TABLE 5.6. Inaccuracy and bias values (in years) for Ubelaker and Schour and Massler’s
charts (sexes combined). One individual in Stage 8 is included in the totals.

Ubelaker Schour and Massler

Actual Actual
Ubelaker Bias Inaccuracy (n) S&M Bias Inaccuracy (n)
Stage Stage
9 -0.75 0.75 19 9 -0.49 0.69 15
10 -0.57 0.82 43 10 -0.57 0.81 49
11 -0.80 0.93 58 11 -0.73 0.95 52
12 -0.43 0.75 45 12 -0.14 0.71 38
13 -0.59 0.99 52 13 -0.54 0.88 61
14 -1.04 1.20 59 14 -1.05 1.20 62
15 -0.64 0.88 16 15 -0.64 0.88 16
16 -1.34 1.55 83 16 -1.34 1.53 84
17 -0.47 0.85 43 17 -0.40 0.80 42
Avg Avg
Error (all -0.71 1.05 419 Error (all -0.66 1.03 419
stages) stages)

Method 4: Assessment of predicted error ranges. The fourth method of evaluating

the performance of the charts is to calculate the number of individuals correctly falling in the

predicted error ranges as given for each stage (Table 5.7). For Ubelaker’s chart, the actual age

correctly falls within the predicted age ranges 91% of the time for the entire sample, and no stage

performs below about 79%. Schour and Massler’s chart, however, performed less well, with

only 44% of the individuals falling within the predicted ranges for the entire sample. The

difference in success between the two charts is due in part to Ubelaker’s predicted age ranges

including two standard deviations around each mean age, while Schour and Massler’s ranges are

considerably narrower, using only one standard deviation. However, even when Schour and

Massler’s error ranges are doubled, only 69.7% of the individuals fall within the range limits.

Stage 16 performs very poorly with only 18% success when using the non-doubled error range.

51
 TABLE 5.7. Comparison of correct age assessment using Ubelaker and Schour and
Massler’s charts (sexes combined).

Predicted
Observed # Individuals Observed Predicted # Individuals
Ubelaker
Ubelaker Within % S&M S&M Range Within %
Range (in
Stage Range Stage (in years) Range
years)

9 3.70-6.30 15/19 78.9 9 4.25-5.75 9/15 60.0

10 4.00-8.00 40/43 93.0 10 5.25-6.75 28/49 57.1
11 5.00-9.00 52/58 89.7 11 6.25-7.75 28/52 53.8
12 6.00-10.00 41/45 91.1 12 7.25-8.75 25/38 65.8
13 7.00-11.00 49/52 94.2 13 8.25-9.75 28/61 45.9
14 7.50-12.50 52/59 88.1 14 9.25-10.75 25/62 40.3
15 8.50-13.50 16/16 100.0 15 10.25-11.75 8/16 50.0
16 9.00-15.00 71/83 85.5 16 11.50-12.50 15/84 17.9
17 12.00-18.00 43/43 100.0 17 14.50-15.50 19/42 45.2
TOTAL (all stages) 379/418 90.7 TOTAL (all stages) 185/419 44.0

Note that between stages 16 and 17, there is a gap between ages 12.5 and 14.5 years in which no

individual can be placed. Therefore, it is technically impossible to age an individual at, say, 13

years with their chart. Their most accurate stage was stage 12, with 65.8% of the individuals

correctly falling within the (narrow) error range.

In sum, these results suggest that Ubelaker’s (1989) dental aging chart is superior to

Schour and Massler’s (1944) with respect to the robusticity of its error ranges. However, Schour

and Massler’s chart has lower inaccuracy and bias values. Both charts produce similar mean

ages for each stage and demonstrate equivalent regularity across the age range.

Sex Differences

Tables 5.8 through 5.11 present the distribution of individuals by age per observed stage,

but this time separated by sex. Again, the largest numerical grouping for each stage is marked

with a bold font. As would be expected, each of the tables shows a clear trend with the

52
TABLE 5.8. Comparison of number of individuals by age per observed Ubelaker stage
(females).

Observed Ubelaker Stage

Decimal Age 8 9 10 11 12 13 14 15 16 17 Grand Total
5.00-5.99 6 3 9
6.00-6.99 1 11 4 1 17
7.00-7.99 1 14 7 3 25
8.00-8.99 3 9 6 2 20
9.00-9.99 1 2 3 11 4 21
10.00-10.99 1 7 9 2 19
11.00-11.99 1 8 4 8 21
12.00-12.99 2 3 10 4 19
13.00-13.99 1 12 2 15
14.00-14.99 5 3 8
15.00-15.99 9 8 17
Grand Total 0 7 16 24 20 28 26 9 44 17 191

TABLE 8. Comparison of number of individuals by age per observed Ubelaker stage

(males).

Observed Ubelaker Stage

Decimal Age 8 9 10 11 12 13 14 15 16 17 Grand Total
5.00-5.99 1 7 6 14
6.00-6.99 5 13 7 25
7.00-7.99 6 11 8 25
8.00-8.99 1 13 8 5 27
9.00-9.99 1 2 5 9 5 22
10.00-10.99 1 4 8 5 1 2 21
11.00-11.99 1 15 3 4 23
12.00-12.99 1 5 3 9 18
13.00-13.99 3 13 5 21
14.00-14.99 8 11 19
15.00-15.99 3 10 13
Grand Total 1 12 27 34 25 24 33 7 39 26 228

53
TABLE 9. Comparison of number of individuals by age per observed Schour and Massler
stage (females).

Observed Schour & Massler Stage

Decimal Age 8 9 10 11 12 13 14 15 16 17 Grand Total
5.00-5.99 5 4 9
6.00-6.99 12 3 2 17
7.00-7.99 1 12 9 3 25
8.00-8.99 3 3 11 3 20
9.00-9.99 1 2 1 13 4 21
10.00-10.99 1 6 10 2 19
11.00-11.99 9 4 8 21
12.00-12.99 2 3 11 3 19
13.00-13.99 1 12 2 15
14.00-14.99 5 3 8
15.00-15.99 9 8 17
Grand Total 0 5 18 21 15 33 29 9 45 16 191

TABLE 10. Comparison of number of individuals by age per observed Schour and
Massler stage (males).

Observed Schour & Massler Stage

Decimal Age 8 9 10 11 12 13 14 15 16 17 Grand Total
5.00-5.99 7 7 14
6.00-6.99 3 15 7 25
7.00-7.99 7 9 8 1 25
8.00-8.99 1 12 8 6 27
9.00-9.99 1 2 4 10 5 22
10.00-10.99 1 3 8 6 1 2 21
11.00-11.99 2 14 3 4 23
12.00-12.99 1 5 3 9 18
13.00-13.99 3 13 5 21
14.00-14.99 8 11 19
15.00-15.99 3 10 13
Grand Total 0 10 31 31 23 28 33 7 39 26 228

54
progression of age. However, a closer analysis of Ubelaker’s chart (Tables 5.8 and 5.9) shows

that the females show a more regular progression of stage per age, while the male’s pattern

displays more irregularity. Ages 11 and 13 seem problematic for both sexes. Similarly, Schour

and Massler’s chart (Tables 5.10 and 5.11) is fairly linear among females but more irregular

among males. A total of 43.7% (76/174) of the females younger than 14 scored with Ubelaker’s

chart fall in the predicted “best” stage, while only 32.6% (70/215) of the males do. A total of

41.4% (72/174) of the females younger than 14 scored with Schour and Massler’s chart fall in

the predicted “best” stage, while only 33.5% (72/215) of the males do. Overall, then the two

charts seem to perform equivalently.

An analysis of covariance for both Ubelaker’s and Schour and Massler’s observed stages

was performed on the data to assess the effects of sex. These results can be seen in Table 5.12.

The semi-continuous dependent variable is the observed stage, with sex as the categorical

independent variable and age being the continuous covariate independent variable:

Observed Dental Stage = Sex + Decimal Age + Error

The independent variables (sex and age) were found to be highly significant for both Ubelaker’s

and Schour and Massler’s charts, indicating that both variables significantly affect the expressed

dental stage.

Additionally, t-tests were utilized to compare mean age by sex for each stage (see Table

5.13). The differences between sexes in most of the stages are not significant. However, in

Ubelaker’s chart females and males are significantly different ages at stages 13 and 14 (ages 9-

10) and are approaching significance at stage 12 (p = 0.077). For Schour and Massler’s chart,

stages 12, 13, and 14 are significantly different between the sexes. These findings are consistent

55
 TABLE 5.12. Analysis of covariance results for sex and age using observed stage as the
dependent variable.

Observed Ubelaker Stage Observed Schour and Massler Stage

(n) Multiple R Squared Multiple R (n) Multiple R Squared Multiple R
419 0.93 0.87 419 0.93 0.87

Source df Mean-Square F-Ratio p Source df Mean-Square F-Ratio p

Sex 1 9.61 12.42 0.00 Sex 1 12.30 15.88 0.00
Age 1 2169.47 2804.57 0.00 Age 1 2078.62 2683.92 0.00
Error 416 0.77 Error 416 0.77

with published data that females’ teeth tend to develop faster than males. As a result, females

are reaching these stages earlier than males, as seen with a lower mean age. The mean age by

stage is always absolutely higher in males in both charts, except for stage 16. This stage includes

individuals ages 12-14, which is the age at which puberty begins. Males may begin to

developmentally catch up with girls in this age range due to a later growth spurt. For those

stages that are significantly different, there may be a need to differentiate them by sex.

TABLE 12. Sex differences in age for each Ubelaker and Schour and Massler stage.
Bold values indicate which sex is older for each stage.

Ubelaker Schour and Massler

Obtained t-Test Obtained t-Test

Obtained Obtained
Stage Female Significance Stage Female Significance
Male Mean Male Mean
Mean (p) Mean (p)
9 5.54 5.87 ns 9 5.45 5.81 ns
10 6.45 6.64 ns 10 6.37 6.60 ns
11 7.72 7.85 ns 11 7.75 7.85 ns
12 8.15 8.65 0.077, df = 43 12 7.75 8.53 0.014, df = 36
13 9.33 9.90 0.048, df = 50 13 9.10 9.79 0.007, df = 59
14 10.80 11.40 0.046, df = 57 14 10.72 11.39 0.027, df = 60
15 11.44 11.91 ns 15 11.44 11.91 ns
16 13.37 13.31 ns 16 13.35 13.31 ns
17 14.30 14.68 ns 17 14.30 14.68 ns

56
Prediction Intervals

The 95% prediction intervals were calculated for all stages using the formula:

Target age ± t(0.05) (1 + 1/n)1/2 (s)

where n is the number of individuals within a stage, and “s” is the standard deviation of that

particular stage being tested (Hahn & Meeker 1991). The data for the 95% prediction intervals

can be found in Tables 5.14 and 5.16 for Ubelaker and Tables 5.15 and 5.17 for Schour and

Massler. These tables display a new target age based on the observed data for this study and the

limits of the prediction interval. In addition, the percentage of individuals that correctly fell

within these parameters was calculated.

Based on the significant differences found between the sexes for Ubelaker’s stages 13

and 14 and Schour and Massler’s stages 12, 13, and 14, the 95% prediction intervals were also

calculated for males and females separately at these stages (Tables 5.16 and 5,17, respectively).

TABLE 5.14. Target ages and prediction intervals for each stage based on Ubelaker's
chart (sexes combined). Intervals are not provided for stages 9 or 17 because they were
artificially truncated by the sampling strategy, and target ages for those stages are suspect.

Observed Range 95% Prediction

Stage (n) Target Age s % w/in PI
(in years) Interval
9 19 (5.75) 0.52 5.0-6.6
10 43 6.57 0.94 5.0-9.3 4.97-8.17 95.4
11 58 7.80 0.91 6.3-10.4 6.27-9.34 94.8
12 45 8.43 0.94 7.0-10.5 6.83-10.03 91.1
13 52 9.59 1.05 7.2-12.0 7.81-11.37 90.4
14 59 11.14 1.16 8.8-13.9 9.18-13.10 89.8
15 16 11.64 0.84 10.1-13.0 10.12-13.16 100.0
16 83 13.34 1.32 10.5-15.8 11.13-15.55 91.6
17 43 (14.52) 1.05 12.1-16.0

57
 TABLE 5.15. Target ages and prediction intervals for each stage based on Schour &
Massler’s chart (sexes combined). Intervals are not provided for stages 9 or 17 because they
were artificially truncated by the sampling strategy, and target ages for those stages are suspect.

Observed Range 95% Prediction

Stage (n) Target Age s % w/in PI
(in years) Interval
9 15 (5.69) 0.52 5.1-6.6
10 49 6.51 0.95 5.0-9.3 4.90-8.12 95.9
11 52 7.81 0.95 6.3-10.4 6.20-9.42 96.2
12 38 8.22 0.97 7.0-10.5 6.56-9.88 89.5
13 61 9.42 1.01 7.2-12.0 7.72-11.12 93.4
14 62 11.07 1.20 8.1-13.9 9.06-13.08 88.7
15 16 11.64 0.84 10.1-13.0 10.12-13.16 100.0
16 84 13.33 1.31 10.5-15.8 11.14-15.52 89.3
17 42 (14.58) 1.00 12.1-16.0

TABLE 5.16. Prediction intervals separated by sex for stages 13 & 14 based on Ubelaker’s
chart.

Observed Range 95% Prediction

Stage (n) Target Age s % w/in PI
(in years) Interval
13 - females 28 9.33 1.08 7.2-11.3 7.46-11.20 85.7
13 - males 24 9.90 0.88 8.5-12.0 8.36-11.44 91.7
14 - females 26 10.80 1.18 8.8-13.9 8.75-12.85 96.2
14 - males 33 11.40 1.04 9.6-13.5 9.61-13.19 87.9

TABLE 5.17. Prediction intervals separated by sex for stages 12, 13, & 14 based on Schour
& Massler’s chart.

Observed Range 95% Prediction

Stage (n) Target Age s % w/in PI
(in years) Interval

12 - females 15 7.75 0.66 7.0-9.3 6.56-8.94 93.3

12 - males 23 8.53 1.00 7.2-10.5 6.77-10.29 91.3
13 - females 33 9.1 0.93 7.2-9.1 7.49-10.71 90.9
13 - males 28 9.79 0.96 7.7-12.0 8.13-11.45 89.3
14 - females 29 10.72 1.23 8.1-13.9 8.60-12.84 93.1
14 - males 33 11.39 1.05 9.6-13.5 9.58-13.20 87.9

58
 For the 95% prediction intervals separated by sex for stage 12 based on Schour and

Massler’s chart, both males and females scored higher than when sexes were combined. The

95% interval for stage 13 individuals evaluated with Ubelaker’s chart was slightly lower for

females than for sexes combined, while the male’s percentage was slightly higher. For Schour

and Massler’s 95% prediction intervals for stage 13, both males and females scored lower than

with sexes combined. At stage 14, for Ubelaker’s chart, the prediction intervals for both the

males and females performed better than the sex-combined interval. However, when the 95%

prediction intervals were based on Schour and Massler’s chart for stage 14, the females’

percentage was higher than the combined sex percentage and the males’ score was lower than the

sex-combined interval.

A comparison of the 95% prediction interval ranges with Ubelaker’s predicted ranges are

presented in Table 5.18 and a comparison of Schour and Massler’s ranges are presented in Table

5.19. The prediction intervals calculated here when compared to Ubelaker’s intervals have a

higher percentage of individuals falling within the determined parameters for all stages except

stage 13, with an overall accuracy of 92.4% for stages 10 to 16. This figure is slightly better than

Ubelaker’s overall accuracy of 90.7% (or 90.2% accuracy for stages 10 to 16). Likewise, Schour

and Massler’s newly determined prediction intervals gave an excellent performance with 92.3%

of individuals falling within the found range. This highly outperforms the overall accuracy of

the original chart of 44%. When these prediction intervals were recalculated with the division of

sexes for Ubelaker’s stages 13 and 14 and the new ranges determined (seen in Table 5.16) the

overall accuracy increased to 93%. Schour and Massler’s division of sexes for stages 12 to 14

did not increase the overall accuracy, remaining constant at 92.3%. It is, therefore, important to

note that while the knowledge of sex at stages 13 and 14 when using the Ubelaker chart can

59
TABLE 5.18. Comparison of prediction interval ranges with Ubelaker’s predicted ranges
and percents of individuals within these ranges.

Predicted % of % of
95% PI
Stage Ubelaker Range Individuals Stage Individuals
Range (in years)
(in years) Within Range Within Range

9 3.7-6.3 78.9 9 4.83-6.68

10 4.0-8.0 93.0 10 4.97-8.17 95.4
11 5.0-9.0 89.7 11 6.27-9.34 94.8
12 6.0-10.0 91.1 12 6.83-10.03 91.1
13 7.0-11.0 94.2 13 7.81-11.37 90.4
14 7.5-12.5 88.1 14 9.18-13.10 89.8
15 8.5-13.5 100.0 15 10.12-13.16 100.0
16 9.0-15.0 85.5 16 11.13-15.55 91.6
17 12.0-18.0 100.0 17 12.73-16.31
TOTAL (all stages) 90.7 TOTAL (stages 10-16) 92.4

TABLE 18. Comparison of prediction interval ranges with Schour and Massler’s
predicted ranges and percents of individuals within these ranges.

% Schour &
Predicted 95% PI % Within PI
Massler
Stage S&M Range Stage Determined Determined
Samples
(in years) Range (in years) Range
Within Range
9 4.25-5.75 60.0 9 4.74-6.64
10 5.25-6.75 57.1 10 4.90-8.12 95.9
11 6.25-7.75 53.8 11 6.20-9.42 96.2
12 7.25-8.75 65.8 12 6.56-9.88 89.5
13 8.25-9.75 45.9 13 7.72-11.12 93.4
14 9.25-10.75 40.3 14 9.06-13.08 88.7
15 10.25-11.75 50.0 15 10.12-13.16 100.0
16 11.50-12.50 17.9 16 11.14-15.52 89.3
17 14.50-15.50 45.2 17 12.88-16.28

TOTAL (all stages) 44.0 TOTAL (stages 10-16) 92.3

60
increase age prediction accuracy, it is not entirely necessary to identify the sex in order to get a

good age estimate.

While the differences are not absolutely great, a general evaluation of the new prediction

intervals compared to Ubelaker’s ranges show that the new parameters have smaller ranges,

allowing for tighter estimates of age. The lower limits of the new intervals are always higher

(and frequently substantially so) than Ubelaker’s lower limits, while the upper limits are more

comparable. A noteworthy example can be seen in stage 14, where Ubelaker’s age range is 7.5-

12.5 years. This study, however, produces a prediction interval beginning 1.7 years later and

ending 0.6 years later, at 9.18-13.10 years for the same stage. This range is with the sexes

combined, even though they were shown to be significantly different at this stage. It is of

importance to note however, that this difference could be due to the scoring strategies at this

stage. At stages 14 and 15 the transition begins from mixed dentition to permanent dentition.

Thus, for both charts, even if most of the teeth were in stage 15, if any deciduous teeth were

present, the individual was placed into stage 14. This could have skewed the data.

61
 CHAPTER 6: DISCUSSION AND CONCLUSIONS

The objective of this study was to reevaluate and test known standards of skeletal aging

using the Schour and Massler (1944) and Ubelaker (1989) dental aging charts, to determine their

accuracy when applied to modern subadults, if their target age and associated error ranges are

still applicable, and whether or not these charts need to be differentiated by sex. It is hoped that

these results will assist in improving the accuracy of estimating age for unknown subjects from

their teeth and that this approach will assist in their identification.

To date, both charts are widely duplicated and both are utilized by anthropologists and

dentists. Therefore, it is the suggestion of this author that the line drawings remain the same, but

modifications must be made on the target ages and their associated error intervals. When this

study’s 95% prediction intervals were calculated, both charts performed equally well, thus this

study suggests that the prior error intervals be modified for stages 10-16 (ages 6 to 14) to include

the newly determined mean age and intervals (see Table 6.1).

Accordingly, the question remains as to which of the two charts is better. With the newly

determined prediction intervals, they are now equally useful in their age determinations. Thus,

the slight differences in formation and eruption between these charts are accommodated by the

new means and error intervals.

An analysis of covariance found that sex and age are highly significant for both

Ubelaker’s and Schour and Massler’s charts, indicating that both variables affect the expressed

dental stage. Additionally, t-tests were used to compare the mean age by sex for each stage with

differences between sexes in most stages not being significant. However, in Ubelaker’s chart,

males and females are significantly different at stages 13 and 14, and in Schour and Massler’s

62
TABLE 6.1. Comparison of Schour and Massler and Ubelaker’s mean ages and 95% error
intervals (sexes combines) derived from this study.

Schour and Massler Ubelaker

Stage 10 6.51 ± 0.95 6.57 ± 1.60

Stage 11 7.81 ± 1.61 7.80 ± 1.54

Stage 12 8.22 ± 1.66 8.43 ± 1.59

Stage 13 9.42 ± 1.70 9.59 ± 1.78

Stage 14 11.07 ± 2.01 11.14 ± 1.96

Stage 15 11.64 ± 1.52 11.64 ± 1.52

Stage 16 13.33 ± 2.19 13.34 ± 2.21

TABLE 6.2. Comparison of Schour and Massler and Ubelaker’s mean ages and 95% error
intervals for males and females derived from this study.

Schour and Massler Ubelaker

Female 7.75 ± 1.19

Stage 12
Male 8.53 ± 1.76

Female 9.10 ±1.61 9.33 ± 1.91

Stage 13
Male 9.79 ± 1.66 9.90 ± 1.58

Female 10.72 ± 2.12 10.80 ± 2.10

Stage 14
Male 11.39 ± 1.81 11.40 ± 1.82

63
chart stages 12, 13, & 14 are significantly different between the sexes. Therefore, in order to

obtain the most accurate age estimate, when sex is known, there is a need for both charts to have

these ages separated by sex for these stages (see Table 6.2). It is recommended that these new

prediction intervals be used when the sex of an unidentified individual is known.

Since these newly derived intervals have not been widely used, any potential limitations

have not been delineated. Thus, replication on a larger scale with known-age samples is required

to examine the robusticity of this study’s results. It is also important to note that these intervals

were derived solely from modern individuals of European ancestry, and thus application to

individuals from different time periods or of different ancestries must be made with caution.

64
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