Tooth Coronal Index: A Novel Tool For Age Estimation on Cone-Beam Computed Tomography


  • Bharati R. Doni
  • Santosh Rayagouda Patil
  • Ruchi Agrawal
  • Narges Ghazi
  • Kazuyuki Araki
  • Garima Dewangan
  • Mohammad Khursheed Alam


Diagnostic Imaging, Cone-Beam Computed Tomography, Age Determination by Skeleton


Objective: To evaluate dental age assessment reliability through Tooth Coronal Index (TCI) method. Material and Methods: The cone-beam computed tomography (CBCT) scans of 160 individuals aged between 20-70 years were analyzed in the present study. The height of the crown, i.e., coronal height, and the height of the coronal pulp cavity, i.e., coronal pulp cavity height, of mandibular second premolars and first molars were calculated and then TCI was measured. The actual age of a subject was compared with TCI of tooth and the acquired data were subjected to Pearson’s correlation and unpaired t-tests. Results: Negative correlation was observed between the real age and TCI of mandibular first molar (r = -0.094, p=0.382) and second premolar (r = -0.176, p=0.0961. Statistically significant difference was observed between actual age and TCI for mandibular second premolar and first molar (p<0.001). Conclusion: Tooth coronal index has the potential to estimate age of an individual on CBCT scans. It is simple, cost-effective than histological methods and can be applied to both living and unknown dead.


Santoro V, De Donno A, Marrone M, Campobasso CP, Introna F. Forensic age estimation of living individuals: a retrospective analysis. Forensic Sci Int 2009; 193(1-3):129.e1-4.

Schour I, Massler M. Development of human dentition. J Am Dent Assoc 1941; 20:379-427

Demirijian A, Goldstein H. New systems for dental maturity based on seven and four teeth. Ann Hum Biol 1976; 3(5):411-21.

Veera SD, Kannabiran J, Suratkal N, Chidananada DB, Gujjar KR, Goli S. Coronal pulp biomarker: A lesser known age estimation modality. J Indian Acad Oral Med Radiol 2014; 26(4):398-404.

AlQahtani SJ, Hector MP, Liversidge HM. Brief communication: The London atlas of human tooth development and eruption. Am J Phys Anthropol 2010; 142(3):481-90.

Jain RK, Rai B. Age estimation from permanent molar’s attrition of Haryana population. Indian J Forensic Odontol 2009; 2(2):59-61.

Juneja M, Devi YB, Rakesh N, Juneja S. Age estimation using pulp/tooth area ratio in maxillary canines: A digital image analysis. J Forensic Dent Sci 2014; 6(3):160-5.

Saxena S. Age estimation of Indian adults from orthopantomographs. Braz Oral Res 2011; 25(3):225-9.

Jeevan MB, Kale AD. Age estimation by pulp/tooth area ratio in canines: Cameriere’s method assessed in an Indian sample using radiovisiography. Forensic Sci Int 2011; 204(1-3):209.e1-5.

Cameriere R, De Luca S, Aleman I, Ferrante L, Cingolani M. Age estimation by pulp/tooth ratio in lower premolars by orthopantomography. Forensic Sci Int 2012; 214(1-3):105-12.

Nagi R, Jain S, Agrawal P, Prasad S, Tiwari S, Naidu GS. Tooth coronal index: Key for age estimation on digital panoramic radiographs. J Indian Acad Oral Med Radiol 2018; 30(1):64-7.

Shah PH, Venkatesh R. Pulp/tooth ratio of mandibular first and second molars on panoramic radiographs: An aid for forensic age estimation. J Forensic Dent Sci 2016; 8(2):112.

Mathew DG, Rajesh S, Koshi E, Priya LE, Nair AS, Mohan A. Adult forensic age estimation using mandibular first molar radiographs: A novel technique. J Forensic Dent Sci 2013; 5(1):56-9.

Talabani RM, Baban MT, Mahmood MA. Age estimation using lower permanent first molars on a panoramic radiograph: A digital image analysis. J For Dent Sci 2015; 7(2):158-62.

Cameriere R, Ferrante L, Cingolani M. Precision and reliability of pulp/tooth area ratio (RA) of second molar as indicator of adult age. J Forensic Sci 2004; 49:1319-23.

Paewinsky E, Pfeiffer H, Brinkmann B. Quantification of secondary dentine formation from orthopantomograms – a contribution to forensic age estimation methods in adults. Int J Legal Med 2005; 119(1):27-30.

Jain S, Nagi R, Daga M, Shandilya A, Shukla A, Parakh A, et al. Tooth coronal index and pulp/tooth ratio in dental age estimation on digital panoramic radiographs - A comparative study. Forensic Sci Int 2017; 277:115-21.

Shrestha M. Comparative evaluation of two established age estimation techniques (two histological and radiological) by image analysis software using single tooth. J Forensic Res 2014; 5(4):3-6.

Devlin H, Yuan J. Object position and image magnification in dental panoramic radiography: a theoretical analysis. Dentomaxillofac Radiol 2013; 42(1):29951683.

Ikeda N, Umetsu K, Kashimura S, Suzuki T, Oumi M. Estimation of age from teeth with their soft X-ray findings. Nihon Hoigaku Zasshi 1985; 39(3):244-50.

Koranne VV, Mhapuskar AA, Marathe SP, Joshi SA, Saddiwal RS, Nisa SU. Age estimation in Indian adults by the coronal pulp cavity index. J Forensic Dent Sci 2017; 9(3):177.

Drusini AG, Toso O, Ranzato C. The coronal pulp cavity index: A biomarker for age determination in human adults. Am J Phys Anthropol 1997; 103(3):353-63.

Zadzinska E, Drusini AG, Carrara N. The comparison between two age estimation methods based on human teeth. Anthropol Rev 2000; 63:95-101.

Igbigbi PS, Nyirenda SK. Age estimation of Malawian adults from dental radiographs. West Afr J Med 2005; 24(4):329-33.

Gotmare SS, Shah T, Periera T, Waghmare MS, Shetty S, Sonawane S, et al. The coronal pulp cavity index: A forensic tool for age determination in adults. Dent Res J 2019; 16(3):160-5.

Nagammai N, Saraswathi Gopal K, Srividhya S. Tooth coronal pulp index as a tool for age estimation: an institutional based retrospective cone beam computed tomography study. Indian J Forensic Odontol 2019; 12(2):35-43.




How to Cite

Doni, B. R. ., Patil, S. R. ., Agrawal, R. ., Ghazi, N. ., Araki, K. ., Dewangan, G. ., & Alam, M. K. . (2021). Tooth Coronal Index: A Novel Tool For Age Estimation on Cone-Beam Computed Tomography. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 21, e0215. Retrieved from



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