title: Combining wrist age and third molars in forensic age estimation: how to calculate the joint age estimate and its error rate in age diagnostics.
abstract: BACKGROUND
  Forensic age estimation in living adolescents is based on several methods, e.g. the assessment of skeletal and dental maturation. Combination of several methods is mandatory, since age estimates from a single method are too imprecise due to biological variability. The correlation of the errors of the methods being combined must be known to calculate the precision of combined age estimates.
  
  
  OBJECTIVE
  To examine the correlation of the errors of the hand and the third molar method and to demonstrate how to calculate the combined age estimate.
  
  
  METHODS
  Clinical routine radiographs of the hand and dental panoramic images of 383 patients (aged 7.8-19.1 years, 56% female) were assessed.
  
  
  RESULTS
  Lack of correlation (r = -0.024, 95% CI = -0.124 to + 0.076, p = 0.64) allows calculating the combined age estimate as the weighted average of the estimates from hand bones and third molars. Combination improved the standard deviations of errors (hand = 0.97, teeth = 1.35 years) to 0.79 years.
  
  
  CONCLUSIONS
  Uncorrelated errors of the age estimates obtained from both methods allow straightforward determination of the common estimate and its variance. This is also possible when reference data for the hand and the third molar method are established independently from each other, using different samples.
authors.affiliation: a Department of Orthodontics , University Hospital Leipzig , Germany .
authors.forename: Bianca
authors.initials: B
authors.lastname: Gelbrich
authors.affiliation: a Department of Orthodontics , University Hospital Leipzig , Germany .
authors.forename: Carolin
authors.initials: C
authors.lastname: Frerking
authors.affiliation: b Department of Orthodontics , University Hospital Würzburg , Germany .
authors.forename: Sandra
authors.initials: S
authors.lastname: Weiss
authors.affiliation: a Department of Orthodontics , University Hospital Leipzig , Germany .
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schwerdt
authors.affiliation: b Department of Orthodontics , University Hospital Würzburg , Germany .
authors.forename: Angelika
authors.initials: A
authors.lastname: Stellzig-Eisenhauer
authors.affiliation: c Department of Orthodontics , University Hospital Dresden , Germany .
authors.forename: Eve
authors.initials: E
authors.lastname: Tausche
authors.affiliation: d Institute of Clinical Epidemiology and Biometry, University of Würzburg , Germany , and.|e Clinical Trial Centre, University Hospital Würzburg , Germany.
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D000366:Age Determination by Teeth / Q000379:methods*; D002113:Calcification, Physiologic; D002648:Child; D005260:Female; D005858:Germany; D006801:Humans; D016014:Linear Models; D008297:Male; D008964:Molar, Third / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014074:Tooth Calcification; D014953:Wrist / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Age estimation error; combined methods; dental panoramic radiograph; forensic age estimation; hand radiograph