title: Dental Age Estimation-Root Pulp Visibility (RPV) patterns: A reliable Mandibular Maturity Marker at the 18 year threshold.
abstract: The purpose of this paper was to explore the potential application of Root Pulp Visibility (RPV) to determine whether or not a subject of unknown date of birth is under or over the 18year threshold.
  
  
  METHODS
  Two thousand Dental Panoramic Radiographs comprising equal numbers of females and males evenly distributed between the ages of 16 and 26 years were examined. All third molars were scored using the Anglo-Canadian 8 Stage Tooth Development system [1]. The Lower Left Third Molar was censored to avoid redundant data being included in the data array for the Age at Attainment of Stage H, the final stage of tooth development (Roberts et al., 2015 [2]). A filter cascade was applied to the data to select the data array for 1. Teeth in the final stage of development, 2. Female or male gender, 3. The definitive stage of RPV: RPV-A, RPV-B, RPV-C, or RPV-D.
  
  
  RESULTS
  The summary data for each of these stages was derived and the minimum value for each was used to determine the relationship of the minimum value of A, B, C or D to the 18 Year threshold. It was found that for both females and males the minimum value for RPV-A and RPV-B indicated that subjects displaying this could be under 18 years old. For RPV-C and RPV-D, the minimum values show unequivocally that for both females and males the subject was over 18 years old.
  
  
  CONCLUSIONS
  RPV has an important role in unambiguously determining whether a subject is below or above the 18year threshold.
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
authors.forename: Victoria S
authors.initials: VS
authors.lastname: Lucas
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
authors.forename: Fraser
authors.initials: F
authors.lastname: McDonald
authors.affiliation: Patient and Population Health Division (Dental Public Health), King's College Dental Institute, 2nd Floor, Dental Hospital Extension, KCH Campus, Denmark Hill, SE5 9RS, UK.
authors.forename: Manoharan
authors.initials: M
authors.lastname: Andiappan
authors.affiliation: Department of Orthodontics, King's College London Dental Institute, Floor 25 Tower Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK. Electronic address: graham.j.roberts@kcl.ac.uk.
authors.forename: Graham
authors.initials: G
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000366:Age Determination by Teeth / Q000379:methods*; D003782:Dental Pulp / Q000000981:diagnostic imaging* / Q000254:growth & development; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008964:Molar, Third / Q000000981:diagnostic imaging* / Q000254:growth & development; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D014092:Tooth Root / Q000000981:diagnostic imaging* / Q000254:growth & development; D055815:Young Adult
keywords: 18 year threshold; Dental Age Estimation; Mandibular Maturity Marker; Root Pulp Visibility; Tooth Development Stage