Dental age assessment: A proposal for refining and extending the Demirjian stages for third molar mineralization evaluation

Dental methods are now an integral component of forensic age assessment procedures. The stage classification for evaluating the mineralization of third molars in radiographs, as originally proposed by Demirjian et al. (1973), is well-established for this purpose. In practice, a modified version of this classification, based on the work of Mincer et al. (1993), is commonly employed. However, the verbal definitions of the stages exhibit notable inconsistencies. This method paper introduces a revised stage classification. Specifically, the stage definitions have been clarified, and the guidelines for applying the classification have been updated to align with the digital age. Additionally, new schematic illustrations are provided. These modifications aim to improve the reliability of the classification's application. In a second approach, four new intermediate stages-some of which have been previously proposed by other researchers-have been incorporated into the classification. The inclusion of these additional stages seeks to enhance the accuracy of age estimation. Whether the modified stages and the newly introduced intermediate stages provide significant added value will need to be determined through future studies.