Incremental Lines in Dental Cementum as Age Estimation Biomarker
DOI:
https://doi.org/10.35790/eg.v13i2.59061Abstract
Abstract: Age estimation is an important part of forensic identification, and teeth are among the most reliable structures used for this purpose. One of the promising histological methods is tooth cementum annulation (TCA), which involves counting of incremental growth lines in the cementum to estimate chronological age. These cementum incremental lines formed through the rhythmic deposition of mineralized tissue, appear as alternating dark and light bands and are thought to reflect annual biological cycles. The constant and non-adaptive growth of acellular cementum is considered as the ideal part of cementum to be used in cementochronology analysis. Therefore, this study aimed to explore the principles, applications, and potential of TCA. Currently, TCA or cementochronology has been widely used as an age estimation method in the forensic field, but the results of existing studies to date vary due to different preparation techniques and analysis techniques. A standardized protocol for cementochronology has now been adopted in multiple studies, often conducted in ISO 9001-certified laboratories to ensure consistency in histological preparation. While this standardization has improved methodological reliability, further research is still needed to evaluate the accuracy and applicability of cementochronology for age-at-death estimation in various forensic contexts. However, its implementation in peripheral or resource-limited settings remains challenging, as the method is invasive, requires specialized equipment, and involves laboratory-based histological processing. This review highlights that these incremental lines, particularly in acellular cementum that formed consistently over time, show a strong correlation with chronological age. Tooth cementum annulation has shown promising results and is considered a valuable complementary method for forensic age estimation.
Keywords: age estimation; tooth cementum annulation; cementochronology; forensic odontology
References
Bassed, R, Graham J, Taylor JA. Forensic Odontology: Principles and Practice. John Wiley & Sons; 2016. p. 209–27. Doi: 10.1002/9781118864418
Swetha G, Kattappagari K, Poosarla C, Chandra L, Gontu S, Reddy Badam V. Quantitative analysis of dental age estimation by incremental line of cementum. J Oral Maxillofac Pathol. 2018;22(1):138. Available from: https://doi.org/10.4103/jomfp.jomfp_175_17
Phulari RGS, Dave EJ. Evolution of dental age estimation methods in adults over the years from occlusal wear to more sophisticated recent techniques. Egypt J Forensic Sci. 2021;11(1):36. Available from: http://dx.doi.org/10.1186/s41935-021-00250-6
Quendangen A. Catatan-catatan Odontologi Forensik (1st ed). Yogyakarta: Penerbit Andi; 2022. p. 143–5. Available from: https://repository.petra.ac.id/id/eprint/19925
Mallar K, Girish H, Murgod S, Yathindra Kumar B. Age estimation using annulations in root cementum of human teeth: A comparison between longitudinal and cross sections. J Oral Maxillofac Pathol. 2015; 19(3):396. Available from: https://doi.org/10.4103/0973-029x.174620
Gualdi-Russo E, Saguto I, Frisoni P, Neri M, Mongillo J, Rinaldo N. Age estimation using tooth cementum annulations: bias and sources of inaccuracy. Front Biosci (Landmark Ed). 2022;27(5):141. Available from: https://doi.org/10.31083/j.fbl2705141
Perrone V, Gocha TP, Randolph-Quinney P, Procopio N. Tooth cementum annulation: a literature review. Forensic Sci. 2022;2(3):516–50. Available from: ttps://doi.org/10.3390/forensicsci2030038
Bertrand B, Oliveira-Santos I, Cunha E. Cementochronology: a validated but disregarded method for age at death estimation. In: Age Estimation [Internet]. Elsevier; 2019 [cited 2023 Dec 26]. p. 169–86. Available from: http://dx.doi.org/10.1016/B978-0-12-814491-6.00012-1
Suciyanie IM, Gultom FP, Hidayat AN, Suhartono AW, Yuniastuti M, Auerkari EI. Accuracy of forensic age estimation using cementum annulation and dentin translucency in adult: a systematic review and meta-analysis. Int J Legal Med. 2022;136(5):1443–55. Available from: https://doi.org/10.1007/s00414-022-02777-2
Berkovitz BKB, Holland GR, Moxham BJ. Oral Anatomy, Histology and Embryology (4th ed). Mosby Elsevier; 2009. Available from: http://dx.doi.org/10.1093/ejo/cjp045
Rajkumar K, Ramya R. Textbook of Oral Anatomy, Histology, Physiology, and Tooth Morphology (2nd ed). India: Wolters Kluwer; 2017.
Hinrichs C, Nicklisch N, Mardare CC, Orechovski B, Hassel AW, Kleber C, et al. Incremental lines in human acellular tooth cementum – New insights by SEM analysis. Annals of Anatomy - Anatomischer Anzeiger. 2022;243:151933. Available from: https://doi.org/10.1016/j.aanat.2022.151933
Yamamoto T, Hasegawa T, Yamamoto T, Hongo H, Amizuka N. Histology of human cementum: Its structure, function, and development. Japanese Dental Science Review. 2016;52(3):63–74. Available from: https://doi.org/10.1016/j.jdsr.2016.04.002
Takahashi S, Yamamoto T, Takahashi T, Yawaka Y. Incremental lines in human cellular cementum: A histological study. Journal of Oral Biosciences. 2023;65(1):55–61. Available from: https://doi.org/10.1016/j.job.2022.12.001
Lieberman DE, Meadow RH. The biology of cementum increments (with an archaeological application). Mammal Review. 1992;22(2):57–77. Available from: https://doi.org/10.1111/j.1365-2907.1992.tb00120.x
Lieberman D, Meadow R. The biological basis for seasonal increments in dental cementum and their application to archaelogical research. J Archaelogical Sci. 1994;21(4):525–39. Available from: http://dx.doi.org/10.1111/j.1365-2907.1992.tb00120.x
Mjör IA, Fejerskov O. Embriologi dan Histologi Rongga Mulut (Volume 1). Yuwono L, editor. Jakarta: Widya Medika; 1991.
Colard T, Bertrand B, Naji S, Delannoy Y, Bécart A. Toward the adoption of cementochronology in forensic context. Int J Legal Med. 2018;132(4):1117–24. Available from: https://doi.org/10.1007/s00414-015-1172-8
Cool SM, Forwood MR, Campbell P, Bennett MB. Comparisons between bone and cementum compositions and the possible basis for their layered appearances. Bone. 2002;30(2):386–92. Available from: https://doi.org/10.1016/S8756-3282(01)00686-X
Veiberg V, Nilsen EB, Rolandsen CM, Heim M, Andersen R, Holmstrøm F, et al. The accuracy and precision of age determination by dental cementum annuli in four northern cervids. Eur J Wildl Res. 2020;66(6):91. Available from: https://link.springer.com/article/10.1007/s10344-020-01431-9
Renz H, Radlanski RJ. Incremental lines in root cementum of human teeth —A reliable age marker? HOMO. 2006;57(1):29–50. Available from: https://doi.org/10.1016/j.jchb.2005.09.002
Milovanovic P, Vom Scheidt A, Mletzko K, Sarau G, Püschel K, Djuric M, et al. Bone tissue aging affects mineralization of cement lines. Bone. 2018;110:187–93. Available from: https://doi.org/10.1016/ j.bone.2018.02.004
Chen MC. Observations on the structure of matrix fibers in human cementum. J StomatolSoc,Jpn. 1987; 54(4):635–75. Available from: https://doi.org/10.5357/koubyou.54.635
Kagerer P, Grupe G. Age-at-death diagnosis and determination of life-history parameters by incremental lines in human dental cementum as an identi®cation aid. Forensic Science International. 2001;118(1):75-82. Available from: https://doi.org/10.1016/s0379-0738(00)00382-0
Pinto PHV, Fares LC, Silva RHAD. Dental age estimation by cementum incremental lines counting: A systematic review and meta-analysis. Forensic Sci Int. 2022;341:111492. Available from: https://doi.org/10.1016/j.forsciint.2022.111492
Alghonamy WY, Gaballah OM, Labah DA. Age estimation in adult human sound and periodontally affected teeth using tooth cementum annulations. Tanta Dental Journal. 2015;12(4):277–85. Available from: http://dx.doi.org/10.1016/j.tdj.2015.07.002
Bertrand B, Cunha E, Bécart A, Gosset D, Hédouin V. Age at death estimation by cementochronology: Too precise to be true or too precise to be accurate? American J Phys Anthropol. 2019;169(3):464–81. Available from: https://doi.org/10.1002/ajpa.23849
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Copyright (c) 2025 Nadilla I. Wahyu, Nurtami Soedarsono, Mindya Yuniastuti, Ria Puspitawati, Antonius W. Suhartono

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