Non-Cochrane · other · PM42481609
A systematic review and meta-analysis of Gustafson's six dental variables for age estimation in adults.
Merdietio Boedi Rizky, Angelakopoulos Nikolaos, Fonseca Gabriel M, et al. · Scientific reports · 2026 · PubMed · doi:10.1038/s41598-026-62961-x
Findings
Population Modern human adults (teeth with known chronological age)
21 findings
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Area of Translucent Dentin | Pearson r (Fisher z back-transformed, three-level random effects) 0.96 [0.85, 0.99] Low Downgraded: inconsistency, indirectness 1 study |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Johanson | Pearson r (Fisher z back-transformed, three-level random effects) 0.57 [0.30, 0.75] Low Downgraded: inconsistency, indirectness 6 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Sensitivity: all 27 studies including 8 high risk of bias studies | Pearson r (Fisher z back-transformed, three-level random effects) 0.68 [0.54, 0.78] GRADE not reported 27 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Tooth preparation: Intact teeth | Pearson r (Fisher z back-transformed, three-level random effects) 0.61 [0.33, 0.79] Low Downgraded: inconsistency, indirectness 11 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Lamendin | Pearson r (Fisher z back-transformed, three-level random effects) 0.53 [0.29, 0.72] Low Downgraded: inconsistency, indirectness 8 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Average Stage of Attrition | Pearson r (Fisher z back-transformed, three-level random effects) 0.53 [0.19, 0.76] Low Downgraded: inconsistency, indirectness 3 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Tooth preparation: Sectioned teeth | Pearson r (Fisher z back-transformed, three-level random effects) 0.73 [0.47, 0.88] Low Downgraded: inconsistency, indirectness 8 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Jaw: Upper jaw | Pearson r (Fisher z back-transformed, three-level random effects) 0.56 [0.10, 0.82] Low Downgraded: inconsistency, indirectness 6 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Sensitivity: leave-one-out Unresolved: the two extractors disagree on this row. | pooled correlations ranging from r = 0.63 to r = 0.69 GRADE not reported Studies not reported |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Gustafson | Pearson r (Fisher z back-transformed, three-level random effects) 0.54 [0.26, 0.73] Low Downgraded: inconsistency, indirectness 3 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Overall (19 studies after excluding 8 high risk of bias) | Pearson r (Fisher z back-transformed, three-level random effects) 0.67 [0.49, 0.80] Low Downgraded: inconsistency, indirectness 19 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Jaw: Lower jaw | Pearson r (Fisher z back-transformed, three-level random effects) 0.59 [0.15, 0.83] Low Downgraded: inconsistency, indirectness 6 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Length % of Translucent Dentin | Pearson r (Fisher z back-transformed, three-level random effects) 0.80 [0.63, 0.89] Low Downgraded: inconsistency, indirectness 2 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Length of Translucent Dentin | Pearson r (Fisher z back-transformed, three-level random effects) 0.82 [0.59, 0.93] Low Downgraded: inconsistency, indirectness 5 studies |
| Gustafson-derived variables (all six, direct visualization) | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age Methodology: Dalitz | Pearson r (Fisher z back-transformed, three-level random effects) 0.57 [0.28, 0.76] Low Downgraded: inconsistency, indirectness 1 study |
| Attrition | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age | Pearson r (Fisher z back-transformed, three-level random effects) 0.63 [0.39, 0.79] Low Downgraded: inconsistency, indirectness 3 studies |
| Periodontosis | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age | Pearson r (Fisher z back-transformed, three-level random effects) 0.60 [0.37, 0.76] Low Downgraded: inconsistency, indirectness 9 studies |
| Secondary dentin deposition | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age | Pearson r (Fisher z back-transformed, three-level random effects) 0.65 [-0.38, 0.96] Low Downgraded: inconsistency, indirectness 1 study |
| Cementum apposition | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age | Pearson r (Fisher z back-transformed, three-level random effects) 0.35 [-0.67, 0.91] Low Downgraded: inconsistency, indirectness 1 study |
| Root resorption | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age | Pearson r (Fisher z back-transformed, three-level random effects) 0.28 [-0.71, 0.90] Low Downgraded: inconsistency, indirectness 1 study |
| Transparency of the root | Chronological age | Pearson correlation (r) between Gustafson-derived variable and chronological age | Pearson r (Fisher z back-transformed, three-level random effects) 0.75 [0.59, 0.86] Low Downgraded: inconsistency, indirectness 14 studies |
Included primary studies 54
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Acharya & Kumar 2011 Grating coupled compound resonators. PMID:20111228 | 1971 | this review only | not stated | not extracted yet |
| Acharya & Kumar 2011 Age estimation in Indians from extracted unsectioned teeth. PMID:21764231 | 2011 | this review only | not stated | not extracted yet |
| Acharya 2011 A new digital approach for measuring dentin translucency in forensic age estimation. PMID:20081523 | 2010 | this review only | not stated | not extracted yet |
| Acharya 2011 Method of using the reflectance ratios of different angles of incidence for the determination of optical constants. PMID:20111127 | 1971 | this review only | not stated | not extracted yet |
| Baz 2022 Age-at-death assessed with Lamendin's original and population-specific models in a modern Brazilian osteological collection. PMID:36623297 | 2022 | this review only | not stated | not extracted yet |
| Baz et al. 2022 The Bishop of San Juan vs. the US Surgeon General, 1939. PMID:20222339 | 2010 | this review only | not stated | not extracted yet |
| Bommannavar & Kulkarni 2015 PMID:20151430 | NR | this review only | not stated | not extracted yet |
| Bommannavar & Kulkarni 2015 Comparative study of age estimation using dentinal translucency by digital and conventional methods. PMID:25709325 | 2015 | this review only | not stated | not extracted yet |
| Drusini 1990 Age determination in human adults by dental histology. PMID:2077769 | 1990 | this review only | not stated | not extracted yet |
| Drusini 1991 Root dentine transparency: age determination of human teeth using computerized densitometric analysis. PMID:1853940 | 1991 | this review only | not stated | not extracted yet |
| Drusini et al. 1990 Alopecia. PMID:1990117 | 1991 | this review only | not stated | not extracted yet |
| Drusini et al. 1991 The reproducibility of measuring the anorectal angle in defecography. PMID:1991420 | 1991 | this review only | not stated | not extracted yet |
| Foti 2001 Limits of the Lamendin method in age determination. PMID:11672963 | 2001 | this review only | not stated | not extracted yet |
| Foti et al. 2001 Concise assembly of linear alpha(1-->6)-linked octamannan fluorescent probe. PMID:20011026 | 2008 | this review only | not stated | not extracted yet |
| Garizoain 2020 Age-at-death estimation in adults using three forensic methodologies: A Lamendin's technique approach for Latin American context and the… PMID:34723398 | 2021 | this review only | not stated | not extracted yet |
| Garizoain et al. 2020 Use of the wearable external cardiac defibrillator in children. PMID:20202137 | 2010 | this review only | not stated | not extracted yet |
| Kattappagari 2014 Age estimation by assessment of dentin translucency in single rooted permanent teeth. PMID:25628481 | 2014 | this review only | not stated | not extracted yet |
| Kattappagari et al. 2014 Albumin overload induces apoptosis in renal tubular epithelial cells through a CHOP-dependent pathway. PMID:20141329 | 2010 | this review only | not stated | not extracted yet |
| Kavya 2023 Age estimation using extracted teeth in coastal Karnataka population. PMID:37854921 | 2023 | this review only | not stated | not extracted yet |
| Kavya et al. 2023 [Seroepidemiological survey on echinococcosis in primary school pupils of Liyang City of Jiangsu Province]. PMID:20232642 | 2009 | this review only | not stated | not extracted yet |
| Li & Ji 1995 Comparison of rats of the Fischer 344 and Long-Evans strains in their autonomic thermoregulatory response to trimethyltin administration. PMID:1995925 | 1991 | this review only | not stated | not extracted yet |
| Li & Ji 1995 Age estimation from the permanent molar in northeast China by the method of average stage of attrition. PMID:8586343 | 1995 | this review only | not stated | not extracted yet |
| Limdiwala 2021 Application and Validation of Lamendin et al.'s Adult Age Estimation Method using Mandibular Premolar Teeth on Western Indian (Gujarati)… DOI:10.4103/jiaomr.jiaomr_33_21 | 2021 | this review only | not stated | not extracted yet |
| Limdiwala et al. 2021 Papilledema as the sole magnetic resonance imaging finding in leptomeningeal metastasis. PMID:20212238 | 2010 | this review only | not stated | not extracted yet |
| Lopez-Nicolas 1990 Application of automatic image analysis (IBAS system) to age calculation. Efficiency in the analysis of several teeth from a single subject. PMID:1748356 | 1991 | this review only | not stated | not extracted yet |
| Lopez-Nicolas et al. 1990 Evaluation of initial hepatic allograft function with changes of free plasma amino acids in canine orthotopic liver transplantation. PMID:1990218 | 1991 | this review only | not stated | not extracted yet |
| Munoz 2023 Accuracy of age estimation using root dentin translucency in Peruvian adults. A pilot study. PMID:37149751 | 2023 | this review only | not stated | not extracted yet |
| Munoz et al. 2023 PMID:20232541 | NR | this review only | not stated | not extracted yet |
| Parra 2020 Root Dentin Translucency and Forensic International Dental Database: Methodology for estimation age-at-death in adults using single-rooted… PMID:33232857 | 2020 | this review only | not stated | not extracted yet |
| Parra et al. 2020 Aortic root replacement using a biovalsalva prosthesis in comparison to a "handsewn" composite bioprosthesis. PMID:20202036 | 2010 | this review only | not stated | not extracted yet |
| Pinto 2024 Dental age estimation in adults using the Lamendin criteria: Validation of a bayesian model in the Brazilian population. PMID:39490286 | 2024 | this review only | not stated | not extracted yet |
| Pinto et al. 2024 [X-ray image of the normal chest]. PMID:20242743 | 1947 | this review only | not stated | not extracted yet |
| Puneeth 2016 A comparative study of efficacy of single rooted and double rooted teeth in age estimation using dentin translucency. PMID:28520559 | 2016 | this review only | not stated | not extracted yet |
| Puneeth et al. 2016 Insertion of tetracysteine motifs into dopamine transporter extracellular domains. PMID:20161733 | 2010 | this review only | not stated | not extracted yet |
| Ruiz 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ruiz et al. 2016 In vitro viability and cytotoxicity testing and same-well multi-parametric combinations for high throughput screening. PMID:20161834 | 2009 | this review only | not stated | not extracted yet |
| Santoro 2015 Validity Comparison of Three Dental Methods for Age Estimation Based on Tooth Root Translucency. PMID:26272815 | 2015 | this review only | not stated | not extracted yet |
| Santoro et al. 2015 Environmental Management System (ISO 14001) certification in developing countries: challenges and implementation strategies. PMID:20151632 | 2010 | this review only | not stated | not extracted yet |
| Shah 2020 Age estimation by assessment of dentin translucency in permanent teeth. PMID:32246678 | 2020 | this review only | not stated | not extracted yet |
| Shah et al. 2020 MAOA alters the effects of heavy drinking and childhood physical abuse on risk for severe impulsive acts of violence among alcoholic… PMID:20201935 | 2010 | this review only | not stated | not extracted yet |
| Shruthi 2015 Comparison of the validity of two dental age estimation methods: A study on South Indian population. PMID:26814052 | 2015 | this review only | not stated | not extracted yet |
| Shruthi et al. 2015 [Reactive thrombocytosis: on the importance of hemostasis monitoring]. PMID:20151531 | 2009 | this review only | not stated | not extracted yet |
| Shylaja 2022 Reliability of dentin translucency and incremental cemental lines in age estimation using light and stereomicroscopes: A comparative study. PMID:35088895 | 2022 | this review only | not stated | not extracted yet |
| Shylaja et al. 2022 [Screening and identification of a fungal strain functioning in hydroxylation of puerarin]. PMID:20222440 | 2009 | this review only | not stated | not extracted yet |
| Solheim & Kvaal 1993 Prosthetic arthroplasty of the knee after resection of a sarcoma in the proximal end of the tibia. A report of sixteen cases. PMID:1993723 | 1991 | this review only | not stated | not extracted yet |
| Solheim & Kvaal 1993 Dental root surface structure as an indicator of age. PMID:9227059 | 1993 | this review only | not stated | not extracted yet |
| Solheim 1990 Report cards: a preparation strategy for NCLEX-RN. PMID:1990319 | 1991 | this review only | not stated | not extracted yet |
| Solheim 1990 Dental cementum apposition as an indicator of age. PMID:2091247 | 1990 | this review only | not stated | not extracted yet |
| Solheim 1990 (Johanson) Amount of secondary dentin as an indicator of age. PMID:1439521 | 1992 | this review only | not stated | not extracted yet |
| Solheim 1990 (Johanson) TNF as a mediator of cardiac transplant rejection, including effects on the intragraft protein C/protein S/thrombomodulin pathway. PMID:1990521 | 1991 | this review only | not stated | not extracted yet |
| Solheim 1992 Recession of periodontal ligament as an indicator of age. PMID:1342054 | 1992 | this review only | not stated | not extracted yet |
| Solheim 1992 On the occasion of Dr. Zeek's 91st birthday. PMID:1992622 | 1991 | this review only | not stated | not extracted yet |
| Thomas 1994 A comparative study of translucent apical dentine in vital and non-vital human teeth. PMID:8179506 | 1994 | this review only | not stated | not extracted yet |
| Thomas et al. 1994 Proposed recommended practices. Documentation of perioperative nursing care. AORN Recommended Practices Coordinating Committee. PMID:1994824 | 1991 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Modern human populations (teeth of adults with known chronological age) | Modern adults; extracted intact or sectioned teeth (27 studies in review, 19 studies with 131 effect sizes in meta-analysis) |
| Intervention | Measurement or scoring of individual Gustafson-derived variables (attrition, periodontosis, secondary dentin deposition, cementum apposition, root resorption, transparency of the root) by direct visualization of teeth | Gustafson-derived variables by Gustafson, Johanson, Lamendin, Dalitz, Bang & Ramm adaptations, average stage of attrition (151 correlation coefficients in 27 studies) |
| Comparison | Chronological age | Chronological age |
| Outcomes | Correlation coefficient between the variables and chronological age | Pearson correlation coefficient (r) with chronological age |
| Study designs | Full-text peer-reviewed observational or cross-sectional studies published after 1990 | Cross-sectional/observational studies (n=27) |
| Timing | Not specified | Not specified |