Age estimation using exfoliative cytology and radiovisiography: A comparative study


Shilpa Nallamala
Venkateswara Guttikonda
Praveen Manchikatla
Sravya Taneeru


Introduction: Age estimation is one of the essential factors in establishing the identity of an individual. Among various methods, exfoliative cytology (EC) is a unique, noninvasive technique, involving simple, and pain-free collection of intact cells from the oral cavity for microscopic examination. Objective: The study was undertaken with an aim to estimate the age of an individual from the average cell size of their buccal smears calculated using image analysis morphometric software and the pulp–tooth area ratio in mandibular canine of the same individual using radiovisiography (RVG). Materials and Methods: Buccal smears were collected from 100 apparently healthy individuals. After fixation in 95% alcohol, the smears were stained using Papanicolaou stain. The average cell size was measured using image analysis software (Image-Pro Insight 8.0). The RVG images of mandibular canines were obtained, pulp and tooth areas were traced using AutoCAD 2010 software, and area ratio was calculated. The estimated age was then calculated using regression analysis. Results: The paired t-test between chronological age and estimated age by cell size and pulp–tooth area ratio was statistically nonsignificant (P > 0.05). Conclusion: In the present study, age estimated by pulp–tooth area ratio and EC yielded good results.


How to Cite
Shilpa Nallamala, Venkateswara Guttikonda, Praveen Manchikatla, & Sravya Taneeru. (2017). Age estimation using exfoliative cytology and radiovisiography: A comparative study. Journal of Forensic Dental Sciences, 9(3), 144–148.


  1. Shetty DC, Wadhwan V, Khanna KS, Jain A, Gupta A. Exfoliative cytology: A possible tool in age estimation in forensic odontology. J Forensic Dent Sci 2015;7:63-6.
  2. Juneja M, Devi YB, Rakesh N, Juneja S. Age estimation using pulp/ tooth area ratio in maxillary canines-A digital image analysis. J Forensic Dent Sci 2014;6:160-5.
  3. Azevedo Ade C, Alves NZ, Michel-Crosato E, Rocha M, Cameriere R, Biazevic MG. Dental age estimation in a Brazilian adult population using Cameriere’s method. Braz Oral Res 2015;29. pii: S1806-83242015000100215.
  4. Papanicolaou GN. A new procedure for staining vaginal smears. Science 1942;95:438-9.
  5. Cameriere R, Ferrante L, Cingolani M. Variations in pulp/tooth area ratio as an indicator of age: A preliminary study. J Forensic Sci 2004;49:317-9.
  6. Joseph CC, Reddy BH, Cherian NM, Kannan SK, George G, Jose S. Intraoral digital radiography for adult age estimation: A reliable technique. J Indian Acad Oral Med Radiol 2013;25:287-90.
  7. Kumaresan GD, Jagannathan N. Exfoliative cytology –A predictive diagnostic tool. Int J Pharm Sci 2014;6:1-3.
  8. Anuradha A, Sivapathasundharam B. Image analysis of normal exfoliated gingival cells. Indian J Dent Res 2007;18:63-6.
  9. ReddyVS, KumarGS, VezhavendhanN, PriyaS. Cytomorphometric analysis of normal exfoliative cells from buccal mucosa in different age groups. Int J Clin Dent Sci 2011;2:53-6.
  10. Cowpe JG, Longmore RB, Green MW. Quantitative exfoliative cytology of normal oral squames: An age, site and sex-related survey. J R Soc Med 1985;78:995-1004.
  11. Patel PV, Kumar S, Kumar V, Vidya G. Quantitative cytomorphometric analysis of exfoliated normal gingival cells. J Cytol 2011;28:66-72.
  12. Star H, Thevissen P, Jacobs R, Fieuws S, Solheim T, Willems G. Human dental age estimation by calculation of pulp-tooth volume ratios yielded on clinically acquired cone beam computed tomography images of monoradicular teeth. J Forensic Sci 2011;56 Suppl 1:S77-82.
  13. Afify MM, Zayet MK, Mahmoud NF, Ragab AR. Age estimation from pulp/tooth area ratio in three mandibular teeth by panoramic radiographs: Study of an Egyptian sample. J Forensic Res 2014;5:1-5.