Mandibular condylar cortication and third molar apical closure on cone beam computed tomography for the assessment of legal adulthood: a pilot retrospective study.

INTRODUCTION

Accurate estimation of legal adulthood in undocumented individuals remains a major challenge in forensic and medico-legal contexts. This study evaluates mandibular condylar cortication and third molar apical closure assessed by cone beam computed tomography (CBCT) as potential indicators of age of majority. A retrospective observational pilot study was conducted on 142 individuals aged 13-25 years from six geographic regions (Spain, Uruguay, Peru, Mexico, Venezuela and Colombia). Two radiological variables were analyzed: the presence of cortical bone in the mandibular condyle and apical closure of the mandibular third molars. Associations with chronological age were explored descriptively, considering sex and geographic origin.

RESULTS

Mandibular condylar cortication was identified exclusively in individuals aged 18 years or older. It showed 89.2% sensitivity, 100% specificity, 100% positive predictive value, and 89.5% negative predictive value for identifying legal adulthood. Complete third molar apical closure showed lower sensitivity (64.7%) and specificity of 96.6%. Both markers were significantly associated with legal adulthood (Fisher's exact test, p < 0.001).

CONCLUSION

Within the limitations of this pilot study, mandibular condylar cortication assessed by CBCT appears to be a promising indicator of legal adulthood, potentially offering higher specificity than third molar apical closure. Further large-scale studies are required to validate these findings.