Brief Communication: The London Atlas of Human Tooth Development and Eruption S.J. AlQahtani, M.P. Hector, and H.M. Liversidge* Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK KEY WORDS dental; age; estimation; forensic; odontology ABSTRACT The aim of this study was to develop a comprehensive evidence-based atlas to estimate age using both tooth development and alveolar eruption for human individuals between 28 weeks in utero and 23 years. This was a cross-sectional, retrospective study of archived material with the sample aged 2 years and older having a uniform age and sex distribution. Devel- oping teeth from 72 prenatal and 104 postnatal skeletal remains of known age-at-death were examined from col- lections held at the Royal College of Surgeons of Eng- land and the Natural History Museum, London, UK (M 91, F 72, unknown sex 13). Data were also collected from dental radiographs of living individuals (M 264, F 264). Median stage for tooth development and eruption for all age categories was used to construct the atlas. Tooth development was determined according to Moor- rees et al. (J Dent Res 42 (1963a) 490–502; Am J Phys Anthropol 21 (1963b) 205–213) and eruption was assessed relative to the alveolar bone level. Intraexa- miner reproducibility calculated using Kappa on 150 teeth was 0.90 for 15 skeletal remains of age <2 years, and 0.81 from 605 teeth (50 radiographs). Age categories were monthly in the last trimester, 2 weeks perinatally, 3-month intervals during the first year, and at every year thereafter. Results show that tooth formation is least variable in infancy and most variable after the age of 16 years for the development of the third molar. Am J Phys Anthropol 142:481–490, 2010. V V C 2010 Wiley-Liss, Inc. Age estimation for humans plays an important role in mass disasters and unaccompanied or asylum-seeking minors in the absence of proper documents. It also con- tributes to anthropology and forensic sciences, where age at death is estimated for skeletal remains (Hillson, 1996). Teeth survive inhumation well and show less vari- ability than skeletal age, and the developing dentition is therefore better than other developmental indicators available for age estimation up to maturity (Garn et al., 1960; Demirjian, 1986; Smith, 1991). Humans have two generations of teeth: the deciduous dentition, which begins to develop around the sixth week in utero, and the permanent dentition, which reaches completion in early adult life. This long span of tooth development, eruption, shedding, and maturing is an orderly and se- quential process. Crown or root growth and maturation stages as well as eruption relative to the alveolar bone level can be used to estimate dental age in both living and skeletal remains. (Demirjian, 1986) The aim of this study was to develop a comprehensive evidence-based atlas to estimate age using both tooth development and alveolar eruption for individuals between 28 weeks in utero and 23 years. MATERIALS AND METHODS Materials This was a cross-sectional retrospective study of 704 archived records: radiographs of known age individuals and known age-at-death skeletal remains. Individuals aged 28 weeks in utero to less than two years of age. All available individuals aged between 28 weeks in utero and 2 years of age were examined from two collections of known age-at-death human remains detailed in Table 1. The first was the Spital- fields Collection at the Human Origins Group, Paleontol- ogy Department, Natural History Museum, London (Molleson and Cox, 1993), that consists of 15 females, 22 males, and 13 unknown sex (N 5 50); the second was Maurice Stack’s collection, which is part of the Odonto- logical Collection at the Royal College of Surgeons of England (Stack, 1960) made up of 69 males and 57 females (N 5 126). Individuals aged 2–24 years of age. Good quality archived dental panoramic radiographs were selected, with all teeth in focus, of healthy individuals (N 5 528) aged 2–24 years from the Institute of Dentistry, Barts and the London School of Medicine and Dentistry. All ra- diographs had previously been taken for diagnosis and treatment. The sample was made up of two ethnic groups: about half were white and half Bangladeshi. Mean ages of tooth development are not significantly dif- ferent in these groups (Liversidge, 2009). Each chrono- logical year was represented by 12 males and 12 females. A uniform age distribution was chosen to equalize accu- racy over all age groups (Konigsberg and Frankenberg, Grant sponsor: Ministry of Higher Education, Saudi Arabia (to SJA). *Correspondence to: Dr. Helen Liversidge, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, UK. E-mail: h.m.liversidge@qmul.ac.uk Received 21 August 2009; accepted 4 December 2009 DOI 10.1002/ajpa.21258 Published online 22 March 2010 in Wiley InterScience (www.interscience.wiley.com). V V C 2010 WILEY-LISS, INC. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 142:481–490 (2010)