Reframing Adult Age Determination in Forensic Odontology Through a Certainty-Based Hybrid Human–AI Dental Maturity Approach

Abstract

Forensic age determination in presumed minors is affected by a structural tension between biological uncertainty, juridical thresholds, and the ethical duty to protect childhood. Conventional dental age estimation methods provide point estimates of chronological age but do not directly address the question central to legal proceedings: whether adult status can be affirmed with certainty. This short communication introduces MIDAS (Maturity Index for Determination of Adult Status), a certainty-based, hybrid human–AI framework for adult age determination. Two forensic odontologists independently assessed mandibular third-molar development (Radicular Completion Ratio, R8; Apical Closure Index, A8) in 180 anonymized orthopantomographs of individuals aged 14–25 years, complemented by an AI-assisted radiomorphometric module extracting root density relative to enamel (D7) and trabecular texture homogeneity (Tm). These parameters were integrated into a continuous Integrated Dental Maturity Index (IMD). By raising the biological reference age to 20 years and excluding the 17–20-year interval from affirmative adult classification, the framework operationalizes the precautionary principle, interpreting residual uncertainty in favor of childhood protection. As a proof of concept, this study establishes the conceptual and operational architecture of MIDAS rather than its diagnostic accuracy. Formal validation on larger and more diverse populations is required before routine forensic and medico-legal application. Should such validation confirm its performance, MIDAS could offer an ethically grounded, legally coherent, and scientifically transparent complement to conventional methods of dental age estimation and adulthood determination.