Abstract
BACKGROUND AND AIM: Forensic odontology plays a crucial role in age estimation and personal identification, especially in cases where only dental remains are available. In a similar context, various newer innovations in digital software are a key tool to assess age from such remains in contemporary times. The present systematic review and meta-analysis focuses on the use of various digital software used in forensic odontology for age estimation from dental remains in a range of studies that were published between 2006 and 2023. MATERIALS AND METHODS: Relevant studies were sourced from Google Scholar, Directory of Open Access Journals, PubMed, U.S. National Institutes of Health/National Library of Medicine (NIH/NLM), Scimago Journal Ranking, SCOPUS, and Web of Science (WoS) using keywords such as forensic odontology, age estimation, and digital cone-beam computed tomography (CBCT), while only original research articles published between 2006 and 2023 were included. Again, digital software tools such as Adobe Photoshop CS2, AutoCAD, i-Dixel imaging software, ImageJ, ITK-SNAP 3.8, MIMICS, and OsiriX among others were evaluated for their precision and efficacy. The extracted data were organized in an Excel sheet including categories such as author, year, software used, sample size included, age estimation method used, age group included, teeth used, and location of the study, while the data obtained were subjected to statistical analysis. RESULTS: The analysis revealed AutoCAD software to be the most common digital software used with a valid percentage of 31.5 and cumulative percentage of 48.2, followed by MIMICS and Adobe Photoshop CS2 to be the next in order. Furthermore, i-Dixel imaging software was the least common tool used in the list. Again, Kvaal's and Demirjian's methods were the most common methods employed, while pulp/tooth area ratio and pulp/tooth volume were the most common techniques used across the various studies published for age estimation in the defined period in descending order. CONCLUSIONS: Advancements in software tools and digital CBCT imaging have significantly improved the precision of age estimation in the field of forensic odontology. These tools possess enhanced features of image segmentation and three-dimensional reconstructions, leading to more accurate and reproducible results. Further research is, however, needed to standardize methods, refine population-specific equations, and improve the applicability of these techniques across diverse populations.