Scientific Reports Article in Press
AI-assisted age estimation from occlusal tooth wear using biofluorescence imaging
Authors: Sang-Kyeom Kim, Eun-Song Lee, & Baek-Il Kim
This proof-of-concept study evaluated feasibility of an AI-based age estimation model using an occlusal tooth wear parameter (∆Fwear) quantified from biofluorescence. Quantitative light-induced fluorescence (QLF) images from 104 adults (20-70 years; 2,733 teeth) were analyzed. To prevent data leakage, the dataset was split at the participant level. A Random Forest (RF) regressor was optimized, and recursive feature elimination with cross-validation (RFECV) identified efficient tooth subsets. Final models were validated using an independent test set, and correlations between mean ∆Fwear and chronological age were assessed. Cross-validation (CV) performance peaked with three teeth; however, independent testing showed that a model incorporating seven key teeth achieved the best generalization performance. This 7-tooth model achieved a mean absolute error of 7.49 years (95% CI: 5.90–9.17), comparable to the full 28-tooth model (MAE: 7.27 years; p = 0.79), with a stronger Pearson correlation with age (r = 0.78 vs. 0.71) and an equivalent R2 of 0.61. These findings support the feasibility of integrating ∆Fwear with an interpretable machine-learning framework for non-invasive age estimation. While the reduced 7-tooth model offers analytical efficiency, further validation in larger and more diverse cohorts is required to confirm its generalizability for broader forensic or epidemiological applications.
Keywords: Forensic Odontology, Quantitative Light-induced Fluorescence (QLF), Random Forest, Feature Selection, Explainable AI
Quantifying Age with AI: Key Performance Indicators
Our AI-driven methodology achieved high accuracy in age estimation, demonstrating robust performance with a streamlined tooth subset.
Deep Analysis & Enterprise Applications
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Quantitative Light-induced Fluorescence (QLF) for Wear Analysis
QLF is a non-invasive biofluorescence technology. It quantifies tooth wear by measuring changes in fluorescence intensity, with worn areas exhibiting higher intensity than sound enamel. This provides a precise, objective metric (∆Fwear) to assess cumulative tooth wear, overcoming limitations of subjective visual assessments.
Random Forest Regression & Optimized Feature Selection
We utilized a Random Forest (RF) regressor optimized via Bayesian optimization to build a predictive model. Recursive Feature Elimination with Cross-Validation (RFECV) was crucial in identifying an efficient subset of key teeth, significantly reducing model complexity while maintaining performance.
Enhancing Trust with Explainable AI
The Random Forest algorithm provides intrinsic interpretability through feature importance scores, allowing clinicians and forensic experts to understand the model's decision-making process. This aligns with Explainable AI (XAI) principles, fostering trust and practical acceptance in high-stakes medical applications beyond black-box models.
Core Age Estimation Performance
7.49 Years (Mean Absolute Error, 7-Tooth Model)Our AI model achieved a mean absolute error of 7.49 years in age estimation using a refined 7-tooth subset, demonstrating high accuracy comparable to a full dentition analysis.
Enterprise Process Flow: AI-assisted Age Estimation
| Model Type | Selected Teeth | MAE (years) | R² | Pearson's r |
|---|---|---|---|---|
| 3-tooth | 11, 27, 44 | 9.11 | 0.40 | 0.69 |
| 7-tooth (Optimized) | 11, 16, 17, 21, 27, 31, 44 | 7.49 | 0.61 | 0.78 |
| 28-tooth (Full) | All teeth | 7.27 | 0.61 | 0.71 |
| The 7-tooth model provides optimal balance between performance and analytical efficiency. | ||||
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Phase 01: Strategic Assessment & Data Readiness
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Phase 02: Pilot Development & Feature Engineering
Develop initial AI models, focus on critical feature extraction (e.g., ∆Fwear), and establish baseline performance metrics.
Phase 03: Model Optimization & Validation
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