###### Abstract  
The pulp-tooth area ratio (PTR) from radiographic dental archives is considered useful for age estimation in the forensic field. Since there have been no studies conducted in the Saudi Arabian population using the PTR method, this study aimed to assess the relationship between the pulp-tooth area ratio of maxillary amines and central incisors and chronological age among Saudi Arabian adults using CBCT and to compare the selected teeth's predictive power. For this, 100 CBCT scans of 62 male and 38 female patients aged between 20 and 60 years were assessed using OnDemand 3D DentalITM software (Cybermed Co., Tustin, CA, USA) in the axial and sagittal section of each tooth. The mean age estimated using the PTR of the maxillary incisors (39.98 years) was higher than the canines' (37.9 years). A negative correlation coefficient 'r' value was seen between PTR and age. The strongest inverse correlation was noted between age and incisor axial view (0.47) (\(p<0.05\)), Maximillary central incisors had higher R\({}^{2}\) in both genders (males: PTRS-0.18, PTRA-0.17; females: PTRS-0.19, PTRA-0.35) than canines. We conclude a weak correlation between the pulp-tooth ratio and chronological age estimation. CBCT pulp-tooth ratios of axial and sagittal sections of incisors were inconclusive in estimating the age of Saudi Arabian individuals owing to their low coefficient of estimation. Among the tooth types studied, maxillary incisors were better predictors than canines. ag +
Footnote †: journal: Medical Imaging  
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Footnote 1: email: [EMAIL_ADDRESS]  
Footnote †: journal: Medical Imaging  
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Footnote 1: email: addumid@gmail. the remaining portions. Thus, it is essential to re-evaluate and validate the age estimation using the pulp-tooth ratio with three-dimensional radiological measures [20]. Multiple pieces of evidence using three-dimensional imaging to estimate age demonstrated that PTR is a valuable tool for age prediction [21; 22; 23; 24]. For example: a study was carried out in an Egyptian population by [PERSON] et al. [21] using the principles of [PERSON] et al. [25] to assess the pulp and tooth areas. This study assessed 500 panoramic radiographs of individuals from Egypt. These were from 262 males and 238 females with the age ranging from 18 to 71 years. Using AutoCAD 2010, the PTR was estimated. The collected data underwent correlation and regression analysis, showing a high correlation with age (r = \(-0.95\) in terms of second premolar and canine (r = \(-0.94\))). On the other hand, the first premolar displayed a lesser degree of correlation (r = \(-0.91\)). Based on the findings of this study, it was concluded that this method is a valuable approach for reasonably accurate age assessment. In a separate investigation conducted by [PERSON] et al. [22] among the Japanese population, it was observed that the pulp volume decreases over time. A Bayesian approach was proposed for estimating human age in the canines of the mandibular arch. A likelihood function was generated for pulp volume ratio by fitting the model and a probability density function was estimated for a given age based on a given PVRrt. [PERSON] et al. [24] conducted another study in a Belgian population to establish a connection between dental age and an individual's chronological age. An X-ray microfocus computed tomography unit (microCT) with a spatial resolution of 25 \(\upmu\)m was employed. This scanning technique was applied to examine 43 single-root extracted teeth obtained from 25 individuals with well-documented chronological ages. Two examiners employed custom-made analysis software to derive numerical measurements for both pulp and tooth volumes. Subsequently, the ratio between the two volumes was calculated and subjected to statistical analysis. The study revealed no significant differences either within or between examiners, indicating a high level of agreement. When performing linear regression analysis, a low coefficient of determination (0.31) was obtained.