I.O.F.O.S. Recommendations for quality assurance: Bone age assessment in living individuals

Abstract

Age assessment in living individuals is an important question of legal and humanitarian decision-making when reliable identification documents are unavailable.

In January 2026, the International Organization for Forensic Odonto-Stomatology (IOFOS) finalized, for the first time, the IOFOS Recommendations for Quality Assurance: Bone Age Assessment in Living Individuals. This document establishes a harmonized framework for the scientific, ethical, and legal application of bone age assessment in living persons.

The recommendations define minimum standards for the selection and interpretation of bone indicators addressing imaging modalities, reference population requirements, uncertainty reporting, and integration with dental age assessment. Particular emphasis is placed on transparency, protection of individual rights, and the forensic implications of legal age thresholds.

These recommendations are intended to be applied alongside IOFOS Recommendations for Quality Assurance: Dental Age Assessment in Living Individuals and to serve as an international reference framework, to be adapted and incorporated into national legal and regulatory systems according to jurisdiction-specific requirements.

Keywords: Age Estimation; Bone Age Assessment; Living Individuals, Recommendations; IOFOS.