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 Table of Contents  
FORENSIC ODONTOLOGY: ORIGINAL ARTICLE
Year : 2019  |  Volume : 31  |  Issue : 2  |  Page : 155-158

Occlusal radiograph a hidden tool for sex determination: A radiographic study


1 Department of Oral Medicine and Radiology, Mamata Dental College and Hospital, Khammam, Telangana, India
2 Department of Oral and Maxillofacial Pathology, Mamata Dental College and Hospital, Khammam, Telangana, India

Date of Submission25-Feb-2019
Date of Acceptance30-Apr-2019
Date of Web Publication24-Jun-2019

Correspondence Address:
Dr. Kotya Naik Maloth
Department of Oral Medicine and Radiology, Mamata Dental College and Hospital, Giriprasad Nagar, Khammam - 507 002, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaomr.jiaomr_44_19

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   Abstract 


Aim: To evaluate the reliability of dental arch linear and angular measurements on occlusal radiographs and to assess the usefulness of occlusal radiographs in sex determination. Materials and Methods: A prospective study was conducted on 50 patients (25 males and 25 females) using occlusal radiographs with age ranging from 20 to 25 years. Standard occlusal radiographs were taken without any errors by intraoral dental X-ray machine with required ideal exposure parameters after taking due radiation protection and safety measures. The radiographs were carefully processed and the images obtained were traced for angular and linear measurements, attributing capital letters to the maxillary arch and small letters to the mandibular arch. The obtained data were analyzed by ANOVA using SPSS Software Version 22.0 for statistical analysis using discriminate methods. Results: In the present study, all the linear measurements of occlusal radiographs showed a statistically significant differentiation and angular measurements namely “CIA” L, “MIC” L, “CIA” R, and “MIC” rare found highly significant in the differentiation of sex. Conclusion: We conclude that the occlusal radiographic measurements (odontometry) can be used for sex determination and is recommended as an aid for sex determination in forensic science.

Keywords: Dental arch, occlusal radiograph, sex determination


How to cite this article:
Maloth KN, Reddy KV, Anusha NV, Sunitha K, Saraswathi C, Iraganaboina RC. Occlusal radiograph a hidden tool for sex determination: A radiographic study. J Indian Acad Oral Med Radiol 2019;31:155-8

How to cite this URL:
Maloth KN, Reddy KV, Anusha NV, Sunitha K, Saraswathi C, Iraganaboina RC. Occlusal radiograph a hidden tool for sex determination: A radiographic study. J Indian Acad Oral Med Radiol [serial online] 2019 [cited 2019 Nov 12];31:155-8. Available from: http://www.jiaomr.in/text.asp?2019/31/2/155/261091




   Introduction Top


Sex identification was considered one of the major step and challenging tasks for forensic experts in recognition of deceased individuals at social and medico-legal issues, mass disaster such as tsunami, explosions, and hurricanes, where complete body is deface afar identification.[1] In 95% of cases, good skeleton stature is the best morphological indicator for sex determination, but the difficulty lies in obtaining a correct diagnosis in mass disasters where only a part of bony fragments or skeleton is found.[2],[3]

Human identification can be done by performing various methods like soft tissue analysis such as fingerprints and lip prints that are commonly used when soft tissues are preserved. In the absence of soft tissue, bony fragments or skeleton analysis and dental analysis are done.[4] According to the literature and studies conducted by Rosing FW,[1] Saini V, et al.[5] Scheuer L,[6] and Hu KS, et al.[7] pelvis and skull bones are the well-grounded source among human bones providing accuracy more than 92% for sex determination.[5] Medical, dental records, and radiographs also plays a major role in sex determination.[8] The radiographic usage has long been used for routine examination procedures, as well in forensic science for the identification of unknown person. The demand was raised universally day to day in forensic science because its application in identification is orderly, cost-effective compared to DNA test, speedy and relatively simple.[9] Various radiographic imaging modalities such as orthopantomograph, skull views, hand wrist, and occlusal radiographs play a vital role and one of the powerful tool in forensic science.[9] In the literature hunt, only two research articles till now highlighted the importance of dental arch linear and angular measurements by using occlusal radiograph for sex determination. Therefore, the present study was conducted to evaluate the reliability of dental arch linear and angular measurements on occlusal radiographs and to assess the usefulness of occlusal radiographs in sex determination.


   Materials and Methods Top


After obtaining institutional ethical committee clearance, a prospective study was conducted using occlusal radiographs of 50 subjects (25 male and 25 female) with an age ranging from 20 to 25 years. Patients with complete dentition without any abnormality (class- I occlusion) and “U” shaped palate were included and patients with morphological tooth abnormalities like attrition, caries, H/o tooth extractions/missing tooth, and anatomical abnormalities in maxillary and mandibular dental arches were excluded from the study.

After obtaining consent from patients, standard occlusal radiographs (50 maxillary and 50 mandibular) were taken on intraoral dental X-ray machine with required ideal exposure parameters after taking due radiation protection and safety measures such as the use of lead aprons. The radiographs were carefully processed and the images obtained were traced for angular and linear measurements, attributing capital letters to the maxillary arch and small letters to the mandibular arch. The letter “L” indicates the left side and “R” indicates the right side of the patient on occlusal radiograph [Figure 1]a and [Figure 1]b.
Figure 1: Maxillary occlusal radiograph (a) Mandibular occlusal radiograph (b)

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Angular measurements

The median line is drawn touching the vestibular area of the occlusal radiographic projections of the maxillary central incisors. The intersection of these points denoted as “I” point. From this point, another line was drawn toward the most vestibular portion of the canine tooth denoted as “C” point, and this line named as angular measure “IC”. The angle formed by these two points and “A” point, locating in the line that coincides with the union of the palatal processes of maxillary bone, i.e. medial line, named as CIA”.

Following the same methodology, a line from “I” point to the most vestibular portion of the second pre-molar denoted as “P” point and second molar as “M” point were drawn and named as angular measure “IP”and “IM,” respectively. The angle obtained by these two points (”IP” and “IM”) and “B” and “C” points located in the line that coincides with the medial line of palate, called as “PIB”and”MIC,” respectively [Figure 2]a.
Figure 2: The presentation of angular measurements on maxillary occlusal radiograph (a) mandibular radiograph (b)

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Similarly, in mandibular arch, the angular measures abbreviated as “ic,” “ip,” and “im” and the angles formed by these two points, and “a” point, “b” point, and “c” point were abbreviated as “cia,””pib,”and “mic” [Figure 2]b.

Linear Measurements

Measures related to the maxillary and mandibular dental arches width were made in three portions corresponding to the line drawn from the most vestibular portions of the left and right canines, second premolars and second molars named as CC, PP, and MM for maxillary arch and cc, pp, and mm for mandibular arch. [Figure 3]a and [Figure 3]b The obtained data were analyzed by ANOVA using SPSS Software Version 22.0. (SPSS Inc., Chicago, IL, USA).
Figure 3: The presentation of linear measurements on maxillary occlusal radiograph (a) mandibular radiograph (b)

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   Results Top


Mean and standard deviation obtained from linear measurements and angular measurements for males and females are exhibited in [Table 1] and [Table 2], respectively.
Table 1: The presentation linear measurements (cm)

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Table 2: The presentation of angular measurements

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All the linear variables analyzed by t test showed higher values in males than in females that were found statistically highly significant (P < 0.001) for gender differentiation [Table 1].

Angular measurement values have shown highly significant differences (P < 0.004) between males and females only in “CIA” L, “MIC” L, “CIA” R, and “MIC” R, angle measures [Table 2].


   Discussion Top


Sex determination from human remains is the primitive step in the establishment of biological demands of the deceased individuals in anthropology and forensic science, go after age and stature appraisal as both are sex-dependent.[1]

Various methods were performed for human identification and sex determination such as soft tissue analysis, hard tissue bone analysis, and dental analysis that correlating with the medical and dental records (radiographs). Worldwide from ancient days fingerprints the most popular, reliable source with excellent result and commonly used till today for human identification in medico-legal cases and deceased individuals, when soft tissue is preserved.[10]

In absence of soft tissue or destruction of soft tissue, bony fragments of the skull or pelvic bones are considered as it provides meticulous results more than 92% for sex determination.[3],[5] In addition to skull, mandible and dental arch with dentition also plays a vital role in sex determination. The mandible is contemplate more for sex determination because of its unique features such as sexually dimorphic, strongest, and largest intact bone of skull.[5],[7] Morphological impressions play a minor role in sex identification is one of the drawbacks, to overcome this morphometric measurements methods are followed for sex determination, which gives valid results without any error.[11] Dental arch with dentition also has unique features and plays an important role for sex determination. Taken this into consideration, we searched in literature and found only two published articles till today. These articles highlighted the importance of morphometric measurements on dental arch in sex determination using occlusal radiograph.

According to Merz (1991)[12] in his study concluded that there was no significant differences regarding the tooth size and shape of dental arches between genders. Therefore, the present study was conducted to evaluate the reliability of dental arch linear and angular measurements on occlusal radiographs and to assess the usefulness of occlusal radiographs in sex determination.

In the present study, all the dental arch linear measurements unveil highly significant differentiation, whereas angular measurements namely, “CIA”L,”MIC”L,”CIA”R, and “MIC” R, unveil highly significant in differentiation of sex.

The results of our study are in agreement with the results of Santos LF, et al.[9], and Sathawane RS, et al.,[13] further more “CIA” R and “MIC” R are statistically significant in the present study.

Santos LF, et al.[10] conducted a study on 50 Brazilian people to analyze the dental arches by occlusal radiographs for possible gender differentiation, and he concluded that sex can be determined using occlusal radiographs with greater reliability when linear measurements are performed.

Sathawane RS, et al.[13] conducted a study on 60 Indian people to determine gender by analyzing dental arches using occlusal radiographic linear and angular measurements, and he concluded that all linear measurements are definite key measurements for gender determination, whereas only two angular measurements “CIA” L and “MIC” L are useful. However, in the present study, we found all the angular measurements namely “CIA”L, “MIC”L,”CIA”R, and “MIC” R unveil highly significant in differentiation of sex.

Thus, dental arch occlusal radiographic measurements (odontometry) can be used for sex determination and is recommended as an aid for sex determination in forensic science. The main advantages of this technique is simple, quick, economical, and precise result for sex determination by using dental arch all linear measurements and “CIA L,” “MIC L,” “CIA R,” “MIC R,” angular measurements on occlusal radiograph.

The limitation of the present study is smaller sample size and inability to assess the sex in cases of teeth attrition, caries tooth, H/o tooth extractions/missing tooth, and anatomical abnormalities in maxillary and mandibular dental arches. However, further studies with large sample size recommended setting our populations for sex determination in forensic science.


   Conclusion Top


The results of the present study established evidence that dental arch linear and angular measurement using occlusal radiographs in sex determination. It is a simple, quick economical, and valid technique for sex determination. Hence, we conclude that the use of occlusal radiographs is recommended as an aid for sex determination in forensic science.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Rosing FW, Graw M, Marre B, Ritz-Timme S, Rothschild MA, Rotzscher K, et al. Recommendations for the forensic diagnosis of sex and age from skeletons. Homo 2007;58:75-89.  Back to cited text no. 1
    
2.
Kimmerle EH, Ross A, Slice D. Sexual dimorphism in America: Geometric morphometric analysis of the craniofacial region. J Forensic Sci 2008;53:54-7.  Back to cited text no. 2
    
3.
Maloth KN, Kundoor VK, Vishnumolakala SL, Kesidi S, Lakshmi MV, Thakur M. Mandibular ramus: A predictor for sex determination-A digital radiographic study. J Indian Acad Oral Med Radiol 2017;29:242-6.  Back to cited text no. 3
  [Full text]  
4.
Gupta A, Kumar K, Shetty DC, Wadhwan V, Jain A, Khanna KS. Stature and gender determination and their correlation using odontometry and skull anthropometry. J Forensic Dent Sci 2014;6:101-6.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Saini V, Srivastava R, Rai RK, Shamal SN, Singh TB, Tripathi SK. Mandibular ramus: An indicator for sex in fragmentary mandible. J Forensic Sci 2011;56:S13-6.  Back to cited text no. 5
    
6.
Scheuer L. Application of osteology to forensic medicine. ClinAnat 2002;15:297-312.  Back to cited text no. 6
    
7.
Hu KS, Koh KS, Han SH, Shin KJ, Kim HJ. Sex determination using nonmetric characteristics of the mandible in Koreans. J Forensic Sci 2006;51:1376-82.  Back to cited text no. 7
    
8.
Kirk NJ, Wood RE, Goldstein M. Skeletal identification using the frontal sinus region: A retrospective study of 39 cases. J Forensic Sci 2002;47:318-23.  Back to cited text no. 8
    
9.
Kahana T, Hiss J. Forensic radiology. In: Tsokos M, editor. Forensic Pathology Reviews. Vol 3. Humana Press Inc.;2005. p. 443-60.  Back to cited text no. 9
    
10.
Santos LF, Galo R, Alves da silva RH. Gender evaluation in human beings by occlusal radiographs. Braz J OralSci 2015;14:23-6.  Back to cited text no. 10
    
11.
Franklin D, O'Higgins P, Oxnard CE. Sexual dimorphism in the mandible of indigenous South Africans: A geometric morphometric approach. SAfr JSci 2008;104:101-6.  Back to cited text no. 11
    
12.
Merz ML. Tooth diameters and arch perimeters in a black and white population. Am J OrthodDentofacOrthop 1991;100:53-8.  Back to cited text no. 12
    
13.
Sathawane RS, Tripathi K. Determination of gender from occlusal radiographic measurements.IP Int J MaxillofacImag 2017;3:92-4.  Back to cited text no. 13
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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