

FORENSIC ODONTOLOGY: ORIGINAL RESEARCH ARTICLE 

Year : 2020  Volume
: 32
 Issue : 4  Page : 376383 

Correlation of anthropometric measurements and odontometric measurements: A possible forensic tool in stature estimation
Tungala Navya Teja^{1}, K Naga Venkata Sai Praveen^{1}, Reddy Sudhakara Reddy^{2}, Tatapudi Ramesh^{2}, K Roja Reddy^{2}, D Geetanjali^{2}
^{1} Department of Oral Medicine and Radiology, CKS Theja Dental College, Tirupathi, Andhra Pradesh, India ^{2} Department of Oral Medicine and Radiology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
Date of Submission  08Jun2020 
Date of Decision  24Oct2020 
Date of Acceptance  29Oct2020 
Date of Web Publication  28Dec2020 
Correspondence Address: Dr. Tungala Navya Teja Cks Theja Dental College, Tirupathi, Andhra Pradesh India
Source of Support: None, Conflict of Interest: None  Check 
DOI: 10.4103/jiaomr.jiaomr_105_20
Abstract   
Background: Stature or body height is one of the most essential and useful anthropometric parameters; determining an individual's physical identity. A proportional biological relationship of stature exists with every part of the human body, which plays a vital role in forensic investigations. Apart from them, teeth also have the advantage of being composed mainly of hard tissue, which is relatively indestructible. The careful study of these can enable reliable determination of the stature of the person. Aim: The aim is to correlate hand length, middle phalanx length and Carrea's index with that of actual individual height in determining the stature. Materials and Methods: A total of 150 subjects constituting a sample size of 300 (both right and left sides) of age range 2025 years were considered in the present study. Height of the subject was measured using Standard Anthropometer. Hand length and Middle phalanx length was measured using digital vernier callipers. Mandibular impression was taken using alginate impression material, arch and chord length was measured on dental cast using digital vernier callipers. Statistical Analysis and Results: Regression equations were derived for hand and middle phalanx length to calculate estimated height and Carrea's index was used to calculate estimated height. The estimated heights from all parameters were compared with the actual height and linear correlation was obtained for all the parameters. Conclusion: Among all parameters hand length on both right and left sides predict stature more accurately whereas Carrea's method was used just as an auxillary tool.
Keywords: Carrea's Index, hand length, middle phalanx length, stature
How to cite this article: Teja TN, Sai Praveen K N, Reddy RS, Ramesh T, Reddy K R, Geetanjali D. Correlation of anthropometric measurements and odontometric measurements: A possible forensic tool in stature estimation. J Indian Acad Oral Med Radiol 2020;32:37683 
How to cite this URL: Teja TN, Sai Praveen K N, Reddy RS, Ramesh T, Reddy K R, Geetanjali D. Correlation of anthropometric measurements and odontometric measurements: A possible forensic tool in stature estimation. J Indian Acad Oral Med Radiol [serial online] 2020 [cited 2021 Jan 28];32:37683. Available from: https://www.jiaomr.in/text.asp?2020/32/4/376/305263 
Introduction   
Stature is the height of a person in the upright posture and has a definite and proportional biological relationship with each and every part of human body i.e., head, face, trunk, extremities. This relationship helps a forensic scientist to calculate stature from dismembered and mutilated body parts during forensic examinations and thus aids in narrowing down the investigation process by providing useful clues to the investigation agencies.^{[1]} Every person tends to undergo change in varying degrees from birth to death, in health and in disease and this inturn depends upon gender, ethnicity, ancestry, various climatic and hormonal changes. Hence, the determination of stature is a major concern in forensic medicine and forensic anthropology.^{[2]}
Anthropometry, a typical and traditional tool of physical anthropology, provides the scientific methods and the techniques for estimating the various measurements and the observations on the living as well as the skeleton of man. Forensic anthropometry is a scientific specialization emerged from the discipline of forensic anthropology dealing with identification of human remains with the help of metric techniques.^{[3]} The use of anthropometry in the field of forensic science and medicine dates back to 1882 when Alphonse Bertillon, a French police expert invented a system of criminal identification based on anthropometric measurements.^{[4]}
In modern era, mutilated body parts are found due to increased events of natural and manmade disasters and also due to increased events of the murders where the mutilation of dead body is done by a murderer to destroy all traces of identity as well as to facilitate the disposal of the dead.^{[4]} In such cases, forensic anthropologist can provide a tentative identification of unknown remains by formulating a 'biological profile' which involves the determination of stature, sex, age, and ethnicity.^{[5]}
Identification of an individual is an essential prime task for investigating officer when the deceased found, at least by estimation of the stature of an individual from the skeletal remains from the mutilated and amputated limbs, has a prominent significance in the personal identification.^{[6]} There is an established relationship between stature and various body parts like head, trunk, upper and lower extremities. It is common to find the peripheral parts of the body such as hand and foot in explosions, aircraft and railway accidents.^{[7]} Different hand dimensions have been used to predict the stature of an individual in different populations but sometimes an intact hand is not available for examination. Thus, the need arises to estimate the stature by using a portion of a hand. So measurements from hand length and phalanx length can be used as an alternative measure to estimate stature when stature cannot be measured directly.^{[8]}
Apart from this, the evidence based literature states that tooth is also useful tool in stature estimation. “Forensic Odontology” is the branch of dentistry which, in the interest of justice, deals with proper handling and examination of dental evidence and with the proper evaluation and presentation of dental findings.^{[9]} The Forensic Dentistry in the human identification is an area of great support for the forensic medicine due to the excellent results obtained through the use of refined techniques and precise conclusions.^{[10]} The dental arch has uncountable individual variables that make it impossible for two different individuals to have identical dental elements. This fact often allows irrefutable proof of identification for legal purposes. Teeth play an important role in identification of the deceased since they can resist the effect of time, resistant to fire and trauma.^{[11]}
However, few studies have been done correlating various odontometric parameters with the height of an individual. Carrea described a mathematical calculation to determine the stature considering the size of anterior mandibular teeth.^{[12]} Carrea's index basically measured two dimensions: the Arch and the Chord. The “arch” represented by the sum of mesiodistal widths of anterior teeth on one side and the “chord” represents the direct distance between mesial edge of central incisor and the distal edge of canine on the same side. Using these measurements, the upper and lower range of the height estimates are derived.^{[12]}
The stature prediction occupies relatively a central position in the identification necessitated by the medicolegal experts or medical jurisprudence and also in the anthropological research. So, there is a need for easily available and readily accessible method for the estimation of stature.
With this background, the present study was undertaken to estimate the stature of each subject using the above mentioned three dimensions namely hand length, middle phalanx length, and Carrea's index.
Materials and Methods   
A total of 150 subjects constituting a sample size of 300 (both right and left sides) were selected randomly of age range 2025 years were considered in the present study. All the data were collected from December 2015 to December 2016.
Sample size was calculated using an online sample size calculator, Clincalc.com.
Sample size was calculated using the following parameters.
Mean Actual length of population (from literature) = 162.99 ± 11.84
Mean estimated height of sample (Pilot study) = 160.16
Allowed TypeI error = 5%
Allowed TypeII error = 20%
Power of the study = 80%
The online tool applies the following formula for calculating the sample size of each group.
N = 137
Where μ_{0} = population mean
μ_{1} = mean of study population
N = sample size of study population
σ = variance of study population
α = probability of type I error (usually 0.05)
β = probability of type II error (usually 0.2)
Z = critical Z value for a given α or β
The online calculator suggested a sample size of 137, which is rounded off to 150.
Subjects with abnormal bony growth patterns or Syndromes that interferes with growth of the body or tooth anomalies, missing anterior tooth, subjects undergoing orthodontic treatment procedures and subjects who are allergic to alginate impression were excluded from the study.
The study was performed on the subjects who have attended the Department of Oral Medicine and Radiology, Vishnu Dental College, Bhimavaram (Institutional Ethical Clearence Number: IEC/VDC/MDS/15OMR02) seeking various dental treatments from December 2015 to December 2016. All procedures followed were by the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and later versions. With the obtained informed consent, height of the patient was measured using Standard Anthropometer. Hand length and Middle finger length was measured using Digital Vernier Callipers. Mandibular impression was taken by using alginate impression material.
Methodology
Height (stature) of the subject was measured in standing posture. The subjects were instructed to stand barefooted on the board of a standard stadiometer with both feet in close contact with each other, trunk braced along the vertical board, and head oriented in ear–eye plane by keeping the lateral palpebral commissure and the tip of auricle of the pinna in a horizontal plane parallel to the feet. The measurement was taken in centimeters by bringing the horizontal sliding bar to the vertex.^{[13]}
The length of each hand was measured using a sliding caliper. The subjects were instructed to place his hand on a table with the fingers together and thumb abducted. Hand length was measured as the straight distance from the metacarpophalangeal wrist crease to the most forwardly projecting point on the middle finger [Figure 1]. The measurements were recorded in centimeters.^{[14]}
Subjects were instructed to place their hands with palms facing upwards and fingers extended on a flat horizontal surface. Middle phalanx length was measured as the distance from the most proximal flexion crease of middle finger, till the projecting point on the tip of the finger with the help of a sliding caliper [Figure 2]. The measurements were recorded in centimeters.^{[15]}
Plaster models of the lower dental arch of each subject was obtained from alginate impressions poured in dental stone. A standardized procedure was followed for mixing of dental stone with water, taking fixed water/powder ratio (W/P ratio) for all the models constructed. A calibrated dispenser was used for dispensing of dental stone and water so that a uniform W/P ratio was maintained.
For examining the plaster models, each hemiarch was considered separately. The greatest MesioDistal crown widths of the mandibular anterior permanent teeth and the chord was measured using the modified method for Carrea's index where dividers with fixing device was used. The distance between divider points was read on a stainless steel scale and recorded to the nearest millimeter.
Statistical analysis: Regression equations and Pearson's correlation are used.
The regression equations obtained for Hand Length were [Table 1]:  Table 1: Regression Equations For The Estimation of Stature From Hand Length
Click here to view 
Y (Estimated Height Using Right Hand Length) =6.031XRight Hand Length + 56.010
Y (Estimated Height Using Left Hand Length) =6.009XLeft Hand Length+56.455
The regression equation obtained for Middle Finger Length were [Table 2]:  Table 2: Regression Equations For The Estimation Of Stature From Middle Finger Length
Click here to view 
Y (Estimated Height Using Right Middle Finger Length) =11.137XRight Middle Finger length + 77.724
Y (Estimated Height Using Left Middle Finger Length) =11.067XLeft Middle Finger length + 78.145
In Carrea's Index arch and chord dimensions were measured.^{[16]} [Figure 3]
 Arch: The sum of MesioDistal (MD) widths of mandibular anterior teeth on one side.
 Chord: The direct distance between mesial edge of central incisor and the distal edge of canine on the same side.
The estimated height was calculated using the formula below:
Formulae:
Results: Thus, recorded descriptive data was converted to numerical data and subjected to statistical analysis. Simple Linear Regression test and Pearson Correlation test were used to analyze the data.
In the present study Regression Analysis was done by considering Right and Left hand length as Independent Variable and Actual Height as Dependent Variable. When Linear Regression Analysis was done, all regression parameters were statistically significant (p value = 0.000*). Hence the given equation was accepted to be valid.
Regression Equations For The Estimation of Stature From Hand Length
The regression equations obtained are shown in [Table 1].
Y (Estimated Height Using Right Hand Length) = 6.031XRight Hand Length + 56.010
Y (Estimated Height Using Left Hand Length) = 6.009XLeft Hand Length + 56.455
In the present study the coefficient of determination (R^{2}) value was 0.337 for Right Hand Length means that 33 percent of the variance in Actual Height is predictable from Right Hand Length and the coefficient of determination (R^{2}) value was 0.338 for Left Hand Length means that 33 percent of the variance in Actual Height is predictable from Left Hand Length.
Regression Analysis was done by considering Right and Left middle finger length as Independent Variable and Actual Height as Dependent Variable. When Linear Regression Analysis was done, all regression parameters were statistically significant (p value = 0.000*). Hence the given equation was accepted to be valid. [Graph 1]
Regression Equations For The Estimation of Stature From Middle Finger length are shown in [Table 2]. The regression equation obtained are:
Y (Estimated Height Using Right Middle Finger Length) = 11.137XRight Middle Finger length + 77.724
Y (Estimated Height Using Left Middle Finger Length) = 11.067XLeft Middle Finger length + 78.145
In the present study, the coefficient of determination (R^{2}) value was 0.260 for Right Middle Finger Length [Graph 2] means that 26 percent of the variance in Actual Height is predictable from Right Middle Finger Length and the coefficient of determination (R^{2}) value was 0.253 for Left Middle Finger Length means that 25 percent of the variance in Actual Height is predictable from Left Middle Finger Length [Graph 1]
Correlating Actual Height With Estimated Height Using All Parameters Among Study Population [Table 3]: Pearson correlation (r) is a statistical test which is used to evaluate the correlation between different sets of data and this shows the linear relationship between two sets of data. The results in this test will be in between 1 and 1. A value of 1 implies that a linear equation with all data points lying on a line for which Y increases as X increases. A value of − 1 implies that all data points lie on a line for which Y decreases as X increases. A value of 0 implies that there is no linear correlation between the two variables.  Table 3: Correlating Actual Height with Estimated Height Using All Parameters Among Study Population
Click here to view 
On comparison of Actual Height with Predicted Height From Right Hand Length, Predicted Height From Left Hand Length, Predicted Height From Right Middle Finger Length, Predicted Height From Left Middle Finger Length, Right mean estimated height using Carrea's index and left mean estimated height using Carrea's index the Pearson correlation value “r” was 0.581, 0.582, 0.510, 0.503, 0.256, and 0.273 respectively, which indicates that there is linear correlation between the variables.
Pvalue or Probability value is the probability for a given statistical model. The smaller the P value, the larger the significance. P < 0.05 is considered as statistically significant and P < 0.001 is considered as statistically highly significant.
On correlation of Actual Height with Estimated Height among the total study sample the P values of Predicted Height From Right Hand Length, Predicted Height From Left Hand Length, Predicted Height From Right Middle Finger Length, Predicted Height From Left Middle Finger Length, Right mean estimated height using Carrea's index and left mean estimated height using Carrea's index are 0.000, 0.000, 0.000, 0.000, 0.002, and 0.001, respectively, which indicates that there is statistical significance between the actual height and estimated height in all the variables. In the present study, odontometric parameters did not show high significant results for stature estimation.
Discussion   
Stature being one of the criteria of personal identification helps in narrowing down the investigation process and thus provides useful clues to the investigating agency. Stature has a definite and proportional biological relationship with each and every part of the human body, i.e., head, face, trunk, extremities. This relationship helps a forensic scientist to calculate stature from dismembered and mutilated body parts in forensic examinations.^{[17]} A number of workers have studied the correlation between stature and various long and short bones of the body. Many of them have correlated the dimensions of hand with the stature.^{[7]} Different hand dimensions have been used to predict the stature of an individual in different populations but sometimes an intact hand is not available for examination. Thus, the need arises to derive formulae for stature estimation using a portion of a hand.^{[18]} In such cases length is used to estimate the stature.
Apart from anthropometric measurements, few studies showed that dimensions of the teeth are also used for stature estimation because the dental arch has many variables which makes it almost impossible for two people to have identical tooth features. A “good” correlation between dental measurements, in general and stature can be useful in anthropological and forensic identification since teeth are the strongest structures in the body and survive a variety of peri and postmortem alterations.^{[19]} The most traditional method of estimation of human stature by examining the teeth was proposed by Carrea in 1920 which was based on the relationship of measurements of lower anterior teeth with the actual stature of the person.^{[1]}
The present study showed that there was a statistical significance between the actual height and estimated height from the hand length, middle phalanx length and Carrea's index. Linear regression analysis was done for the anthropometric parameters like hand length and middle phalanx length on both right and left sides and regression equations were derived for the estimation of the stature for the given population. The present study showed high statistical significance for hand length and middle phalanx length which was in accordance with the findings of Waghmare et al.^{[2]} who showed that there was significant positive correlation between the stature and hand lengths.
According to Agarwal et al.^{[7]} there was significant correlation between the stature, hand length and phalanx length and the author provided multiplication factors for stature with all parameters included in the study. By multiplying these multiplication factors with respective parameter, author found some estimated statures which were correlated with the measured stature. All the measurements in the study showed positive as well as a statistically significant correlation with the stature.
Prabhu S et al.^{[20]} correlated buccolingual and mesiodistal dimensions of all teeth (except third molars) with the stature of an individual. Correlation analysis revealed that crown variables had a low statistically significant correlation to stature. This indicates that the dentition may be used only as a supplement to more robust indicators of stature. Agnihotri A K et al.^{[14]} showed that there was a significant correlation between stature of an individual and hand length. But in the present study both right and left hand length showed no statistical variation in stature estimation. This might be due to inherent variations in the hand dimensions which could be attributed to biological and environmental factors.
In the present study, the regression equations were derived from hand length and middle phalanx length on both right and left sides and these equations would help for estimation of stature which was in accordance with findings of Kavyashree AN et al.^{[21]} where regression equations were derived from hand length for estimation of stature. But the formulae derived were different from the present study this might be due to difference in the ethnic groups contributing to different biological and environmental factors.
In the present study, middle phalanx length on both right and left sides also showed statistically significant results for stature estimation which was in accordance with Rastogi et al.^{[18]} who showed that the middle finger length bears a significant relation to stature and can be an important tool for stature estimation. Matheswaran G et al.^{[22]} demonstrated a significant ability to estimate height from digit length in both males and females and from both right and left hands on the subjects from Coastal regions of Andhra Pradesh. In the present study middle finger length from both right and left hands was used for estimation of stature and showed statistical significant results in stature estimation. This suggested that in persons of different population groups (belonging to same race) geographical variation do not have much influence on body proportions.
Many times, mutilated bodies or just fragmentary remains are presented for medico legal examination. However, at times, only skull or facial remains are brought for examination as well as identification. In such cases various Odontometric parameters can be used for forensic identification. Teeth are an excellent material for forensic investigation.^{[23]} Similar to other bones of the body, dimensions of tooth and skull are also genetically determined but they also depend on environmental and dietary factors, so their measurements are unique for each race and geographical region.^{[24]}
In the present study Carrea's index was calculated for both right and left hemiarches on mandibular cast and was used for stature estimation and found statistical significant results on both right and left sides in stature estimation and the Pearson correlation value was 0.256 and 0.273 on both right and left sides respectively which indicates that there was a correlation between stature and Carrea's index.
According to Rekhi et al.^{[1]} the Carrea's index can be used for stature estimation for both males and females as well as in right and left hemi arches and stated that Carrea's formula showed good reliability and applicability of estimates for a sample taken from a mixed population of North India, which was in accordance with the present study where Carrea's index shows statistical significant results in stature estimation with P values of 0.002 and 0.001 on right and left hemi arches respectively but in the present study anthropometric parameters (hand length and middle phalanx length) showed high statistical significant results than Odontometric parameter (Carrea's index) in stature estimation.
According to Lima et al.^{[11]} any side of the arch can be used for stature estimation as there was no statistically significant difference between them. According to the “Principle of Bilateral symmetry” given by Carrea, any hemi arch can be used for stature estimation by accepting small variations as physiological asymmetries. In Carrea's index, successful prediction of stature depends on the alignment of the mandibular anterior teeth. In the present study mandibular anterior teeth on both hemi arches were used for stature estimation and found that there was a correlation between stature and teeth in both hemi arches with Pearson correlation value of 0.256 and 0.273 on right and left sides respectively.
A study conducted by Sruthi R et al.^{[25]} in the mixed population of southern India showed a strong correlation between estimated stature by Carrea's index and real stature. Moreover, this correlation is more valid on male sample and right side of the inferior hemi arches and author stated that although a correlation between actual stature and estimated stature was established, Carrea's index as a predictor tool may not give accurate estimations. Nevertheless, it could only act as an auxiliary tool in person identification which was in accordance with the present study where anthropometric measurements using hand length, middle finger length shows high significant results in stature estimation when compared with Odontometric measurements using Carrea's index.
Conclusion   
Stature estimation is an imperative component of forensic anthropology as it greatly helps in narrowing the search for a person's identification. Further, the human dentition is credited to be a highly durable tissue as it can withstand postmortem changes, even after other tissues succumb to destruction and hence is considered ideal for person identification in these situations.
The current study was conducted to correlate the Anthropometric parameters (hand length, middle phalanx length) and Odontometric parameters (Carrea's index) in stature estimation. Within the limitations, the following observations were obtained from the present study. All the parameters showed statistical significant results in stature estimation. Estimated height from hand length and middle phalanx length on both right and left sides was in moderate correlation with actual height compared to that of estimated height from Carrea's index on both right and left hemi arches which was in weak correlation.
Limitations and Future Prospects
There are lot of variations in estimating stature from measurement of people of different regions and races. So, there is a need to conduct more studies among people of different regions and ethnicity so that stature estimation becomes more reliable in identification of an individual.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2], [Table 3]
