|Year : 2019 | Volume
| Issue : 1 | Page : 69-73
Mandible: An indicator for sex determination – A three-dimensional cone-beam computed tomography study
Anas Salem Albalawi1, Mohammad Khursheed Alam2, Sudhakar Vundavalli1, Kiran Kumar Ganji3, Santosh Patil4
1 Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
2 Department of Orthodontic, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
3 Department of Periodontology, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
4 Department of Oral Medicine and Radiology, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
|Date of Web Publication||17-Dec-2019|
Dr. Mohammad Khursheed Alam
Department of Orthodontic, College of Dentistry, Jouf University, Sakaka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Mandible is considered as one of the stronger bones of skull available for gender identification. Mandibular measurements can be used for the identification of gender either on dry mandible or through panoramic radiography or cone-beam computed tomography (CBCT). Aim: To determine the gender from mandibular measurement using CBCT. Materials and Methods: The Morphometric analysis was performed on 200 CBCT scans of the subjects using OnDemand 3D software (Seoul, Korea). Morphometry of mandibular is measured by estimation of the angles formed at different locations on mandible to predict the gender. Statistical analysis was performed; independent samples “t-” test was used to compare the mean values between males and females. Discriminant function analysis was used for gender prediction. Results: The subject's age ranged from 18 to 60 years with an equal number of males and females. The mean angle formed by the intersection of lines from the left and right gonion to menton in males was 129.9 ± 11.9 and it was 126.7 ± 12.6 in females. The mean linear distances from the right gonion to menton in both males and females were 86.8 ± 5.3 and 82.6 ± 6.2, respectively. The mean linear distances from the left gonion to menton were 49.5 ± 5.1 in males and 47.7 ± 3.9 in females. The mean linear distance from the right gonion to left gonion was 47.7 ± 4.4 in males and 46.6 ± 4.2 in females. The Box's M statistics was applied to verify the applicability of mandibular measurements in gender prediction. The values indicate that gender can be predicted using these four variables, which is statistically significant (P = 0.000). The overall prediction accuracy of this model was 67%, with 66.7% in males and 67.3% in females being correctly classified.
Conclusion: The angle formed by the intersection of lines from the left and right gonion to menton (Gn-M0) helps provide anthropological data, which can be used in dental and medicolegal practices.
Keywords: Cone-beam computed tomography, gender determination, mandibular ramus
|How to cite this article:|
Albalawi AS, Alam MK, Vundavalli S, Ganji KK, Patil S. Mandible: An indicator for sex determination – A three-dimensional cone-beam computed tomography study. Contemp Clin Dent 2019;10:69-73
|How to cite this URL:|
Albalawi AS, Alam MK, Vundavalli S, Ganji KK, Patil S. Mandible: An indicator for sex determination – A three-dimensional cone-beam computed tomography study. Contemp Clin Dent [serial online] 2019 [cited 2022 Jun 30];10:69-73. Available from: https://www.contempclindent.org/text.asp?2019/10/1/69/273149
| Introduction|| |
Forensic dentistry gained its importance in victim identification in criminal investigations, mass disasters, and war crimes. The precision in identification of human skeletal is vital for forensic identification of victim. Gender identification from the skeletal remnants was considered as one of the foremost steps in forensic identification. Pelvic bones were considered as the most accurate bones for gender identification; however, pelvic bones are one of the weakest bones and may not be available in many cases. Mandible is considered as one of the stronger bones of skull available for gender identification. Gender identification is mainly based on the morphological characteristics of mandible, and radiology plays an important role in it.
Using conventional two-dimensional (2D) cephalometric analysis may lead to bias due to difficulties in finding accurate measurement point due to overlapping of bony structures. To overcome this problem, 3D modality such as 3D cone-beam computed tomography (CBCT) has been suggested. CBCT has been revealed to be a superior tool than conventional imaging modalities for the depiction of the bone morphology; however, the visibility of this structure may vary significantly, even within the same individual.,, Discriminant function analysis is the commonly used statistical procedure in gender identification. It is population specific, and different populations need different regional criteria or formulae in using discriminant function analysis. As literature search could not identify studies using 3D modality in gender identification among population of Saudi Arabia, the study aimed to assess the usefulness of 3D radiographic analysis of mandible in gender identification among population of Saudi Arabia.
| Materials and Methods|| |
Ethical clearance had been obtained from the local committee of bioethics with the approval number of 9-16-8/39.
This retrospective study was conducted over a period of 6 months from the CBCT scans obtained from the Radiology department, College of Dentistry, Al Jouf University. CBCT scans were obtained from the OnDemand 3D software (Seoul, Korea). The samples were selected based on the systematic random sampling technique. The inclusion criteria included the age group of 18–60 years, full complement of teeth in mandible, and systemically healthy. Patients with a history of bone disorders, severe developmental anomalies, and the presence of any bony lesions leading to variation in morphology of mandible were excluded from the study. Morphometry of mandibular is measured by estimation of the angles formed at different locations on mandible to predict the gender as shown in [Figure 1].
|Figure 1: Mandibular morphometry for the gender determination. (Upper row for female cone-beam computed tomography image and lower row for male cone-beam computed tomography image). A: Angle formed by gonion right to menton to gonion left. B: Linear distance from the gonion right to menton. C: Linear distance from the gonion left to menton. D: Linear distance from the gonion right to gonion left|
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Sample size calculations
The sample size was based on the recommendations of Hair et al., who stated that at least fifty samples are needed for each independent variable in multiple discriminant analysis. In this study, four independent variables were considered in discriminate analysis (4 × 50 = 200), so the final sample size was determined as 200.
Collected data were analyzed using Statistical Package for the Social Sciences (SPSS, version 20, Chicago, Inc., IL, USA). Descriptive statistics were done initially; independent samples “t-” test was used to compare the mean values between males and females. Discriminant function analysis was used for gender prediction and P ≤ 0.05 was considered statistically significant for all comparisons.
| Results|| |
The age of the study participants ranged from 18 to 60 years with the mean age of 39 (±2.05) years. Of 200 participants, 96 were male and 104 were female. [Table 1] describes descriptive statistics of various variables in both genders. The mean angle formed by the intersection of lines from the left and right gonion to menton in males was 129.9 ± 11.9 and it was 126.7 ± 12.6 in females. The mean linear distances from the right gonion to menton in both males and females were 86.8 ± 5.3 and 82.6 ± 6.2, respectively. The mean linear distances from the left gonion to menton were 49.5 ± 5.1 in males and 47.7 ± 3.9 in females. The mean linear distance from the right gonion to left gonion was 47.7 ± 4.4 in males and 46.6 ± 4.2 in females. The Box's M statistics was applied to verify the applicability of mandibular measurements in gender prediction. The values indicate that the gender can be predicted using these four variables, which is statistically significant (P = 0.000) [Table 2]. Unstandardized coefficient values obtained from the Canonical Discriminant Function Coefficients [Table 2] were used in gender prediction. The estimated sex was calculated using the following equation: N = −17.3+ (0.31 × Gonion-Menton) + (0.149 × right Gn-M) + (0.86 × left Gn-M) + (−0.07 × right Gn-left Gn). The sectioning (Eigen) value for gender prediction was 0.41; if the calculated value is 0.41 or above, then that mandible belongs to male and for females it is below 0.41 [Table 3]. Considering the four independent variables, 66.7% of males were correctly classified and 67.3% of males were correctly classified, and the overall prediction accuracy of this model is 67% [Table 4].
| Discussion|| |
Sex determination of adult skeleton is usually the first step of the identification process, as subsequent methods for age and stature estimation are sex dependent. Jaws and teeth have been used since olden times to ascertain the sex of an individual. The mandible is the largest and toughest bone in the face with a horizontally curved body that is convex forward with two broad rami, which ascend from the posterior end of the body. The mandible is considered suitable for the study as it is the most durable bone of the facial skeleton and retains its shape better than other bones. Sexual dimorphism in the mandible may be due to the relative difference in the development of the musculoskeletal system, especially the muscles of mastication attached to the mandible.
In the present study, the angle formed by the intersection of lines from the left and right gonion to menton was evaluated to determine the sex dimorphism which ranged from 129.9 ± 11.9 in males and 126.7 ± 12.6 in females. These findings were in accordance with the study conducted earlier on the angle of the mandible on a mixed population by various researches., The angle varied between 110° and 140°. It was also concluded that in the patients who retained their teeth, there is no tendency of increase in the angle with advancing age. The findings from the present study revealed that using the measured parameters on mandible, a prediction rate of 66.7% for males, 67.3% for females, and overall 67% could be projected, which is very low in comparison with the prediction rate proposed by Abu-Taleb and El Beshlawy. The difference in such variation could be with the aspect of methodology and more accurate measurements were done on CBCT. Various researchers conducted studies on dry adult mandibles of known sex using anthropometric measurements and found an accuracy rate ranging from 69% to 94% and reported that ramus height and breadth were highly significant parameters. A detailed comparison of the findings from the present study can be analyzed with the various studies done by researches listed in [Table 5]. Major limitations of the study are sample size, arbitrary measurement, and analysis of the mandible, which are subject to the whim of each examiner and dental profile changes over a period of time. More research is needed to confirm these findings on cadavers.
| Conclusion|| |
The angle formed by the intersection of lines from the left and right gonion to menton (Gn-M0) helps in providing anthropological data, which can be used in dental and medicolegal practices.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
More CB, Vijayvargiya R, Saha N. Morphometric analysis of mandibular ramus for sex determination on digital orthopantomogram. J Forensic Dent Sci 2017;9:1-5.
] [Full text]
Carvalho SP, Brito LM, Paiva LA, Bicudo LA, Crosato EM, Oliveira RN, et al.
Validation of a physical anthropology methodology using mandibles for gender estimation in a Brazilian population. J Appl Oral Sci 2013;21:358-62.
Scheuer L. Application of osteology to forensic medicine. Clin Anat 2002;15:297-312.
Sassouni V. Dentofacial radiography in forensic dentistry. J Dent Res 1963;42:274-302.
Angelopoulos C, Thomas SL, Hechler S, Parissis N, Hlavacek M. Comparison between digital panoramic radiography and cone-beam computed tomography for the identification of the mandibular canal as part of presurgical dental implant assessment. J Oral Maxillofac Surg 2008;66:2130-5.
Kobayashi K, Shimoda S, Nakagawa Y, Yamamoto A. Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants 2004;19:228-31.
Wadu SG, Penhall B, Townsend GC. Morphological variability of the human inferior alveolar nerve. Clin Anat 1997;10:82-7.
Saini V, Srivastava R, Rai RK, Shamal SN, Singh TB, Tripathi SK, et al.
Mandibular ramus: An indicator for sex in fragmentary mandible. J Forensic Sci 2011;56 Suppl 1:S13-6.
Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate Data Analysis. New Jersey, United States. Prentice Hall Upper Saddle River 1998.
Ongkana N, Sudwan P. Gender difference in Thai mandibles using metric analysis. Chiang Mai Med J 2009;48:43-8.
Rai R, Ranade AV, Prabhu LV, Pai MM, Madhyastha S, Kumaran M. A pilot study of the mandibular angle and ramus in indian population Int J Morphol 2007;25:353-7.
Upadhyay RB, Upadhyay J, Agrawal P, Rao NN. Analysis of gonial angle in relation to age, gender, and dentition status by radiological and anthropometric methods. J Forensic Dent Sci 2012;4:29-33.
] [Full text]
Abu-Taleb NS, El Beshlawy DM. Mandibular ramus and gonial angle measurements as predictors of sex and age in an Egyptian population sample: A digital panoramic study. J Forensic Res 2015;6:1.
Maloth KN, Kundoor VK, Vishnumolakala SS, 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.
Bangi BB, Ginjupally U, Nadendla LK, Vadla B. 3D evaluation of maxillary sinus using computed tomography: A Sexual dimorphic study. Int J Dent 2017;2017:9017078.
Khaitan T, Kabiraj A, Ginjupally U, Jain R. Cephalometric analysis for gender determination using maxillary sinus index: A novel dimension in personal identification. Int J Dent 2017;2017:7026796.
Gamba Tde O, Alves MC, Haiter-Neto F. Mandibular sexual dimorphism analysis in CBCT scans. J Forensic Leg Med 2016;38:106-10.
Sairam V, Geethamalika MV, Kumar PB, Naresh G, Raju GP. Determination of sexual dimorphism in humans by measurements of mandible on digital panoramic radiograph. Contemp Clin Dent 2016;7:434-9.
] [Full text]
Tambawala SS, Karjodkar FR, Sansare K, Prakash N. Sexual dimorphism of maxillary sinus using cone beam computed tomography. Egypt J Forensic Sci 2016;6:120-5.
Kharoshah MA, Almadani O, Ghaleb SS, Zaki MK, Fattah YA. Sexual dimorphism of the mandible in a modern Egyptian population. J Forensic Leg Med 2010;17:213-5.
Hsiao TH, Chang HP, Liu KM. Sex determination by discriminant function analysis of lateral radiographic cephalometry. J Forensic Sci 1996;41:792-5.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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