Evaluation of dimensional relationship of different anatomic skull structures to determine sexual dimorphism accuracy in adolescents on lateral cephalometric images

Abstract

Introduction: Determining gender from skeletal remains before puberty is one of the most important reasons for forensic research. The size of different parts of the craniofacial complex (face and skull) is the main influencing factor for determining the gender of people. Regarding the issue of gender determination in identity recognition, the examination of these criteria under the age of 20 years can determine the presence or absence of the effect of hormones on these bones and their relationship with gender. The purpose of this study was to measure the length of the clivus, the length of the nasal bone, and the anterior-posterior length of the frontal sinus and their integration in children under 20 years of age using Lateral cephalometric images.

Methodology: In order to conduct this descriptive-analytical study, 200 lateral cephalometric images of patients referred to the Department of Oral, Maxillofacial Radiology of the Faculty of Dentistry, who were referred for diagnostic and therapeutic purposes, and who met the conditions for entering the study, were used. Nasal bone length, anterior-posterior dimension of frontal sinus and clivus length were measured. Data were analyzed by SPSS 24 software and using U-Man Whitney and independent t tests and logistic regression. The significance level of P was considered less than 0.05.

Results: The length of the nasal bone and the length of the clivus were significantly higher in men than in women (p<0.001). The anterior-posterior dimensions of the frontal sinus were similar in men and women. The sensitivity and specificity of the model, with the values of 66 and 69.70%, indicated the average power of the model in determining gender, and the level under the ROC curve with the value of 0.75 indicated the average ranking of gender determination by the logistic regression model. According to the regression results, the length of the nasal bone ( = 0.04, p < 0.001) and clivus length ( = 0.03, p < 0.001) and the anterior-posterior dimension of the frontal sinus did not have sufficient power to predict and determine gender.

Conclusion: The length of the nasal bone and the length of the clivus were significantly greater in men than in women, but the anterior-posterior dimension of the frontal sinus was not enough to predict and determine gender. Combining the measurement of three skull structures including the length of the clivus, the length of the nasal bone and the anterior-posterior length of the frontal sinus is 67.80% effective in gender discrimination and the combination of these three structures can be used to determine identity.