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Morphometric analysis of canine in gender determination: Revisited in India

Article  in  Indian journal of dental research: official publication of Indian Society for Dental Research · July 2014
DOI: 10.4103/0970-9290.142514 · Source: PubMed

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Original Research

Morphometric analysis of canine in gender determination:

Revisited in India

Geetha Paramkusam, Lakshmi Kavitha Nadendla, Revath Vyas Devulapalli, Archana Pokala

Department of Oral Medicine

and Radiology, Kamineni
ABSTRACT
Institute of Dental Sciences,
Sreepuram, Narketpally,
Nalgonda, Andhra Pradesh,
India
Received : 04‑02‑14
Review completed : 28‑02‑14
Accepted : 13‑06‑14  Key words: Cuspid, forensic dentistry, gender identity, odontometry
Background and Aim: Teeth are excellent material for anthropological, genetic and odontologic
investigations in both living and dead population. Canines are the ideal teeth for identification
of sex, due to its sexual dimorphism and durability in the oral cavity. This study tests the
effectiveness of the canine tooth in predicting sex of an individual.
Materials and Methods: This study involved 60 males and 60 females between the age group
of 20-30 years. Mesio‑distal (MD) widths of maxillary and mandibular right and left canines
and inter‑canine distance of both arches were measured clinically and on cast for all patients.
Standard canine indices were derived from these dimensions and tested for sexual dimorphism
and reliability of canine teeth in gender determination by comparison with the known gender
of the population under investigation.
Results: All measurements showed significant sexual dimorphism. Standard mandibular canine
index (CI) was found to be more reliable in gender estimation than the MD width of canine
and CI values.
Interpretation and Conclusion: Use of the standard mandibular CI in gender determination is
recommended for forensic procedures as it was found to have an acceptable accuracy. MD width
of canine may be used in a setup when only the single tooth or a fragment of a jaw is available
for analysis, with due consideration to its relatively low accuracy.

Forensic medicine, plays a major role in identification of
dead bodies, which may be required in cases of sudden
and unexpected death, fires, explosions, railway or aircraft
accidents, mutilated or hidden decomposed bodies, or foul
play.[1] Today, dentist’s opinion is respected widely as a
source of valuable data that can be used to answer questions
that arise during a death investigation. Forensic dentists
can use this data to provide significant conclusions.[2]
The only method that can give a totally accurate result
is the DNA technique, but in many cases and for several
reasons it cannot be used.[1,3] An important initial step
in identification of the dismembered remains of mass
disaster victims is the separation of sexes.[4] Osteometry
Address for correspondence:
Dr. Revath Vyas Devulapalli
E‑mail: revath.vyas@gmail.com
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DOI:
10.4103/0970-9290.142514
Indian Journal of Dental Research, 25(4) 2014
is considered the preferred technique because it is more
effective in determining sex.[5] Those bodies, which are less
complete and consisting of parts of a skeleton only, present
more problems in identification and in many instances
may not be identified at all.[6] In fragmented cranial bones,
mandible could be obtained and measurements of canine
tooth and the inter‑canine distance (ICD) might prove as
one of the means of determining sex.[7] Canines are also
better likely to survive severe trauma such as air disasters,
hurricanes or conflagration, indicating that mandibular
canines can be considered as the key teeth for personal
identification.[8,9] Various studies have been conducted to
test the reliability of canine teeth in gender establishment,
but the results are conflicting. Most of the studies have
shown a greater mesio‑distal (MD) diameter in males
compared to females.[9‑15] Reverse dimorphism has also
been shown by some of the studies,[8,16,17] and it has been
concluded that the finding can be attributable to evolution
resulting in a reduction in sexual dimorphism, causing an
overlap of tooth dimensions in modern males and females.
Furthermore, it has been stated that “the mandibular canine
showed a greater degree of sexual dimorphism than the
maxillary canine.”[18] However, other investigators,[19,20]
reported that maxillary canine showed a higher degree of
sexual dimorphism compared to the mandibular canine in a
425
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Sex determination using morphology of canine Paramkusam, et al.
Japanese population. Thus, the controversy exists regarding
the degree of sexual dimorphism between mandibular and
maxillary canine teeth in different ethnic groups. There
lies a strong reason for selection of the mandibular canine
in most of these studies of odontometry. The mandibular
canines are not exposed to less plaque,[21] calculus,[21] abrasion
from brushing, or heavy occlusal loading than other teeth,
but they are less severely affected by periodontal disease,[22]
the least frequently extracted because of periodontal disease,
and the last tooth to be extracted in respect to age.[23] The
reason for this increased resistance to damage is not known,
but is presumed to be of systemic origin.[24] This study
was undertaken to investigate the reliability of canines in
predicting sex and also to compare the role of maxillary and
mandibular canines in gender establishment based on the
morphometric criteria of canine teeth.
MATERIALS AND METHODS
The study was conducted in Department of Oral Medicine
and Radiology, Kamineni Institute of Dental Sciences,
India after approval by the Institutional Ethics Committee.
60 male and 60 female patients between the age group of 18
and 25 years were selected for the study. Inclusion criteria
included healthy state of gingiva and periodontium, normal
Angle’s Class 1 molar-canine relationship, caries free teeth,
absence of spacing in the anterior teeth and normal overjet
and overbite. Patients with partial anodontia, supernumerary
teeth, hypoplastic teeth, teeth showing physiologic or
pathologic wear and tear and patients with parafunctional
habits were excluded from the study. Measurements of MD
widths of the four canines and ICD between the maxillary and
mandibular canines were measured clinically [Figures 1 and
2] using digital Vernier calipers with a resolution of 0.01 mm.
Alginate impressions of both maxillary and mandibular arches
were taken for all subjects and casts were poured with dental
stone. MD widths of the four canines and ICD between the
maxillary and mandibular canines were measured on the
Figure 1: Measurement of mesio-distal width of canines clinically on
the patient
426
dental casts using digital Vernier calipers with a least count
of 0.01 mm [Figures 3 and 4]. Clinical measurements were
compared with that of cast measurements and found to
be almost similar. With the measurements on cast, canine
index (CI) was derived as the ratio of the average canine
width to the corresponding arch width. Sexual dimorphism
was also calculated.[11] A mean value of the CI was calculated
for males and females, which were then used to derive the
standard maxillary and mandibular canine indices.
Xm
Sexual dimorphism = −1
Xf
Mesiodistal width of canine
Canine index =
Inter-canine distance
SCI =  (Mean CI of males  −  SD of males)+(Mean CI of
females + SD of females)/2.
Xm = Means of MD width of canine's of males, Xf = Mean
of MD width of canine’s of females.
SCI = Standard Canine Index, CI = Canine Index,
SD = Standard Deviation.
Student’s t‑test was used to compare the mean difference
of all measurements between males and females. The
individuals with CI value less than the standard CI (SCI)
were designated as females and those with higher values as
males. The estimated gender was then compared with the
known gender and percentage accuracy of the determination
of sex using standard maxillary, and mandibular canine
indices were derived.
RESULTS
This study results suggested that the mean values of all
measurements [Table 1] in males were greater compared
to females except for the CI and though statistically
Figure 2: Measurement of inter-canine distance clinically on the patient
Indian Journal of Dental Research, 25(4), 2014
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Sex determination using morphology of canine Paramkusam, et al.

significant difference was found for all four canines, it
was highly significant for left mandibular canine with a
P = 0.001. Though the mean values of MD widths of canine
and ICD are statistically significant, CI values calculated
using them are not statistically significant for both the
maxilla and mandible. This statistically insignificant
results of CI may be because it is a relative value, and it is
obtained as the ratio of two absolute measurements (MD
dimension of canines and ICD), and does not reflect sex
differences that exist in absolute measurements, and these
sex differences might have got cancelled because of the
division between these absolute measurements.
Sexual dimorphism was calculated based on MD width of
canines and was found to be highest for the left mandibular
canine [Table 2].
Standard canine index values for both maxillary and
mandibular arches were derived [Table 3] and gender
determination was done. Subjects with CI values greater than
SCI were considered as males and subjects with CI values
less than SCI were considered as females. The percentage
accuracy of gender determination using such assumption
based on SCI value was calculated [Table 4]. Percentage
accuracy using both standard maxillary and mandibular
canine indices was >70%. It was also observed that standard
mandibular CI value is more reliable than standard maxillary
CI value with a higher percentage of (about 78%) accuracy
in gender determination. It was also found that the gender
prediction in males is more reliable than in females with
higher percentage of accuracy (around 78%).
Considering the standard mandibular CI to be more
reliable in determining the sex of an individual, the
standard mandibular CI values of other similar studies
were tabulated and percentage accuracy of gender

Figure 3: Measurement of mesio-distal width of canines on the cast

Table 1: Mean values of MD dimensions of canines and

inter‑canine distance and CI of maxilla and mandible and Figure 4: Measurement of inter-canine distance on the cast
mean difference between males and females
Measurements of Males Females Mean P value
Table 3: SCI values for maxilla and mandible
(Xm) (Xf) difference±SD
between SCI Value
males and Standard maxillary CI 0.22
females Standard mandibular CI 0.26
Right maxillary canine 7.72 7.43 0.33±0.76 0.023 SCI=Standard canine index, CI=Canine index
Left maxillary canine 7.65 7.34 0.30±0.84 0.05
Right mandibular canine 6.76 6.26 0.51±0.70 0.002 Table 4: Percentage accuracy of gender prediction using
Left mandibular canine 6.8 6.28 0.53±0.67 0.001 SCI values
Maxillary ICD 34.4 32.7 1.67±3.51 0.014
Gender Number Number of Percentage Number of Percentage
Mandibular ICD 25.9 23.7 2.24±2.82 0.000
Maxillary CI 0.22 0.22 0.003±0.02 0.443 cases cases with of cases with of
Mandibular CI 0.25 0.26 0.004±0.02 0.373 studied correct accuracy correct accuracy
gender gender
MD=Mesio‑distal, ICD=Inter‑canine distance, CI=Canine index, SD=Standard
deviation prediction prediction
using using
standard standard
Table 2: Sexual dimorphism of canines maxillary mandibular
Canine Sexual dimorphism CI CI
Right maxillary canine 4.4 Male 60 46 76.66 48 80.00
Left maxillary canine 4.1 Female 60 44 73.33 46 76.66
Right mandibular canine 8.0 Total 120 90 75 94 78.3
Left mandibular canine 8.4 CI=Canine index, SCI=Standard canine index

Indian Journal of Dental Research, 25(4) 2014 427

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Sex determination using morphology of canine Paramkusam, et al.

determination using mandibular CI of other studies on the absolute measurements used to derive the mandibular
this study data were calculated [Table 5], showed that the CI, viz. MD dimension of canines and ICD were both
standard mandibular CI value of our study was very close significantly larger in males (P < 0.01).
to other studies and the percentage accuracy was also found
to be >70% except for the standard mandibular CI value Using standard mandibular CI value, Rao et al.[11] obtained a
derived by Rao et al. healthy 85.9% accuracy in sex identification. Later, Muller
et al.[12] tested Rao et al.’s standard mandibular CI on a
DISCUSSION French sample of 210 girls and 214 boys and could correctly
identify the sex in just 59.4% of cases. In an attempt to
This study results suggested that the MD width of both the improve the accuracy they derived a separate standard
mandibular and maxillary canines was significantly larger mandibular CI on their sample, which marginally improved
in males compared to females, consistent with the results of sex classification to 63%. Considering this improvement, we
the previous studies,[7‑14] in contrast to a study by Al‑Rifaiy also derived a standard mandibular CI on our sample and
et al.,[15] where the differences between males and females compared its effectiveness of this standard mandibular CI,
were not statistically significant. They also suggested that as well as those derived earlier, in determining sex of our
the canine teeth were bilaterally symmetrical in both sample [Table 6]. The standard mandibular CI of our study
arches and found 55% and 65.5% correct classification of was also close to that derived in the previous studies and
females and males respectively using MD canine width proved equally effective in determining sex. The ability of
and ICD. Whereas our study showed differences between identifying males was slightly higher in our study, similar to
dimensions of right and left canines with greater sexual a study by Reddy et al.[13] whereas few studies had relatively
dimorphism (8.4) for mandibular left canine, a finding in high ability to identify females.
agreement with earlier studies by Kaushal et al.,[9] Kapila
et al.,[14] showed a statistically significant dimorphism in In conclusion, though the results are in agreement with
mandibular canines with 8.8 and 9.7, respectively. most of the previous studies, the present study has its own
limitations. Smaller sample size, single examiner might
Hashim and Murshid[25] studied 720 teeth on pretreatment have resulted in few errors or bias in the dimensions and
orthodontic casts in a Saudi population aged 13-20 years results. This study measured only linear dimensions because
noticed that the canines were the only teeth to exhibit of the simplicity, reliability, and inexpensivity. More
the dimorphism and also determined that there was no accuracy could have been obtained by the application of
statistically significant difference between the left and Moire’s topography and Fourier’s analysis that however
right canines, suggesting that measurement of teeth on one require sophisticated equipment and the use of complex
side could be truly representative when the corresponding mathematical equations, respectively. Future studies have
measurement on the other side was unobtainable.[26] to include larger sample size, multiple observers to check
intraobserver variation and interobserver agreement.
In contrast to our study, few studies showed reverse sexual
dimorphism, where the females show larger teeth than Table 5: Percentage accuracy of gender determination
males. Boaz and Gupta[8] in their study on 100 dental casts for the present data using standard mandibular CI value
derived from various studies
of a South Indian population in the age group of 14-20 years,
Study Standard Percentage accuracy for
observed that the mean of the buccolingual and MD mandibular CI the data of present study
dimensions of the mandibular left canine and the mean Present study 0.260 78.3
of the MD dimensions of the mandibular right canine in Acharya and Mainali[10] 0.260 78.3
females were greater compared to males without significant Muller et al.[12] 0.269 72.5
statistical difference. Acharya and Mainali[16] found reverse Rao et al.[11] 0.274 58.5
Reddy et al.[13] 0.256 72.5
dimorphism in the MD dimension of mandibular second
CI=Canine index
premolars in a Nepalese population. Yuen et al.[17] measured
MD crown diameters in both primary and permanent teeth
Table 6: Comparing percentage accuracy of gender
in a Chinese population and observed reverse dimorphism determination with various similar studies
in the mandibular incisors. However, their findings were Various studies Percentage Percentage Total
not statistically significant. on standard accuracy in accuracy in percentage
mandibular CI predicting predicting accuracy
Rao et al.[11] calculated the mandibular CI on a sample of on males females
384 females and 382 males of the South Indian population Present study 80 76.66 78.3
in the age group of 15-21  years, found significant sexual Acharya and Mainali[10] 57.14 44.44 51.28
Muller et al.[12] 62.15 63.81 63
dimorphism. Mandibular CI values between males and Rao et al.[11] 84.3 87.5 85.9
females, in our study were not statistically significant Reddy et al.[13] 78 66 72
similar to the study by Acharya and Mainali.[10] However, CI=Canine index

428 Indian Journal of Dental Research, 25(4), 2014

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Sex determination using morphology of canine Paramkusam, et al.
CONCLUSION
Left mandibular canine showed significant sexual
dimorphism and the standard mandibular CI is a quick
and easy method for determining sex with an accuracy of
around 70-80%, when the standard for the population is
available. It is better to confirm the results by using other
methods of determining sex like the morphometric criteria
because sex determination using the pelvis and skull bones
shows an accuracy of 95% and above,[27] but the accuracy of
mandibular CI in identification of sex have never exceeded
87.5%. Hence, it can only be used as a supplement tool.
ACKNOWLEDGMENTS
We would like to thank Mr. Ramesh, Statistician, Department of
Community Medicine, Kamineni Institute of Medical Sciences,
Narketpally.
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How to cite this article: Paramkusam G, Nadendla LK, Devulapalli RV,
Pokala A. Morphometric analysis of canine in gender determination: Revisited
in India. Indian J Dent Res 2014;25:425-9.
Source of Support: Nil, Conflict of Interest: None declared.
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