rugae patterns and odontometry tools for sex …

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International Journal of Innovative Research in Dental Sciences Vol. 4, Issue 4, July-August 2019

Copyright to IJIRDS 569

RUGAE PATTERNS AND

ODONTOMETRY – TOOLS FOR SEX

DETERMINATION

1.Dr. Nitu Mishra, 2.Dr. Aparna Trivedi, 3. Dr. Shivangi Trivedi, 4. Dr. Garima Mukhopadhyay, 5. Dr. Sajda Khan Gajdhar, 6. Dr. Dinraj Kulkarni

1.)Associate professor, Dept of Oral Pathology and Microbiology, Modern Dental College and Research Centre, Indore

(M.P.)

2.)Assistant professor, Dept of Prosthodontics, Crown and bridge and Implantology Modern Dental College and

Research Centre, Indore (M.P.)

3.)Post Graduate Dept of Conservative dentistry and Endodontics Maharishi Markandeshwar College of dental

science & research, Ambala

4.)MDS, Dept of Prosthodontics , Crown and bridge and Implantology Modern Dental College and Research Centre,

Indore (M.P.)

5.)Lecturer Dept of Oral Pathology and Microbiology, Oral Basic and clinical sciences, Ibn Sina National college for

medical studies, Jeddah Kingdom of Saudi Arabia 6.)Associate professor, Dept of Oral Pathology and Microbiology, MA Rangoonwala College of Dental Sciences and

Research Centre, Pune, Maharashtra

Corresponding Author

Dr. Aparna Trivedi

Assistant professor, Dept of Prosthodontics, Crown and bridge and Implantology Modern Dental College and Research

Centre, Indore (M.P.) Mail Id : [email protected]

ABSTRACT: Teeth and palatal rugae being resistant to various insult are being used as tool in

forensic odontology for sex determination. The aims of our study was to compare rugae patterns,

sexual dimorphism and accuracy in both the sexes using width of molars and canine, inter canine

width and MCI. 50 subjects each males and females were included. Alginate impression taken and

study models prepared. Various patterns of rugae, MD and BL width of maxillary molars and MD

width of canines, Intercanine distance and MCI was measured and tabulated. Males showed straight,

converging and forwardly directed rugae while females showed curved, diverging and backwardly

directed. MD and BL of molars and MD of canines were more in males. Highest percentage of sexual

dimorphism was shown by MD of right molar and left canine. Highest percentage of accuracy was

seen in BL width of left molar and left canine. Accuracy of 96% was obtained by measuring

intercanine width and 63% by measuring MCI. We concluded that rugae pattern and dentition can be

used as tool for personal identification and sex determination.





KEYWORDS: Human identification, odontometry, rugoscopy, sex determination, sexual

dimorphism.

I. INTRODUCTION

Among the oral tissues, palatal rugae are permanent, unique to each individual and can establish

identity through discrimination. Palatal rugae, due to their internal position are protected from trauma

and high temperatures by lips, cheek, tongue and buccal pad of fat, teeth and bone and do not

demonstrate age related changes.(1,2)

Palatal rugae also referred to as plicae palatine transversae or rugae palatine are asymmetrical and

irregular elevations of mucosa located in the anterior third of the palate, made from the lateral

membrane of the incisive papilla arranged in transverse direction from palatine raphe located in the

mid sagittal plane. (3,4)

Palatal rugae are formed by the 12th to 14th week in utero from the hard connective tissue covering

the bone and it remains stable throughout the life.(5,6)

Palatoscopy/ Rugoscopy is the study of palatal rugae that helps in sex determination.

Palatal Rugoscopy was first proposed in 1932 by Spanish investigator named Trobo Hermosa.

Application of palatal rugae pattern for personal identification was suggested by Allen in 1889. (7)

Palatal rugae analysis may serve as an important aid in forensic investigations as they are

considered unique to each individual. Their shape, direction and unification remains stable

throughout life.(8) Palatal rugae may aid in post mortem identification provided antemortem record

exist. (9) Rugae analysis may helpful in racial profiling as studies indicate that they may be specific

to certain racial groups. (4,10)

Sexual dimorphism refers to those differences in size, stature, and appearance between male and

female that can be applied to dental identification because no two mouths are alike. Teeth are

considered to be a very useful tissue for sex assessment and molars are among the most dimorphic

teeth. Molars are the first permanent teeth to erupt in the oral cavity; and hence, they are available

for use in sex assessment at an early age as compared to other permanent teeth.11 Thus the present

study aims to compare the distribution of various palatal rugae pattern in both the sexes and also

to calculate sexual dimorphism and accuracy based on the width of molars and canine, inter canine

width and MCI.





II. DISCUSSION

The present study was cross- sectional community based study conducted at Sai Baba Mandir trust,

Chattribagh in Indore. All individuals of the study belong to the same geographical population from

Indore. The study sample consisted of 100 participants which included 50 males and 50 females. A

detailed case history was recorded and thorough clinical examination was performed. Written

informed consent was obtained from the participants.

Inclusion criteria

Patient with age group of 18-30 years were considered for the study,

Completely dentulous subjects,

Presence of fully erupted bilateral and caries, attrition, abrasion free permanent maxillary first molars

and canine, with healthy periodontium and intact contact area

Exclusion criteria

Subjects below the age of 18 years and over 30 years,

Previous history of orthognathic surgery/ orthodontic treatment,

Subjects who are allergic to impression material,

Syndromic patients, any pathology or anomaly affecting maxillary permanent first molars and canine,

any dento-alveolar or maxillofacial fracture, mal aligned teeth, any restoration in maxillary

permanent first molars and canine.

Analysis

The participants were briefly explained about the study and were asked to rinse the oral cavity with

water. Maxillary impression were made with Alginate impression material using sterilized perforated

tray. These impressions obtained were poured with type III dental stone following manufacturer’s

instructions. The cast thus obtained was used for analysis. All selected casts from the individuals

were free of air bubbles or voids especially in the anterior one third of the palate. The rugae pattern

was traced on these casts under proper light using a 0.5mm black graphite pencil. A magnifying hand

lens was used to visualize and analyse the rugae pattern. The size of the each rugae was traced by

using digital caliper and a metallic scale. The number, type and unification pattern were recorded in





accordance with the classification of Thomas and Kotz. The shape was recorded based on Kapali et

al’s classification.

Odontometric measurements

BL and MD dimensions of maxillary first molar were measured using digital Vernier caliper to the

nearest of 0.01 mm. The MD dimension was defined as the greatest distance between the contact

points on the proximal surfaces of the tooth crown. The BL dimension was defined as the greatest

distance between the labial surface and the lingual surface of the tooth crown, measured with the

calliper beaks held at right angles to the MD dimension. Similarly the MD crown dimensions of

maxillary right and left canines were measured from the anatomical contact points with beaks parallel

to the long axis of the tooth. Intercanine width was measured from canine tip of one side to the canine

tip on the other side. All the measurements were performed by one observer twice to assess the

reliability of the measurements and to remove the intra-observer error.

CI was calculated by dividing the MD width of the maxillary canine by the Intercanine

distance.

Indices calculated:

𝐶𝑎𝑛𝑖𝑛𝑒 𝐼𝑛𝑑𝑒𝑥 (𝐶𝐼): 𝑀𝐷 𝑤𝑖𝑑𝑡ℎ 𝑜𝑓 𝑡ℎ𝑒 𝐶𝑎𝑛𝑖𝑛𝑒

𝐼𝑛𝑡𝑒𝑟𝑐𝑎𝑛𝑖𝑛𝑒 𝑑𝑖𝑠𝑡𝑎𝑛𝑐𝑒× 100

Based on above values the standard MCI was derived as follows:

Standard MCI=Type equation here.

[

(𝑀𝑒𝑎𝑛 𝑚𝑎𝑙𝑒 𝑀𝐶𝐼−𝑆𝐷)+(𝑀𝑒𝑎𝑛 𝑓𝑒𝑚𝑎𝑙𝑒 𝑀𝐶𝐼+𝑆𝐷)

]

2

Descriptive statistics (mean and standard deviation) and sexual dimorphism of the crown widths were

performed. The percentage of dimorphism is defined as the percent by which tooth size of males

exceeds that of females. The percentage of dimorphism for each tooth was calculated using the

formula given by Garn and Lewis as follows:

Sexual dimorphism = [(Xm/Xf) − 1] × 100

Where Xm=mean male tooth dimension, Xf=mean female tooth dimension.

STATISTICAL ANALYSIS





Student t test for two sample, discriminent analysis and bivariate logistic regression was used to

assess the sex difference. The data collected was statistically analysed using Microsoft excel trial

version of minitab 17,R studio.

RESULTS

In our study number of rugae in males were 8.88 while in females it was 9.30 which is non

significant (Table1, Graph 5). Males showed more number of converging rugae (54%) whereas

females showed equal number of converging and diverging rugae (50% each). The decrease

percentage of various shape in in males it is straight (44%) wavy (28%), curved (24%) and circular

(4%) on the other hand females are curved (38%), straight (34%), wavy (18%) and circular (10%).

Both males and females had highest percentage of primary rugae (70% and (82% respectively) and

least percentage of tertiary rugae (8% and 4 % respectively). The forward directed is common in

males (27%) and backward directed rugae is predominantly seen in females (25%). (Graphs 1,2,3,4)

Graph:1 Shape Distribution

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

Circular Curved Straight Wavy

Female 10.0% 38.0% 34.0% 18.0%

Male 4.0% 24.0% 44.0% 28.0%

Per

cen

tage

Shape Distribution





Graph:2 Incidence Distribution

Graph 3: Unification Distribution

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Primary Secondary Tertiary

Female 70.0% 22.0% 8.0%

Male 82.0% 14.0% 4.0%

Pe

rce

nta

ge

Incidence Distribution

42.0%

44.0%

46.0%

48.0%

50.0%

52.0%

54.0%

Converge Divergence

Female 50.0% 50.0%

Male 54.0% 46.0%

Pe

rcen

tage

Unification Distribution





Graph 4 : Direction Distribution

Graph 5: Mean Comparison of width of Molars and canines, Intercanine width and MCI

ODONTOMETRIC ANALYSIS

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

0. N P

Female 2.0% 50.0% 48.0%

Male 18.0% 28.0% 54.0%

Pe

rce

nta

ge

Direction Distribution

0.002.004.006.008.00

10.0012.0014.0016.0018.0020.0022.0024.0026.0028.0030.0032.0034.0036.0038.0040.00

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

Mal

e

Fem

ale

No ofRugae

MD-R MD-L BL-R BL-L Can-R Can-LIntercaninewidth

MCI

Mean Comparison

Mean





The mean MD width of maxillary molars of males was 9.68mm on right side and 9.62 on left side

whereas it was 9.18 and 9.34 on right and left side respectively in females. The mean BL width 9.16

in right side and 8.94 on left side in males in contrast to 8.76 right side and 8.58 left side in females.

The above values were higher in males as compared to females.

The MD width of maxillary canine was 7.64 on right (R)and 7.68 on left side (L)of males and 7.36

on right side and 7.22 on left side of females. The mean values of these measurements were more in

males than females. When a comparative analysis of the odontometric data was done, all were

statistically significant except MD of left molar which is non significant p> 0.05. The intercanine

width and MCI was statistically highly significant. (Table 1)

Sexual dimorphism was highest in MD of right molar (5.44%) followed by BL of right molar

(4.56%), BL of left (4.19%) and MD of left molar (2.99%).

Left canine showed dimorphism of 6.37% and right canine has 3.80%. The canine arch width showed

a dimorphism of 11.54% while canine index was 4.76% (Table 2)

When overall accuracy was calculated it was found BL of L molar showed 65% and BL of R molar

62% while MD of both R and L molar showed 60% accuracy. The canine dimensions accuracy was

68% (left side) and 58%( right side). It was 96% for the canine arch width and 63% when MCI was

calculated. (Table 3)

Variable Group N Mean Std.

Deviation T Test P VALUE

No of Rugae Male 50 8.88 1.599

-1.163 0.248

Non Sig Female 50 9.30 1.992

MD-R Male 50 9.68 0.844

3.087 0.003

Significant Female 50 9.18 0.774

MD-L Male 50 9.62 1.008

1.453 0.149

Non Sig Female 50 9.34 0.917

BL-R Male 50 9.16 0.710

2.698 0.008


BL-L Male 50 8.94 0.818 2.245 0.027





Female 50 8.58 0.785 Significant

Can-R Male 50 7.64 0.631

2.113 0.037


Can-L Male 50 7.68 0.653

3.377 0.001


Inter canine

width

Male 50 38.64 1.587

14.327

0.000

Highly

significant Female 50 34.64 1.173

MCI

Male 50 0.40 0.031

3.667

0.000

Highly

significant Female 50 0.42 0.037

Table 1: Comparison of Mean values of Maxillary Crown Dimensions

Variable Sexual Dimorphism( %)

MD-R 5.44%

MD-L 2.99%

BL-R 4.56%

BL-L 4.19%

Can-R 3.80%

Can-L 6.37%





Inter canine

width 11.54%

MCI 4.76%

Table 2: Sexual Dimorphism( %)

Variable SEX Female Male Total Overall

Accuracy

MD-R Female 32(64) 18(36) 50(100)

60.000 Male 22(44) 28(56) 50(100)

MD-L Female 30(60) 20(40) 50(100)

60.000 Male 20(40) 30(60) 50(100)

BL-R Female 18(36) 32(64) 50(100)

62.000 Male 6(12) 44(88) 50(100)

BL-L Female 28(56) 22(44) 50(100)

65.000 Male 13(26) 37(74) 50(100)

Can-R Female 30(60) 20(40) 50(100)

58.000 Male 22(44) 28(40) 50(100)

Can-L Female 39(78) 11(22) 50(100)

68.000 Male 21(42) 29(58) 50(100)

Inter canine

width

Female 49(98) 1(2) 50(100) 96.000

Male 3(6) 47(94) 50(100)

MCI Female 31(62) 19(38) 50(100) 63.000





Male 18(36) 32(64) 50(100)

Table 3: Accuracy of Sex Assessment for Molars and Canines

Formula for odontometric data was

GENDER = -17.13(Constant) + 0.452 BLR + 0.240 BLL + 0.877 MDR - 0.411 MDL - 0.054 CR

+ 0.941 CL

Where RC-MD dimension of right canine, LMM-MD dimension of left molar, RMB-BL dimension

of right molar, RMM-MD dimension of right molar, CL dimension of left canine and CR dimension

of right canine.

On substituting the value if the value of gender was 0.5 and above then it is male and below it was

female.

III. CONCLUSION

Palatal rugae own the features of an ideal forensic parameters- uniqueness, post mortem resistance,

constancy and facilitating personal identification procedure. It is cost effective, reliable and simple

technique. Several studies done in the past have revealed and had statistically proved that the rugae

pattern is highly individualistic and there are racial and gender variations. No two palates to be alike

in their configuration and even between twins, rugae pattern are said to be similar but not identical.

12

In our study females had more number of rugae when compared to males p> 0.001, NS which is

comparable to the findings of Verma et al. 13 and Manjunath et al 14. Neha et al. 15 and Indira et

al. 16 in contrast found more number of rugae in males. Our study found that straight rugae were

more common in males which was not in line with Sharma et al. 17 and Kamala et al.18 Females

had more number of curved rugae in our study in contrast to the findings of Babu et al who found

wavy pattern to be more common in both genders.19 Our study observed that males had converging

type and females had equal converging and diverging type of rugae. Neha et al.15found converging

type of rugae to be higher in males and females both. In our study we found that males had more

forwardly directed rugae and females showed backwardly directed rugae. However studies conducted





by Azab et al. 20 and Saxena et al.21 did not find any significant difference win the direction of rugae

between males and females.

The comparison of mean values of parameters measured between males and females showed

statistically significant difference with p<0.05 in the BL and MD dimensions of molars ( except MD

of left molar). Rao et al.22 and Ghodosi et al.23 in their studies observed that the males have bigger

teeth than females.

In the present study maximum sexual dimorphism was shown by MD of right molar (5.44%)

analogous to study conducted by Narang et al. 24 showing highest dimorphism by BL of right molar

(7.7%).

Our study showed that canine arch width and intercanine distance were more in males and

statistically it was significant and highly significant respectively. Syed et al. found similar results

and were statistically highly significant. Sexual dimorphism of right and left canine in our study was

3.80% and 6.37% while it is 8.20% and 8.09 % in the findings of Syed et al.25Filipovic G et al.26

conducted a study on 200 Serbian subjects and revealed that there are significant differences between

the sexes in canine dimorphism. Parikh27 showed that the most sensitive predictors for gender

determination were the maxillary and mandibular inter-canine distance. In our study the accuracy of

intercanine width was 96%. Our study showed intercanine width dimorphism of 11.54% in contrast

to the findings of Jakhar et al.28 which was about 3.18%. The accuracy of MCI in our study was

63% which was in favour of study done by Garn et al.29, that MCI can only be used as supplemental

tool along with other parameters because the accuracy of the MCI in the identification of sex has

never exceeded 87.5%.

The present study proves that odontometric analysis and palatal rugae can serve as supplemental

tool for person identification and sex determination in forensic investigations.

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