Abstract

Introduction: Forensic odontology relies on craniofacial features for identification when traditional methods fail. The maxillary sinus, with its variable dimensions, offers potential for profiling, yet its link to facial profiles remains under explored. This study aims to assess whether CBCT-derived maxillary sinus dimensional ratios can reliably distinguish frontal and lateral facial profile types in a living population. Methodology:This cross-sectional study enrolled 50 adults (18–60 years) at Kothiwal Dental College, Moradabad, with no craniofacial trauma or sinus pathology. Standardized frontal and lateral photographs categorized profiles (Oval, Square, Round; Convex, Straight, Concave) using anthropometric guidelines. CBCT scans measured bilateral sinus height, width, and depth, calculating ratios (H/W, H/D, W/D, left-right asymmetry). Two blinded observers assessed data, with reliability confirmed by ICC (>0.75). Spearman’s correlation, Kruskal-Wallis, and linear discriminant analysis evaluated associations, using SPSS with p<0.05 significance. Results: Analysis revealed significant gender differences in the Height-to-Width (H/W) ratio (males: 1.95±0.21, females: 1.82±0.24, p=0.033). Frontal profiles showed significant variations in H/W (oval: 1.98±0.43, p=0.047), H/D (round: 1.12±0.36, p=0.001), and W/D (round: 0.56±0.12, p=0.008). Side profiles exhibited significant differences in H/W (straight: 2.05±0.58, p=0.041), H/D (concave: 1.15±0.26, p=0.018), and W/D (concave: 0.58±0.18, p=0.021), suggesting sinus ratios as potential profile markers. Conclusion: Maxillary sinus ratios, particularly H/W, correlate with gender and facial profiles, enhancing forensic identification. CBCT provides a precise tool, though larger, diverse samples are needed to validate findings and address limitations like post-mortem applicability, advancing individualized profiling in forensic odontology.

• 1.   Krishan K., Kanchan T., Garg A.K. Dental Evidence in Forensic Identification: An Overview, Methodology and Present Status. Open Dent J. 2015 Jul 31; 9: 250-6. doi: 10.2174/1874210601509010250.
• 2.   Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K. Computed tomography measurements of different dimensions of
• 3.   Moustansir Hassanaly, Inês Morais Caldas, Alexandra Teixeira and Daniel Pérez-et al. (2023). “Applications of CBCT in forensic odontology.” Current Forensic Science, 1, 288, 19 10.2174/2666484401666230516103852
• 4.   Deshpande A.A., Munde A.D., Mishra S.S., Kawsankar K.D., Sawade R.V., Mandar B. Determination of sexual dimorphism of maxillary sinus using cone-beam computed tomography in a rural population of western Maharashtra: A retrospective, cross-sectional study. J Family Med Prim Care. 2022 Apr; 11(4):
• 5.   De Greef S., Willems G. Three-dimensional cranio-facial reconstruction in forensic identification: latest progress and new tendencies in the 21st century. J Forensic Sci. 2005 Jan; 50(1): 12-7.
• 6.   Maspero C., Farronato M., Bellincioni F., Annibale A., Machetti J., Abate A., Cavagnetto D. Three-Dimensional Evaluation of Maxillary
• 7.   Tambawala S.S., Karjodkar F.R., Sansare K., Prakash N. 2016. Sexual Dimorphism of Maxillary Sinus using Cone Beam Computed Tomography. Egyptian Journal of Forensic Sciences. 6: 120-125.
• 8.   Uthman A., Al-rawi N., Al-naaimi A. 2011. Evaluation of Maxillary Sinus Dimensions in Gender Determination Using Helical CT
• 9.   Takeda M., Kujirai K, Takahashi M., Hatanaka R., Koizumi S., Hikita Y., Yamaguchi T. Correlation Between Facial Asymmetry and Maxillary Sinus Size or Volume Using Dental Cone-Beam Computed Tomography Images. Cureus. 2025 Mar 5; 17(3): e80118. doi: 10.7759/ cureus.80118.
• 10.   Jain D., Nimbalkar K.A., Datana S., Chopra S.S. Evaluation of maxillary sinus dimensions and volume in different sagittal and vertical facial types: A CBCT based study. JCO. 2023; 7(4): 287-292. doi:10.18231/j.jco.2023.049
• 11.   Chen H.S., Hsiao S.Y., Lee K.T. Analysis of Facial Skeletal Morphology: Nasal Bone, Maxilla, and Mandible. Chen MY, ed. BioMed Research International. 2021; 2021(1): 5599949. doi:10.1155/2021/5599949
• 12.   Hanafi MGS, Utsuno H., Namiki S., Aoki N., Saitoh H., Minegishi S., Yamada S, Makino Y., Iwase H., Sakurada K. Assessing the contribution of orthodontic profiles in predicting facial soft tissue thickness for forensic facial approximation. Int J Legal Med. 2025 Jun 18. doi: 10.1007/s00414-025-03542-x.
• 13.   Guo Y.X., Lan J.L., Bu W.Q., Tang Y., Wu D., Yang H., Ren J.C., Song Y.X., Yue H.Y., Guo Y.C., Meng H.T. Automatic maxillary sinus segmentation and age estimation model for the northwestern Chinese Han population. BMC Oral Health. 2025 Feb 26; 25(1): 310. doi: 10.1186/s12903-025-05618-x.

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