Abstract

Background: Gender determination is a crucial aspect of forensic anthropology, playing a vital role in the identification process of unknown human remains. Recent advancements in imaging technologies, particularly Cone Beam Computed Tomography (CBCT), have the way for more accurate and non-invasive methods of gender estimation through morphometric analysis.1 The maxillary sinus, orbital index, and foramen magnum are anatomical structures that exhibit sexual dimorphism, meaning their dimensions differ between males and females.1 The maxillary sinus, located within the maxillary bone, shows distinct variations in size and shape based on gender. Similarly, the orbital index, which is the ratio of the orbital height to its width, varies significantly between the gender.2 The foramen magnum, a crucial structure at the base of the skull, also presents measurable differences in size and shape between males and females.3 This retrospective study aims to evaluate the efficacy of using CBCT to determine gender through the morphometric analysis of these anatomical structures.  Aim and Objectives: Aim of the study is to determine gender using morphometric analysis of maxillary sinus, orbital index &foramen magnum using CBCT. Objectives of the study is to evaluate the morphometric analysis of maxillary sinus of height, width and depth, morphometric analysis of orbital index of height and width and to evaluate the morphometric analysis of foramen magnum of length width and shape. Methodology: 90 CBCT images of patients were taken from the department database. The DICOM data will be imported to ROMEXIS 6.1.0 software. The age group selected between 13 and above. Maxillary Sinus: Axial view: a) The width was the longest distance perpendicular from the medial wall of the sinus to the most lateral wall of the lateral process of maxillary sinus in axial view. b) The depth was defined as the longest distance from the most anterior point to the most posterior point of the medial wall in the axial view. In coronal view a) The height was measured away from the inner surface of the anterior border of maxillary sinus and was defined as the longest distance from the lowest point of the sinus floor to the highest point of sinus roof in the coronal view. Orbital Index: In coronal view a) Orbital height: Highest distance between the superior and inferior  orbital margin. b) Orbital width: Maximum lateral curved distance between the medial margin and lateral margin of the orbit. Foramen Magnum: a) In axial view the anteroposterior dimension and transverse dimension are measured from the most prominent point. b) The shape of the foramen magnum determined based on the Richards and Jabbour classification. c) Shape of the magnum was found to be circle, semicircle, wide oval, heart, bipointed, birounded, venterally rounded and dorsally convergent. Results: There were about 48.8% of males and 51.2% of females in the study. there is a significant difference in length, height and width of maxillary sinus between males and females and hence, maxillary sinus can be used as an effective parameter in gender determination. The length of orbital index was more in males than females and width of orbital index was less in males than females the mean differences between the gender was found to be statistically nonsignificant. The mean length and width of foramen magnum was more in males than females. This mean difference was found to be statistically significant (p-value=0.01), indicating foramen magnum’s length, width and area can be used as an effective parameter in sex determination. Conclusion: CBCT-based morphometric analysis of the maxillary sinus, orbital index, and foramen magnum is a reliable method for gender determination. This approach shows great potential for enhancing forensic anthropological practices and assisting in the identification of human remains. Future research should focus on validating these findings across larger and more diverse populations and exploring additional cranial landmarks to further improve the robustness of gender determination methods. 

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