Abstract

Background: Palatal rugoscopy is a reliable forensic tool for human identification due to the uniqueness and stability of palatal rugae. However, orthodontic treatment, especially involving palatal appliances, may alter rugae morphology, potentially affecting its accuracy in gender identification. This study aimed to evaluate the reliability and diagnostic accuracy of palatal rugoscopy for sex determination in orthodontic patients. Methods: A cross-sectional analytical study was conducted on 360 participants divided into three groups: non-orthodontic controls, orthodontic patients without palatal appliances, and those treated with palatal appliances. Rugae patterns were assessed using Lysell and Thomas & van Wyk classifications. Statistical analysis included ANOVA, chi-square test, ROC analysis, and logistic regression. Results: Significant sexual dimorphism was observed in controls, with higher rugae counts in females (p < 0.05). Diagnostic accuracy was highest in controls (86.7%, AUC = 0.91), reduced in orthodontic patients without appliances (74.2%), and lowest in those with palatal appliances (61.7%) (p < 0.001). Palatal appliances significantly reduced rugae count and increased asymmetry, affecting sex prediction. Conclusions: Orthodontic treatment, particularly with palatal appliances, compromises the reliability of rugoscopy for gender identification. Caution is advised when applying this method in forensic cases involving orthodontically treated individuals.

• 1.   Kumar T: Role of palatal rugoscopy to establish sexual dimorphism as an adjunct in personal identification: A forensic study. J Forensic Dent Sci. 2023, 84–96. 10.18311/jfds/13/2/2021.17
• 2.   Paliwal A, Wanjari S, Parwani R: Palatal rugoscopy: Establishing identity. J Forensic Dent Sci. 2010, 2:27–31. 10.4103/0974- 2948.71054
• 3.   Ata-Ali J, Ata-Ali F: Forensic dentistry in human identification: A review of the literature. J Clin Exp Dent. 2014, 6:e162-7. 10.4317/jced.51387.
• 4.   Smitha T, Vaswani V, Deepak V, Sheethal HS, Hema KN, Jain VK: Reliability of palatal rugae patterns in individual identification. J Oral Maxillofac Pathol. 2021, 25:555. 10.4103/jomfp. jomfp_269_21.
• 5.   Roselli L, Mele F, Suriano C, Santoro V, Catanesi R, Petruzzi M: Palatal rugae assessment using plaster model and dental scan: a cross-sectional comparative analysis. Front Oral Health. 2024, 5:1456377. 10.3389/froh.2024.1456377.
• 6.   Gautam N, Patil SG, Krishna RG, Agastya H, Mushtaq L, Kumar KV: Association of palatal rugae pattern in gender identification: An exploratory study. J Contemp Dent Pract. 2017, 18:470–3. 10.5005/jp-journals-10024-2067.
• 7.   Bavaresco D, Von Meusel LDZ, Franco A, Makeeva I, Paranhos LR, Cericato GO: Morphology of the palatal rugae before and after orthodontic treatment with and without rapid maxillary expansion and dental extractions. Indian J Dent Res. 2020, 31:241–6. 10.4103/ijdr.IJDR_12_19.
• 8.   Hashim A, Mascarenhas R, Umar D, Amin V, Shetty S, Bavikara Maniyankod S: Stability of palatal rugae post-orthodontics: implications for forensic identification and clinical superimposition. Egypt J Forensic Sci. 2025, 15:. 10.1186/s41935-025-00483-9.
• 9.   Andrade RNM, Vieira WA, Bernardino ÍM, Franco A, Paranhos LR. Reliability of palatal rugoscopy for sexual dimorphism in forensic dentistry: A systematic literature review and meta-analysis. Arch Oral Biol. 2019 Jan;97:25- 34. doi: 10.1016/j.archoralbio.2018.10.009.
• 10.   Lavanya R, Boringi M, Alluri K, Sujatha M. Palatal Rugae in Gender Discrimination: Auxiliary or Hindrance? A Systematic Review. J Res Dent Maxillofac Sci. 2022; 7(4):260-266.
• 11.   Kapoor P, Ragini, Kaur H (2015) Rugoscopy: A Diagnostic Appurtenance for Malocclusion or just a Forensic Aid? - A Pilot Study. J Forensic Res 6: 272. doi: 10.4172/2157-7145.1000272.
• 12.   Makrygiannakis MA, Konstantonis D, Vastardis H, Athanasiou AE, Halazonetis DJ. Palatal rugae change shape following orthodontic treatment: a comparison between extraction and non-extraction borderline cases using fractal analysis and 3D superimposition. Eur J Orthod. 2024 Dec 4;47(1):cjae070. doi: 10.1093/ejo/cjae070.
• 13.   Tey, Sock Nee, et al. “Stability of palatal rugae after orthodontic/orthopaedic expansion: a scoping review.” Australasian Orthodontic Journal, vol. 39, no. 1, Australian Society of Orthodontists Inc., 2023, pp. 158-170. https:// doi.org/10.2478/aoj-2023-0018.19 IJFO / Volume 19 Number 1 / January – June 2026
• 14.   Deepak V, Malgaonkar NI, Shah NK, Nasser AS, Dagrus K, Bassle T. Palatal rugae patterns in orthodontically treated cases, are they a reliable forensic marker? J Int Oral Health. 2014 Sep;6(5):89-95.
• 15.   Ali B, Shaikh A, Fida M. Stability of Palatal Rugae as a Forensic Marker in Orthodontically Treated Cases. J Forensic Sci. 2016 Sep;61(5):1351-5. doi: 10.1111/1556-4029.13129.
• 16.   Shukla D, Chowdhry A, Bablani D, Jain P, Thapar R. Establishing the reliability of palatal rugae pattern in individual identification (following orthodontic treatment). J Forensic Odontostomatol. 2011 Jul 1;29(1):

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