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The Open Dentistry Journal, 2014, 8, 269-279 269

Open Access

Cheiloscopy, Palatoscopy and Odontometrics in Sex Prediction and Dis-

crimination - a Comparative Study

Nagalaxmi V.1, Sridevi Ugrappa1, Naga Jyothi M.1,*, Lalitha Ch.1, Kotya Naik Maloth2 and Srikanth
Kodangal1

1
Sri Sai College Of Dental Surgery, Vikarabad, Telangana, India
2
Mamata Dental College. Khammam, Telangana, India

Abstract: Background and Objectives: Human identification is the forensic odontologist’s primary duty in the fields like
violent crime, child abuse, elder abuse, missing persons and mass disaster scenarios. In each context, dental traits may
produce compelling evidence to aid victim identity, suspect identity and narrow down the outcome of investigative case-
work. Sometimes it becomes necessary to apply some least known and less popular techniques in identification procedure
where lip prints, rugae patterns and canine odontometrics can give us comparatively valid conclusions pertaining to per-
son’s identification. This study elucidates the significance of cheiloscopy, palatoscopy and canine odontometry in sex
prediction and discrimination.
Materials and Methods: A cross- sectional study involving a total of 60 subjects, 30 males and 30 females were selected
from the outpatient department of oral medicine and radiology. Lip prints were recorded using lipstick, palatal impres-
sions were taken with alginate and odontometric measurements were taken with digital vernier calipers from every sub-
ject. All the obtained records were analyzed by two observers.
Results: Reliability of lip prints was assessed using Kappa coefficient. Comparison of rugae patterns was done using Chi-
square test. Mean canine and inter canine width was compared using t test. A p-value of <0.05 was considered significant.
Statistically significant difference was found with the different lip print patterns analyzed in males and females, while no
significant difference was observed in the rugae patterns but a significant difference in the mesio-distal width of mandibu-
lar canines in males and females was found with right mandibular canine(3.73%) showing greater sexual dimorphism
compared to left mandibular canine(3.06%).
Conclusion: This study shows the uniqueness of the lip prints and rugae patterns with the lip prints showing sensitivity of
81.7% giving reliable prediction of sex over palatoscopy. Hence, cheiloscopy along with the canine odontometrics aid in
sex determination and can be considered as an ancilliary forensic tool in identification.

Keywords: Forensic identification, lip prints, mandibular canine index, rugae patterns, sex discrimination.

INTRODUCTION examination of dental evidence, from which a proper evalua-

tion and presentation of dental findings can be made. (Cam-
Establishing the human identity using skeletal and dental
eron and Sims, 1974 and Keiser-Nielson, 1980).
traits provides a comprehensive data and compelling evi-
dence that holds a paramount importance in the routine fo- No two individuals in the world look alike and are unique
rensic investigations, Law enforcement agencies, Judicial and this concept of uniqueness is utilized in the human iden-
system, mass disasters, palaeoanthropology. Though human tification procedures. Although DNA profiling, finger prints,
beings belong to same species, the genetic determinants en- anthropometric data, dental records can be used as standard
code the distinctive characteristics of every individual facili- methods, sometimes it becomes obvious to employ some of
tating the identification possible. the least and unusually used ancilliary methods like cheilo-
Forensic dentistry is a specialized branch of forensic scopy, palatoscopy and other odontometric measurements
medicine and may be described as that part of odontology that are capable of giving comparatively reliable results
which, in the interests of justice, deals with the handling and when performed systematically [1]. Gender discrimination is
the important aspect of the human identification procedures
that help in the establishment of biological profile from the
*Address correspondence to this author at the Q.NO. B-4/59, NTPC, Rama- skeletal and dental remains and also help in the facial recon-
gundam, Telangana (505215); India; Tel: 91-8019138210; struction of unidentified bodies.
E-mail: [email protected]

1874-2106/14 2014 Bentham Open

270 The Open Dentistry Journal, 2014, Volume 8 Nagalaxmi et al.

Age, race, sex and stature determination along with den- LIP PRINTS
tal evidence collection and facial reconstruction over the
The materials used for recording the lip print are:
skeletal remnants are the important specialities of the foren-
sic dentistry [2]. 1. Lipstick – of a bright red colour and non-glossy, Rev-
Latent imprints recorded on the smooth surfaces in the lon Red (number 64), REVLON, made by Aero
Pharma Pvt Ltd, Mumbai was used.
crime scene area requires evidence based comparative analy-
sis for the identification of suspect as well as victim in the 2. Cellophane tape that was transparent and glued on one
field of criminology [3-5]. These imprints are derived from side of 24mm width (Hi- TECH). This is sufficient to
the sources like fingers, palms, foot including the lips with take the print of one lip at a time.
its characteristic grooves and furrows although lip prints 3. Deep pore cleanser
have not been as popular as others.
4. Scissors.
Similarly the patterns of palatine rugae exhibit racial and
gender variations where they are not subjected to gross 5. A4 size white bond paper (JK excel bond).
changes except in the length during the person’s growth. 6. Tissue paper.
They are protected from trauma and other extreme condi-
tions like high temperatures as they are shielded by the lips, 7. Gauze with saline to remove the lipstick.
cheeks, tongue, teeth and bone and retain the same position The upper surface of the lipstick was wiped clean on tis-
and shape throughout the person’s life once formed [1, 6]. sue paper prior to each use for hygienic purpose. The subject
They also serve as a valuable tool in the conditions where was asked to open the mouth and lipstick applied in a single
finger prints or lip prints cannot be recorded like decom- stroke evenly on the upper lip followed by the lower lip. The
posed or burnt bodies. Its importance is justified by using it
subject was asked to rub his or her upper and lower lips to-
in the identification of pilots in aeronautical accidents with
gether gently to ensure even application of the lipstick
the aid of antemortem data [1].
throughout the lips. A strip of cellophane tape, 1 inch long
Likewise the odontometric parameters also show ethnic, was cut out with scissors. The subject was asked to open the
racial, and individual and to some extent geographic varia- mouth slightly, and to keep the mouth stationary during the
tions and they are least susceptible to the catastrophic procedure. The glued portion of the cellophane tape was then
changes and help in collecting the appropriate dental evi- applied on the lower lip and held in place, applying gentle
dence. Teeth unlike soft tissues with their physiologic varia- and even pressure for a few seconds, to allow the print to
tions, pathoses and the ability to withstand extreme condi- form on the tape. Then the tape was carefully lifted from the
tions of post mortem changes like decomposition, carboniza-
lip, from one end of the strip to the other, in a single jerk
tion and fragmentation, are capable of providing information
avoiding any smudging of the print. The strip of cellophane
that remains throughout the life and beyond. Canines display
tape was then stuck on to a piece of white bond paper for
sexual dimorphism and serve as a supplemental forensic tool
in sex determination. They last long in the oral cavity as they further analysis by using magnifying lens. Each lip print was
are least prone to caries or periodontal disease and also with- coded without revealing the name and sex of the subject to
stand vulnerable conditions [7, 8]. the observers (Fig. 1).
Odontometrics is the measurement and study of tooth
size used in biological anthropology, bioarchaeology to
study human phenotypic variations. The present study is
aimed at envisaging the application of the ancilliary methods
in identification and sex discrimination – cheiloscopy, pala-
toscopy and mandibular canine index. This study also shows
the inter and intra observer variability in the evaluation of
these parameters.

MATERIALS AND METHODS

A total of 60 subjects, 30 males and 30 females were se- Fig. (1). Lip print of a female subject.
lected from the out-patient department of oral medicine and
radiology attending the hospital for routine dental check up
after acquiring the informed consent with the age groups ANALYSIS OF LIPPRINTS
ranging between 20-30 years. All subjects are absolutely Topographically, each lip print was divided into 6 areas
normal with no evidence of congenital anomalies, soft tissue such that each lip have 3 zones. Right upper lateral, upper
surgeries, trauma, orthodontic treatment, orthognathic sur- middle, left upper lateral, left lower lateral, lower middle and
geries, malocclusions, attrition and other regressive altera- right lower lateral zones as in (Fig. 2). The most predomi-
tions of teeth, caries free teeth, normal molar and canine re- nant and clearly visible patterns in each zone are considered
lationship. From every subject, the lip prints, palatal impres- in sex determinations which were later verified from the ac-
sions and odontometric measurements were recorded on the tual details of the subjects for drawing conclusions. In our
same day. study we followed the classification of the lip-patterns sug-
Cheiloscopy, Palatoscopy and Odontometrics in Sex Prediction The Open Dentistry Journal, 2014, Volume 8 271

poured in dental stone along with the plaster bases for further
analysis. Care was taken to rule out any palatal swelling or
other pathologies, denture wearers and subjects with full
complement of teeth. Rugae were delineated with dark
graphite lead black pencil as in (Fig. 3), under adequate day
light and the patterns were analyzed by the observers using
magnifying lens. The following criteria were considered in
analyzing them which are as follows:
1. Total number of rugae.
2. Primary rugae with length in its greatest dimension 
5mm were considered.
3. Secondary or fragmentary rugae with length
5mm
Fig. (2). Topographic division of lip into 6 zones for lip print pat-
were not considered.
tern analysis. 4. Predominant shape of the rugae.
5. Fusion and course of direction of the rugae from the
gested by Suzuki and Tsuchihashi [9] giving the arrangement mid-palatine raphe.
of grooves.
The analysis was done using modified Lysell [10] who
Type 1-Clear-cut grooves running vertically across the
proposed the following patterns based on the shape as fol-
lip
lows:
Type I The grooves are straight vertical but discontinu-
1. Straight: They follow a straight or linear pattern from
ous not running entirely across the lip.
the origin to termination.
Type II- The grooves branch in their course in the shape
of Y 2. Curved: They depict a crescent shape with a slight
bend either at the origin or termination or both of the
Type III- Intersecting grooves rugae under consideration.
Type IV- Reticular pattern
3. Wavy: Curved rugae with slight curve at the origin or
Type V- The grooves do not fall into any of the types I- termination in the wave form.
IV, and cannot be differentiated morphologically and are
irregular. 4. Circular: Rugae that form a definite circular ring.
5. Unification (diverging): Two rugae with common ori-
ANALYSIS OF PALATAL RUGAE gin but separate terminations.

For palatal rugae, we recorded alginate impressions of 6. Unification(converging): Two rugae with separate
the maxillary arch of the same subjects and models were origins but uniting at the termination laterally.

Fig. (3). Casts showing different palatal rugae patterns.

272 The Open Dentistry Journal, 2014, Volume 8 Nagalaxmi et al.

Fig. (4). Digital Vernier calipers device.

The corresponding patterns for each subject were coded

as the numbers 1 – 6 as mentioned above by the two observ-
ers who were blinded from each other.
Odontometric measurements were recorded intraorally
using digital vernier calipers with a resolution of 0.02mm
from the informed consent and other indices were derived (Xm = mean value of male canine width; Xf = mean
from the recorded values excluding the subjects with brux- value of female canine width).
ism, morphological and pathological alterations of teeth (Fig. Standard Mandibular canine index (MCIs) value was ob-
4 & 5). tained from the derived values for the comparative analysis
using the formula as:

RESULTS
All the analysis was done using SPSS version 14. A p-
value of <0.05 was considered significant. Reliability of lip
prints to predict gender was assessed using Kappa coefficient
(Fig. 6). Comparison of rugae patterns between male and
females was done using Chi-square test. Mean canine and
inter canine width was compared using t test. The Objectives
of this study include:
1. Identification of sex by means of cheiloscopy, rugo-
scopy and odontometric methods.
Fig. (5). Measurement of mesiodistal width of mandibular canine 2. Evaluate the inter and intra-observer variability after
by clinical examination.
studying the above three parameters.
3. To assess and compare the reliability of these parame-
1. The mandibular canine width: The greatest mesio- ters in identification of sex.
distal width (MDW) between the mesial and distal
contact points of the right and left mandibular canine.
2. The mandibular inter canine width (ICW) or arch
width: was measured as the distance between the cusp
tips of right and left mandibular canines.
Each parameter was repeated three times to get average
measurements. Mandibular canine indices were calculated as
per the formula used by Rao et al. [11] as
Mesio - distal width of right & left lower canine ( MDW )
Mandibular canine index (MCI) =
Mandibular inter canine width ( ICW )

All the values were tabulated in the standard Microsoft

excel sheet and subjected to statistical analysis using “t” test.
Sexual dimorphism for both right and left mandibular ca-
Fig. (6). Kappa measurement scale.
nines was also calculated according to Garn and Lewis [12]
as follows:
Cheiloscopy, Palatoscopy and Odontometrics in Sex Prediction The Open Dentistry Journal, 2014, Volume 8 273

Table 1. Kappa coefficient test for proportion to assess sex differences in lip print patterns.

Predicted Lip Gender

Kappa % Agreement
Male Female

Male 28 2
Actual gender 0.633 81.67
Female 9 21

Table 2. Inter and intra observer variability assessed by kappa co-efficient to assess sex differences in lip print patterns.

2nd Observer
Kappa % Agreement
Female Male

Female 20 9
1st observer 0.465 73.33
Male 7 24

LIP PRINTS tribute to the statistical difference. The predominant shape of

rugae in males was wavy followed by curved with straight
According to our study lip print analysis gave us the fol-
pattern showing the least. The ring form was rare and we
lowing observations.
found in only one female subject. In females the predomi-
No two lip prints showed similar patterns and distribution nant shape was also wavy and curved followed by the unifi-
in each quadrant by both the observers. We observed more cation (diverging) pattern and straight pattern respectively as
than two patterns in each individual and the distribution of corroborated in Table 3. No significant inter- observer varia-
these patterns in each quadrant we divided also showed tion was seen in the rugae shapes but variable rugae shapes
variations from each other. Type I’ pattern was dominant in were seen in males and females thus serving as an adjunct
predicted female gender with an overall contribution of tool in sex discrimination. Applying the Chi-square test, we
43.3% taken from both the observers with average readings observed a p value of 0.785 which was non-significant as in
followed by Type I with 10%, Type II with 28.3%, Type III Table 3 and the chart 1.
sharing 11.6%, Type IV with 3.3% and Type V with 6.6%
respectively. In males Type III was dominant with 46.6%
followed by Type IV with 26.6%, Type V with 15%, Type II CANINE INDEX
with 8.3% and Type I’ with 6.6% respectively. We also re- Mean canine and inter canine width was compared using
corded the lip prints in 10 subjects after 3 months and com- t test. The statistical derivations for all the odontometric
pared the two patterns before and after 3 months to rule out measures were given in the Table 4 and chart 2 & 3.
any variations, but they remained to be same indicating their
permanence once they are formed which don’t change in the The mean inter canine width showed higher value of
lifetime. We also observed the lip prints patterns in the same 26.76±1.90 in males in contrast to 25.77±1.66 as in females
family in three subsequent generations in 5 subjects which with a p-value significant. Similarly, the mean mesio-distal
showed similar pattern in the Upper and lower middle zone widths of right and left mandibular canines also showed sta-
of the lips but showed variation in the distribution indicating tistically significant difference whereas the right and left
its uniqueness in the same family. Two zones in each lip canine indices showed the p-value as non-significant. The
showed similar patterns in 46% of the individuals while overall assessment showed lower parametric values in fe-
other zones showed varied patterns hence showing the dif- males with respect to inter-canine width and mesio-distal
ferences in distribution helping in identification. Total num- widths of both the canines than in males. Similar observa-
ber of females correctly predicted was 81.7% and in males tions in males and females has been observed by Kaushal et
88.4% were correctly predicted. The reliability of this al. [13] (male: 25.873±1.253, female: 25.070±1.197), Reddy
method using kappa co-efficient showed minimal difference et al. [14] (male: 26.860±1.48, female: 26.287±1.45),
between actual and predicted gender with an agreement Kaushal et al. [15] (male: 25.87±1.25, female: 25.07±1.19),
81.67% indicating substantial agreement as in Table 1. Abdullah et al. [16] (male: 26.9552±2.3129 female:
26.4575±2.7790).
The inter and intra observer variability also assessed
by kappa co-efficient showed 73.33% of agreement as in Table 5 & 6 shows percentage of sex correctly predicted
Table 2. using right and left side Mandibular Canine Index (MCIs)
with the overall percentage of subjects correctly identified
was found to be 61.7% using left canine (33) and 71.7% us-
PALATAL RUGAE
ing right canine (43) respectively with the right mandibular
We observed a total of 243 primary rugae in females and canine as a reliable tool compared to left canine. The prob-
238 primary rugae in males in the study which did not con- ability of sex determination using right MCI for males and
274 The Open Dentistry Journal, 2014, Volume 8 Nagalaxmi et al.

Table 3. Chi square test for proportion to assess sex differences in palatal rugae patterns.

Actual Gender

S.No. Male Female p-value

N % N %

1 2 6.7% 1 3.3%

2 5 16.7% 5 16.7%

3 17 56.7% 19 63.3%
Rugae 0.785; NS
4 0 .0% 1 3.3%

5 3 10.0% 3 10.0%

6 3 10.0% 1 3.3%

Chart :
63.30%

70.00%
56.70%

60.00%

50.00%

40.00% Male

30.00% Female
16.70%
16.70%

10.00%
10.00%

10.00%
20.00%
6.70%
3.30%

3.30%

3.30%
0.00%

10.00%

0.00%
1 2 3 4 5 6

Chart 1. Graphical presentation of palatal rugae patterns in males and females.

Table 4. t test for proportion to assess sex differences in mandibular canine odontometrics.

Actual Gender

Male Female t p-value

Mean SD Mean SD

MDW43 (right) 6.66 .37 6.42 .28 2.866 0.066; Sig

MDW33 (left) 6.73 .34 6.53 .31 2.32 0.024; Sig

ICW 26.76 1.90 25.77 1.66 2.151 0.036; Sig

MCI _right (43) .2501 .0213 .2497 .0128 0.073 0.942; NS

MCI _left (33) .2524 .0203 .2540 .0127 -0.349 0.729; NS

MDW = Mesio-distal width. MCI= Mandibular canine index. ICW= Inter canine width
Cheiloscopy, Palatoscopy and Odontometrics in Sex Prediction The Open Dentistry Journal, 2014, Volume 8 275

Chart:
30
26.76
25.77
25

20

15 Male
Female
10
6.66 6.42 6.73 6.53
5

0
MDW 43 MDW 33 ICW

Chart 2. Graphical presentation of mandibular canine odontometric measurements.

Chart 3. Graphical presentation of standard mandibular canine index in males and females.

Table 5. MCI 43 (Right canine): Percentage of sex correctly predicted using right Mandibular Canine Index (MCIs).

Predicted

Observed Actual gender

Percentage Correct
Male Female

Male 22 8 73.3
Actual Gender
Female 9 21 70.0

Overall Percentage 71.7

276 The Open Dentistry Journal, 2014, Volume 8 Nagalaxmi et al.

Table 6. MCI 33(left canine): Percentage of sex correctly predicted using left Mandibular Canine Index (MCIs).

Predicted

Observed Actual gender

Percentage Correct
Male Female

Male 20 10 66.7
Actual Gender
Female 13 17 56.7

Overall Percentage 61.7

Table 7. Assessment of sexual dimorphism in right and left mandibular canine.

Actual Gender

Male Female Sexual dimorphism

Mean SD Mean SD

MDW43 6.66 .37 6.42 .28 3.73%

MDW33 6.73 .34 6.53 .31 3.06%

females was 73.3% and 70.0% and by using left MCI for forensic investigations. The most common role of the foren-
males and females, it was 66.7% and 56.7% respectively. sic dentist is the identification of deceased individuals [17].
Further, the probability of correct prediction of sex using Forensic dentistry represents the overlap between the
MCI is higher for females. We have noted an overall higher
dental and the legal professions which plays a major role in
percentage of accuracy for sex prediction from right side
body identification. Human identification by dental and other
MCI as compared to left side MCI.
allied orofacial structures beholds importance for various
It has been observed that the right mandibular canine ex- purposes like criminal, legal, mass causalities, aviation disas-
hibited greater sexual dimorphism (3.73%) as compared to ters, legal heirship, marital affairs, divorce, human traffick-
left canine (3.06%) as in Table 7. It has been further ob- ing, child abuse and similar other antisocial crimes [18].
served that whenever mesio-distal canine width was greater Sometimes dental appliances like labeled dentures, ortho-
than 7.3 mm, the probability of sex being male was ascer- dontic braces and other dental materials also provide clues to
tained but it must be substantiated and validated by large assist in the identification procedures. The traditional meth-
sample size. Our findings are different to those of other stud- ods for personal identification include anthropometry, finger
ies who have reported the left mandibular canine to exhibit prints, sex determination, age estimation, measurement of
greater percentage of dimorphism with still higher value of height, and differentiation by blood groups, DNA and odon-
7.954%, 9.058%, and 8.891% respectively [13-15] influ- tology [9]. Identification in forensic dentistry is a compre-
enced by ethnic and geographical variations. hensive procedure utilizing traditional, ancilliary tools and
also taking the help of novel and accurate methods like DNA
A comparison of observed MCI with standard MCI has
profiling. Because of the resistant nature of dental tissues to
also been utilized for predicting sex of an individual. Ac-
cording to Rao et al. [11], if the calculated Mandibular Ca- environmental assaults, such as incineration, immersion,
trauma, mutilation and decomposition, teeth represent an
nine Index (observed MCI) for the individual is higher than
excellent source of DNA material which aid in sex determi-
the Standard Mandibular Canine Index (MCIs) the individual
nation [19]. Teeth represent an excellent source of genomic
is considered to be male while if it is less than the standard
and mitochondrial DNA obtained by cryogenic grinding.
MCI, the subject is considered to be female. In our study we
Inspite of all these advance methods of sex determination,
obtained a standard MCI value as 0.246 with the help of
which the overall accuracy of predictive value was found to the other ancilliary methods like cheiloscopy, palatoscopy
and odontometry also gives reliable results in the face of
be 61.6% in males and 33.3% in females.
being cost effective and easy to perform on the living as well
as deceased [20].
DISCUSSION Lip prints bring added evidence to a crime scene that can
The positive identification of the living or deceased indi- be valuable, especially in cases lacking other evidence like
vidual is using various dental and skeletal traits owing to fingerprints, although the credibility of lip prints is still not
their unique features with variations and stability against established in the court system. The study of lip prints is
external factors remains to be the important sources of known as cheiloscopy. Cheiloscopy (from the Greek words
Cheiloscopy, Palatoscopy and Odontometrics in Sex Prediction The Open Dentistry Journal, 2014, Volume 8 277

cheilos meaning “lips” and eskopein meaning “to see”) is the the overlay prints of palatal rugae in a maxillary cast, stere-
name given to the lip-print studies. Like fingerprints and oscopy method giving three dimensional image of palatal
palatal rugae, the lip grooves are permanent and unchange- rugae anatomy. However, due to its simplicity, price and
able. It is possible to identify the lip print patterns as early as reliability, the study of maxillary dental casts is the most
the sixth week in intrauterine life. From that moment on, the used technique. From our study we could establish that rugae
lip groove patterns rarely change, resisting many afflictions patterns showed distinctive patterns but no specific charac-
and hence lip prints aid as a tool in human identification [21, teristic pattern was observed in either sex with much signifi-
22]. cant difference. However palatal rugae still holds a unique
feature of an individual aiding in the forensic dentistry. Its
Lip prints can be obtained at the crime scene from cloth-
importance can be validated on the large sample of popula-
ing, cups, glasses, cigarettes, windows and doors [22]. Even
the invisible lip prints can be used and can be lifted using tion.
aluminum and magnetic powder similar to finger prints. Lip Apart from skeletal domain, dental hard tissue domain
prints are invariable, permanent and allow establishing a involving odontometric analysis of the teeth also helps in
classification. Lip print analysis in our study by both the identification of sex. The study of teeth holds importance in
observers showed the distinct patterns from each other where anthropological, archaeological, odontological, genetic, fo-
no two patterns were identical in compliance with other stud- rensic investigations.
ies conducted by Tsuchihashi and Suzuki [9] and also other
Canines differ from other teeth with respect to survival
authors [23-25]. The biological phenomenon of systems of
and sex dichotomy and are supported by their high level of
furrows on the red part of human lips was first noted by an-
survival in the dentition. The mandibular canines are not
thropologists, R. Fischer who was the first to describe it in
only exposed to less plaque, calculus, abrasion from brush-
1902 [23]. Use of lip prints in personal identification and
ing, or heavy occlusal loading than other teeth, they are also
criminalization was first recommended in France by Edmond less severely affected by periodontal disease and so, usually
Locard [23]. Some researchers are trying to relate character-
are the last teeth to be extracted with respect to age. These
istic lip patterns with person’s gender, and detected DNA in
findings indicate that mandibular canines can be considered
latent lip prints [25]. We found type I’ pattern to be domi-
as the “key teeth” for personal identification [38].
nant in females and type III in males consistent with other
studies [26-28]. However, Dongarwar et al. [29] in their Mandibular canines are found to exhibit the greatest
study found type IV and type V patterns to be dominant in males sexual dimorphism among all teeth [9]. The notable differ-
and type I and type I’ patterns to be dominant in females with slight ence between canine in determining sex was noted to be due
deviation from our study. to the influence of the Y chromosome which was not uni-
form in all teeth. On the other hand, the X
linked genetic
Palatoscopy or palatal rugoscopy is the name given to
influence on tooth width was rather uniform for all teeth
the study of palatal rugae in order to establish a person’s
[11].
identity. Palatal rugoscopy was first proposed in 1932, by a
Spanish investigator called Trobo Hermosa. Palatal rugae are Sexual Dimorphism refers to differences in size, stature
irregular, asymmetric ridges of mucous membrane extending and appearance between male and female [39]. In the field of
from the incisive papilla laterally and the anterior part of the forensic odontology, permanent canine teeth and their arch
median palatal raphe [30]. width (distance between the canine tips) have been reported
Palatal rugae are formed in the 3rd month in utero from to show sexual dimorphism [40]. Sex determination using
the hard connective tissue covering the bone. The occur- dental characteristics is based on the comparison of tooth
rence, number and arrangement of palatal rugae in mammals size between male and female [41] or the frequency of char-
are species-specific. In humans they are asymmetrical, which acteristic evolutionary morphological features, such as the
is an exclusive feature of human beings [31, 32]. As with presence of the cusp of Carabelli on the maxillary molars.
lips, inter-racial differences in palatoscopy can also be estab- The two most commonly used odontometric parameters in
lished [33]. However, to reach definitive conclusions, more determining a person’s sex based on dental measurements
studies should be carried out. The most predominant pattern are the mesiodistal and bucco-lingual crown diameter of the
in our study was wavy, followed by curved pattern, which permanent teeth [42]. The mesiodistal diameter of the maxil-
was in accordance with the other studies [34, 35]. The di- lary and mandibular canines provides evidence of sex deter-
verging pattern was equal in both the genders while the con- mination based on the existence of sexual dimorphism [43].
verging pattern was predominant in males whereas in the In our study we considered mandibular canines and eluci-
study by Divya et al. [36], diverging pattern was found to be dated the role of canine indices of right and left mandibular
dominant in females although the reliability and variability is canine in sex determination including the sexual dimorphism
needed to be evaluated on large sample size. The individual- in both the canines which showed statistically significant
ized pattern of palatal rugae and their low utilization costs results. We also attempted to compare the percentage accu-
make it a reliable guiding tool in forensic identification and racy of gender determination of our study with those done by
its clinical importance can be found in the field of dentistry. various authors (Table 8).
There are several ways to analyze palatal rugae. Intraoral It is concluded that the mesiodistal widths of mandibular
inspection is the common method and others include oral canines and inter-canine widths are significantly different in
photography and oral impressions [37]. Calcor rugoscopy or males and females, as are the mandibular canine indices.
278 The Open Dentistry Journal, 2014, Volume 8 Nagalaxmi et al.

Table 8. Comparing Percentage Accuracy of Gender Determination with Various Similar Studies.

Percentage Percentage
Total
Accuracy in Accuracy in
Author Region Percentage
Predicting Predicting
Accuracy
Males Females

Present study Telangana 73.3% 70% 71.7%

Geeta et al. [44] Telangana 80% 76.66% 78.3%

Acharya & Mainali [45] Karnataka 57.14% 44.44% 51.28%

Rao et al. [11] Karnataka 84.3% 87.5% 85.9%

Reddy et al. [14] Uttar Pradesh 78% 66% 72%

Dhara Parekh [46] Gujarat 50.5% 55.3% 52.4%

Ahmed [47] Iraq 32% 59% 45.5%

Kakkar et al. [48] Punjab 53.54% 55.03% 54.44%

Narang S et al. [38] Punjab 68% 67.6% 67.8%

The right mandibular canine was found to be more dimor- canine teeth in gender determination as an easy, reproducible
phic than left mandibular canine. The parameters measured and objective method.
in the present study will be of immense help in identification
of sex in forensic investigations.
CONCLUSION
Kaushal et al in their study on North Indian population
have concluded that the probability of sex determination Forensic identification of living or deceased though is a
using right MCI for males and females is 70% and 80% re- tedious job but is a comprehensive work involving the co-
spectively and that with left MCI for males and females has ordinated efforts of multidisciplinary team employing differ-
been 66.67% and 83.33% respectively. This is in contrast to ent techniques in the face of which it also involves various
our findings which showed73.3% in males and 70.0% in other accessory methods like cheiloscopy, palatoscopy,
females using MCI of right side and 66.7% males and 56.7% odontometry which are unique and show individual varia-
females using MCI of left side [15]. tions. Although there are many research studies on the above
three methods, the study comparing the three methods to-
Further, the probability of correct prediction of sex using
gether with respect to reliability in sex discrimination is
MCI is higher for males in our study which was in agree-
ment with the study conducted by Fouad Ayoub et al. [44- minimal. Our attempt of conducting this study gave a com-
49] on Lebanese population showed the probability of male paratively reliable significance of each method albeit large
sex determination to an extent as high as 95% having the scale study is required in order to validate or substantiate our
width of either canine greater than 7.104mm in its dimen- results to arrive at a definitive results and values. However
sions We have noted an overall higher percentage of accu- the present study proves that the lip prints, rugae patterns
racy for sex prediction from right side MCI as compared to and odontometric measurements have the potential in human
left side. It is also concluded that a canine width greater than identification where lip prints are more reliable in gender
7.3 mm is 100% suggestive of males. determination when compared to palatal rugae with the man-
dibular canine odontometrics also sharing an equal role in
From the findings of this study and those done on other meeting the objective of this study on par with them. Hence
populations, the mandibular canine width and inter-canine all the above three methods of sex identification holds im-
distance have indeed proven beyond doubt high degree of portance as an ancilliary and supplemental tools of forensic
sexual dimorphism, hence can be used as a useful material in investigations.
forensic identification as an adjunct tool along with other
procedures for the determination of sex in cases of highly
mutilated and damaged bodies where jaws are at hand. CONFLICT OF INTEREST
Variations in the intensity of sexual dimorphism and per-
centage accuracy of sex determination in different studies The authors confirm that this article content has no con-
and different populations may be explained by genetics, the flicts of interest.
influence of environmental factors, different eating habits
and the complex coordinated action of environmental factors ACKNOWLEDGEMENTS
and biological influences [50]. Thus these findings support
the usefulness of employing odontometric analysis of the Declared none.
Cheiloscopy, Palatoscopy and Odontometrics in Sex Prediction The Open Dentistry Journal, 2014, Volume 8 279

REFERENCES [27] Sharma P, Saxena S, Rathod V. Comparative reliability of cheilo-

scopy and palatoscopy in human identification. Ind J Dent Res
[1] Caldas IM, Magalhaes T, Afonso A. Establishing identity using 2009; 20: 453-7.
cheiloscopy and palatoscopy. Forensic Sci Int 2007; 165: 1-9. [28] Harpreet S, Pankaj C, Rituha. Lip prints as evidence. J Punjab
[2] Lampe H, Roetzscher K. Forensic Odontology: age determination Acad Forensic Med Toxicol 2011; 11: 23-5.
from adult human teeth. Med Law 1994; 13(7-8): 623-8. [29] Dongarwar GR, Bhowate RR, Degwekar SS. Cheiloscopy-Method
[3] Segui MA, Feucht MM, Ponce AC, Pascual F. Persistent lipsticks of person identification and sex determination. OA Sci Rep 2013;
and their lip prints: New hidden evidence at the crime scene. Fo- 2(1): 1-4.
rensic Sci Int 2000; 112: 41-7. [30] Rai B, Anand SC. Palatal rugae: In forensic examination. Ind Int J
[4] Sivapathasundharam B, Prakash PA, Sivakumar G. Cheiloscopy. Forensic Med Toxicol 2007; 5: 14-6.
Indian J Dent Res 2001; 12: 234-7. [31] Gondivkar SM, Patel S, Gadbail AR, Gaikwad RN, Chole R,
[5] Prabhu RV, Dinkar AD, Prabhu VD, Rao PK. Cheiloscopy: Revis- Parikh RV. Morphological study of the palatal rugae in westernIn-
ited. J Forensic Dent Sci 2012; 4:47
52. dian population. J Forensic Leg Med 2011; 18: 310-12.
[6] Saraf A, Bedia S, Indurkar A, Degwekar S, Bhowate R. Rugae [32] Venegas VH, Valenzuela JS, López MC, Galdames IC. Palatal
patterns as an adjunct to sex differentiation in forensic identifica- rugae: Systematic analysis of its shape and dimensions for use in
tion. J Forensic Odontostomatol 2011; 29:14
9. humanidentification. Int J Morphol 2009; 27: 819-25.
[7] Bakkannavar SM, Monteiro FNP, Arun M, Kumar GP. Mesiodistal [33] Bharath ST. Sex determination by discriminant function analysis of
width of canines: a tool for sex determination. Med Sci Law 2012; palatal rugae from a population of coastal Andhra. J Forensic Dent
52(1): 22-6. Sci 2011; 3: 58-62.
[8] Kapila R, Nagesh KS, Iyengar RA, and Mehkri S. Sexual dimor- [34] Byatnal A, Byatnal A, Kiran AR, Samata Y, Guruprasad Y, Telagi
phism in human mandibular canines: a radiomorphometric study in N. Palatoscopy: An adjunct to forensic odontology: A comparative
South Indian population. J Dental Res Dental Clin Dental Prospects study among five different populations of India. J Nat Sci Biol Med
2011; 5(2): 51-4. 2014; 5(1): 52-5.
[9] Tsuchihashi Y. Studies on personal identification by means of lip [35] Nayak P, Acharya AB, Padmini AT, Kaveri H. Diff erences in the
prints. Forensic Sci 1974; 3: 233-48. palatal rugae shape in two populations of India. Arch Oral Biol
[10] Lysell L. Plicae palatinae transversae and papilla incisive in man: 2007; 52: 977-82.
A morphologic and genetic study. Acta Odont Scand 1955; 13: 1- [36] Shetty D, Juneja A, Jain A, et al. Assessment of palatal rugae pat-
137. tern and their reproducibility for application in forensic analysis. J
[11] Rao NG, Rao NN, Pai ML, Kotian MS. Mandibular canine index - Forensic Dental Sci 2013; 5(2): 106-9.
A clue for establishing sex identity. Forensic Sci Int 1989; 42: 249- [37] Bansode SC, Kulkarni MM. Importance of palatal rugae in individ-
54. ual identification. J Forensic Dent Sci 2009; 1: 77
81.
[12] Garn SM, Lewis AB. Bucco-Lingual size asymmetry and its devel- [38] Narang RS, Manchanda AS, Malhotra R, Bhatia HS. Sex determi-
opmental meaning. Angle Orthod 1967; 37(1): 186-93. nation by mandibular canine index and molar odontometrics: A
[13] Kaushal S, Patnaik VVG, Agnihotri G. Mandibular Canines in sex comparative study. Ind J Oral Sci 2014; 5(1): 16-20.
determination. J Anat Soc India 2003; 52 (2): 119-24. [39] Ghose LJ, Baghdady VS. Analysis of the Iraqi dentition: mesiodis-
[14] Reddy MV., Saxena S, Bansal P. Mandibular canine index as a sex tal crown diameters of permanent teeth. J Dent Res 1979; 58: 1047-
determinant: a study on the population of Western Uttar Pradesh. J 54.
Oral Maxillofac Pathol 2008; 12 (2): 56-9. [40] Garn SM, Lewis AB, Kerewsky RS. The relationship between
[15] Kaushal S, Patnaik VVG, Sood V, Agnihotri G. Sex determination sexual dimorphism in tooth size and body size as studied within
in North Indians using Mandibular canine index. J Indian Acad For families. Arch Oral Biol 1967; 12: 299-301.
Med 2004; 26(2): 45-9. [41] Vodanovic M, Demo Y, Njemirovskij V, Keros J, Brkic H. Odon-
[16] Abdullah MA. A cross sectional study of canine tooth dimorphism tometrics: a useful method for sex determination in an archeologi-
in establishing sex identity: A comparison of two different popula- cal skeletal population? J Arch Sci 2007; 37: 905-13.
tions. Cairo Dental J 1998; 14(2): 191-6. [42] Iscan MY, Kedici SP. Sexual variation in buccolingual dimensions
[17] Jones DG. Odontology often is final piece to grim puzzle. J Calif in Turkish dentition. Forensic Sci Int 2003; 137: 160-4.
Dent Assoc 1998; 26: 650-1. [43] Mohammed QAR, Abdullah MA, Ashraf I, Khan N. Dimorphism
[18] Brannon RB, Kessler HP. Problems in mass disaster dental identi- of mandibular and maxillary canine teeth in establishing identity.
fication: a retrospective review. J Forensic Sci 1999; 44: 123-7. SDJ 1997; 9: 17-20.
[19] Schwartz TR, Schwartz EA, Mieszerski L, McNally L, Kobilinsky [44] Paramkusam G, Nadendla LK, Devulapalli RV, Pokala A. Mor-
L. Characterization of deoxyribonucleic acid (DNA) obtained from phometric analysis of canine in gender determination: Revisited in
teeth subjected to various environmental conditions. J Forensic Sci India. Ind J Dental Res 2014; 25(4): 425-9.
1991; 36: 979-90. [45] Acharya AB, Mainali S. Limitations of the mandibular canine
[20] Indira AP, Gupta M, David MP. Palatal rugae patterns for estab- index in sex assessment. J Forensic Leg Med 2009; 16: 67
9.
lishing Individuality. J Forensic Dental Sci 2012; 4 (1): 2-5. [46] Parekh D, Zalawadia A, Ruparelia S, Patel S, Rathod SP, Patel SV.
[21] Gupta S, Gupta K, Gupta OP. A study of morphological patterns of Study of Mandibular Canine Teeth Dimorphism In Establishing
lip prints in relation to gender of North Indian population. J Oral- Sex Identity In Gujarat Region. Nat J Integr Res Med 2011; 2(2):
Biol Craniofac Res 2011; 1: 12-6. 6-9.
[22] Saraswathi TR, Mishra G, Raganthan K. Study of lip prints. J Fo- [47] Ali Ahmed HM. Genders identification using mandibular canines
rensic Dent Sci 2009; 1: 28-31. (Iraqi study). J Bagh Coll Dentistry 2014; 26(1): 150-3.
[23] Naik KS, Prabhu A, Nargund R. Forensic odontology: cheiloscopy. [48] Kakkar T, Sandhu JS, Sandhu SV, Sekhon AK, Singla K, Bector K.
Hong Kong Dent J 2011; 8: 25-28. Study of mandibular canine index as a sex predictor in a Punjabi
[24] Vahanwala SP, Parekh BK. Study of lip prints as an aid to forensic population. Ind J Oral Sci 2013; 4(1): 23-6.
methodology. J Ind Dent Assoc 2000; 71: 16-19. [49] Ayoub F, Shamseddine L, Rifai M, Cassia A, Diab R, Zaarour I.
[25] Castello A, Alvarez M, Verdu F. Just lip prints? No: there could be Mandibular Canine Dimorphism in Establishing Sex Identity in the
something else. FASEB J 2004; 18(6): 615-6. Lebanese Population. Int J Dentistry 2014; 1: 1-4.
[26] Rohit M, Sumit G. Cheiloscopy: A Deterministic Aid for Forensic [50] Reddy LVK. Lip prints: An overview in Forensic Dentistry. J Adv
Sex Determination. J Ind Acad Oral Med Radiol 2011; 23: 17-9. Dent Res 2011; 2: 17-20.

Received: November 04, 2014 Revised: November 22, 2014 Accepted: November 24., 2014
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