‌Research dynamics in the applicability of radiological mandibular parameters for forensic sex and age estimation: A systematic review

Abstract

IntroductionThe mandible is the largest and strongest bone of the human facial skeleton. The absence of any overlying bony structure makes it suitable for radiological imaging in both living as well as deceased or skeletonized individuals. In this systematic review we aim to aid forensic practitioners in making informed decisions about the techniques and parameters involving the human mandible to ensure high quality and credibility of forensic analyses needed for medico-legal as well as humanitarian purposes. Aim Our review investigates the research dynamics and utility of radiological mandibular dimensions for forensic sex and age estimation. Methodology Out of 175 articles obtained from scientific databases including PubMed, Google Scholar, Web of Science and Scopus, 55 full-text articles were found eligible for this systematic review. The articles were extracted systematically considering the authorship, year of publication, country, population studied, the mandibular parameters and radiological modality used, sample size, and age thresholds of the subjects. Results and DiscussionThe maximum number of studies (60%) used radiological mandibular dimensions for sex estimation and 38% researchers estimated both sex and age from these parameters. 69.1% (n=38) articles used panoramic radiographs, 21.8% (n=12) articles utilized cone beam computed tomography/computed tomography scans and only four articles used cephalometric scans for sex and/or age estimations. Orthopantograms (OPGs) were found to be the more commonly used imaging modality in clinical practice. The majority of studies reported mandibular ramus height as the most reliable parameter for sex and age estimation. Fewer than half of the studies reported accuracy percentages of their estimations; around 70% of them reported accuracies below the acceptable forensic thresholds, thus clearly indicating that sex and age estimation should not be performed based on mandibular measurements only. ConclusionThis systematic review is expected to inform future forensic anthropologists that only mandibular morphometry should not be attempted for human identification in medico-legal contexts.