Coronoid Height Research Articles

Linear measurements of the mandible on panoramic radiograph for sex estimation in populations in Yogyakarta, Indonesia

BackgroundIdentification is one of the main aspects of forensics. Sex estimation is an essential part of identification because it can simplify the whole process. Mandible is the largest, strongest, and sexually dimorphic bone and is part of the orofacial structure, which has the second highest level of dimorphism after the pelvic bone. Sex estimation using the mandible can be performed by conducting various linear measurements on a panoramic radiograph, including right minimum ramus width (RMiRW), left minimum ramus width (LMiRW), right projective height of ramus (RPHR), left projective height of ramus (LPHR), right maximum ramus width (RMxRW), left maximum ramus width (LMxRW), right coronoid height (RCH), left coronoid height (LCH), symphysis height (SH), right mandibular corpus height (RMCH), and left mandibular corpus height (LMCH). This study aimed to analyze how linear measurements in panoramic radiographs differ between men and women and to estimate sex by utilizing these parameters.ResultsIn this study, 195 panoramic radiographs from 95 men and 100 women aged 20–40 years obtained from our dental hospital were used as a training data. Meanwhile, 61 panoramic radiographs from 29 men and 32 women outside the training data with same characteristics were used as the testing data. The linear measurements of the mandible using panoramic radiographs were taken with EzDent-i Vatech software. Independent t-test showed significant difference (p < 0.05) in some linear measurements of the mandible between adult men and women. These significantly different linear measurements were then subjected to discriminant function analysis to produce sex estimation equations. The equation accuracy percentage ranged between 63.6 and 94.4% for the training sample and 59.5% and 85% for the testing sample.ConclusionThe linear measurements of the mandible using diagnostically acceptable panoramic radiographs taken from a patient with standardized head positioning can serve as an alternative method for sex estimation. The accuracy of discriminant analysis for sex estimation varies depending on the parameter used in the estimation.

Biometric analysis of the cranial features of common voles

Although cranial bones reliably identify the features of mammals, these traits can be affected by sex, population size and seasonality. This paper biometrically analyses the cranial features of the common vole. The research sample consisted of adult (n = 134), subadult (n = 57), of western Slovakia. Overall, software based on the highlighted marks measured 29 cranial features. Significant sexual dimorphism was observed for three features in adult individuals (width of the maxillary tooth row – right side “WMTRR”, maximum height of the mandibula excluding coronoid process “AMdm” and coronoid height of the mandibula “AMd”) and four features in subadults (length of the tooth row in the maxilla “LOSD”, “WMTRR”, length of the molar “LoM” and alveolar length of the lower molars “ALLM”). Results showed a significant positive relationship between body weight and cranial size in 18 of the 29 features. They also suggested a weak but significant positive effect of common vole abundance on cranium size (Chitty effect) likewise in 6 of the 29 features. In several cases, this effect affects, in addition to the abundance, the onset of sexual maturity of individuals.

Coronoid height index: a reliable and reproducible technique for quantifying coronoid bone loss in elbow instability

Coronoid height index: a reliable and reproducible technique for quantifying coronoid bone loss in elbow instability

Increasing Severity of Radial Longitudinal Deficiency Correlates With the Degree of Proximal Ulnar Hypoplasia

Classification systems and treatment for children with radial longitudinal deficiency are classically focused on the hand and wrist. However, the elbow can affect the function of these patients secondary to stiffness or instability. The objective of this study was to determine if a correlation exists between severity of radial longitudinal deficiency (RLD) and degree of proximal ulnar hypoplasia. A single-institution retrospective review was performed at a pediatric hospital. One hundred elbows were identified in 72 patients who met the inclusion criteria. Measurements such as the coronoid height, olecranon coronoid angle (OCA), and the anterior coverage index were obtained from lateral radiographs of children with RLD. Ten elbows had posterior subluxation of the ulnohumeral joint radiographically. Eleven patients had thrombocytopenia absent radius (TAR) syndrome. There was a significant mean difference for OCA between RLD types. Type 4 RLD (mean [M]=17.9; standard deviation [SD]= 11.3) had a significantly lower OCA than type 0 (M=26.4; SD= 5.9) and type 1 (M= 31.0; SD= 5.0). A subanalysis of the 58 elbows with type 4 RLD demonstrated that those with TAR (n= 11) had significantly higher anterior coverage index total scores (M = 1.7; SD= 0.3) than those with type 4 without TAR (M = 1.5; SD= 0.2). The degree of proximal ulnar hypoplasia is correlated with increasing severity of RLD, with significantly lower OCA and coronoid height observed in the elbow radiographs of patients with type 4 RLD compared with type 0 and type 1. Children with TAR have less proximal ulnar dysplasia and higher anterior coverage index than children with type 4 RLD without associated TAR. Prognostic IV.

Evaluation of Sexual Dimorphism Using Condylar and Coronoid Mandibular Parameters in Orthopantomograms: A Pilot Study.

Background Gender determination is critical to forensic science and medico-legal applications. Given that it is the most dimorphic bone in the skull and is frequently found intact, the mandibular bone may be extremely important in determining gender. Orthopantomograms (OPGs) are quite helpful in accurately estimating age and sex in this regard. It is a laborious task for forensics to determine the gender of victims of mass casualties, natural disasters, and severely dismembered bodies. The mandible, which is susceptible to development spurts, has a high degree of accuracy for determining sex. Aim This study aims to evaluate the potential use of coronoid height and condylar height as reliable anatomical markers for determining gender. Materials and methods In this study, 100 samples were used as study samples, 50 of which were male and 50 of which were female, in the age group of 20-30 years. The OPGs were obtained using a Planmeca Promax Scara 3 Digital OPG Machine (Planmeca, Helsinki, Finland), with settings of 70 kVp, 8 mA for 0.9 seconds, ensuring a 1:1 ratio. The images were then transferred to Planmeca Romexis® Viewer Software, Version 6.0 (Planmeca Oy, Helsinki, Finland) for measurement recording. Results Descriptive statistical analysis was done for this study and discriminant analysis was also done to create a population-specific formula. Results showed that the standard mean error for males concerning condylar height was 2.3 and coronoid height was 0.7. The standard mean error for females by condylar height was 1.6 and coronoid height was 0.6. The p-value was significant for coronoid height in both males and females. The p-value was not clinically significant for condylar height in both males and females. Conclusion The study's findings indicate that a larger mandibular angle is advantageous for gender assessment and helps with gender dimorphism. Out of both the parameters evaluated, coronoid height has shown statistical significance in both males and females. Hence, the study concludes that the parameter, coronoid height can be utilized to assess the gender of an individual.

Biomechanical evaluation of the modified lasso technique

BackgroundThe Terrible Triad of the elbow is a constellation of elbow dislocation, radial head fracture and coronoid process fracture. A common type of coronoid fracture documented with this triad is type II Regan-Morrey coronoid fractures. The preferred fixation method for this fracture type is the lasso technique, medial-lateral tunnel orientation being the traditional approach. Considering elbow anatomy, we saw an opportunity to potentially improve fixation by altering the suture lasso tunnel orientation to a proximal-distal orientation. HypothesisTwo tunnels in the proximal-distal direction would result in greater biomechanical stability as compared to the traditional lasso technique. Material and methodsA type 2 Regan-Morrey fracture was created in 12 fresh frozen cadaveric elbows at 50% of the coronoid height using an oscillating saw. The humero-ulnar joint was placed in 0 degrees flexion then loaded at a rate of 10mm/min to failure. ResultsThe control technique (medio-lateral tunnels) showed failure load of 150±81N that was not significantly different (p=0.825) than the 134±116N measured for the modified technique (distal-proximal tunnels). The portion of the load-displacement curve used to calculate stiffness was linear (R^2=0.94±0.04) with determination coefficients that did not differ between the two groups (p=0.351). For stiffness, we measured 17±13N/mm and 14±12N/mm respectively for control and modified techniques that did not result in a significant difference (p=0.674). ConclusionIn this attempt to improve the shortcomings of the lasso technique, we found that changing from medio-lateral to proximal-distal drilling directions did not result in an appreciable biomechanical benefit. Level of evidenceBasic science study; Biomechanics.

Comparison of mandibular morphometric parameters in digital panoramic radiography in gender determination using machine learning.

This study aimed to evaluate the usability of morphometric features obtained from mandibular panoramic radiographs in gender determination using machine learning algorithms. High-resolution radiographs of 200 patients aged 20-77 (41.0 ± 12.7) were included in the study. Twelve different morphometric measurements were extracted from each digital panoramic radiography included in the study. These measurements were used as features in the machine learning phase in which six different machine learning algorithms were used (k-nearest neighbor, decision trees, support vector machines, naive Bayes, linear discrimination analysis, and neural networks). To evaluate the reliability, we have performed tenfold cross-validation and we repeated this 10 times for every classification process. This process enhances the reliability of the results for other datasets. When all 12 features are used together, the accuracy rate is found to be 82.6 ± 0.5%. The classification accuracies are also compared using each feature alone. Three features that give the highest accuracy are coronoid height (80.9 ± 0.9%), condyle height (78.2 ± 0.5%), and ramus height (77.2 ± 0.4%), respectively. When compared to the classification algorithms, the highest accuracy was obtained with the naive Bayes algorithm with a rate of 84.0 ± 0.4%. Machine learning techniques can accurately determine gender by analyzing mandibular morphometric structures from digital panoramic radiographs. The most precise results are achieved by evaluating the structures in combination, using attributes obtained from applying the MRMR algorithm to all features.

Gender Determination by Radiographic Evaluation of Condylar Length, Coronoid Height and Gonial Angle

Introduction: Forensic dentistry plays an important role in the identification of the gender of an individual in situations like natural disasters (eg. earthquakes, floods, etc.) or man-made disasters (such as accidents and bombings). Among all the bones in the human body, the pelvis and the skull show the maximum sexual dimorphism. But in cases where an intact skull is not found, the mandible becomes our first choice for gender determination, as it is covered with dense, compact bone, which makes it very durable and well-preserved. Aims and Objectives: To determine the effectiveness of condylar height, coronoid height and gonial angle of the mandible for sex determination using orthopantomography and to compare and determine the most reliable parameter for gender determination. Materials and Method: This study was conducted using digital panoramic images of 25 patients of each gender. The images captured were viewed on AutoCAD 2014 software and were subjected to measurements of the condylar, coronoid heights and gonial angles both on the left and right side using AutoCAD 2014 imaging software. The data was entered into a Microsoft Excel sheet and statistical analysis was done. Results: The Student t-test showed significant (P &lt; 0.05) differences and higher values for both condylar height and coronoid height on both the right and left sides of males as compared to females. However, the difference in the mean gonial angle on both the right and left sides did not differ (P &gt; 0.05) between the two genders. All three variables were higher in males as compared to females. Conclusion: The parameters such as condylar height, coronoid height and gonial angle using orthopantomographs are reliable in gender determination and the condylar height of the left side is the best parameter in gender determination.

Morphometric Analysis of Mandible for Gender determination in adult patients: A Cone Beam Computed Tomography Study

Context: Gender determination is an important component of personal identification. Aims: Assessment of gender using mandible with Cone Beam Computed Tomography (CBCT). Settings and Design: This cross-sectional prospective study was conducted on dental outpatients in the department of Oral Medicine and Radiology. Methods and Material: 148 dental outpatients were selected and subjected to CBCT. Mandibular landmarks such as gonial angle, alveolar ridge to mental foramen distance, mental foramen to the inferior border of mandible distance, mandibular canal to the most anterior tangent point of buccal and lingual mandibular plate distance, mandibular canal border to the lowest tangent point on the inferior border of the mandible, coronoid height, bigonial breadth, minimal ramus breadth and ramus length were assessed on CBCT scan. Statistical Analysis Used: Data was represented as mean and Standard Deviation (SD). Parameters were compared between males and females using Kruskal-Wallis and Student’s independent T-test. A value below 0.05 represented significant results. Results: All parameters except gonial were significantly higher in males as compared to females angle (P&lt; 0.05). The distance from the lowest point of the mandibular canal to the most posterior tangent point of the Mandibular Lingual Plate (MCLM) and bigonial breadth was higher in males than females but the difference was non-significant (P&gt;0.05). The accuracy of CBCT was found to be 89.7% in males and 88.5% in females. Conclusions: Gender determination by morphometric analysis of the mandible using cone beam computed tomography is an effective method and provides higher accuracy as compared to two-dimensional conventional radiographs.

Morphological and Morphometric study of Mandible using Orthopantogram (OPG) in central Indian Population

Introduction: The mandible is the biggest bone responsible for holding the lower teeth in place, assisting in mastication, and forming the lower jawline. The mandible is made up of two parts: the body and the ramus, and it is placed below the maxilla. The lower jawline is formed by a horizontally curved section of the body. The rami are two vertical processes that link the body at the angle of the mandible on either side of the body. Material and Methods: This study was carried out on 150 digital orthopantogram (OPG’S). A total number of patient’s time of life selected between ranges of 20-60 years of age group. The sample was of 150 subjects. Data was collected from college who will come for OPD. Socio-demography, physical findings on examination during admission. Details of patient, parity, age and gender would be recorded. Results: Mandibular ramus of male Mean (mm)±SD of Minimum ramus breadth was 29.26±3.01 followed by Maximum ramus breadth 34.30±3.31, Maximum ramus height 75.24±5.62, Projective ramus height 69.25±5.54 and Coronoid height 62.49±5.60. Mandibular ramus of female Mean (mm)±SD of Minimum ramus breadth was 27.62±3.62 followed by Maximum ramus breadth 32.36±3.37, Maximum ramus height 70.33±5.34, Projective ramus height 64.20±5.76 and Coronoid height 58.19±5.74. Each of the five variables measured on mandibular ramus using orthopantomograph showed statistically significant gender differences, indicating that ramus expresses strong gender dimorphism. Conclusion: The present study has suggested that the accuracy of gender determination using mandibular measurements of the Indian population can be improved by deriving a discriminant function, which utilizes a combination of the six respective dimensions. Our study showed that minimum ramus breadth and maximum ramus breadth are most accurate in predicting gender on OPG while projective height was least reliable. Orthopantomogram is a reliable and accurate tool to record the various measurements in order to determine the gender of the given mandible.

Can body mass and skull morphology predict seed and fruit ingestion potential for mammal species? A test using extant species and its application to extinct species

Abstract Larger animals are assumed to ingest larger seeds and consume larger fruits, but empirical studies reveal inconsistent trends between body mass and the average size of fruits and seeds ingested. Furthermore, no studies have explored seed size relationships with morphological traits, such as skull dimensions. Such characteristics might provide more reliable estimates of ingestion ability and allow for accurate predictions of seed dispersal capacity in species for which we lack empirical data, especially extinct species. To determine whether (i) mammalian skull dimensions are better predictors of the maximum size of ingested seeds and fruits, compared to body mass and (ii) body mass are the better predictors of mean fruit and seed sizes, we studied these relationships across three mammalian orders: Chiroptera, Primates and Carnivora. We collected novel data on skull dimensions and collated available data on body mass and maximum and mean sizes of ingested fruits and seeds for mammals (N = 100) across the Neotropics, Asia, Africa and Madagascar. We explored the relationships between anatomical traits and fruit and seed sizes of extant species and made predictions for five extinct species. Our results revealed that body mass and skull dimensions are essential determinants of ingested fruit and seed size in mammals. The latter traits can generate predictions for extinct species, especially coronoid height and maximum jaw gape. Nevertheless, body mass predicted larger ingested fruits and seeds than skull dimensions and explained a greater part of the variance for both maximum and mean sizes in our dataset. Our results show how body mass and cranial anatomy constrain seed size and reinforce the importance of maintaining functional diversity in seed dispersers to maintain tropical forest structure. We also show that scientists can use morphological characteristics to predict the seed dispersal potential of extinct mammals allowing better inferences on past and future consequences of frugivore extinctions within tropical forests. Read the free Plain Language Summary for this article on the Journal blog.

Forensic Gender Determination by Using Mandibular Morphometric Indices an Iranian Population: A Panoramic Radiographic Cross-Sectional Study.

Gender determination is the first step in forensic identification, followed by age and height determination, which are both affected by gender. This study assessed the accuracy of gender estimation using mandibular morphometric indices on panoramic radiographs of an Iranian population. This retrospective study evaluated 290 panoramic radiographs (145 males and 145 females). The maximum and minimum ramus width, coronoid height, condylar height, antegonial angle, antegonial depth, gonial angle, and the superior border of mental foramen were bilaterally measured as well as bicondylar and bigonial breadths using Scanora Lite. Correlation of parameters with gender was analyzed by univariate, multiple, and best models. All indices except for gonial angle were significantly different between males and females and can be used for gender determination according to univariate model. Condylar height, coronoid height, and superior border of mental foramen and ramus were still significantly greater in males than in females after controlling for the effect of confounders (p < 0.05). Based on the best model, a formula including five indices of bicondylar breadth, condylar height, coronoid height, minimum ramus width, and superior border of mental foramen was used for gender determination. Values higher than 56% indicate male gender, while lower values indicate female gender, with 81.38% specificity for correct detection of females and 88.97% sensitivity for correct detection of males. Despite the satisfactory results, future research should focus on larger populations to verify the accuracy of the present findings.

A Comparative Analysis of Mandibular Ramus and Maxillary Sinus in Sex Determination among the Population of West Godavari, India: A Tool in Forensic Identification

Introduction: The application of dental principles to legal issues is known as forensic dentistry. Among the skull’s various bones, mandible is the strongest and most diverse bone and is crucial in determining sex. It is been reported in many studies that maxillary sinus seems to be intact, although other bones may be severely deformed and can be applied to determine sex. Aim: To assess, analyse and compare the morphometric analysis of maxillary sinus and ramus of mandible for gender determination using digital Orthopantamograph (OPG). Materials and Methods: A cross-sectional study comprising of 64 individual radiographs (32 men and 32 women) were measured for mandibular ramus (maximum ramus width, condylar and coronoid height) and maxillary sinus length, width and compared bilaterally. The results were tabulated and statistically analysed using discriminant functional analysis after the mean values were calculated. Results: In this study, the overall measurements of mandibular ramus were more in males than females whereas maxillary sinus measurements were more in females when compared with males. Condylar length (right and left), width of ramus (right) and width of maxillary sinus (left) were found to have statistical significance in determining the gender (p-value&lt;0.001,0.024,0.024). Length of the condyle showed highest accuracy of 73.8% in gender determination. Conclusion: This study suggests that the mandibular ramus and maxillary sinus measurements using OPG are helpful in dealing forensics, with condylar height being the most accurate indicator for gender determination.

Computed Tomographic Evaluation of Mandibular Ramus for Gender Identification

Background: The ability to identify sex is essential for identification and plays a significant role in forensic medicine and medico legal investigations. Identification's first purpose is sex determination, which is followed by estimations of age, size, and ethnic population, all of which are influenced by the gender. When identifying morphologic characteristics for gender determination, gender analysis and estimate are carried out with almost 90% to 100% accuracy using a whole skeleton. On the other hand, partial or fragmented bones and badly injured bodies, such as in the case of a mass tragedy, might be challenging to analyse. The skull is the second-best marker for gender identification after the pelvis. However, as the mandible is the biggest bone of the skull, it may be crucial in circumstances when a whole skull is not recovered for gender identification. Objectives: To ascertain how computed tomography can be utilised to know a person's gender with the help of mandibular measurements. Methods: The study was done with the Siemens Somatom 16 slice CT machine. Patients who match the inclusion criteria and have received CT for a wide range of reasons will be considered. Various measurements such as Condylar height, Maximum ramus breadth, Minimum ramus breadth projective height of ramus, Coronoid height shall be measured. Data analysis must be done with SPSS 20. For comparisons between the right and left sides, the student t-test shall be applied. Results: 58 individuals between the ages of 18 and 35 (29 females, mean age, 26.3, 29 males, men age, 26.9 &amp; overall mean for both sexes was 26.6 years). In the present study, mean score of five distinct mandibular parameters were calculated. All mandibular ramus variables on CT models were discovered to exhibit a statistically significant gender difference (p = 0.001). It was discovered that the mean condylar height was 64.5 mm in men and 59.56 mm in women, which was a significant (P = 0.001). It was noteworthy (P = 0.001) that whereas the mean maximal ramus width was 35.0 mm in females and 38.0 mm in men. Males and females had different mean values for the minimum ramus width, which were 31.3 mm and 28.8 mm, respectively (P = 0.001). Males and females had mean ramus projection height measurements of 52.38 mm and 47.91 mm, respectively. This difference was significant (P = 0.004). The mean coronoid height was 63.42 mm in men and 56.80 mm in women, which was significant (P = 0.001). 27 out of 29 female mandibular measures correctly identified the gender, with a prediction rate of 96.4%, and 27 out of 29 male mandibular measurements correctly identified the gender, with a prediction rate of 96.4%. The threshold for determining a per- son's sex. As a cut-off for predicting male sex, values over 62.8 mm for condylar height, 36.9 mm for maximum ramus height, 30.0 mm for lowest ramus height, 50.4 mm for projective ramus height, and 61.3 mm for coronoid height can be used. Conclusion: In forensic medicine, the assessment of mandible, particularly the ramus area, plays a crucial factor in determining gender. Future research should evaluate gender determination recommendations using various criteria in bigger sample sizes and across a range of age groups. Although there are differences in ramus measurements between both the genders, there are variations in measures between societies. Therefore, to accurately identify gender from skeletal remains, criteria that are unique to each population must be developed. We think the results of this study will be helpful to radiologists making diagnoses and surgeons working on the mandible and facial area. Keywords: Mandible, Determination of gender, Paranasal sinuses

Morphometric feature description of the proximal ulna based on quantitative measurement: a key consideration for implant design.

To perform quantitative measurements of the anatomic morphology of the proximal ulna and establish the morphologic references based on Chinese for the surgical protocol and implant design. The computed tomography data of 156 upper extremities were involved in this study. The ulna model was reconstructed in Mimics. Ten distance and 6 angle parameters were measured by 4 independent investigators with a new quantitative measurement method. The intraclass correlation coefficient was used to evaluate the measuring reliability. Gender and side differences of measured parameters were evaluated. Measurements showed a mean coronoid height of 15mm, which was 42% of ulnar height with gender-specific differences (mean 16mm in men and 14mm in women, P < 0.001). A mean unsupported anteromedial facet width of 8mm was 61% of the coronoid anteromedial facet. A larger opening angle correlates to a larger olecranon-diaphysis angle (P < 0.001) and larger coronoid height (P = 0.001). A mean proximal ulna dorsal angulation of 4.7° is present in 80% of models at an average of 52mm distal to olecranon tip. The average proximal ulna varus angulation was 16° at a mean of 74mm distal to the olecranon tip. Morphological features between the left and right sides were highly consistent. The ICC was between 0.789 and 0.978 for inter-observer and between 0.696 and 0.997 for intra-observer reliability. The proximal ulna features variable morphology but minor side differences among individuals. Over half of the anteromedial facet was not supported by the proximal ulnar diaphysis, making the coronoid vulnerable to elbow trauma. Preconditioning or customized design of the ulnar plate in the clinical setting with the help of contralateral morphology may be a good choice.

Detection and diagnosis of cleidocranial dysplasia by panoramic radiography: a retrospective study

BackgroundCleidocranial dysplasia (CCD) is a rare and underdiagnosed congenital disorder in dentistry. The purpose of this study was to illustrate and quantify the maxillofacial bone abnormalities detected on panoramic radiographs from a relatively large retrospective case series and to provide a series of diagnostic references for dentists to indicate the presence of disease and help in making an early and accurate diagnosis.MethodsThe dental panoramic radiographs of thirty CCD patients aged 11 to 45 years (18 males and 12 females) were examined retrospectively. The dentition states, including supernumerary teeth and impacted teeth, were recorded. Twelve quantified measurements were adopted to determine the abnormalities of maxillofacial bones, including the degree of the zygomatic arch downward bend, bicondylar breadth, ramal height, mandibular height, mandibular aspect ratio, mandibular body height, condylar height, coronoid height, distance between the coronoid process and the condyle, bigonial width, gonial angle and best-fit gonial circle diameter. The Wilcoxon rank-sum test was used to compare the findings of the CCD patients with those of their matched controls (n = 300).ResultsSupernumerary teeth were detected in 27 patients (90.0%), and all 30 patients presented impacted teeth. Compared to the matched controls, the CCD patients had a significantly larger degree of zygomatic arch downward bend (ZAD), a larger diameter of the best-fit gonial circle (BGC), and a shorter distance between the coronoid process and the condyle (DCC) in panoramic radiographs (P < 0.001). According to the reference cutoff values established from the 5th or 95th percentile of the measurements in the control group, ZAD higher than 6.90 mm, DDC less than 22.37 mm and BGC higher than 52.41 mm were significantly associated with the CCD features identified. Other panoramic measurements were not significantly different between the two groups.ConclusionsPanoramic radiographs had great value in the diagnosis of CCD. In this study, we identified some dental and maxillofacial features on panoramic radiographs from a relatively large retrospective case series of CCD. A series of reliable quantitative indicators were provided for dentists that can indicate the presence of disease and improve the diagnostic specificity.

Mandibular Ramus: An Indicator of Gender and Chronological Age - A Digital Radiographic Study

Background: The determination of sex and age of individual is important in forensic practice and medico legal purposes. Mandible may play a vital role in sex estimation as it is the most dimorphic bone of skull that often is recovered intact. The present study was conducted to evaluate the reliability of mandibular measurements in gender determination and age estimation as seen on digital panoramic radiographs. Aims and Objectives: The aim of the study was to evaluate and compare seven parameters of the mandibular ramus obtained from digital orthopantomographs, and to assess the usefulness of these parameters as aids in gender and age estimation. The objectives were: 1. To assess:-Maximum ramus breadth in mm, Minimum ramus width in mm, Projective height of ramus in mm, Maximum height of the ramus in mm, Maximum coronoid height in mm, Gonial width in mm and Bigonial angle in degrees, 2. To correlate each of these seven variables with the age of the patient, and 3. To compare these seven parameters between males and females. Materials and Methods: OPGs of 500 patients satisfying inclusion and exclusion criteria selected from the Dept. of Oral Medicine and Radiology, Govt. Dental College, Kottayam, were being studied. Permission from the concerned departments was taken. The measurements were made on this radiograph using GIMP 2.8 Software. Results: All the parameters were found to show statistically significant difference between males and females. After performing logistic regression, an equation was formulated to determine gender from the parameters that were statistically significant in regression analysis. The cut off was set at 0.5. Values above the cut off value were interpreted as males and values below the cut off were interpreted as females. The overall accuracy of sex determination at this cut off value from this method was 73.9%. Significant correlation was not noted between the mandibular parameters and age of the individual. Conclusion: It can be concluded that the mandibular ramus can be considered as a valuable tool in gender estimation since it possesses resistance to damage and disintegration processes. Nevertheless, the age of the individual cannot be determined using this method.

Morphometric Analysis of Mandibular Ramus for Sex Determination on Orthopantomogram.

Mandible is the strongest and most dimorphic bone of skull which resists postmortem changes and plays an important role in sex determination. Skeletal characteristic differ in different population therefore need of population specific studies. The aim of present study was to determine sex by morphometric analysis of mandibular ramus. A cross sectionalstudy was performed in orthopantomogram of patients collected from Dental Department of Patan Hospital, Lalitpur, Nepal. One hundred and fifty digital orthopantomogram of patient fulfilling inclusion criteria were included in the study. Five different mandibular parameters (maximum ramus breadth, minimum ramus breadth, condylar height/maximum ramus height, projective height of ramus, and coronoid height) were measured bilaterally resulting in total 300 rami being assessed. Orthopantomogram were made with Planmeca ProMax classic 2D machine and all the measurements on digital radiograph were performed with Planmeca Romexis viewer software version 5.1.0.R. Discriminant function analysis was performed to find the most significant predictors for determining sex. All the measured mandibular parameters were statistically significantly higher in male than females (P<0.001). Condylar height was the most significant predictors for determining sex. The discriminate function equation was derived to determine sex with an overall accuracy of 84.0%. Morphometric analysis of mandibular ramus using digital orthopantomogram showed a high sexual dimorphism.

The coronoid opening angle: a novel radiographic technique to assess bone loss in coronoid trauma.

Elbow fracture dislocations are complex injuries that often require surgical treatment in order to obtain a stable and congruent elbow joint. The coronoid plays a key role in the stability of this joint. Accurately identifying the degree of coronoid bone loss in the setting of traumatic elbow injuries is challenging. The purpose of this study is to describe a newradiographic measure, the coronoid opening angle (COA), to assist in estimating bone loss in these challenging fractures. Radiographs were drawn from a regional database in a consecutive fashion. Candidate radiographs were excluded on the basis of radiographic evidence of degenerative changes, previous surgery or injury, bony deformity, and inadequate lateral view of the elbow. Normal COA, coronoid height, and calculated COA at varying amounts of bone loss were determined by 3 reviewers. A total of 120 subjects were included. The normal coronoid opening angle was 34° (95% CI 32.9°-34.0°) and the coronoid height, 18.8 mm (18.1-19.6). Ninety-five percent of the population had an opening angle greater than 29° (95% CI 27.2°-29°). The COA limit was calculated at 20%, 33%, and 50% of baseline coronoid height corresponding to degree of bone loss. Coronoid opening angles of 24°, 20°, and 16°, respectively, indicate the minimum bone loss of interest in 95% of the population. The intraclass correlation coefficient was found to be 0.89 or higher. In the setting of elbow trauma, it is often challenging to predict the amount of coronoid bone loss. The coronoid opening angle is a newtechnique and an adjunct for lateral elbow radiographs to predict the minimum coronoid bone loss. This can be used to guide clinical decision making, aid in predicting instability, and guide treatment. Future research will aim to validate this tool in the clinical trauma setting.

Mandibular Ramus as a Tool For Sexual Determination: A Systematic Review

Introduction: Mandible being one of the sturdy bone resists damage and therefore its fragments are mostly available after mass disasters like explosions. After the pelvis, the mandible of the skull has significant sexual dimorphism. Many parameters of the mandible altogether make it suitable to identify sex from a given bone. Aim: To determine sex with the help of parameters of the ramus of human mandible. Materials and Methods: This systematic review included the articles from 2000 to 2020 and took a one-year duration. All studies were categorised under dry bone and radiological study. Only original articles of a cross-sectional study, cohort study and case-control study related to ramus and sex determinations were selected online by using available databases like Medline, Embase, and Google Scholar. All selected articles were then analysed for different types of ramus parameters studied. Studies that considered more than one parameter of ramus were included or otherwise rejected. Research articles that mentioned the efficacy of gender identification of bone by considering parameters of the ramus of the mandible were tabulated. Results: Commonly used ramus parameters by different researchers were maximum ramus breadth/width, minimum ramus breadth/width, ramus flexure and ramus height. In addition, coronoid height and projection height was also used by some. In most of the studies, parameters in males were higher than in females whereas gender predictive value was seen higher i.e, 70-83% when a combination of all ramus parameters was taken. In the case of consideration of a single parameter, gender predictive values ranged from 45-79%, and a higher sex predictive value was seen for males. Conclusion: Only when the fragment of the mandible ramus is available, then it can be utilised for gender identification by using ramus width, ramus height along with other parameters based on availability. Ramus alone is a good tool for sex determination in the mandible.