Radiomorphometric Evaluation of the Frontal Sinus in Relation to Age and Gender in Saudi Population

J Int Soc Prev Community Dent. 2019 Oct 22;9(6):584-596. doi: 10.4103/jispcd.JISPCD_222_19. eCollection 2019 Nov-Dec.

Abstract

Background: Radiographs have been used for forensic identification purpose. At times when only skull remains are found and other means of identification fail, radiographs of skull may be used for identification purpose.

Aim: The objective of this study was morphometric evaluation of the frontal sinus by using digital posteroanterior skull radiograph in relation to age and gender and to establish its forensic importance.

Materials and methods: The study was conducted at Alfarabi Private College for Dentistry and Nursing, Jeddah, Kingdom of Saudi Arabia. It included 400 subjects (200 males and 200 females), aged 14-70 years. Radiographs of the individuals were taken by digital radiography, and morphometric evaluation of frontal sinus was carried out by using Adobe Photoshop CS3 Extended.

Results: Unilateral absence of sinus was noted in 2.5% males and 1.5% females. Bilateral absence was noticed in 2% males and 0.5% females. Right and left frontal sinus symmetry was seen in 83.20% of the individuals. The left-dominated asymmetry was observed in 6.98% individuals. The right-dominated asymmetry was observed in 9.82% individuals. Simple logistic regression analysis of gender by different variables showed right width and left width, which are most suited regressors for sex determination. The rate of accuracy in classification of males and females varied from 67.70% to 95.90%. Stepwise multiple regression analysis of estimation of age by different variables showed right sinus height is the best predictor of age.

Conclusion: In this study, the radiographic images of the frontal sinus showed significant morphological difference in relation to age and gender in Saudi population. On the basis of this evidence, it is proposed that the morphologic evaluation of frontal sinus can be used for personal identification.

Keywords: Digital posteroanterior skull radiograph (PA skull radiograph); forensic odontology; forensics; frontal sinus; personal identification.