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Radiographic methods using pulp-tooth volume ratio (PTVR) are important for dental age estimation. According to previous studies, using PTVR possesses different relationships with age in males and females but none of the studies have used a homogenous (approximately equal numbers of individuals in each age range) age distribution to assess this relationship and the effect of sex as a predictor on age estimation. This study was performed on Cone-beam computed tomography (CBCT)images of 521 left maxillary and 681 left mandibular canines of 719 subjects of Pakistani origin (368 females and 349 males) aged from 15 to 65 years. Planmeca Romexis® software was used to trace the outline of the pulp cavity and tooth and to calculate respective volumes. Subsequently, Microsoft® Office Excel 2016 was used to calculate the ratios. Regression analysis was performed to assess the relationship between PTVR factoring sex as apredictor for age estimation. The obtained results showed that including sex as predictor with maxillary PTVR (R2 = 0.46) have the highest predictive power. The relationship between maxillary PTVR including sex with chronological age demonstrates anon-linear relationship. The conclusion is that including sex as predictor with maxillary PTVR produced the best estimate of chronological age.
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