Sex Estimation by Metric Analysis of the Angle of Mandible and the Mandibular Ramus: A Systematic Review

Abstract

Sex estimation is the first step in human identification.The mandibular ramus and the condyle have been widely used as indicators for sexual diagnosis because they are regions that undergo important morphological changes which increase sexual dimorphism.The object of the present study was to carry out a systematic review to determine the metric parameters of the mandibular ramus that present the greatest sexual dimorphism, and to sex estimation from the angle of mandible (MA).We included documents in English, Spanish and Portuguese which analysed sex estimation or sex diagnosis by metric analysis of the mandibular ramus in humans.The search was conducted in PubMed/MEDLINE, EMBASE, LILACS, up to December 2020.The risks of bias were analysed using the AQUA tool.The search identified 538 studies.After exclusion of duplicates and irrelevant articles, 39 studies were included for qualitative analysis.Of these, 18 studies were carried out on dry mandibles and 21 by imaging techniques, totalling 7270 participants of 14 different nationalities.We found 14 sex-estimation parameters in the mandibular ramus, plus the MA.Sex estimation by the MA is variable; it is a good predictor only for some populations.The height of the mandibular ramus, the angle of mandible, the bicondylar angle and the height of the coronoid process were the estimation parameters cited in the greatest number of studies.The mandibular ramus presents great sexual dimorphism and can be used as a sex predictor in different populations.Although some parameters of the mandibular ramus can present accuracy of almost 80 % when analysed in isolation, more accurate sex estimation is achieved when the parameters are analysed in conjunction.

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