Forensic

Forensic DDentistry
entistry

June 2014

Dimensions of mandibular canine for gender

identification in forensic odontology: a pilot study

Dr. Md Nurul Islam

Dr. Sibu Simon

Dr. Omar Taufiq

Professor, Deputy Dean

Lecturer

Lecturer

Faculty of Dentistry, SEGi University, Selangor, Malaysia

Introduction
Teeth have been accepted as tools for the purposes of forensic
identification because teeth being covered by enamel are remarkably
resistant to mutilation from all sorts of external factors.1 One of the
major issues in forensic dentistry is the identification of the gender
of the individual based on the dimensions of various teeth.2 Maxillary
and mandibular canine have been used commonly for this purpose.
Controversy exists, whether mesio-distal dimensions of mandibular
canine can be used to identify the gender of the individual.3-10 Many
studies have been performed on this topic in different populations
with contrasting results.3-10 This pilot study aims to evaluate whether
the mesio-distal dimensions of the mandibular canine can be used
for gender identification purposes. The article also summarizes the
pertinent scientific literature regarding the dimensions of mandibular
canine being used in gender identification for purposes in forensic
dentistry.

Material and Methods

Ethical approval for the study was obtained from the Institutional
Ethics Committee, SEGi University, Selangor, Malaysia. Thirty
patients reporting to Oral Health Center, Faculty of Dentistry, SEGi
University were included in this pilot study. Patients in the age group
of 18-38 years with all six mandibular anterior teeth were included in
the study. Patients with missing mandibular anterior teeth, attrition
on mandibular anterior teeth, history of previous orthodontic
treatment and any form of restorative treatment performed on
mandibular anterior teeth were excluded from the study. If any
teeth were migrated due to periodontal disease in the mandibular
anterior sextant, such patients were also excluded from the study.
Impressions of the mandibular jaw were made using alginate

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Background: Teeth have been accepted as tools for the

purposes of forensic identification because teeth being
covered by enamel are remarkably resistant to all sorts of
destruction or damage from external factors. One of the
major issues in forensic dentistry is the identification of the
gender of the individual based on the dimensions of various
teeth. Studies have shown that canine is the least frequently
extracted teeth and most resistant to disease. Material and
Methods: Mesio-distal dimensions of mandibular canine and
intercanine distance of the mandibular anterior segment was
measured using digital vernier caliper. Mandibular canine
index was calculated by dividing the mesio-distal dimension
of mandibular canine by the inter-canine distance in the
mandibular anterior sextant. Data collected was statistically
analyzed by using Mann-Whitney test. Results: The mean
intercanine distance for females was 27.07 mm as against
26.19 mm for males. The mean mandibular canine index
for both males and females was 0.25. Despite, the marginal
difference in the measurements of mesio-distal dimensions
of mandibular canine and the mean intercanine distance, the
differences were not statistically significant. Discussion: This
article also summarizes the scientific literature regarding the
use of dimensions of mandibular canine for gender identification
purposes. As the scientific community is divided on the use of
the dimensions of mandibular canine as one of the methods
for gender identification, it is our recommendation to conduct
similar studies among various other ethnic populations to
authenticate the same for use in forensic dentistry.
Keywords: mandibular canine index, gender identification,
forensic dentistry, mesio-distal dimension

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impression material. Dental study models were prepared using

dental stone. Care was taken to ensure that the dimensions of the
teeth were exactly reproduced especially in the mandibular anterior
sextant. Digital vernier caliper (Mitutoyo, Japan; Figure 1) was used
to measure the mesio-distal dimensions of the mandibular canine
and the intercanine distance in the mandibular anterior sextant
by two examiners (SSR and MNI). Mesiodistal dimensions of the
right and left mandibular canine were measured from just beneath
the contact point of two adjacent teeth (Figure 2). The intercanine
distance in the mandibular anterior region was measured from the
cusp tips of the right mandibular canine to the left mandibular canine
(Figure 3). Mandibular canine index was calculated by dividing the
mesio-distal dimension of mandibular canine by the inter-canine
distance in the mandibular anterior sextant. Data collected was
statistically analyzed by using Mann-Whitney test. T-value was
replaced by Z-value.

Fig 1: Digital vernier caliper (Mitutoyo, Japan) used to measure the dimensions on
the dental models.

Results
The mean mesio-distal dimensions of the mandibular canine were
6.85 mm for females and 6.78 mm for males by one of the examiner
(MNI). The mean mesio-distal dimension of the mandibular canine
was 6.72 mm for females and 6.65 mm for males by the other examiner
(SSR). The mean intercanine distance for females was 27.07 mm as
against 26.19 mm for males. The mean mandibular canine index for
both males and females was 0.25. Despite, the marginal difference
in the measurements of mesio-distal dimensions of mandibular
canine and the mean intercanine distance, the differences were
not statistically significant. The mandibular canine index which is
the ratio of the mean mesio-distal dimensions of the mandibular
canine to the mandibular intercanine distance was equal for both
the sexes.

Fig 2: Representative image of the digital vernier caliper used to measure the
mesio-distal dimension of the mandibular canine just beneath the contact
points.

Discussion
In forensic science, identification of deceased individuals is a major
challenge. Identification of deceased individuals is essential for
religious, emotional and personal reasons.2 An important initial
step in identification of the dismembered remains of mass disaster
victims is the separation based on gender. Sex assessment of
skeletal remains is part of the archaeological and many medicolegal examinations. Sexual dimorphism refers to the differences in
size, shape, etc., between males and females. Hard tissues primarily
cranial bones and pelvic bones are used for gender identification
after accidents. However, these bones are susceptible to fracture
and may get fragmented during trauma. One of the realiable
indicators used for forensic identification are teeth, since they are
relatively more resistant to fracture and burns. The use of dentition
in sex assessment has been explored and advocated owing to its
strength and resistance to pre- and post-mortem insults. Maxillary
and mandibularcaninesare called the cornerstone of the mouth
because they are located two teeth away from the midline, and

Fig 3: Representative images of the digital vernier caliper used to measure the
mandibular intercanine distance from the cusp tips of the right and left mandibular
canines.

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separate the premolars from theincisors.10 Canine are also the teeth
which are highly resistant to disease. Caries is rarely seen on the
canines because of the absence of pits and fissures, which are the
common niches for initiation of dental caries.10 Canines are usually
the last teeth to be extracted from the mouth due to the long length
of their roots. Studies have shown that molars were most frequently
extracted, whereas canines were least frequently extracted.10
Our pilot study showed that despite the marginal difference in
mesio-distal dimensions of mandibular canine and mandibular
intercanine distance between males and females these
differences are not statistically significant. Our study results
are against the use of mandibular canine index for gender
identification purposes in forensic odontology. However, the
data collected is on a small sample of 30 dental models. The
following paragraphs summarize the articles which are in
favour and against utilizing mandibular canine index for gender
identification purposes in forensic dentistry.

Studies favoring the use of

Mandibular canine index for gender
dimorphism
Rao et al., in 1989 studied 766 subjects in a South Indian population
in the age group of 15-21 years.1 The study reported that accuracy
ofsexdeterminationidentitywas found to be 84.3% in the males
and 87.5% in females. The study concluded that using mandibular
canine index for gender is a simple and inexpensive method for
gender identification in forensic odontology.1 Vishwakarma et al.,
studied 180 dental models of subjects in the age group of 17-23
years among the North Indian population.2 Significant differences
were found between males and females with regards to mandibular
canine index, mesio-distal dimensions of the mandibular canine.
However, no statistically significant differences were found between
the genders with regards to the intercanine distance.2 Yuwanati et
al., studied 100 subjects in the age group of 17-21 years to evaluate
whether dimensions of canine can be used to identify gender in
the central Indian population.3 This study was different from the
earlier ones in that the researchers measured both the maxillary
and mandibular canines, while the earlier studies measured only
the mandibular canine. The study concluded that both mandibular
as well as maxillary canine can be used in gender identification.3
Ayoub et al., studied the dental models of 133 dental students in
the age group of 18-25 yrs in a Lebanese University.4 The mesiodistal dimensions of the canine and the intercanine distance were
significantly greater in males as compared to females.4 Singh et
al., studied cheiloscopy and mandibular canine index among 60
dental students in a North Indian population in the age group of
20-25 yrs.5 The study concluded that mandibular canine index and
lip prints were accurate and specific for gender identification. The
study suggested that dental tissues make good witness in criminal
investigations, personal identification, and genetic studies.5

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Fig 4: Graph showing the marginal difference between mesio-distal dimensions of

mandibular canine in dental models of males against females.

Fig 5: Graph showing no difference in the mean mandibular canine index(MCI) of

males versus females.

Studies against the use of

mandibular canine index for gender
dimorphism
Acharya et al., studied 117 dental models in the Nepalese
population.7 Hosamani et al., calculated the mandibular canine
index of 50 dental models in the age group of 15-21 years.8 Even

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Table No.1 shows mean mesio-distal dimension of canines, mean intercanine distance and mandibular canine index among males and females.

Variables

Gender

Mean

SD

Median

IQR

t-value

p-value

M-D canine (MNI)-Left

Female

6.86

0.34

6.84

0.60

0.450

0.656

Male

6.81

0.24

6.76

0.44

Difference is not significant

Female

6.84

0.48

6.70

0.76

-0.373

Male

6.74

0.35

6.71

0.57

Difference is not significant

Female

6.72

0.45

6.70

0.78

0.273

Male

6.68

0.31

6.60

0.59

Difference is not significant

Female

6.73

0.52

6.50

0.90

-0.834

Male

6.62

0.48

6.34

0.75

Difference is not significant

Female

6.85

0.40

6.75

0.68

0.579

Male

6.78

0.28

6.73

0.52

Difference is not significant

Female

6.72

0.48

6.55

0.80

-0.125

Male

6.65

0.38

6.45

0.67

Difference is not significant

Female

27.07

2.13

26.50

3.10

1.301

Male

26.19

1.53

26.00

1.50

Difference is not significant

Female

0.25

0.03

0.25

0.02

-0.465

Male

0.25

0.02

0.25

0.02

Difference is not significant

M-D canine (MNI)-Right ^

M-D canine(SSR)-Left
M-D canine(SSR)-Right ^
Mean MNI
Mean SSR
Mean ICD
MCI ^

0.709
0.787
0.404
0.567
0.901
0.204
0.642

^ Data failed Normality test. Hence Mann-Whitney test applied. T-value replaced by Z-value.
Table 2: Lists the details of the scientific literature which advocated the use of mandibular canine index for gender identification.

Method used: Mandibular canine index =

No

Study done by researchers and in year

Rao et al., Mandibular canine index-a clue

for establishing sex identity. Forensic Sci Int.
1989;42(3):249-54.

Mesio - distal dimensions of mandibular canine

Mandibular inteercanine arch width

Details of the population studied Inference from the study

South Indian Population

Number: 766
Age: 15 - 21 years
Vishwakarma et al., A study of sexual dimorphism Nepalese population
in permanent mandibular canines and its
No. studied: 180
implications in forensic investigations. Nepal Med Age: 17-23 yrs
Coll J. 2011 ;13(2):96-9.

Yuwanati etal.,Canine tooth dimorphism: An

adjunct for establishing sex identity. J Forensic
Dent Sci. 2012;4(2):80-3.

Ayoub et al., Mandibular canine dimorphism

in establishing sex identity in the lebanese
population. Int J Dent. 2014; 235204.

Singh et al., Sex determination using cheiloscopy

and mandibular canine index as a tool in forensic
dentistry. J Forensic Dent Sci. 2012;4(2):70-4.

Khamis et al., Odontometric sex variation in

Malaysians with application to sex prediction.
Forensic Sci Int. 2014;234:183.e1-7.

Central Indian population.

No.studied:100
Age: 17-21 yrs
Lebanese population
No. studied: 133
Age: 18-25 years
North Indian dental students
No.Studied:60
Age: 20-25 yrs
Malaysian population
Malays, Chinese and Malaysian Tamils
No. studied: 400
Age: young adults

Gender identification was found to be correct in

males in 84.3% and in females in 87.5%.
Significant differences were found in the
dimensions of the mandibular canine between
males and females.
No difference was found between the two genders
with regards to inter-canine distance
Both maxillary canine and mandibular canine
dimensions can be used to identify genders.
The mesiodistal dimensions of the mandibular
canine and intercanine distance were significantly
greater in males than females.
The mandibular canine index and lip prints were
very accurate in gender identification.
Mandibular canine index can be used to
differentiate dental models between male and
female genders, thus helpful in forensic purposes.

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though the mean values of the mesio-distal dimensions of the

canine in males were slightly higher than in females, the values
were not statistically significant. The intercanine distance
though marginally higher, was not statistically significant. The
mandibular canine index was equal in both the genders. The
study concluded that the mesio-distal dimensions of mandibular
canine and mandibular canine index do not reflect sexual
dichotomy and that the use of this index for gender identification
purposes should be discontinued.8

June 2014

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Khamis MF, Taylor JA, Malik SN, Townsend GC.
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Summary
Rao et al., proposed the mandibular canine index in 1989 as a
tool for gender identification in forensic dentistry. Many studies
have validated this index. However recent studies have refuted
the use of mandibular canine index for gender identification
10- front
view not
3 months
post opthe use of MCI for
purposes. Our pilotFig.study
does
support
the purpose of gender identification. Malaysia offers an unique
opportunity to study the above mentioned data, because of the
presence of three different ethnicities (Malay, Chinese and
Indians) in its population.

Acknowledgment
We appreciate the contribution of Dr. Srinivas Sulugodu
Ramachandra, MDS, Senior Lecturer, Faculty of Dentistry, SEGi
University, Selangor, Malaysia, for his highly valuable contribution
during this study.

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DISCUSSION

2. Yuwanati M, Karia A, Yuwanati M. Canine tooth dimorphism:

There are still unsolved questions regarding the approaches for
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reducing zygomatic complex fractures. The surgical approach
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could inuence the ease of reduction and xation of the fragments,
3.
Vishwakarma
N, Guha
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study
of ofsexual
dimorphism
the length
of operating
time, and
length
hospital
stay. The
in
permanent
mandibular
canines
and
its
implications
approaches for zygomatic complex fractures are generally divided
in categories:
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Med Coll J. 2011
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local, and coronalNepal
scalp incisions.
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Ayoub F, Shamseddine
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It is an extremely useful incision where there is combination of the
5.
Singh J,and
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