An Odontometric Approach for Estimation of Stature in Indians: Cross- Sectional Analysis

Establishment of identity of unknown is the main aim of anthropometry, to supplement the law enforcement agencies. Routine methods have some limitations, especially, in highly mutilated bodies which makes identification difficult. In forensic investigations of such cases, estimation of stature becomes equally important along with other identification parameters like age, sex, race, etc., [1–3].

Stature or body height is an important anthropometric parameter that can be used to determine physical identity as it is one of the distinct visible factors of an individual [4, 5]. In the events of murders, accidents or natural disasters, which results in highly decomposed, fragmentary and mutilated human remains, stature estimation provides relevant data for personal identification [6]. A proportional biological relationship of stature exists with every part of human body including head, face, trunk, extremities etc., which plays a vital role in forensic examination to calculate the stature from dismembered and mutilated body parts [3]. Scientists have worked on various bones of the human skeleton for reconstruction of stature with varying degree of accuracy [7–16]. Even foot and shoe print length are not exempt from scrutiny [17–22]. In extreme situations where the evidences are incomplete and fragmented, sections of long bones have also been used for the estimation of stature by forensic anthropologists with great accuracy [23]. It is frequently observed that during forensic and archeological excavations, all the bones of the individual are usually not retrieved and it is common to have the head amputated from the trunk in mutilated body [24]. Consequently, teeth being relatively resistant to decay [24–26], therefore, careful study of teeth can enable reliable determination of stature of the person in life particularly when other predictors are destroyed or fragmented.

Looking at the paucity of studies pertaining to estimation of stature from odontometry in India and usefulness of these studies in forensic and legal medicine, the present study was designed to elucidate the anthropometric correlation of tooth dimensions with stature and also devises regression formulae.

Materials and Methods

Sample: After obtaining the institutional ethical clearance from KLE VK Institute of Dental Sciences, Belgaum and informed consent from all the participants, a cross- sectional study was done on 361 healthy Indian students (151 males and 210 females) in the age range of 21-45 years from our dental college. Subjects with history of orthodontic and orthognathic treatment were excluded from the study as after such kind of treatments minor changes in facial profile can be seen.

Anthropometric measurements and techniques: Stature was measured as the vertical distance from the plane where the subject stands barefooted to the vertex on the head with their back to a standard anthropometer scale. All measurements were taken from 9am-12pm to avoid any diurnal variation in stature [27]. The parameters concerned to odontometry were greatest mesio-distal crown width of six maxillary anterior permanent teeth including central incisor, lateral incisor, and canine of right and left quadrant (RCI, RLI, RC, LCI, LLI, LC) measured directly on the subjects between anatomic contact points of each tooth on either side of the maxilla with the help of digital Vernier’s Caliper (Mituyoto, Japan, precision value +/- 0.01 mm) [Table/Fig-1] and these were checked regularly before usage for precision and accuracy; Combined Mesio-Distal Width (CMDW) of maxillary anterior teeth was calculated by adding these measurements.

[Table/Fig-1]:

Mesio-distal crown width.

Statistical Analysis

All measurements were entered into SPSS software package (version 10). Karl Pearson’s correlation co-efficient of odontometric parameters with stature was obtained. Simple linear regression analysis was done and regression equations were derived for each parameter.

Results

The mean age of male participants was 22.4 years (range= 21-30 years) while for female participants mean age was 22.2 years. Karl Pearson’s correlation coefficient (r) of stature with seven odontometric parameters was obtained for all participants without gender specification. Regression equations have been calculated by regression analysis of the data with stature (y) = a+bx and the values of constants ‘a’ and ‘b’ are calculated; where ‘a’ is the regression coefficient of the dependent variable, i.e. stature and ‘b’ is the regression coefficient of the independent variable, i.e. any odontometric measurements considered in the study. The Standard Error of Estimate (SEE) was calculated for each formula, which depicts the deviation of estimated stature from the actual stature. A low value is indicative of the greater reliability of prediction from a particular measurement and the higher value of SEE denotes less reliability of prediction. The regression equation with the least Standard Error (SE) was considered to be the best regressor for the estimation of stature.

The findings of the present study revealed that all odontometric parameters showed positive correlation with stature independent of gender with correlation coefficient (r) value ranges from 0.104 to 0.297. Among them maxillary canine width showed highest correlation [Table/Fig-2].

[Table/Fig-2]:

Correlation co-efficient of stature with odontometry and linear regression analysis.

Variable	r	Regression equation (y= a+ bx)[y→stature,x→variables, b→regression coefficient]	SEE	p-value
Combined group (n=251)
R 11	0.174	y= 139.33 + 2.97 R11	8.907	0.001*
R 12	0.104	y= 153.32 + 1.67 R12	8.997	0.048*
R 13	0.278	y= 126.22 + 5.06 R13	8.690	0.000*
L 21	0.174	y= 138.28 + 3.09 L21	8.908	0.001*
L 22	0.116	y= 151.43 + 1.93 L22	8.984	0.027*
L 23	0.297	y= 120.73 + 5.77 L23	8.639	0.000*
MDW	0.237	y= 124.69 + 0.87 MDW	8.789	0.000*

R11: right central incisor, R12: right lateral incisor, R13: right canine, L11: left central incisor, L12: left lateral incisor, L13 left canine, MDW: mesio-distal width SEE: Standard estimate of error; r: correlation with observed stature, *: Statistically significant (p<0.05)

Discussion

Stature is an inherent characteristic, which constitutes an essential element in the description of an individual, for physical anthropological and medico legal investigations [28]. Scientists from all over the world substantially used all the bones of human skeleton right from femur to metacarpals for stature estimation [2, 6–23]. However, when these bones are not available, measurements from other body parts should be used to predict body height. Similar to other bones of the body, dimensions of tooth and skull are also genetically determined [29]; but they also depend on environmental and dietary factors, so their measurements are unique for each race and geographical region [30]. Studies concerning the estimation of stature from odontometric parameters are limited in Indian population. Therefore, the present research aimed to provide the valuable data pertaining to the correlation of stature with tooth for Indians. The idea of deriving combined regression formulae by considering males and females as a whole group is in the situations where gender identification of teeth is questionable.

The findings of the present study revealed that all odontometric parameters were positively and significantly correlated with stature independent of gender, where maxillary canine width showed highest correlation with least error. In contrast, individual tooth measurement had no correlation with stature in Mysorean population [24]. Filipson and Goldson in early 1963 demonstrated no correlation between tooth width and stature in 110 subjects of Sweden, this low correlation could be attributed to smaller sample size or difference in ethnicity [31]. Another research among Caucasians also found no association between tooth width and stature [32]. Nevertheless Garn et al., found a significant correlation between stature and mesio-distal and bucco-lingual dimensions of permanent maxillary lateral incisor, while no such correlation was found with maxillary central incisor [33]. Contradicting to this, another research in African Americans found correlation of stature with maxillary central incisor tooth width in males, while lateral incisor did not show any such correlation [34]. Similar recent studies regarding stature estimation from odontometric parameters are formulated in [Table/Fig-3].

[Table/Fig-3]:

Recent studies of stature estimation from odontometric parameters.

S. No	Authors	Year	Odontometric parameters	Results	Conclusion
1.	Shalini Kalia et al., [24]	2006	combined mesiodistal width of maxillary anterior teeth	Statistically significant	Provide reliable method of estimation of height.
2.	Amit Gupta et al., [35]	2014	combined mesiodistal width of maxillary anterior teeth	Statistically insignificant	Combined mesiodistal width is unreliable for stature estimation.
3.	Rajbir Khangura et al., [36]	2015	a. combined mesiodistal width of maxillary anterior teeth	Statistically insignificant	Intercanine and interpremolar width can be used to calculate the stature.
			b. intercanine width and interpremolar width	Statistically significant
4.	Present study	2016	Individual tooth dimension of maxillary anterior teeth and their combined mesiodistal width	Statistically significant	Amongst all parameters canine width is the best predictor for stature estimation.

Our results hypothesize that odontometry is as such unreliable for stature estimation but in situations when only teeth are available for identification, the maxillary canine width can be used as an adjunct in the estimation of stature for Indian population irrespective of gender.

Limitation

There are few limitations of the present study like ethnic or regional specific regression formulae are not obtained and only anterior teeth have been included in the study. Future implications are further investigations on large sample size and gender specific formulas should also be generated.

Conclusion

From the present study, it can be concluded that regression equations generated from odontometric parameters can be used as a supplementary approach for the estimation of stature when extremities are not available but with caution as these are population specific and cannot be used on other populations of the world. However, canine width can aid in estimation of stature as an adjunct when only teeth are available for identification; further investigations should be carried out on large sample by considering ethnic and community background.

R11: right central incisor, R12: right lateral incisor, R13: right canine, L11: left central incisor, L12: left lateral incisor, L13 left canine, MDW: mesio-distal width SEE: Standard estimate of error; r: correlation with observed stature, *: Statistically significant (p<0.05)

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