Introduction
Methods and material
Focused question and study eligibility
Inclusion criteria for the studies were as follows
Exclusion criteria for the studies were as follows
Study search strategy and process
Data extraction and outcome of interest
Quality analysis
Results
Study selection
Sl No | Author | Title | Reason for exclusion |
---|---|---|---|
1 | Tardivo et al. 2011 [13] | Three-dimensional Modeling of the Various Volumes of Canines to Determine Age and Sex: A Preliminary Study | The sample consisted of 58 dental computerized tomography (CT) scans. |
2 | Tardivo et al. 2015 [14] | Gender Determination of Adult Individuals by Three-Dimensional Modeling of Canines | The types of CT scans selected for the sample were brain scans, brain angioscans, dental scans, and ENT scans. |
3 | García-Campos et al. 2018 [15] | Modern humans sex estimation through dental tissue patterns of maxillary canines | The sample was selected from the anthropological collections housed Madrid (Spain), Pretoria (South Africa) and Sudan. The specimens were scanned in three facilities: Microtomographic system housed in the Microscopy Laboratory. |
4 | García-Campos et al. 2018 [16] | Contribution of dental tissues to sex determination in modern human populations | Teeth included in this study were selected from anthropological collections from Spain, South Africa and Sudan. One part of the sample was scanned using a microtomographic system housed in the Microscopy Laboratory. |
5 | Krenn et al. 2019 [17] | Variation of 3D outer and inner crown morphology in modern human mandibular premolars | MicroCT datasets Premolars specimens with morphological variation within and between geographically diverse modern human groups from five continents using Geometric morphometric analysis |
6 | Sorenti et al. 2019 [18] | Sexual dimorphism of dental tissues in modern human mandibular molars | Variables were assessed from two-dimensional (2D) mesial planes of section obtained from microtomographic scans. Spanish anthropological collection of teeth used for this study was scanned using a CTPMlab micro-CT. |
Studies characteristics
Serial No | Author & Year Country | Age of the participants | Sample size or CBCT Images (female/male) | Linear/ Volumetric | CBCT features (Device type, voxel resolution,slice type) | Parameters assessed in the odontometric methods | Teeth analyzed | Sexual dimorphism present (yes/no) | Accuracy of sex estimation |
---|---|---|---|---|---|---|---|---|---|
1 | Paknahad et al. 2022 [24] Iran | 15–25 years; (21.28 ± 2.47 yrs) | 200 CBCT images of 200 subjects; 100 females and 100 males | Linear | New Tom VGi; scan time, 8.9 seconds; 5 mA; 19 mAs; 120 kV; coronal slices reconstructed with a slice thickness of 0.3 and a slice interval of 1 mm | The roof, floor, height of the pulp chamber, mesial and distal enamel thickness, dentin thickness at the height of contour and crown length | Maxillary and mandibular first molar teeth | Yes | Overall 80.5% accuracy in sex estimation when first molars were used. |
2 | Bansal et al. 2022 [7] India | 20–65 years | 60 CBCT images of 60 subjects; 29 females and 31 males | Linear | Sirona digital imaging system with 70–74 kV, 10 mA, and 10.8 s, with a field of view (FOV) 8 cm × 8 cm, and voxel size of 160 μm [3]; sliced into three dimensions; sagittal, coronal and axial sections of central incisor | Pulp-to-tooth area ratio | Maxillary canines and central incisors | No | Not stated |
3 | Warnecki et al. 2022 [29] Poland | 17–35 years | 92 CBCT images of 92 subjects;43 females & 49 males | Linear | Carestream CS 8200 CS 3D, Carestream Health, Rochester, NY, USA; length of each tooth was measured separately in the sagittal section with 3D Slicer | Lateral skull radiograph; SNA, SNB and ANB angles; presence (or absence) of asymmetry in facial features; a shift of the chin greater than 5 mm relative to the facial midline; length of each tooth | Single rooted and multi-rooted teeth | Yes | Not stated |
4 | Yagci et al. 2021 [28] Turkey | 20.88 ± 2.48 years | 560 CBCT images of 101 subjects;57 females and 44 males | Linear | NewTom 5G, QR, (Verona, Italy); scanning time 14–18 seconds; collimation height 13 cm; exposure time 3.6 seconds; and voxel sizes were 50 μm) | Enamel thickness; proximal areas of maxillary and mandibular incisors, canines, and premolars. | Maxillary and mandibular incisors, canines and premolars | Yes | Not stated |
5 | Esmaeilyfard et al. 2021 [23] Iran | 15–25 years; Mean age of 21.28 ± 2.47 years | 485 CBCT images of 485 subjects;240 females and 245 males | Linear | New Tom VGi; scan time 8.9 s, 5 mA, 19 mAs, 120 kV; corrected sagittal and coronal slices were reconstructed with a slice thickness of 0.3 and a slice interval of 1 mm | Roof, floor, and height of the pulp chamber, enamel and dentin thickness at the height of contour, tooth width, crown length in both buccolingual and mesiodistal aspects | Permanent first molars | Yes | Average classification accuracy was 92.31%. |
6 | De Koninck et al. 2021 [30] Portugal | 18–60 years | 58 CBCT of 58 subjects; 27 females and 31 males | Linear | ProMax 3D Plus device (Planmeca, Finland); voxel size of 0.2 mm and 0.15 mm and the same energy parameters (90 kV and 10 mA) | Maximum buccolingual dimension of the cervical root measured in the midsagittal plane | Mandibular canine | Yes | 79% accuracy in estimating the sex. |
7 | Denny et al. 2021 [8] India | 15–30 years | 100 CBCT images of 100 subjects; 56 females and 44 males | Linear +Volumetric | Promax 3D, Mid version (Planmeca Oy., Helsinki, Finland) | Height of the crown, height of the coronal pulp cavity, tooth – coronal index | Four mandibular molars | No | Not stated |
8 | Fauzi 2021 [21] India | No Mention | 100 CBCT images of 100 subjects; 56 females and 44 males | Linear | CBCT | Mesiodistal width | Mandibular central incisor | Yes | Not stated |
9 | Fardim et al. 2021 [3] Brazil | 20–65 years | 1190 CBCT image of 1190 subjects;606 females and 584 males | Volumetric | I-CAT Next Generation (Imaging Sciences International, HA, PA, EUA); voxel of 0.25 mm; Axial, coronal and sagittal image slices. | Pulp chamber volume | Mandibular canines, pre-molars and molars | Yes | Not stated |
10 | Topbas and Okkesim 2021 [27] Turkey | 12–69 years | 332 CBCT images of 332 subjects; 162 females and 170 males | Volumetric | Planmeca 3D Mid (Planmeca, Helsinki, Finland) device with a voxel size of 200 μm and using 85 kVp, 10 mAs and 14 s scanning time; field of view was 15 × 9 cm.; voxel size: a 0.2 mm3 | Pulp volume, tooth volume | Maxillary or mandibular molar tooth | Yes | 76.6% in estimating female sex and 56.3% accuracy in estimating male sex. |
11 | Salam et al., 2021 [9] Eygpt | 18–25 years | 100 CBCT images of 100 subjects; 50 females and 50 males | Linear | Planmeca, Promax 3D Max, Finland; all scans were output with 512 X 512 pixels per slice and 8 bits per pixel; voxel size: 0.16 mm3. | Crown width and height, enamel thickness, arch depth, and width. | Mandibular permanent canines and first molars | Yes | Not stated |
12 | Issrani et al. 2020 [5] Saudi Arabia | 17–35 years | 400 CBCT images of 100 subjects; Equal males and females | Volumetric | 3D CBCT | Mesio-distal width; inter-canine distance; Mandibular canine index | Mandibular canines | No | 47.8% accuracy in estimating sex. |
13 | Shalakizadeh et al., 2020 [25] Iran | 20–50 years | 133 CBCT of 266 subjects; 156 females and 110 males | Linear | Newtom VGi CBCT unit (Verona, Italy). 1536 × 1920 pixels, a pixel size of 127 × 127, a pixel depth of 14 bits, a rotation of 360 degrees, a scan time of 18 s and a kVp of 110; slice thickness of 1 mm at 0.25 mm intervals | Mean length of canine teeth | Maxillary and mandibular canine | Yes | Not stated |
14 | Manhaes-Caldas et al. 2019 [19] Brazil | 8–36 years | 128 CBCT images of 128 subjects; 64 females and 64 males | Volumetric | Picasso Trio unit (Vatech, Hwaseong, South Korea), adjusted at 80 kVp, 3.7 mA and a voxel size of 0.2 mm; 3D Slicer software, version 4.8 (sagittal and coronal reconstruction). | Total volume of the dental crown; Image-based volumetric assessment by manual segmentation | Upper central incisors, upper and lower canines, and lower lateral incisors | Yes | 83.7% accuracy in estimating sex. |
15 | Alam et al. 2019 [4] Saudi Arabia | 20–45 years | 252 CBCT Images;252 subjects; 93 females and 159 males | Linear + Volumetric | 3D CBCT | Tooth size from 2nd molar to 2nd molar of maxillary and mandibular arch | Full dentition (except 3rd molars) | No | Not stated |
16 | Andrade et al. 2019 [2] Brazil | 13–70 years | 116 CBCT images of 116 subjects sample were homogenous in terms of age and sex; total of 232 teeth | Volumetric | Kodak K9500R scanner (Carestream Health, Rochester, RY); voxel size of 0.2 mm3 and 0.3 mm3 and the same energy parameters (90 kVp and 10 mA); field of view (15 × 9 cm and 20 × 18 cm). | Pulp volumes | Upper central incisors and canines | Yes | High accuracy of sex estimation |
17 | Rahman and Ramakrishnan 2019 [22] India | 18–40 years | 50 CBCT images of 50 subjects;25 females and 25 males | Linear | CBCT | Mesio-distal width at apical third, middle third, and cervical third region. | Maxillary central incisors | Yes | Not stated |
18 | Kavas and Tumen 2019 [26] Turkey | 7–18 years | 80 CBCT images of 80 subjects; 40 females & 40 males; 160 M | Volumetric | i-CAT (Imaging Sciences International, Hatfield, PA, USA); voxel size: 0,3 mm; 3D Slicer | Pulp chamber volume | Mandibular and maxillary first molars | Yes | Not stated |
19 | Marchenko et al. 2017 [31] Ukraine | Adolescents | 77 CBCT images of 77 subjects; 42 females and 35 males; mesocephalic boys - 16, boys brachycephalic – 19, mesocephalic girls – 16, brachycephalic girls– 26 | Linear | Veraviewepocs 3D, Morita (Japan); 3D image - cylinder 8x8cm - thickness 0,2/0,125 mm, dose of radiation 0,11–0,48 mSv, voltage and amperage 60-90 kV/2-10 mA | Vestibular-oral and mesio-distal projection length of the root; Length of roots of incisors and canines of the upper and lower jaw | Upper and lower Incisors and canines | Yes | Not stated |
20 | De Angelis et al. 2015 [32] Italy | 15–83 years | 87 CBCT images of 87 subjects; 46 females and 41males | Volumetric | i-Cat Next Generation (Imaging Sciences International, Hatfield, Pa); voxel size: 0.4 mm; scan time: 8.9 s; scan width: 23.2 cm; scan height: 17 cm | Dental volume; mean dental volume, minimum dental volume; maximum dental volume mean pulp chamber volume, minimum pulp chamber volume; maximum pulp chamber volume; mean percentage ratio between pulp chamber and tooth. | Upper Canines | Yes | Overall 80.5% accuracy in estimating the sex. |
21 | Porto et al.2015 [20] Brazil | 22–70 years | 72 CBCT images of 118 subjects; 60 females and 58 males | Volumetric | i-CAT® Next Generation (Cone Beam 3-D Dental Imaging System e Imaging Sciences International, Hat!eld, PA/USA); (voxel-size) of 0.25 mm; stores only the axial images | Pulp cavity volume, hard tissue volume, tooth volume and pulp cavity/tooth volume ratio | Upper central incisors | No | Not stated |
22 | Llena et al. 2014 [33] Spain | Mean age of 45.26 years | 70 CBCT images of 70 subjects;31 females and 39 males;126 premolars | Linear | Kodak 9000 3D unit (Carestream Dental, Atlanta, GA, USA); 70 kV, 10 mA, and 10.8 s; μm; voxel size: 76 μm | Tooth position in the arch, number of roots, length of the tooth and root, number of canals, canal system configuration; Distance from the cemento-enamel junction to the canal bifurcation and canal reunification, number of foramina, root curvature, angle location, and distance of the angle vertex to the apex | Lower premolars | Yes | Not stated |
23 | Alam et al. 2014 [6] Malaysia | 16–35 years | 53 CBCT images of 53 subjects; 21 females and 32 males | Linear | Plameca Promax 3D (Helsinki, Finland); transaxial and sagittal slices (1 mm) | Tooth size, arch length, arch perimeter, inter-canine, inter-first premolar, inter-second premolar and inter-molar widths | Incisors, canines, premolars, 1st molar; arch length & arch perimeter | Yes | Not stated |
Study quality assessment
Author | Risk of bias (High/Low/Unclear) | Applicability concerns (High/Low/Unclear) | |||||
---|---|---|---|---|---|---|---|
Patient selection | Index test | Reference standard | Flow and timing | Patient selection | Index test | Reference standard | |
Paknahad et al. 2022 [24] | + | + | + | + | + | + | + |
Bansal et al. 2022 [7] | ? | + | + | + | ? | + | + |
Warnecki et al. 2022 [29] | ? | + | + | + | ? | + | + |
Yagci et al. 2021 [28] | + | + | + | + | + | + | + |
Esmaeilyfard et al. 2021 [23] | + | + | + | + | + | + | + |
De Koninck et al. 2021 [30] | + | + | + | + | + | + | + |
Denny et al. 2021 [8] | ? | + | + | + | ? | + | + |
Fauzi 2021 [21] | ? | ? | + | + | ? | ? | + |
Fardim et al. 2021 [3] | ? | ? | ? | + | ? | ? | ? |
Topbas and Okkesim 2021 [27] | + | + | + | + | + | + | + |
Salam et al., 2021 [9] | – | + | + | + | – | + | + |
Issrani et al. 2020 [5] | + | + | + | + | + | + | + |
Shalakizadeh et al., 2020 [25] | + | + | + | + | + | + | + |
Manhaes-Caldas et al. 2019 [19] | – | + | + | + | – | + | + |
Alam et al. 2019 [4] | + | + | + | + | + | + | + |
Andrade et al. 2019 [2] | + | + | + | + | + | + | + |
Rahman&Ramakrishnan 2019 [22] | ? | + | + | + | ? | + | + |
Kavas ans Tumen 2019 [26] | + | + | + | + | + | + | + |
Marchenko et al. 2017 [31] | + | + | + | + | + | + | + |
De Angelis et al. 2015 [32] | + | + | + | + | + | + | + |
Porto et al. 2015 [20] | + | + | + | + | + | + | ? |
Llena et al. 2014 [33] | ? | + | + | + | ? | + | + |
Alam et al. 2014 [6] | + | + | + | + | + | + | + |