Cephalometric radiograph-based approach for sex determination using maxillary sinus index in Surabaya, Indonesia

Accurate sex determination is a critical aspect of individual identification in various fields, including anthropology, forensic science, and archaeology. Various parameters from the skull, mandible, pelvis, and long bones are commonly utilized for this purpose. Recently, the potential of the maxillary sinus as a sex-discriminatory parameter has been studied by Khaitan et al. through the analysis of lateral cephalometric radiography. This study aimed to evaluate the feasibility of implementing the sex determination formula devised by Khaitan et al. for the adult population of Surabaya, Indonesia. For this purpose, 130 digital cephalometric radiographs of outpatients in the DHDC Dental Office in Surabaya, Indonesia, were assessed. The maxillary sinus height and width were measured to derive the maxillary sinus index (MSI) and calculate the discriminant score (D) for sex identification. This study revealed that the maxillary sinus’s average height in males was 37.111+5.13 mm, while in females, it was 34.538+4.36 mm. Males had an average maxillary sinus width of 44.152+4.11 mm, while in females it was of 38.849+3.33 mm. The MSI values for males (1.204±0.14) were higher than for females (1.135±0.10). The discriminant scores showed notable variations between males and females, with an 86% success rate for females and 27.8% for males. The present study provides evidence that the Khaitan formula can serve as a valuable complementary approach for sex determination in females. Sex determination based on the MSI is thought to be a population-dependent parameter in forensic sciences and requires careful interpretation in its application.