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Artificial Intelligence-Assisted Sex Estimation from Canine Measurements on Panoramic Radiographs: Comparison with
Oana-Mihaela Ciobanu1,2, Alexia-Ecaterina Cârstea3, Alexandru Gingă-Grigorescu4
1Department of Legal Medicine and Bioethics, Faculty of Stomatology, "Carol Davila" University of Medicine and Pharmacy, 010221 Bucharest, Romania.
Diagnostics (Basel, Switzerland)
|June 26, 2026
Summary
Odontometrics, the study of teeth, can estimate sex using canine measurements. Both manual and AI-based methods showed similar accuracy, suggesting integration into forensic analysis.
Area of Science:
- Forensic Anthropology
- Odontology
- Biometrics
Background:
- Odontometrics offers a durable method for sex estimation when skeletal remains are scarce or DNA analysis is impractical.
- Teeth possess superior resistance to taphonomic influences compared to other skeletal elements.
- Canine teeth are particularly valuable in forensic odontology for identification and sex determination.
Purpose of the Study:
- To evaluate the efficacy of canine odontometrics for sex estimation in a Romanian population.
- To compare the accuracy of manual versus artificial intelligence (AI)-based measurement techniques.
- To assess the discriminatory power of canine dimensions and distances for sex determination.
Main Methods:
- Analysis of 134 orthopantomograms from Romanian individuals (64 females, 70 males).
- Manual and AI-based measurements of total canine length and intercanine distances.
- Statistical analysis, including cross-validation and receiver operating characteristic (ROC) curves, to assess sex discrimination accuracy.
Main Results:
- Excellent inter-observer agreement (ICC = 0.923-0.992) for measurements.
- Mandibular canines, especially tooth 33, demonstrated the highest sex-discriminatory performance (69.4% manual, 64.9% AI).
- Multivariate models using manual and AI measurements showed comparable performance (AUC = 0.765 vs. 0.732), with no significant difference (p = 0.375).
Conclusions:
- AI-based and manual odontometric measurements exhibit similar performance for sex estimation in this Romanian sample.
- Canine odontometrics, when integrated into a broader forensic assessment, can aid in sex determination.
- Further research should explore the application of AI in forensic odontology for enhanced accuracy and efficiency.
