Abstract
BACKGROUND: Sex estimation is crucial to forensic examinations. In order to estimate sex, intact bones are used if the majority of bones are severely deformed and recovered in fragments. This study aims to analyze sexual dimorphism in intact maxillary sinuses using CBCT scanning to evaluate morphometric properties for sex identification. METHODS: A total of 318 subjects, consisting of 159 males and 159 females, aged between 20 and 60 years without sinus pathology were included in this diagnostic, retrospective cross-sectional study. Bilateral measurements of the volume, height, width, and length of the maxillary sinuses were obtained and compared to evaluate the differences between sexes. Subsequently, a descriptive analysis using mean and standard deviation was performed, followed by a comparison between sexes with a p-value being less than 0.05 and Student's t-test. Finally, a discriminant analysis was performed separately for the right and left maxillary sinuses. RESULTS: Males and females showed statistically significant variations in the length, width, and volume of the maxillary sinuses. Specifically, on the right side, males had longer maxillary sinuses than females (t = 5.6203, p < 0.0001). Meanwhile, on the left side, females had wider maxillary sinuses than males (t = 8.621, plt0.0001). In addition, males had greater volumes of maxillary sinuses on the right (t = 6.373, p < 0.0001) and left (t = 3.091, p < 0.0001) sides than females. The results of the discriminant analysis showed that the left width parameter had the highest accuracy of sex estimation (74.21%), followed by the Right Length (70.07%) and left volume (66.66%) parameters. The left height parameter had the lowest accuracy of sex estimation (49.37%). CONCLUSION: In forensic odontology, the volume of maxillary sinus can serve as a valid radiographic indicator of sex estimation.