Sex estimation through lateral cephalometric analysis in a Brazilian sample using a binary logistic regression model

Objective

The aim of this study was to verify the application of linear, angular and area measurements using lateral teleradiography to estimate sex in a sample of the Brazilian population.

Material and Methods

Linear, angular and area measurements were performed on 320 lateral teleradiographs equally distributed between sexes. For the analyses, eight cephalometric points (glabella, orbitale, sella, basion, porion, nasion, anterior nasal spine and posterior nasal spine) were considered. Lateral teleradiography of participants aged 20–40 years was included. Examinations with trauma or cranial pathologies, changes in bone development, or artifacts that made it impossible to adequately visualize the regions of interest were excluded. Landmarks were identified using ImageJ® software version 1.52a (National Institute of Health, Bethesda, Maryland, USA).

Results

Data were organized in Microsoft© Excel© 365 software version 2204 (Microsoft Corp., Redmond, WA, USA) spreadsheets and statistically analyzed using the RStudio software version 2023.06.0+421 (R foundation, Vienna, Austria). After removing outliers, 252 exams (127 of males and 125 of females) comprised the sample. Two angular measurements (glabella-nasion-sella and porion-orbitale-glabella) and one area measurement (sella-nasion-orbitale-porion) were related to the sex variable and were used to develop a binary logistic regression (BLR) model. In the training sample, sex was estimated with accuracy of 82.14 %. In the test sample (20 % of the sample, 64 teleradiographs), the model showed accuracy of 84.38 %.

Conclusion

The BLR model developed proved to be useful for estimating sex in the evaluated sample.