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 Table of Contents  
REVIEW ARTICLE
Year : 2023  |  Volume : 15  |  Issue : 2  |  Page : 142-149

Stature estimation using various odontometric parameters: A narrative review


1 Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
2 Indonesian Forensic Science Association (IFSA), Surabaya, Indonesia
3 Universitas Airlangga, Surabaya, Indonesia

Date of Submission06-Sep-2021
Date of Decision02-Dec-2022
Date of Acceptance03-Dec-2022
Date of Web Publication28-Apr-2023

Correspondence Address:
Ms. Dina K Putri
drg, Jl. Major General Prof. Dr. Moestopo No. 47, Surabaya, 60132, East Java
Indonesia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jioh.jioh_236_21

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  Abstract 

Aim: Indonesia is the most disaster-prone country in the world, which can cause many dead victims, therefore, the identification process becomes essential, but the difficulties increase when only the skulls, partial jaws, and teeth remain found in the body. Some researchers began to pay attention to estimating stature through teeth dimensions because teeth have high individual characteristics and are the most muscular body structures. This study aims to describe several studies and methods that have been used by researchers from outside Indonesia in estimating stature using odontometric parameters. Materials and Methods: This narrative literature review was conducted by reviewing several studies of stature estimation using odontometric parameters based on PubMed Central and indexed articles and documents published by authorities and boards. Some of the methods found and included in this study include parameters of maxillary permanent dentition, mandibular permanent dentition, all maxillary and mandibular permanent dentition except third molars, and also deciduous dentition. Result: From all parameters above, the easiest method and most applicable in Indonesia is the method using permanent mandibular dentition because it uses the Carrea’s index formula, so the measurement becomes easier and faster to get the desired result. Conclusion: The odontometric parameters used to estimate height vary greatly, although some still showed a low-moderate relationship to height. Carrea’s index is one of the easiest, cheapest, and most reliable and straightforward methods to estimate the height.

Keywords: Body Height, Forensic Dentistry, Human and Health, Individual Identification, Odontometric Parameters


How to cite this article:
Putri DK, Putra MA, Sunniyyah D, Putra AP. Stature estimation using various odontometric parameters: A narrative review. J Int Oral Health 2023;15:142-9

How to cite this URL:
Putri DK, Putra MA, Sunniyyah D, Putra AP. Stature estimation using various odontometric parameters: A narrative review. J Int Oral Health [serial online] 2023 [cited 2023 Dec 1];15:142-9. Available from: https://www.jioh.org/text.asp?2023/15/2/142/375369


  Introduction Top


According to data compiled by the United Nations in the International Strategy on Disaster Risk Reduction (UN-ISDR), Indonesia is the most disaster-prone country globally. This can be seen from the large number of Indonesian people who are at risk of losing their lives if a disaster occurs. Disasters can be caused by natural factors (natural disasters) or human action (unnatural disasters). It is undeniable that various disasters can cause many victims, both those who are still alive and dead.[1],[2]

Determining the identity of an individual is easy. However, in the case of death, the individual’s body becomes difficult to recognize because of the trauma it received, such as transportation accidents, fires, explosions, decomposition, and skeletonization. This identification process is necessary because it involves the medicolegal and human rights aspects.[3]

The biological identity can be known from sex, age, stature (height), and origin.[4] In the science of anthropology, height can be estimated from various parts of the body, especially the long bones. Nevertheless, not all parts of human bones can be found in some cases.[5] The difficulty increases when the body is found mutilated, damaged by severe accidents (mass disasters, conflagration, plane crashes), fragmented/crushed, and already decomposing.[6] A common situation is the discovery of the skull and the jaw and the remaining of the tooth. Therefore, investigators and researchers begin to pay attention to estimating height through skull and tooth dimensions in these circumstances.[5],[7] But until now, little research has evaluated the possibility of estimating height through teeth dimensions.[6] No two individuals have identical teeth, and dental properties are resistant to premortem and postmortem changes. This specificity makes teeth play an essential role in identifying individuals.[7] Till date, there is little literature or research about estimating stature from odontometric parameters in Indonesia. Therefore, in this article, the authors review and compare some research and methods used by researchers from outside of Indonesia in estimating height through the teeth dimension to support further study related to this topic in Indonesia.


  Materials and Methods Top


This narrative literature review was conducted by reviewing several studies of stature estimation using odontometric parameters. Articles were collected using search terms in PubMed Central database and the research of indexed articles and documents published by authorities and boards up to September 20, 2021. In order to find the relevant papers, the search method used free-text searching across all relevant fields. The text-word terms were selected based on the names mostly encountered in stature estimation using odontometric parameters.

Here were the results of the PICOS analysis:

Problem  (P): Stature or body height estimation

Interventions (I): Odontometric parameter; tooth dimension

Comparison (C): Body height

Outcomes  (O): Successful prediction; accuracy

A broad search strategy was applied and the following keywords were used in order to search articles from 10 years ago (to get an adequate amount of paper) until recent literature data, as seen in [Table 1].
Table 1: List of keywords concept selection

Click here to view


Editorials and reviews were excluded, and a set of inclusion and exclusion criteria were used to choose solely original studies on the issue.

Inclusion criteria of the article were collected:

  • - using odontometric parameter or tooth dimension


  • - using manual or digital vernier caliper for measuring the tooth dimension


  • - free and open-source article, be in English


Exclusion criteria of the article were collected:

  • - the measurement of dental dimension was done by radiograph analysis


  • - using measurement of long bones, or other body bones, facial bones, and jaw


  • - reviews, editorials, case reports, comments, and preclinical studies


The title and abstract of studies discovered through database searches were initially evaluated. If it was evident from the article title or abstract that a study did not fit the inclusion criteria or was not relevant, it was excluded. The abstract was examined by all four reviewers, who then included research based on their content. After reading the title and abstract, the first author decided if there was a dispute. In order to verify the inclusion and exclusion criteria, full manuscripts were read.

The PRISMA Flow Chart can be seen in [Figure 1].
Figure 1: PRISMA Flow Chart

Click here to view



  Results Top


The findings revealed over 265 interesting citations in the initial electronic searches, of which 43 were considered potentially pertinent and evaluated for eligibility, leaving 24 works for formal assessment. The articles grouped the parameters into four groups: the permanent maxillary dentition (twelve articles), permanent mandibular dentition (nine articles), and maxillary and mandibular dentition, except for the third molars (one article) and deciduous dentition (three articles).

Parameters of permanent maxillary/upper jaw dentition

Gupta et al.[4] researched populations in Northern India in the 18–30 years’ age range by counting the mesiodistal widths of six anterior teeth and the width of the right and left canine teeth. Hinduja et al.[8] also conducted a study with the same parameter, combining mesiodistal widths of six anterior teeth but without canine width, and the age range from 18 to 21 years.

Khangura et al.[9] also conducted a study on the same population by adding the width of the distance between the right and left canine teeth and the left and right first premolar and the length of the jaw arch of the right and left canine teeth. Jani et al.[10] also conducted a study with the same parameter without the length of the jaw arch, but adding summation of each intercanine (IC) width, interpremolar (IP) width, and combined mesiodistal widths (CW) of six anterior teeth. Otherwise, Rao et al. researched with the same parameter as Khangura et al.[9],[11] but in different populations: three Asian ethnicities, Malay, Indian, and Chinese. Ganesh et al.[12] conducted a study that used not only IC distance but also mandibular IC distance (will explain below).

Hossain et al.[6],[13] conducted a study on Malaysia while Eboh (2016) in the South Nigerian population with the same parameters of height and mesiodistal and labiolingual diameters of the central incisor crowns, lateral incisors, and right and left canine teeth. Yadav et al.[14] concluded that the upper jaw (UJ) teeth parameters that could be used as a different approach to the estimation of height if the extremity bones are not available and closely significant, is the mesiodistal width of the canine with a note when used in the same specific population.

Chandrappa et al. (2017) conducted a study on the Indian population with the parameters studied, namely crown length of tooth numbers 11, 12, 13, 16, and 17 among males and females, and also in deciduous teeth (will be explained below).[15] Otherwise, Jani et al.[10] conducted a study by measuring all anterior maxillary teeth (11, 12, 13, 21, 22, and 23) with the same population. Thatchani et al.[16] also used the same parameters, but the result was different, not statistically significant. This result was because, in Thatchani et al.’s study, the subject was between 18 and 60 years of age, whereas in Jani et al.’s study, subjects were aged between 18 and 30 years.[10],[16] All explanations have been summarized in [Table 2].
Table 2: Parameters of permanent maxillary/upper jaw dentition

Click here to view


Parameters of permanent mandibular/lower jaw dentition

Lima et al., Rekhi et al., Silva et al., Sruthi et al., and Rangari et al.[5],[7],[17],[18],[19] conducted a height estimation study using the same method with Carrea’s index but performed on different treatment groups. This method measures the two dimensions such as the arch (the sum of mesiodistal widths of six anterior teeth measured from the labial surface on the same side) and the chord (the linear distance between the mesial edge of the central incisor and the distal edge of canine teeth on the same side and measured from the lingual surface). Those measurement results are then incorporated into Carrea’s index formula as below:





with the arch values for the maximum estimated height and the chord for the minimum estimated height. Lima et al., Rekhi et al., Sruthi et al., and Rangari et al.[5],[7],[17],[19] conducted a study in the same grouping, by dividing the groups based on the dental alignment, such as normal, crowded, and diastema. Whereas, Silva et al.[18] conducted a study in different groups with other studies, using a control group (not using orthodontic treatment), group of crowded teeth before using orthodontic treatment as well as the subject group with normal tooth structure after orthodontic treatment.

Some researchers only used Carrea’s index on normal dentition, for example, Putri et al., Anita et al., and Nandita et al.[20],[21],[22] Anita et al. researched two racial populations in India, namely Aryan and Dravidian, whereas Nandita et al. conducted the study on the Indian population in general. In contrast to their research, Putri et al. conducted a study on the Mongoloid population in Indonesia. Although most of the researchers above who used the lower teeth parameters used Carrea’s index, Ganesh et al.[12] used a different IC distance parameter. All explanations have been summarized in [Table 3].
Table 3: Parameters of permanent mandibular/lower jaw dentition

Click here to view


Parameters of permanent dentition upper jaw and lower jaw (except for the third molar)

On these parameters, Prabhu et al.[23] conducted a study on the Indian population using mesiodistal and buccolingual dimensional parameters of all permanent teeth in the UJ and lower jaw (LJ) except the third molar as measured using a digital caliper and analyzed by t-test statistical analysis and correlation test using ridge regression analysis. All explanations have been summarized in [Table 4].
Table 4: Parameters of permanent dentition upper jaw and lower jaw (except for the third molar)

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Parameters of deciduous dentition

Chandrappa et al.[24], used the length of clinical crown parameters on the right side UJ teeth (central incisor to second molar) in 60 children (30 boys and 30 girls) aged between 3 and 6 years considering all the deciduous teeth had erupted within this age range, measured by a digital caliper. A year later, they conducted a study by adding permanent dentition parameters [see [Table 1]].[15] Savla et al.[25] also conducted a study with the same parameters and in the same population with slightly different results. All explanations have been summarized in [Table 5].
Table 5: Parameters of deciduous dentition

Click here to view



  Discussion Top


Stature is the height of an individual in an upright position and directly proportional to the natural biological relationship with each part of the human body, such as the head, face, trunk and extremities. Stature or height estimation has been performed using various anthropometric parameters such as length and height of long bone, sternum, leg and arm length, knee height, and vertebrae, but the estimation of height through the dimensions of teeth is still very rare in the literature.[7],[9],[17]

According to scientific proof, the relationship of height to the teeth can be seen from the similarity of the embryological process or its formation.[7],[20] The tooth’s dentin layer forms most of the tooth and determines the dimensions derived from the ectomesenchymal layer (neural crest cells) and long bones, which is the most commonly used in measuring height, derived from the mesodermal layer. Both layers of this tissue are mesenchymal tissue (connective tissue) which has the same structural components, namely an organic matrix made up of collagen and an inorganic matrix of hydroxyapatite crystals.[20],[23] This is one reason many anthropologists, odontologists, and forensic scientists have begun to study and examine the possibility that the teeth can be used to estimate the height where the long bones cannot be used.

Researchers who were using dental morphometry in their research have used various methods or parameters. Dental morphometry is a quantitative analysis to form a concept that includes the size and shape of the tooth (odontometric parameter). The composition of adult dentition consists of incisors, canines, premolars, and molars, whereas decidual teeth do not have premolars, with the shape, size, and gap between the individual teeth, as well as the location of its composition within the arch of the jaw that is different from each individual.

As described above, some permanent maxillary dentitions can estimate height. However, a parameter that is closely significant and could be used as a different approach to the estimation of height if the extremity bones are not available is the dimension of canine (based on Gupta’s results, which showed a significance value of P < 0.005 on measuring the width of the canine teeth) and the distance between right and left canine. However, these researches have only studied the normal teeth structure without spacing and malalignment. Therefore, the reliability of this method to be used in crowded and diastema teeth cannot be ascertained.[4]

Several studies using maxillary dentition parameters used the combined mesiodistal width of the anterior maxillary teeth, with results showing low correlation and no statistical significance.[4],[8],[9],[10],[11] This proves that people with tall postures do not necessarily have wider teeth. Meanwhile, several studies using the maxillary crown length parameter still showed statistically significant results (based on the results of Chandrappa et al.[15] and Jani et al.[10] studies). Therefore, this illustrates that people with tall posture tend to have longer teeth in the vertical direction because they support the height of the face. However, it is different from the results obtained in the study of Thatchani et al.[16], which also used the crown length parameter of the permanent maxillary teeth, where the results were not statistically significant and showed low correlation. This difference can occur due to differences in the age range of the subjects used; in the research of Chandrappa et al. and Jani et al., subjects were between 18 and 26 and 18 and 30 years old, respectively, whereas in Thatchani et al.’s study, the age of the subjects ranged from 18 to 60 years. A previous study explained a decrease in height over 25 years. There is also a decrease in tooth height and width due to aging or everyday wear, such as occlusal and proximal attrition. Therefore, in studies using odontometric parameters, it is important to select criteria for teeth in normal and good condition, and to select subjects in the young adult age range to minimize errors, and the expected results must be ideal and representative.[10],[16],[24]

Unlike the maxillary dentition parameters, most studies used mandibular dentition parameters using a formula called Carrea’s index, which is easier and simpler. Furthermore, this formula has been studied in any condition of teeth, such as in normal teeth, crowded teeth, diastema teeth, and even in orthodontic patients who have undergone orthodontic treatment. Moreover, the results were good and significantly accurate, although used in different populations and on normal and crowded teeth. However, for the diastema teeth, all studies showed very low accuracy. The increase of chord values makes the spacing between the teeth higher than the arch values. Although chord is used to estimate the minimal height while the arch estimates maximum height, this method becomes inaccurate. Therefore, the use of Carrea’s index method is the most ideal for use in normal dentition, as evidenced in the research of Anita et al., Nandita et al., and Putri et al., who got a predictive rate of success in estimating height using Carrea’s index with numbers above 50%, but showing a slight difference between sides and gender.[20],[21],[22] Differences in results also occur between Lima et al. and Rekhi et al., questioning the accuracy of this method in crowded teeth. It may be due to differences in group age ranges in each study.[5],[7],[17] Rekhi et al.’s subjects ranged in age between 21 and 25 years whereas Lima et al.’s was between 18 and 30 years. According to some of the literature, a person’s height increases progressively and peaks at the age of 21–25 years, after which every 25 years, there will be a decrease of as much as 2.5 cm, which is probably because of the thinning of the spinal disc, posture bending, decreased muscle tone, and osteoporosis. This method can also be used on subjects who have undergone orthodontic treatment, based on Silva’s studies that showed a fairly good significance value of P < 0.05.[17],[18]

For studies that include all permanent maxillary and mandibular dentition as parameters to estimate height, the results showed a low-moderate correlation, although statistically significant and different from other parameters, such as long bone maturity, which is the most commonly used to estimate height, indicating a moderate-to-high correlation. This may be due to the early completion of crown growth of all permanent teeth (excluding the third molar) by the age of 10 with a range of 8–12 years, compared with the epiphyseal closure of long bones that occurs between 17 and 19 years. It suggests that the teeth can only be used as an additional method compared with other methods of more accurate parameters, and when long bones are unavailable.

If there are cases with child victims, the remaining teeth found on their body can also be used to estimate height, based on the studies by Chandrappa et al. and Savla et al..[15],[24],[25] The result of statistical analysis showed the possibility of a correlation between the length of the tooth’s crown with the child’s height. The crown length of the right second molar of UJ in boys, lateral incisor in girls, and canine teeth in a combination of boys and girls showed statistical significance and can predict approximately the height of children with minimal variation. Nevertheless, this method can only be used on child victims with an age range before entering the replacement dentition period, that is, under 6 years of age. Because the measurement consists of a mixture of deciduous and permanent teeth, the results would be inaccurate.

[Table 6] provides a more detailed comparison.
Table 6: Comparison of strengths and weaknesses of each parameter based on result review

Click here to view


The odontometric factors used to measure height vary a lot, yet they all have a low-moderate connection with height. These odontometric characteristics are population specific, and future studies on the current topic are therefore recommended.


  Conclusion Top


Teeth play a crucial role in helping the identification process because it is the most muscular structure in the body, resistant to any damage, and very individualistic, and the process of identification through the teeth is faster than the DNA test and becomes an option when fingerprint examination cannot be done. The odontometric parameters that can be used to estimate height vary greatly, although some parameters still showed a low-moderate relationship to height, making it possible to be developed through further study of variations in various populations, particularly in Indonesia. Carrea’s index is one of the easiest, cheapest, most reliable, and most straightforward methods to estimate the height using the dimensions of the anterior teeth of LJ, in its use in normal or crowded teeth, in both males and females, either right or left sides, but not accurately on the diastema teeth.

Acknowledgement

There is no acknowledgement.

Financial support and sponsorship

There is no source of funding.

Conflicts of interest

There are no conflicts of interest.

Authors’ contribution

Concept: DKP, MADP, DS, APP; Design: DKP, MADP, DS, APP; Definition of Intellectual content: DKP, MADP, DS, APP; Investigation: MADP, DS, APP; Manuscript writing: DKP, MADP, DS, APP.

Ethical policy and institutional review board statement

Not applicable.

Patient declaration of consent

Not applicable.

Data availability statement

Not applicable.

 
  References Top

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Kusumastuti RD, Arviansyah A, Nurmala N, Wibowo SS Knowledge management and natural disaster preparedness: A systematic literature review and a case study of East Lombok, Indonesia. Int J Disaster Risk Reduct 2021;58:102223.  Back to cited text no. 1
    
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DePaoli K, Law C, Lojeski SM Chapter 9—Role of the Forensic Odontologist in a Medical Examiner-Coroner’s Office*. Multidisciplinary Medico-Legal Death Investigation. Academic Press; 2018; 193-214.  Back to cited text no. 2
    
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Taylor J, Kieser J Forensic Odontology: Principles and Practice. John Wiley & Sons; 2016.  Back to cited text no. 3
    
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Gupta S, Verma Y, Chandra A, Khanna S, Suhail S, Gupta OP A study on the reliability of combined width of maxillary anterior teeth, maxillary canine width, head circumference, inner canthal distance, inter-alar width and skull diameter in sex and stature determination. Int J Innovations Bio Chem Sci 2015;6:28-35.  Back to cited text no. 4
    
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Lima L, da Costa Y, Tinoco R, Rabello P, Daruge E Jr. Stature estimation by Carrea’s index and its reliability in different types of dental alignment. J Forensic Odontostomatol 2011;29:7-13.  Back to cited text no. 5
    
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Hossain MZ, Munawar KM, Rahim ZH, Bakri MM Can stature be estimated from tooth crown dimensions? A study in a sample of south-east Asians. Arch Oral Biol 2016;64:85-91.  Back to cited text no. 6
    
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Eboh DEO Determination of stature from combined maxillary anterior teeth and head dimensions among the Efik and Ibibio of South-South Nigeria. Annals Bioanthropology 2016;4:53-59.  Back to cited text no. 13
    
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Yadav AB, Yadav SK, Kedia NB, Singh AK An odontometric approach for estimation of stature in Indians: Cross-sectional analysis. J Clin Diagn Res 2016;10:ZC24-6.  Back to cited text no. 14
    
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Chandrappa R, Kamath VV, Srikanth N, Sharada C Comparative evaluation of the vertical crown length of deciduous and permanent teeth as a predictor of an individual height by linear stepwise regression analysis. Int J Forensic Odontology 2017;2:2.  Back to cited text no. 15
    
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Rekhi A, Marya CM, Nagpal R, Oberoi SS Estimation of stature in a young adult Indian population using the Carrea’s index. J Forensic Odontostomatol 2014;32:15-23.  Back to cited text no. 17
    
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da Silva AEA, Rados PV, da Silva Lauxen I, Gedoz L, Villarinho EA, Fontanella V Nuclear changes in tongue epithelial cells following panoramic radiography. Mutat Res Genet Toxicol Environ Mutagen 2007;1–2:121-5.  Back to cited text no. 18
    
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    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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