Reliability of Cephalometric Lines as Indicators for Dentoalveolar Stability in Forensic Identification: A Cross-sectional Study

Introduction: Cephalometric superimposition is an accepted method that has long been considered helpful for evaluating the growth and displacement of facial bones during orthodontic treatment. However, the use of these cephalometric records for individual identification has not been reported until recently. The present study emphasises the use of lateral cephalographs as a forensic tool for the identification of individuals. Aim: To assess the alterations in the measurements of specific cephalometric lines observed in tracings obtained before and after orthodontic intervention. Materials and Methods: A cross-sectional study was conducted in the Department of Oral Pathology, Vishnu Dental College, Bhimavaram, West Godavari District, Andhra Pradesh, India, from September 2024 to November 2024. Study involved 120 participants to assess the stability of cephalometric lines for forensic identification. Standardised lateral cephalometric radiographs, aligned with the Frankfort horizontal plane, were traced on acetate sheets by a single orthodontist to identify the chosen cephalometric lines: Pterygomaxillary fissure (Ptm)- nasion, basion-nasion, sella-nasion, Anterior Nasal Spine (ANS)- sella (anterior cranial base length), Frankfort Horizontal (FH), Posterior Nasal Spine (PNS)-nasion (posterior maxillary height), ANS-nasion (anterior maxillary height), ANS-PNS (maxillary length) and sella-articulare (posterior cranial base length). Pre and posttreatment cephalometric measurements were analysed using a paired t-test. Statistical analysis, performed using Statistical Package for the Social Sciences (SPSS) software version 26.0, deemed changes significant at p-value<0.05. To find significant differences, a paired t-test was used. Results: Among the 120 samples analysed, the gender distribution was equal, with 50% females and 50% males. The results showed no significant change in the measurements of ANS-sella, FH plane, PNS-nasion, ANS-nasion, ANS-PNS and Sella-articulare, with a p-value >0.05, indicating that skeletal and alveolar stability remained unchanged before and after orthodontic correction. Conclusion: The present study concludes that the ten reference lines taken can be used as reliable antemortem landmarks for personal identification. The present study is novel in the field of forensic dentistry and hence there is a need for further studies using a larger sample in order to establish a reliable forensic base.