Forensic Science International 210 (2011) 74–81

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Forensic Science International

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Sexual dimorphism in permanent teeth of modern Greeks

Eleni Zorba a, Konstantinos Moraitis a,*, Sotiris K. Manolis b
a
Department of Forensic Medicine and Toxicology, School of Medicine, University of Athens, Athens, Greece
b
Department of Animal and Human Physiology, Faculty of Biology, University of Athens, Athens, Greece

A R T I C L E I N F O A B S T R A C T

Article history: Sex determination is considered an important step in reconstructing the biological profile of unknown
Received 19 November 2010 individuals from a forensic context. Forensic anthropologists have long used teeth as an additional tool
Received in revised form 10 January 2011 for sex determination as they resist postmortem destruction. In this case the use of population-specific
Accepted 3 February 2011
data is necessary since sexual dimorphism varies between different populations. Currently there are no
Available online 2 March 2011
odontometric standards for determining sex in Greek populations. The purpose of this study is to
examine the degree of sexual dimorphism in permanent teeth of modern Greeks. A total of 839
Keywords:
permanent teeth in 133 individuals (70 males and 63 females) from the Athens Collection were
Sexual dimorphism
examined. Mesiodistal and buccolingual crown and cervical diameters of both maxillary and mandibular
Tooth size
Dental measurements teeth were measured. It was found that males have bigger teeth than females and in 65 out of 88
Greek population dimensions measured, male teeth exceeded female teeth significantly (P < 0.05). Canines were the most
dimorphic teeth followed by first premolars, maxillary second premolar and mandibular second molar.
Although other teeth were also sexually dimorphic they did not have a statistically significant difference
in all dimensions. The most dimorphic dimension was buccolingual cervical diameter followed by
buccolingual crown diameter. A comparison of sexual dimorphism in teeth between different
populations showed that it differs among different groups. European population groups presented the
highest degree of sexual dimorphism in teeth whereas Native South Americans the lowest.
ß 2011 Elsevier Ireland Ltd. All rights reserved.

1. Introduction investigations have examined the distances of molar cusps [8],

Sex determination is considered an important step in recon-
structing the biological profile of unknown individuals from the
forensic context. The most commonly used techniques are based on
the assessment of the morphological characteristics of the pelvis and
skull [1]. However, it is not uncommon to recover the pelvis and the
skull in a fragmentary state in forensic settings. In this case, teeth can
be used as an additional tool for sex determination as they are very
resilient to destruction and fragmentation in comparison with
skeletal tissues. Metric and non-metric analyses of the human
dentition have played an important role in human biological
research and have formed a central focus in the field of dental
anthropology for over a century [2,3].
Most studies of sexual dimorphism in tooth size are based on
the measurement of the mesiodistal and buccolingual crown
diameters [4–6]. However, a number of other studies have used
alternative measurements such as the mesiodistal and buccolin-
gual cervical and diagonal diameters of teeth [7]. In addition, some
* Corresponding author at: Department of Forensic Medicine and Toxicology,
School of Medicine, University of Athens, 75M. Asias Str., Goudi, Athens 11527,
Greece. Tel.: +30 210 7462426; fax: +30 210 7706868.
E-mail address: kmoraitis@med.uoa.gr (K. Moraitis).
while some more recent research has focused on studying crown
tissue measurements since it has been proved that tooth formation
and tissue proportions are highly regulated by sex-linked genes [9–
18]. Sexual dimorphism in crown morphology and size of the
permanent dentition is the result of the different amount of
enamel, dentin, and pulp tissue between males and females.
A number of investigations have established that sexual
dimorphism exists in the permanent dentition of humans
particularly in the canines, which exhibit the greatest degree of
difference [2,11,12,14,15,19–21]. According to Butler [22] and
Garn et al. [15], a ‘‘canine field’’ exists in the permanent dentition
around which adjacent teeth (lateral incisors and first premolars)
share a tendency for greater sexual dimorphism than do more
distant teeth. In the past, research on sex differences in tooth
morphology has assessed the dimorphism of the mesiodistal and
buccolingual diameters of tooth crowns [15,19,23]. The extent of
this sexual dimorphism varies among populations [14] although
current intra-specific data may not be representative of the total
range of variation across archaeological and contemporary
populations [24]. Furthermore, no positive correlation exists
between the deciduous tooth size and the degree of sexual
dimorphism [25]. Metric approaches confirmed that sexual
dimorphism exists in overall crown size with values for males
exceeding on average those for females [26]. As sexual dimorphism

0379-0738/$ – see front matter ß 2011 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.forsciint.2011.02.001
 E. Zorba et al. / Forensic Science International 210 (2011) 74–81 75

Table 1 Table 2
Descriptive statistics of age in the study sample. The paired t-test evaluating intra-observer variation in tooth measurements.

Females (N = 56) Males (N = 68) Total (N = 124) Tooth N Base Test t-Valuea P-value
observation observation
Mean age 50.7 46.5 48.4
Median age 48.5 44.0 46 Mean S.D. Mean S.D.
Minimum age 14 16 14
Upper I1
Maximum age 85 96 96
MD 29 8.357 0.94 8.362 0.95 1.33 0.195
BL 28 7.160 0.55 7.161 0.55 0.13 0.895
Cervical MD 30 6.191 0.79 6.291 1.02 1.00 0.326
Cervical BL 29 6.309 0.37 6.309 0.37 0.09 0.929
varies between different populations the collection of population-
specific data is of major importance. Thus far there are no Upper I2
odontometric standards of Greek populations for sex determina- MD 36 6.494 0.58 6.493 0.58 0.22 0.834
BL 38 6.326 0.52 6.332 0.52 0.44 0.661
tion.
Cervical MD 40 4.764 0.53 4.767 0.53 1.89 0.066
The purpose of this study is to analyze crown and cervical tooth Cervical BL 42 5.804 0.46 5.803 0.46 0.46 0.649
dimensions and assess the degree of sexual dimorphism in
Upper C
permanent teeth of modern Greeks.
MD 44 7.568 0.53 7.569 0.53 0.80 0.430
BL 47 8.255 0.72 8.261 0.72 2.21y 0.032
2. Materials and methods Cervical MD 50 5.642 0.49 5.645 0.50 0.59 0.561
Cervical BL 52 7.840 0.74 7.840 0.74 0.05 0.959
A total of 839 permanent teeth from 133 individuals (70 males
Upper P1
and 63 females) from the Athens Collection were examined. The MD 40 6.857 0.68 6.865 0.67 1.60 0.119
Athens Collection of the Department of Animal and Human BL 46 8.896 0.70 8.899 0.70 1.04 0.305
Physiology at the University of Athens currently consists of 225 Cervical MD 49 4.666 0.48 4.674 0.47 2.02y 0.049
skeletons of known sex, age, occupation, cause of death, and place Cervical BL 45 8.147 0.71 8.147 0.17 0.07 0.945
of birth [27]. The skeletons belong to individuals who lived mainly Upper P2
in the second half of the twentieth century and come from MD 36 6.566 0.54 6.574 0.54 1.36 0.183
cemeteries in the region of Athens. This sample is considered to be BL 42 9.040 0.68 9.044 0.68 0.99 0.327
Cervical MD 41 4.603 0.39 4.602 0.39 0.46 0.649
representative of modern Greeks, at least those from urban
Cervical BL 39 8.202 0.75 8.209 0.74 1.84 0.074
contexts. Descriptive statistics of the studied sample for the
average ages of females, males and the two sexes are presented in Upper M1
MD 48 10.255 0.70 10.261 0.70 1.84 0.073
Table 1. BL 60 11.091 0.59 11.092 0.59 0.50 0.616
Two crown and two cervical tooth dimensions were measured. Cervical MD 55 7.539 0.53 7.543 0.52 0.90 0.371
An 8-in. digital sliding caliper (Absolute Digimatic Caliper1, Cervical BL 60 10.366 0.68 10.374 0.67 1.62 0.111
Mitutoyo) with calibration 0.01 mm was used for the measure- Upper M2
ments. Each dimension was measured twice at a different time MD 61 9.528 0.84 9.533 0.85 1.45 0.153
interval by one observer. Descriptive statistics for intra-observer BL 63 10.986 0.91 10.991 0.91 1.49 0.140
error are presented in Table 2. The following measurements were Cervical MD 63 7.556 1.02 7.553 1.02 0.64 0.524
Cervical BL 62 10.279 1.08 10.284 1.08 0.93 0.354
taken as defined by Hillson et al. [7]:
Upper M3
 Maximum mesiodistal crown diameter (MD) is defined as the MD 35 8.864 0.89 8.859 0.89 1.14 0.261
BL 35 10.576 0.86 10.583 0.86 1.45 0.156
maximum distance between the most mesial and the most distal
Cervical MD 32 6.799 0.84 6.799 0.84 0.00 1.000
point of the crown. Cervical BL 33 9.747 1.03 9.751 1.03 -0.91 0.368
 Maximum buccolingual crown diameter (BL) is defined as the
Lower I1
maximum distance between the most lingual/palatal and the
MD 35 5.313 0.38 5.313 0.38 0.10 0.919
most buccal/labial point of the crown. BL 35 5.727 0.34 5.735 0.34 2.61y 0.013
 Mesiodistal cervical diameter (cervical MD) for incisors and Cervical MD 35 3.489 0.43 3.491 0.43 0.50 0.621
canines is defined as the distance between the most occlusal Cervical BL 33 5.480 0.62 5.476 0.62 0.75 0.459
point of the cement–enamel junction curve on the mesial and Lower I2
distal side, and for premolars and molars as the midway point MD 51 5.845 0.49 5.850 0.49 1.79 0.080
along the cement–enamel junction on the mesial and distal side BL 52 6.141 0.48 6.102 0.42 1.01 0.318
Cervical MD 51 3.882 0.49 3.943 0.57 1.04 0.302
of the crown.
Cervical BL 50 5.925 0.45 5.928 0.45 0.98 0.331
 Buccolingual cervical diameter (cervical BL) for incisors, canines,
and premolars is defined as the maximum measurement at the Lower C
MD 59 6.598 0.50 6.598 0.50 0.09 0.929
cement–enamel junction from labial/buccal to lingual/palatal,
BL 57 7.611 0.67 7.610 0.67 0.11 0.914
and for molars as the maximum measurement between the Cervical MD 59 5.248 0.49 5.259 0.49 2.97z 0.004
cement–enamel junction at points midway along the buccal and Cervical BL 57 7.483 0.68 7.482 0.67 0.33 0.741
lingual/palatal sides.
Lower P1
MD 54 6.847 0.54 6.849 0.53 0.65 0.519
The measurements were taken from the left maxillary and BL 60 7.557 0.70 7.557 0.70 0.20 0.841
mandibular teeth. In case of absence of the left tooth the Cervical MD 55 4.794 0.40 4.796 0.40 0.63 0.531
Cervical BL 53 6.822 0.66 6.827 0.66 1.18 0.245
dimensions of the right tooth were taken. Some measurements
could not be taken because of fragmentary teeth, or from Lower P2
crowns with a high degree of attrition, pathology or any MD 53 6.985 0.55 6.986 0.54 0.43 0.671
BL 59 7.994 0.65 7.996 0.64 1.02 0.310
restorative work. In addition, there was a difficulty to take the
Cervical MD 51 5.010 0.39 5.010 0.40 0.05 0.961
measurements of some teeth that were still held in the Cervical BL 52 7.190 0.73 7.189 0.72 0.16 0.871
tooth socket, especially the cervical dimensions. This problem,
76 E. Zorba et al. / Forensic Science International 210 (2011) 74–81

Table 2 (Continued )
3. Results
Tooth N Base Test t-Valuea P-value
observation observation
3.1. Intra-observer error
Mean S.D. Mean S.D.

Lower M1 Table 2 shows the intra-observer error between two measure-

MD 45 10.824 0.68 10.822 0.68 0.49 0.625 ments for each diameter and each tooth taken in different times
BL 55 10.145 0.49 10.144 0.50 0.22 0.826 using a paired t-test. For this analysis all maxillary and mandibular
Cervical MD 50 8.579 0.55 8.578 0.55 0.18 0.858
teeth were tested. In most cases there was no statistically
Cervical BL 49 8.910 0.54 8.909 0.55 0.22 0.827
significant difference between the base and the test measurement.
Lower M2 However, a statistically significant difference was observed for
MD 60 10.545 0.73 10.544 0.72 0.45 0.655
cervical MD diameter in upper P1, lower C and lower M2, and for BL
BL 67 9.888 0.63 9.889 0.63 0.10 0.918
Cervical MD 60 8.903 0.69 8.911 0.70 2.12y 0.038 diameter in upper C and lower I1.
Cervical BL 51 8.813 0.76 8.815 0.76 0.46 0.646

Lower M3 3.2. Sexual dimorphism

MD 53 10.653 0.79 10.648 0.80 1.36 0.180
BL 54 9.708 0.70 9.710 0.70 0.74 0.465 Tables 3–6 present descriptive statistics (mean, standard
Cervical MD 40 8.826 0.82 8.825 0.82 0.22 0.827
deviation and coefficient of variation), percentage of sexual
Cervical BL 37 8.065 0.86 8.067 0.86 0.34 0.737
dimorphism, t-values, and P-values for MD, BL, cervical MD and
a
Statistically significant at yP < 0.05, zP < 0.01.
cervical BL for each tooth of all males and females included in the
study.
In the case of MD diameter (Table 3) there is a statistically
encountered by other researchers as well, is due to the difficulty to significant difference between males and females for upper C,
place the caliper beaks at the right points of the crown between the upper P1, upper P2, upper M3, lower C, lower P1, lower M2, and
teeth [7]. lower M3. For the BL diameter (Table 4) all teeth show a
Statistical analysis was carried out using IBM SPSS Statistics statistically significant difference between males and females
(IBM Inc., version 17 for Windows) software package. Mean, except of lower P2. In the case of cervical MD diameter (Table 5)
standard deviation (S.D.), coefficient of variation (C.V.) and there is a statistically significant difference between males and
percentage of sexual dimorphism were calculated. Also, a Student’s females for upper C, upper P1, upper P2, upper M2, upper M3,
t-test (paired t-test for intra-observer error and independent lower C, lower P1, lower M1, and lower M2. For the cervical BL
samples t-test for the comparison between male and female mean diameter (Table 6) there is a statistically significant difference
values) was performed. t-Values with P < 0.05 were considered between males and females for the majority of teeth except of
statistically significant. upper M3 and lower I1.
In this study the percentage of sexual dimorphism was used as Fig. 1 shows the percentage (%) of sexual dimorphism in each
an indicator to describe the differences between males and dimension (MD, BL, cervical MD, and cervical BL) for all maxillary
females. This index is calculated using the formula of Garn et al. and mandibular teeth. It was observed that the most dimorphic
[15]: dimension was cervical BL diameter followed by BL diameter,
  cervical MD diameter and MD diameter.
male mean  female mean
 100 Maxillary and mandibular canines are the most sexually
female mean
dimorphic teeth with the upper C to be more dimorphic than
Percentage of sexual dimorphism represents the difference the lower C. Also the upper and lower P1 show significant sexual
between male and female mean values. A positive value indicates dimorphism followed by the upper P2 and lower M2. These teeth
larger male tooth dimension, whereas a negative value indicates are dimorphic for all dimensions, having a statistically significant
larger female tooth dimension. If the value is close to zero, the difference between males and females. However, although other
magnitude of sex dimorphism will be lower. teeth are sexually dimorphic they do not have a statistically

Table 3
Descriptive statistics, percentage of sexual dimorphism and t-values of mesiodistal crown dimensions in Greek male and female teeth.

Tooth Male Female % Sexual dimorphisma t-Valueb P-value (2-tailed)

N Mean S.D. C.V. N Mean S.D. C.V.

Upper I1 15 8.51 0.73 8.63 14 8.20 1.13 13.80 3.87 0.90 0.375
Upper I2 21 6.54 0.59 9.05 15 6.44 0.58 8.96 1.57 0.51 0.614
Upper C 29 7.73 0.51 6.60 15 7.26 0.42 5.76 6.48 3.07z 0.004
Upper P1 24 7.03 0.67 9.50 16 6.60 0.63 9.52 6.52 2.04y 0.048
Upper P2 21 6.73 0.43 6.35 15 6.35 0.61 9.66 6.06 2.22y 0.033
Upper M1 24 10.38 0.63 6.11 24 10.14 0.75 7.38 2.37 1.75 0.087
Upper M2 32 9.64 0.92 9.59 29 9.41 0.75 7.99 2.41 1.05 0.300
Upper M3 21 9.18 0.89 9.68 14 8.39 0.68 8.10 9.46 2.83z 0.008
Lower I1 20 5.35 0.41 7.68 15 5.27 0.35 6.59 1.43 0.57 0.572
Lower I2 30 5.92 0.56 9.42 21 5.75 0.37 6.47 2.94 1.21 0.231
Lower C 32 6.77 0.51 7.57 27 6.40 0.40 6.25 5.81 3.06z 0.003
Lower P1 35 6.97 0.50 7.12 19 6.63 0.55 8.23 5.16 2.33y 0.023
Lower P2 31 7.06 0.56 7.92 22 6.88 0.52 7.49 2.54 1.16 0.252
Lower M1 23 10.95 0.63 5.74 22 10.69 0.72 6.77 2.51 1.33 0.191
Lower M2 35 10.75 0.65 6.09 25 10.26 0.74 7.19 4.71 2.67y 0.010
Lower M3 32 10.83 0.80 7.38 21 10.38 0.72 6.98 4.29 2.06y 0.045
a
Calculations made from [(male mean  female mean)/female mean]  100 [15].
b
Statistically significant at yP < 0.05, zP < 0.01.
 E. Zorba et al. / Forensic Science International 210 (2011) 74–81 77

Table 4
Descriptive statistics, percentage of sexual dimorphism and t-values of buccolingual crown dimensions in Greek male and female teeth.

Tooth Male Female % Sexual dimorphisma t-Valueb P-value (2-tailed)

N Mean S.D. C.V. N Mean S.D. C.V.

Upper I1 15 7.42 0.36 4.92 13 6.86 0.59 8.58 8.10 3.05z 0.005
Upper I2 22 6.48 0.51 7.90 16 6.12 0.46 7.48 6.03 2.29y 0.028
Upper C 32 8.55 0.63 7.40 15 7.64 0.46 6.01 11.80 4.93§ 0.000
Upper P1 29 9.17 0.56 6.11 17 8.43 0.69 8.20 8.76 3.95§ 0.000
Upper P2 22 9.32 0.61 6.59 20 8.73 0.63 7.21 6.77 3.08z 0.004
Upper M1 31 11.34 0.52 4.60 29 10.83 0.56 5.16 4.71 3.66§ 0.001
Upper M2 33 11.44 0.71 6.23 30 10.49 0.86 8.19 9.02 4.78§ 0.000
Upper M3 22 10.85 0.72 6.66 13 10.13 0.91 9.01 7.13 2.59y 0.014
Lower I1 20 5.86 0.32 5.38 15 5.56 0.30 5.31 5.36 2.84z 0.008
Lower I2 30 6.24 0.46 7.29 22 5.96 0.34 5.75 4.82 2.48y 0.016
Lower C 32 7.94 0.63 7.87 25 7.19 0.46 6.36 10.51 5.07§ 0.000
Lower P1 36 7.80 0.59 7.53 24 7.20 0.71 9.81 8.31 3.56§ 0.001
Lower P2 34 8.13 0.67 8.26 25 7.81 0.57 7.27 4.09 1.92 0.059
Lower M1 29 10.35 0.38 3.71 26 9.92 0.51 5.13 4.35 3.57§ 0.001
Lower M2 39 10.10 0.60 5.94 28 9.59 0.54 5.67 5.32 3.56§ 0.001
Lower M3 32 9.92 0.70 7.10 22 9.40 0.59 6.24 5.58 2.87z 0.006
a
Calculations made from [(male mean  female mean)/female mean]  100 [15].
b
Statistically significant at yP < 0.05, zP < 0.01, §P < 0.01.

Table 5
Descriptive statistics, percentage of sexual dimorphism and t-values of mesiodistal cervical dimensions in Greek male and female teeth.

Tooth Male Female % Sexual dimorphisma t-Valueb P-value (2-tailed)

N Mean S.D. C.V. N Mean S.D. C.V.

Upper I1 16 6.43 0.79 12.33 14 6.02 0.94 15.59 6.75 1.29 0.209
Upper I2 24 4.86 0.50 10.28 16 4.63 0.56 12.08 4.91 1.34 0.187
Upper C 33 5.84 0.45 7.72 17 5.27 0.34 6.44 10.73 4.54§ 0.000
Upper P1 30 4.84 0.41 8.40 19 4.40 0.45 10.33 10.06 3.55z 0.001
Upper P2 22 4.74 0.37 7.77 19 4.44 0.37 8.30 6.65 2.56y 0.015
Upper M1 27 7.65 0.52 6.76 28 7.43 0.52 6.99 2.95 1.57 0.123
Upper M2 35 7.79 1.19 15.24 28 7.26 0.66 9.11 7.40 2.14y 0.036
Upper M3 20 7.06 0.90 12.72 12 6.37 0.51 7.96 10.90 2.44y 0.021
Lower I1 21 3.53 0.28 8.05 14 3.42 0.59 17.34 3.19 0.73 0.471
Lower I2 29 4.00 0.57 14.28 22 3.80 0.33 8.77 5.24 1.46 0.152
Lower C 32 5.51 0.45 8.24 27 4.95 0.33 6.73 11.13 5.23§ 0.000
Lower P1 32 4.99 0.34 6.87 23 4.52 0.28 6.28 10.56 5.46§ 0.000
Lower P2 28 5.10 0.35 6.79 23 4.90 0.44 8.89 4.04 1.81 0.076
Lower M1 26 8.75 0.54 6.12 24 8.39 0.51 6.11 4.27 2.41y 0.020
Lower M2 33 9.12 0.68 7.41 27 8.65 0.64 7.38 5.42 2.74z 0.008
Lower M3 21 9.02 0.90 9.95 19 8.61 0.69 7.96 4.75 1.61 0.117
a
Calculations were made from [(male mean  female mean)/female mean]  100 [15].
b
Statistically significant at yP < 0.05, zP < 0.01, §P < 0.001.

Table 6
Descriptive statistics, percentage of sexual dimorphism and t-values of buccolingual cervical dimensions in Greek male and female teeth.

Tooth Male Female % Sexual dimorphisma t-Valueb P-value (2-tailed)

N Mean S.D. C.V. N Mean S.D. C.V.

Upper I1 15 6.54 0.25 3.86 14 6.06 0.32 5.25 7.83 4.47§ 0.000
Upper I2 25 5.96 0.43 7.23 17 5.58 0.40 7.25 6.88 2.90z 0.006
Upper C 35 8.15 0.66 8.11 17 7.19 0.42 5.81 13.33 5.46§ 0.000
Upper P1 29 8.42 0.52 6.18 16 7.65 0.74 9.74 10.17 4.10§ 0.000
Upper P2 20 8.60 0.66 7.62 19 7.79 0.61 7.81 10.42 4.00§ 0.000
Upper M1 30 10.65 0.66 6.18 30 10.09 0.57 5.62 5.56 3.53§ 0.001
Upper M2 35 10.59 1.13 10.70 27 9.88 0.88 8.91 7.11 2.66y 0.010
Upper M3 20 10.02 1.15 11.43 13 9.33 0.65 6.98 7.49 1.99 0.055
Lower I1 19 5.59 0.35 6.20 14 5.33 0.85 16.01 4.88 1.21 0.237
Lower I2 29 6.05 0.47 7.72 21 5.76 0.38 6.56 5.09 2.37y 0.022
Lower C 31 7.89 0.57 7.28 26 7.00 0.42 6.06 12.70 6.53§ 0.000
Lower P1 30 7.15 0.46 6.48 23 6.40 0.64 9.94 11.59 4.92§ 0.000
Lower P2 29 7.46 0.55 7.32 23 6.85 0.79 11.50 8.90 3.29z 0.002
Lower M1 27 9.16 0.51 5.56 22 8.60 0.43 5.02 6.46 4.07§ 0.000
Lower M2 30 9.07 0.65 7.12 21 8.45 0.79 9.30 7.26 3.05z 0.004
Lower M3 20 8.33 0.73 8.76 17 7.75 0.91 11.76 7.55 2.17y 0.037
a
Calculations made from [(male mean  female mean)/female mean]  100 [15].
b
Statistically significant at yP < 0.05, zP < 0.01, §P < 0.001.
78 E. Zorba et al. / Forensic Science International 210 (2011) 74–81
Fig. 1. Percentage of sexual dimorphism in maxillary and mandibular permanent teeth of Greek population for each dimension.
significant difference in all dimensions. For example, the upper M2,
upper M3, lower M1 and lower M3 have a statistically significant
difference in three dimensions, the upper I1, upper I2 and lower I2
in two dimensions, and the lower I1 and lower P2 in only one
dimension. A comparison between the maxillary and mandibular
teeth shows that maxillary teeth are more dimorphic than those of
the mandible. It was found that males have larger teeth than
females and in 65 out of 88 dimensions the teeth of males exceeded
the teeth of females significantly (P < 0.05).
4. Discussion
4.1. Intra-observer error
For the vast majority of dimensions that were measured in each
tooth, there is no statistically significant difference between the
base and the test measure. Nevertheless, the upper P1, lower C and
lower M2 show intra-observer variation in cervical MD dimension
and the upper C and lower I1 in BL dimension. Pérez-Pérez et al.
[28] mention that the measurement error may be either systematic
or random, depending not only on the researcher but also on the
tool used, the variable measured and the magnitude of the variable.
Difficulties in measuring certain tooth dimensions may be an
explanation. For measuring the cervical MD diameter in canines,
the caliper’s beaks are placed between the curve that is configured
at the cement–enamel junction on the mesial and distal sides. It
was observed that the mesial curve rises more to the occlusal than
the distal curve, so that the axis of measurement is not strictly
parallel to the occlusal plane of the tooth, or the normal definition
of the axis for the traditional mesiodistal crown diameter [7]. This
may create a problem in measuring. In regards to premolars and
molars there is no curve in the cervix of the tooth and the
measurement point is defined as the midway along the cement–
enamel junction on the mesial and distal sides of the crown [7]. The
absence of naturally defined landmarks complicates measuring. In
the case of BL diameter, the upper C and lower I1 showed intra-
observer variation. There is little difficulty in taking this
measurement for the anterior teeth (incisors, canines, and
premolars) [4,7,29,30].
4.2. Teeth and sexual dimorphism
Many researchers have studied sexual dimorphism in teeth
[2,11,12,14,19–21] and pointed out the high dimorphism of
permanent teeth, particularly the canines [2,15,31]. A number of
studies have demonstrated that the percentage of sexual dimor-
phism in permanent teeth varied between 4% and 6% [32,33].
In the present study it was observed that several teeth are
sexually dimorphic. However, two types of teeth, the upper and
lower C and the upper and lower P1 presented a significant sexual
dimorphism for all dimensions measured. As shown in other
studies, there is a significant sexual dimorphism in permanent
teeth, especially in canines, with males having larger teeth than
females [33–37]. According to Garn et al. [15,33] the teeth located
adjacent to the canines (e.g. first premolar) are more dimorphic
than the others. In addition, the upper P2 and lower M2 show
significant sexual dimorphism in all dimensions. Although other
teeth are sexually dimorphic they do not have a statistically
significant difference in all dimensions, especially in the MD
diameters.
Other studies report that sexual dimorphism is more pro-
nounced in canines and molars [15,32,34,38], less in incisors
[15,32,38] and more for BL than the MD diameters [38]. Acharya
and Mainali [4] have found that except the canines, upper I1 and
molars exhibit consistent univariate sex differences. In addition,
İşcan and Kedici [5] mention that M1 for the upper and P1 and M2
for the lower dentition show significant sexual dimorphism, but
the magnitude of the difference between the sexes appears to
come from the canines. Bishara et al. [39] reported that first molars
also show sexual dimorphism. Contrary to Pereira et al. [40] and
Acharya and Mainali [4], who state that central or lateral incisors
show significant sexual dimorphism, other studies found that
incisors show the least sexual dimorphism [39,41].
The results of this study suggest that the most dimorphic
dimension is cervical BL diameter followed by BL diameter, cervical
MD diameter and MD diameter. The most studied dimensions in
sex determination research are the MD and the BL crown
diameters. Both diameters show advantages and disadvantages
in tooth-measuring methods with BL diameters to be considered
more reliable [5,30,33]. However, Hillson et al. [7] applied a new
method to determine sex from teeth. This method includes the
measuring of cervical diameters in anterior and posterior teeth.
The relationship of cervical alternative measurements in the
overall size of the crown appears to be similar with the maximum
diameters of crown. The alternative measurements are more
suitable for worn teeth that make up the bulk of the archaeological
and fossil record, and also open up the possibility of comparing
directly the little-worn teeth of children with the more heavily
worn teeth of adults [7]. There are no other studies that have
utilized cervical diameters of teeth. On the other hand, the
 E. Zorba et al. / Forensic Science International 210 (2011) 74–81 79

Table 7
Percentage of sexual dimorphism for mesiodistal (MD) and buccolingual (BL) crown diameters in different population groups.

Population group Tooth Teetha

dimension
UI1 UI2 UC UP1 UP2 UM1 UM2 UM3 LI1 LI2 LC LP1 LP2 LM1 LM2 LM3
b
Greek MD 3.87 1.57 6.48 6.52 6.06 2.37 2.41 9.46 1.43 2.94 5.81 5.16 2.54 2.51 4.71 4.29
BL 8.10 6.03 11.80 8.76 6.77 4.71 9.02 7.13 5.36 4.82 10.51 8.31 4.09 4.35 5.32 5.58
Turkish [43] MD 1.19 3.85 5.34 1.60 1.99 1.99 1.52 – 0.94 0.34 5.62 1.01 1.71 1.67 0.67 –
BL 4.04 4.88 8.19 3.52 2.81 3.86 2.78 – 6.20 3.02 9.81 3.46 2.38 1.13 2.12 –
Spanish [50] MD 15.54 3.11 4.78 4.70 1.99 4.50 – – – – – – – 4.65 – –
BL 26.48 20.59 8.16 3.52 3.61 3.49 – – – – – – – 10.35 – –
Portuguese [40] MD 3.44 5.45 4.65 – – – – – – – – – – – – –
BL – – 6.70 – – – – – – – – – – – – –
Swedishc [51] MD 4.72 4.96 8.54 – – – – – – – – – – – – –
BL 1.57 3.85 6.22 – – – – – – – – – – – – –
Icelanderc [52] MD 2.74 1.76 4.49 – – – – – – – – – – – – –
BL 1.80 1.08 5.28 – – – – – – – – – – – – –
Egyptian [39] MD 0.00 1.47 5.33 0.00 0.00 0.97 – – 3.57 0.00 4.54 0.00 1.39 0.91 – –
BL 1.37 3.13 2.50 1.08 1.05 0.00 – – 1.67 1.56 1.37 0.00 0.00 0.93 – –
Jordanian [53] MD 3.59 3.43 5.12 2.42 2.64 3.23 – – 1.62 3.13 5.25 4.84 3.61 4.14 – –
BL – – – – – – – – – – – – – – – –
Iraqi [54] MD 2.04 0.73 2.94 1.56 0.29 0.66 – – 1.06 0.00 3.09 1.27 1.38 1.90 – –
BL – – – – – – – – – – – – – – – –
Nepalase [4] MD 3.29 1.32 4.49 0.57 1.38 1.93 0.72 – 1.11 1.68 5.60 0.43 0.43 1.19 3.65 –
BL 3.49 2.52 5.97 2.91 3.15 3.77 3.86 – 2.51 1.90 6.97 2.40 2.01 1.13 1.73 –
Indian [55] MD 1.81 0.92 2.70 0.44 1.53 0.92 1.63 – 1.71 1.91 2.78 0.88 0.44 2.65 1.65 –
BL 2.69 1.60 4.39 2.31 2.33 3.33 3.81 – 0.00 0.16 4.70 2.32 3.14 3.34 2.34 –
Chilean [50] MD 1.62 0.13 7.98 0.87 2.60 2.71 – – – – – – – 2.42 – –
BL 3.25 7.47 8.18 1.26 0.63 2.98 – – – – – – – 3.05 – –
Mexican [39] MD 2.44 1.54 6.67 6.06 6.06 2.91 – – 1.85 1.69 7.69 4.48 5.71 2.83 – –
BL 2.82 4.84 7.50 4.30 4.25 2.68 – – 5.17 3.23 4.17 5.13 3.57 3.77 – –
American (Iowa) [39] MD 1.18 0.00 4.00 1.47 3.08 3.96 – – 1.89 1.72 6.25 2.94 2.90 4.76 – –
BL 2.90 5.00 2.53 3.37 3.33 4.63 – – 1.69 3.33 2.78 1.32 1.20 3.88 – –
African American [56] MD 4.59 2.54 5.81 3.93 4.47 4.45 3.77 – 2.79 2.34 7.43 4.72 3.15 4.26 5.39 –
BL – – – – – – – – – – – – – – – –
Southern Chinese [41] MD 1.84 2.51 4.80 2.51 2.25 3.00 3.02 – 0.90 1.30 6.10 2.99 2.86 3.54 3.47 –
BL 2.85 2.97 3.20 4.17 4.37 3.19 3.23 – 3.62 2.26 2.27 4.37 3.03 4.21 3.43 –
Native South American MD 0.46 0.67 3.30 0.40 1.13 0.0 2.51 – 2.02 0.63 4.93 1.13 1.97 2.07 3.29 –
(Ticuna) [6]
BL 4.26 0.15 3.98 0.00 0.00 2.45 2.77 – 0.17 0.80 2.90 0.77 1.49 2.84 2.58 –
Australian Aborigines [57,58] MD 3.89 4.22 4.53 2.12 2.57 3.85 3.78 1.13 3.35 3.77 6.85 1.77 3.42 3.61 3.43 2.56
BL 6.00 5.08 5.19 2.77 2.39 3.44 3.30 1.34 6.68 5.73 4.48 1.61 2.35 3.58 2.75 2.24
a
U – upper, L – lower.
b
Present study.
c
Compiled from Pereira et al. [40].

information about MD and BL crown dimensions is satisfactory.
Garn et al. [15] suggest that BL diameter is more dimorphic than
MD diameter, in contrast to Lunt’s findings [42]. Acharya and
Mainali [30] mention that MD measurements are better suited
than BL dimensions for sex discrimination. However, they found
that there are better results in dental sex assessment when both
MD and BL dimensions are used together. In addition, it was
observed that maxillary teeth are more dimorphic than mandibu-
lar (Fig. 1). Ateş et al. [43] found that the most dimorphic variables
are the BL dimensions of the lower I2 and C, whereas MD
dimensions of both jaws show the least accuracy.
One of the findings of this study was that males’ teeth are bigger
in size than females’ for both crown and cervical dimensions.
Especially for crown dimensions there are studies that have
examined the different amount of dentin and enamel between the
two sexes [14]. Some researchers believe that sexual dimorphism
is the result of the different amount of enamel [17,44], whereas
others found significant differences in the amount of dentin
[11,20,45]. Male teeth have a higher amount of dentin compared to
females, while females possess proportionally more enamel in
teeth [11,14,24]. It appears that sex-linked genes on both the X-
and Y-chromosomes are responsible for this difference in the
amounts of dentin and enamel in teeth [44,46,47]. Alvesalo and
Tammisalo [46] and Alvesalo et al. [44,47] found that the Y
chromosome increases the mitotic potential of the tooth germ. It
induces dentinogenesis, while the X chromosome promotes
amelogenesis. According to Garn et al. [15] it is the Y chromosome
which contributes most in the size of teeth by controlling the
thickness of dentin, whereas the X chromosome, for a long time
considered being the chromosome responsible, only comes into
play concerning the thickness of enamel.
4.3. Sexual dimorphism of teeth in different population groups
Sex differences in tooth size are due to differences in body bulk
of the two sexes that exist in any given human population.
Researchers have found that there is a statistically significant
difference in tooth size between males and females [2,15,31,33].
However, sexual dimorphism is a population-specific phenome-
non. In this study the percentage of sexual dimorphism was
calculated for two dimensions (MD, BL) using the formula of Garn
et al. [15]. The same formula has been used to estimate sexual
dimorphism for other populations. Table 7 compares the percent-
age of sexual dimorphism in different populations for MD and BL
crown diameters. Some errors were found in the percentage of
sexual dimorphism for upper P1, lower C and lower M2 in the study
of Harris and Nweeia [6] and the correct values are presented in
Table 7. In most cases there is sexual dimorphism for both MD and
BL crown diameters but the amount differs between different
populations. European population groups show the highest degree
of sexual dimorphism in teeth whereas Ticuna Indians the lower.
Harris and Nweeia [6] suggest that a lack of dimorphism may
characterize native South Americans. A high degree of sexual
dimorphism in tooth size was found in Australian aborigines,
80 E. Zorba et al. / Forensic Science International 210 (2011) 74–81
African Americans, and Mexicans. BL crown diameters are more
dimorphic than MD diameters in most populations. In most
cases canines are the most dimorphic teeth. However, in the
case of Australian aborigines incisors, especially the central
incisors, have been found to be more dimorphic in BL
dimensions than the canines. In the Greek sample, the levels
of sexual dimorphism are more similar to European than to
Asian populations. In Asian populations the percentage of sexual
dimorphism is low in contrast to other population groups.
Richards et al. [48] mention that genetically the Near East and
Europe can be considered as well-separated populations.
However, this overlooks the geographic proximity of Greece
and Turkey. A comparison between Greeks and Turks shows that
the percentage of sexual dimorphism is higher in the Greek
population for both diameters. However for some teeth (e.g.
canines) the percentage is similar between the two populations.
This similarity can be explained from the fact that these two
different populations have many common elements in their
nutrition. The different patterns of sexual dimorphism observed
between different populations reflect genetic, epigenetic and
environmental influences to dental development between these
populations. Among the environmental factors that influence
the variation in tooth size are nutrition, disease and climate. In
humans the masticatory apparatus is very much a function of
the subsistence pattern [43]. Hence eating habits can influence
the size of teeth. Ateş et al. [43] mention that teeth are larger in
populations relying more on plant food than meat. There is
regional variation in dental size [15]. Hanihara and Ishida [49]
propose that the smaller tooth dimensions in Western Eurasian
populations are related to the lower impact of natural selection
on tooth size in these populations over the last few millennia,
associated with cultural changes in food preparation practices
following the adoption of agriculture. It is known that the
magnitude of sexual dimorphism in tooth size is inheritable
[15]. Hence genetic differences between and within populations
contribute to diversity. The differences in tooth dimensions
between the various groups may be related, in part, to the
degree of admixture with other populations [39]. An explanation
for the differences between Mexicans and Americans from Iowa
is the differential amounts of admixture. The genetic pool in the
Mexican population can be assumed to be mainly an admixture
of Spanish (Caucasian) and North American Indian (Mongoloid)
descendants, whereas in the Iowa population the admixture is
between various Caucasian groups, mainly English, Scandina-
vian, and German [39].
Finally, there are differences in sexual dimorphism of teeth
between different populations for both MD and BL crown
dimensions. Hence the use of dental dimensions to construct
discriminant functions for sexing human skeletal remains is
population-specific.
5. Conclusions
Our conclusions are summarized as follows:
 Greek males have larger teeth than females.
 Maxillary teeth are more sexually dimorphic than mandibular
teeth.
 Canines and first premolars in both jaws as well as maxillary
second premolar and mandibular second molar are the most
dimorphic teeth for all dimensions.
 Although other teeth show an overall significant degree of sexual
dimorphism, they do not show a statistically significant difference
between males and females in every dimension examined.
 The alternative measurements proposed by Hillson et al. [7] are
very important in dental studies as they give significant results
about sexual dimorphism and solve several problems that exist
in measurements of teeth (e.g. occlusal attrition).
 In the Greek sample examined cervical tooth dimensions present
the highest sexual dimorphism in BL diameters.
 The degree of sexual dimorphism in tooth size differs between
and within populations and is influenced by genetic, epigenetic,
and environmental factors, affecting dental development in each
group.
Acknowledgements
The authors wish to thank Dr. Constantine Eliopoulos for his
editorial suggestions on this paper. We also thank Dr. Velissaria
Vanna for her assistance.
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