{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:59:10Z","timestamp":1791471550763,"version":"4.3.4"},"reference-count":46,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>In forensics, predicting the sex is a crucial step in identification. Many studies have aimed to find an accurate and fast technique to estimate the sex. This study was conducted to determine the accuracy of volumetric and linear measurements of three-dimensional (3D) images of the mandible obtained from cone beam computed tomography (CBCT) radiographs, using different machine-learning (ML) models for sex identification. The CBCTs of 104 males and 104 females were included in this study. The radiographs were converted to 3D images, and the volume, surface area, and ten linear measurements of the mandible were obtained. The data were evaluated using statistical analysis and five different ML algorithms. All results were considered statistically significant at p &lt; 0.05, and the precision, recall, f1-score, training accuracy, and testing accuracy were used to evaluate the performance of the ML models. All the studied parameters showed statistically significant differences between sexes p &lt; 0.05. The right coronoid-to-gonion linear distance had the highest discriminative power of all the parameters. Meanwhile, Gaussian Naive Bayes (GNB) showed the best performance among all the ML models. The results of this study revealed promising outcomes; the sex can be easily determined, with high accuracy (90%).<\/jats:p>","DOI":"10.3390\/diagnostics13142342","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T01:01:41Z","timestamp":1689123701000},"page":"2342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The Accuracy of Sex Identification Using CBCT Morphometric Measurements of the Mandible, with Different Machine-Learning Algorithms\u2014A Retrospective Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2559-8427","authenticated-orcid":false,"given":"Mohammed Taha Ahmed","family":"Baban","sequence":"first","affiliation":[{"name":"Department of Dental Nursing, Sulaimani Technical Institute, Sulaimani Polytechnic University, Sulaimani 46001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5163-2046","authenticated-orcid":false,"given":"Dena Nadhim","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnosis, College of Dentistry, University of Sulaimani, Sulaimani 46001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"250","DOI":"10.2174\/1874210601509010250","article-title":"Dental Evidence in Forensic Identification\u2014An Overview, Methodology and Present Status","volume":"9","author":"Krishan","year":"2015","journal-title":"Open Dent. J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Prajapati, G., Sarode, S.C., Sarode, G.S., Shelke, P., Awan, K.H., and Patil, S. (2018). Role of Forensic Odontology in the Identification of Victims of Major Mass Disasters across the World: A Systematic Review. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0199791"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jflm.2013.03.040","article-title":"Analyses of Odontometric Sexual Dimorphism and Sex Assessment Accuracy on a Large Sample","volume":"20","author":"Angadi","year":"2013","journal-title":"J. Forensic Leg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Baca, K., Bridge, B., and Snow, M. (2022). Three-Dimensional Geometric Morphometric Sex Determination of the Whole and Modeled Fragmentary Human Pubic Bone. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0265754"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/jfo.jfds_55_17","article-title":"Sex Determination in Forensic Identification, a Review","volume":"10","author":"Nagare","year":"2018","journal-title":"J. Forensic Dent. Sci."},{"key":"ref_6","first-page":"1","article-title":"Sex determination by using Mandibular Ramus\u2014A Forensic Study","volume":"4","author":"Bhagwatkar","year":"2016","journal-title":"J. Adv. Med. Dent. Sci. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4103\/jomfp.jomfp_62_22","article-title":"Mandibular Ramus\u2014An Indicator for Gender Determination: A Digital Panoramic Study in Bagalkot Population","volume":"27","author":"Ingaleshwar","year":"2023","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100018","DOI":"10.1016\/j.fsir.2019.100018","article-title":"Sex Estimation by Discriminant Function Analysis Using Anatomical Location of Mental Foramen","volume":"1","author":"Renjith","year":"2019","journal-title":"Forensic Sci. Int. Rep."},{"key":"ref_9","first-page":"AE01","article-title":"Mandibular Ramus as a Tool for Sexual Determination: A Systematic Review","volume":"16","author":"ThAKur","year":"2022","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1002\/oa.2587","article-title":"Towards a Best Practice for the Use of Active Non-contact Surface Scanning to Record Human Skeletal Remains from Archaeological Contexts","volume":"27","author":"Errickson","year":"2017","journal-title":"Int. J. Osteoarchaeol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Turek, P., and Budzik, G. (2021). Estimating the Accuracy of Mandible Anatomical Models Manufactured Using Material Extrusion Methods. Polymers, 13.","DOI":"10.3390\/polym13142271"},{"key":"ref_12","first-page":"221","article-title":"Gender Determination of Maxillary Sinus Using CBCT","volume":"3","author":"Ravali","year":"2017","journal-title":"Int. J. Appl. Dent. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1109\/TBME.2017.2697916","article-title":"Highly Accurate Facial Nerve Segmentation Refinement from CBCT\/CT Imaging Using a Super-Resolution Classification Approach","volume":"65","author":"Lu","year":"2018","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Issrani, R., Prabhu, N., Sghaireen, M.G., Ganji, K.K., Alqahtani, A.M.A., Aljamaan, T.S., Alanazi, A.M., Alanazi, S.H., Alam, M.K., and Munisekhar, M.S. (2022). Cone-Beam Computed Tomography: A New Tool on the Horizon for Forensic Dentistry. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095352"},{"key":"ref_15","first-page":"23","article-title":"The State of the Art in Machine Learning-Based Digital Forensics","volume":"1","author":"Oladipo","year":"2020","journal-title":"SSRN Electron. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"9163547","DOI":"10.1155\/2019\/9163547","article-title":"Sex Determination of Three-Dimensional Skull Based on Improved Backpropagation Neural Network","volume":"2019","author":"Yang","year":"2019","journal-title":"Comput. Math Methods Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Shen, S., Liu, Z., Wang, J., Fan, L., Ji, F., and Tao, J. (2021). Machine Learning Assisted Cameriere Method for Dental Age Estimation. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01996-0"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101826","DOI":"10.1016\/j.legalmed.2020.101826","article-title":"Application and Performance of Artificial Intelligence Technology in Forensic Odontology\u2014A Systematic Review","volume":"48","author":"Khanagar","year":"2021","journal-title":"Leg. Med."},{"key":"ref_19","first-page":"975","article-title":"A Literature Review on Supervised Machine Learning Algorithms and Boosting Process","volume":"169","author":"Praveena","year":"2017","journal-title":"Int. J. Comput. Appl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"012083","DOI":"10.1088\/1742-6596\/1651\/1\/012083","article-title":"A Review of Decision Tree Classification Algorithms for Continuous Variables","volume":"1651","author":"Jiao","year":"2020","journal-title":"J. Phys. Conf. Ser."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1007\/978-3-030-03146-6_86","article-title":"A Review on Random Forest: An Ensemble Classifier","volume":"26","author":"Parmar","year":"2019","journal-title":"Lect. Notes Data Eng. Commun. Technol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.knosys.2016.06.012","article-title":"KNN-IS: An Iterative Spark-Based Design of the k-Nearest Neighbors Classifier for Big Data","volume":"117","author":"Maillo","year":"2017","journal-title":"Knowl.-Based Syst."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.knosys.2011.02.014","article-title":"A \u2018Non-Parametric\u2019 Version of the Naive Bayes Classifier","volume":"24","author":"Soria","year":"2011","journal-title":"Knowl.-Based Syst."},{"key":"ref_24","first-page":"14","article-title":"Introduction to Machine Learning, Neural Networks, and Deep Learning","volume":"9","author":"Choi","year":"2020","journal-title":"Transl. Vis Sci. Technol."},{"key":"ref_25","first-page":"1","article-title":"A Systematic Review of Odontological Sex Estimation Methods","volume":"35","author":"Capitaneanu","year":"2017","journal-title":"J. Forensic Odontostomatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1016\/j.forsciint.2006.02.015","article-title":"Forensic Aspects of Maxillofacial Radiology","volume":"159","author":"Wood","year":"2006","journal-title":"Forensic Sci. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1016\/j.wneu.2022.06.050","article-title":"Effect of the Segmentation Threshold on Computed Tomography\u2013Based Reconstruction of Skull Bones with Reference Optical Three-Dimensional Scanning","volume":"166","author":"Singh","year":"2022","journal-title":"World Neurosurg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/jiaomr.jiaomr_172_19","article-title":"Mandibular Ramus and Gonial Angle\u2014Identification Tool in Age Estimation and Sex Determination: A Digital Panoramic Radiographic Study in North Indian Population","volume":"32","author":"Behl","year":"2020","journal-title":"J. Indian Acad. Oral Med. Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/0975-1475.109885","article-title":"Mandibular Ramus: An Indicator for Sex Determination\u2014A Digital Radiographic Study","volume":"4","author":"Indira","year":"2012","journal-title":"J. Forensic Dent. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1159\/000504670","article-title":"Testosterone Therapy in Adolescent Boys: The Need for a Structured Approach","volume":"92","author":"Stancampiano","year":"2020","journal-title":"Horm. Res. Paediatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5624\/isd.2020.50.2.117","article-title":"Sex Determination by Radiographic Localization of the Inferior Alveolar Canal Using Cone-Beam Computed Tomography in an Egyptian Population","volume":"50","author":"Mousa","year":"2020","journal-title":"Imaging Sci. Dent."},{"key":"ref_32","first-page":"627","article-title":"Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation","volume":"4","year":"2013","journal-title":"Casp. J. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"444","DOI":"10.4103\/ijdr.IJDR_547_17","article-title":"Gender Determination by Morphometric Analysis of Mandibular Ramus in Sriganganagar Population: A Digital Panoramic Study","volume":"31","author":"Saloni","year":"2020","journal-title":"Indian J. Dent. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/jiaomr.jiaomr_169_19","article-title":"Gender Determination Using Mandibular Ramus and Gonial Angle on OPG","volume":"32","author":"Mehta","year":"2020","journal-title":"J. Indian Acad. Oral Med. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/0975-1475.186367","article-title":"Sex Determination by Mandibular Ramus: A Digital Orthopantomographic Study","volume":"8","author":"Samatha","year":"2016","journal-title":"J. Forensic Dent. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/ccd.ccd_313_18","article-title":"Mandible: An Indicator for Sex Determination\u2013A Three-Dimensional Cone-Beam Computed Tomography Study","volume":"10","author":"Albalawi","year":"2019","journal-title":"Contemp. Clin. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.jobcr.2020.07.019","article-title":"Assessment of Mandibular Ramus for Sex Determination: Retrospective Study","volume":"10","author":"Okkesim","year":"2020","journal-title":"J. Oral Biol. Craniofac. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1080\/00450618.2015.1134657","article-title":"Sexual Determination of the Mandible Breadth in a Central Chinese Population Sample: A Three-Dimensional Analysis","volume":"49","author":"Deng","year":"2016","journal-title":"Aust. J. Forensic Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"124","DOI":"10.7126\/cumudj.679175","article-title":"Mandibular Sexual Dimorphism Analysis in CBCT Scans in a Syrian Sample","volume":"23","author":"Abofakher","year":"2020","journal-title":"Cumhur. Dent. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"294","DOI":"10.15644\/asc54\/3\/7","article-title":"Mandibular Measurements for Sex and Age Estimation in Brazilian Sampling","volume":"54","author":"Gabriela","year":"2020","journal-title":"Acta Stomatol. Croat."},{"key":"ref_41","first-page":"127.e1","article-title":"A Comparison between Neural Network and Other Metric Methods to Determine Sex from the Upper Femur in a Modern French Population","volume":"192","author":"Quatrehomme","year":"2009","journal-title":"Forensic Sci. Int."},{"key":"ref_42","first-page":"1","article-title":"Discriminant Function Analysis","volume":"1","author":"Ramos","year":"2012","journal-title":"Encycl. Appl. Linguist."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"200366","DOI":"10.1016\/j.fri.2020.200366","article-title":"Mandibular Ramus as a Sex Predictor in Adult Jordanian Subjects","volume":"21","author":"Abualhija","year":"2020","journal-title":"Forensic Imaging"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/23311916.2020.1723783","article-title":"Artificial Neural Network for Gender Determination Using Mandibular Morphometric Parameters: A Comparative Retrospective Study","volume":"7","author":"Patil","year":"2020","journal-title":"Cogent Eng."},{"key":"ref_45","first-page":"100570","article-title":"Machine Learning as New Approach for Predicting of Maxillary Sinus Volume, a Sexual Dimorphic Study","volume":"16","author":"Hamd","year":"2023","journal-title":"J. Radiat. Res. Appl. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4278","DOI":"10.1038\/s41598-022-07415-w","article-title":"A Study on Sex Estimation by Using Machine Learning Algorithms with Parameters Obtained from Computerized Tomography Images of the Cranium","volume":"12","author":"Toy","year":"2022","journal-title":"Sci. Rep."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/14\/2342\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:10:38Z","timestamp":1760127038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/14\/2342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,11]]},"references-count":46,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["diagnostics13142342"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13142342","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,11]]}}}