{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:45:56Z","timestamp":1780710356048,"version":"3.54.1"},"reference-count":65,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"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>Lateral cephalometric radiographs are crucial in dentistry and orthodontics for diagnosis and treatment planning. However, their use in forensic identification, especially with burned bodies or in mass disasters, is challenging. AM (antemortem) and PM (postmortem) radiographs can be compared for identification. This study introduces and evaluates a novel algorithm for extracting cranial patterns from digital lateral cephalometric radiographs for identification purposes. Due to the unavailability of AM cephalograms from deceased individuals, the algorithm was tested using pre- and post-treatment cephalograms of living individuals from an orthodontic archive, considered as AM and PM data. The proposed algorithm encodes cranial patterns into a database for future identification. It matches PM cephalograms with AM records, accurately identifying individuals by comparing cranial features. The algorithm achieved an accuracy of 97.5%, a sensitivity of 97.7%, and a specificity of 95.2%, correctly identifying 350 out of 358 cases. The mean similarity score improved from 91.02% to 98.10% after applying the Automatic Error Reduction (AER) function. Intra-observer error analysis showed an average Euclidean distance of 3.07 pixels (SD = 0.73) for repeated landmark selections. The proposed algorithm shows promise for identity recognition based on cranial patterns and could be enhanced with artificial intelligence (AI) algorithms in future studies.<\/jats:p>","DOI":"10.3390\/diagnostics14171840","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T12:53:19Z","timestamp":1724417599000},"page":"1840","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Novel Algorithm for Forensic Identification Using Geometric Cranial Patterns in Digital Lateral Cephalometric Radiographs in Forensic Dentistry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9129-5435","authenticated-orcid":false,"given":"Shahab","family":"Kavousinejad","sequence":"first","affiliation":[{"name":"Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Yazdanian","sequence":"additional","affiliation":[{"name":"Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran"},{"name":"School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Mahboob","family":"Kanafi","sequence":"additional","affiliation":[{"name":"Human Genetics Research Centre, Baqiyatallah University of Medical Science, Tehran 1435916471, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elahe","family":"Tahmasebi","sequence":"additional","affiliation":[{"name":"Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran"},{"name":"School of Dentistry, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.1016\/j.ajodo.2010.09.021","article-title":"How important are lateral cephalometric radiographs in orthodontic treatment planning?","volume":"139","author":"Devereux","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_2","unstructured":"Proffit, W.R., Fields, H., Larson, B., and Sarver, D.M. (2018). Contemporary Orthodontics-E-Book, Elsevier Health Sciences."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20140270","DOI":"10.1259\/dmfr.20140270","article-title":"Validity of the assessment method of skeletal maturation by cervical vertebrae: A systematic review and meta-analysis","volume":"44","author":"Cericato","year":"2015","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1067\/mod.2001.118781","article-title":"Pituitary adenoma: A cephalometric finding","volume":"120","author":"Alkofide","year":"2001","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1007\/s12663-011-0228-7","article-title":"Cephalometric methods of prediction in orthognathic surgery","volume":"10","author":"Kolokitha","year":"2011","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1007\/s11547-011-0677-6","article-title":"Forensic radiology and personal identification of unidentified bodies: A review","volume":"116","author":"Ciaffi","year":"2011","journal-title":"La Radiol. Medica"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/j.1556-4029.2010.01673.x","article-title":"Skeletal identification by radiographic comparison: Blind tests of a morphoscopic method using antemortem chest radiographs","volume":"56","author":"Stephan","year":"2011","journal-title":"J. Forensic Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/1556-4029.12898","article-title":"Human identification via lateral patella radiographs: A validation study","volume":"61","author":"Niespodziewanski","year":"2016","journal-title":"J. Forensic Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"110218","DOI":"10.1016\/j.forsciint.2020.110218","article-title":"Automated Identification from Dental Data (AutoIDD): A new development in digital forensics","volume":"309","author":"Reesu","year":"2020","journal-title":"Forensic Sci. Int."},{"key":"ref_10","unstructured":"Joshi, S.V., and Kanphade, R.D. (2018, January 6\u20138). Forensic approach of human identification using dual cross pattern of hand radiographs. Proceedings of the Intelligent Systems Design and Applications: 18th International Conference on Intelligent Systems Design and Applications (ISDA 2018), Vellore, India."},{"key":"ref_11","first-page":"37","article-title":"Identification of missing persons and unidentified remains in disaster victim identification","volume":"24","author":"Bikker","year":"2014","journal-title":"Adv. Forensic Hum. Identif."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.radi.2013.07.008","article-title":"Combined radiographic and anthropological approaches to victim identification of partially decomposed or skeletal remains","volume":"19","author":"Leo","year":"2013","journal-title":"Radiography"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"543","DOI":"10.4103\/jomfp.jomfp_81_21","article-title":"Role of forensic odontology and anthropology in the identification of human remains","volume":"25","author":"Jayakrishnan","year":"2021","journal-title":"J. Oral Maxillofac. Pathol. JOMFP"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1111\/j.1469-7580.2006.00644.x","article-title":"Craniofacial levels and the morphological maturation of the human skull","volume":"209","author":"Bastir","year":"2006","journal-title":"J. Anat."},{"key":"ref_15","unstructured":"Huang, G.J., Graber, L.W., Vanarsdall, R.L., and Vig, K.W. (2016). Orthodontics-E-Book: Current Principles and Techniques, Elsevier Health Sciences."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1080\/00016350510019847","article-title":"Cranial base in craniofacial development: Developmental features, influence on facial growth, anomaly, and molecular basis","volume":"63","author":"Nie","year":"2005","journal-title":"Acta Odontol. Scand."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1525-142X.2006.00139.x","article-title":"Epigenetic interactions and the structure of phenotypic variation in the cranium","volume":"9","author":"Lieberman","year":"2007","journal-title":"Evol. Dev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"166.e1","DOI":"10.1016\/j.forsciint.2013.03.038","article-title":"Skull sutures: Changing morphology during preadolescent growth and its implications in forensic identification","volume":"229","author":"Jayaprakash","year":"2013","journal-title":"Forensic Sci. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0940-9602(99)80103-4","article-title":"Interpretation of the vertical and longitudinal growth of the human skull","volume":"181","author":"Hanschke","year":"1999","journal-title":"Ann. Anat. Anat. Anz."},{"key":"ref_20","first-page":"e1297","article-title":"Aging and sexual differences of the human skull","volume":"5","author":"Avelar","year":"2017","journal-title":"Plast. Reconstr. Surg.\u2013Glob. Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20200599","DOI":"10.1259\/dmfr.20200599","article-title":"Frontal sinuses as tools for human identification: A systematic review of imaging methods","volume":"50","author":"Pereira","year":"2021","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/0379-0738(93)90222-V","article-title":"Quantified comparison of frontal sinus patterns by means of computed tomography","volume":"61","author":"Reichs","year":"1993","journal-title":"Forensic Sci. Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"124.e1","DOI":"10.1016\/j.forsciint.2009.12.064","article-title":"Evaluation of frontal sinus and skull measurements using spiral CT scanning: An aid in unknown person identification","volume":"197","author":"Uthman","year":"2010","journal-title":"Forensic Sci. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1002\/ar.23614","article-title":"Frontal sinus development and juvenile age estimation","volume":"300","author":"Moore","year":"2017","journal-title":"Anat. Rec."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1002\/jmor.20817","article-title":"Frontal sinus ontogeny and covariation with bone structures in a modern human population","volume":"279","author":"Sardi","year":"2018","journal-title":"J. Morphol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/joa.13687","article-title":"Ontogenetic patterns in human frontal sinus shape: A longitudinal study using elliptical Fourier analysis","volume":"241","author":"Butaric","year":"2022","journal-title":"J. Anat."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/0379-0738(87)90041-7","article-title":"Classification system of frontal sinus patterns by radiography. Its application to identification of unknown skeletal remains","volume":"34","author":"Yoshino","year":"1987","journal-title":"Forensic Sci. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jflm.2015.09.003","article-title":"Human identification through frontal sinus 3D superimposition: Pilot study with Cone Beam Computer Tomography","volume":"36","author":"Beaini","year":"2015","journal-title":"J. Forensic Leg. Med."},{"key":"ref_29","first-page":"170","article-title":"Postmortem Computed Tomography of the Skull for Human Identification Based on the Morphology of Frontal Sinuses","volume":"9","author":"Carvalho","year":"2019","journal-title":"\u0420o\u0441\u0441\u0438\u0439\u0441\u043a\u0438\u0439 \u042d\u043b\u0435\u043a\u0442\u0440o\u043d\u043d\u044b\u0439 \u0416\u0443\u0440\u043d\u0430\u043b \u041b\u0443\u0447\u0435\u0432o\u0439 \u0414\u0438\u0430\u0433\u043do\u0441\u0442\u0438\u043a\u0438"},{"key":"ref_30","first-page":"125","article-title":"Sex determination and personal identification using frontal sinus and nasal septum\u2013A forensic radiographic study","volume":"13","author":"Mohan","year":"2019","journal-title":"Prof. RK Sharma"},{"key":"ref_31","first-page":"1","article-title":"Human identification established by the analysis of frontal sinus seen in anteroposterior skull radiographs using the mento-naso technique: A forensic case report","volume":"6","author":"Silva","year":"2019","journal-title":"RBOL-Rev. Bras. Odontol. Leg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s00414-023-03080-4","article-title":"Evaluating artificial intelligence for comparative radiography","volume":"138","author":"Mesejo","year":"2024","journal-title":"Int. J. Leg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1007\/s00414-021-02654-4","article-title":"Exploring the potential of cranial non-metric traits as a tool for personal identification: The never-ending dilemma","volume":"135","author":"Palamenghi","year":"2021","journal-title":"Int. J. Leg. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"343","DOI":"10.4103\/ccd.ccd_26_18","article-title":"Assessment of the effect of dimensions of the mandibular ramus and mental foramen on age and gender using digital panoramic radiographs: A retrospective study","volume":"9","author":"Dosi","year":"2018","journal-title":"Contemp. Clin. Dent."},{"key":"ref_35","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_36","doi-asserted-by":"crossref","first-page":"32117","DOI":"10.1007\/s11042-023-14746-x","article-title":"Statistical elimination based approach to jaw and tooth separation on panoramic radiographs for dental human identification","volume":"82","author":"Bozkurt","year":"2023","journal-title":"Multimed. Tools Appl."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S260","DOI":"10.4103\/0975-7406.155944","article-title":"Forensic radiology in dentistry","volume":"7","author":"Manigandan","year":"2015","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"227","DOI":"10.15644\/asc51\/3\/6","article-title":"Forensic identification of decomposed human body through comparison between ante-mortem and post-mortem CT images of frontal sinuses: Case report","volume":"51","author":"Franco","year":"2017","journal-title":"Acta Stomatol. Croat. Int. J. Oral. Sci. Dent. Med."},{"key":"ref_39","first-page":"1","article-title":"Personal identification in forensic science using uniqueness of radiographic image of frontal sinus","volume":"33","author":"Nikam","year":"2015","journal-title":"J. Forensic Odonto-Stomatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"20130468","DOI":"10.1259\/bjr.20130468","article-title":"Virtual anthropology and forensic identification using multidetector CT","volume":"87","author":"Dedouit","year":"2014","journal-title":"Br. J. Radiol."},{"key":"ref_41","unstructured":"Re, G., Argo, A., Midiri, M., and Cattaneo, C. (2020). Radiology in Forensic Medicine from Identification to Post-Mortem Imaging, Springer."},{"key":"ref_42","unstructured":"Proffit, W.R., Fields, H.W., and Sarver, D.M. (2007). Contemporary Orthodontics, Elsevier."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Phulari, B. (2013). An Atlas on Cephalometric Landmarks, JP Medical Ltd.","DOI":"10.5005\/jp\/books\/11877"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0889-5406(05)80780-2","article-title":"Color atlas of dental medicine, Orthodontic-Diagnosis","volume":"105","author":"Rakosi","year":"1994","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_45","unstructured":"Weisstein, E.W. (2024, August 15). Heron\u2019s Formula. Available online: https:\/\/mathworld.wolfram.com\/HeronsFormula.html."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1177\/1090820X13503473","article-title":"Dentition, bone loss, and the aging of the mandible","volume":"33","author":"Ozturk","year":"2013","journal-title":"Aesthet. Surg. J."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zhang, S., Hu, Y., and Bian, G. (2017, January 25\u201326). Research on string similarity algorithm based on Levenshtein Distance. Proceedings of the 2017 IEEE 2nd Advanced Information Technology, Electronic and Automation Control Conference (IAEAC), Chongqing, China.","DOI":"10.1109\/IAEAC.2017.8054419"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S0889-5406(97)70242-7","article-title":"Cephalometric landmarks identification and reproducibility: A meta analysis","volume":"112","author":"Trpkova","year":"1997","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"177","DOI":"10.2478\/aoj-1998-0012","article-title":"The reproducibility of cephalometric landmarks: An experimental study on skulls","volume":"15","author":"Cooke","year":"1998","journal-title":"Australas. Orthod. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"JFS2004145","DOI":"10.1520\/JFS2004145","article-title":"Testing the reliability of frontal sinuses in positive identification","volume":"50","author":"Christensen","year":"2005","journal-title":"J. Forensic Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jflm.2008.05.016","article-title":"The forensic importance of frontal sinus radiographs","volume":"16","author":"Prado","year":"2009","journal-title":"J. Forensic Leg. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"213","DOI":"10.5624\/isd.2012.42.4.213","article-title":"Uniqueness of radiographic patterns of the frontal sinus for personal identification","volume":"42","author":"Patil","year":"2012","journal-title":"Imaging Sci. Dent."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1520\/JFS15250J","article-title":"Skeletal identification using the frontal sinus region: A retrospective study of 39 cases","volume":"47","author":"Kirk","year":"2002","journal-title":"J. Forensic Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2","DOI":"10.24198\/pjd.vol29no2.13631","article-title":"Overview of the frontal sinus anteroposterior size based on against lateral cephalometric radiographs chronological age as forensic identification","volume":"29","author":"Marsya","year":"2017","journal-title":"Padjadjaran J. Dent."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e49110313608","DOI":"10.33448\/rsd-v10i3.13608","article-title":"Orthodontic 2D and 3D frontal sinus imaging records: An important role in human identification","volume":"10","author":"Kuhnen","year":"2021","journal-title":"Res. Soc. Dev."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.scijus.2018.08.008","article-title":"Validity of forensic odontology identification by comparison of conventional dental radiographs: A scoping review","volume":"59","author":"Chiam","year":"2019","journal-title":"Sci. Justice"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/20961790.2018.1480460","article-title":"The role of forensic anthropology in disaster victim identification (DVI): Recent developments and future prospects","volume":"4","author":"Blau","year":"2019","journal-title":"Forensic Sci. Res."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Ghanbari, S., Ashtyani, Z.P., and Masouleh, M.T. (2022, January 17\u201319). User identification based on hand geometrical biometrics using media-pipe. Proceedings of the 2022 30th International Conference on Electrical Engineering (ICEE), Tehran, Iran.","DOI":"10.1109\/ICEE55646.2022.9827056"},{"key":"ref_59","first-page":"43","article-title":"Evolutionary insights into global patterns of human cranial diversity: Population history, climatic and dietary effects","volume":"92","year":"2014","journal-title":"J. Anthropol. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1259\/dmfr\/96080236","article-title":"Human identification based on cranial computed tomography scan\u2014A case report","volume":"40","author":"Silva","year":"2011","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.forsciint.2012.03.019","article-title":"A post-processing technique for cranial CT image identification","volume":"221","author":"Wang","year":"2012","journal-title":"Forensic Sci. Int."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"\u0160avc, M., Sedej, G., and Poto\u010dnik, B. (2022). Cephalometric landmark detection in lateral skull X-ray images by using improved SpatialConfiguration-Net. Appl. Sci., 12.","DOI":"10.3390\/app12094644"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"105056","DOI":"10.1016\/j.jdent.2024.105056","article-title":"Automatic cephalometric landmark identification with artificial intelligence: An umbrella review of systematic reviews","volume":"146","author":"Polizzi","year":"2024","journal-title":"J. Dent."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Li, H., Xu, Y., Lei, Y., Wang, Q., and Gao, X. (2022). Automatic classification for sagittal craniofacial patterns based on different convolutional neural networks. Diagnostics, 12.","DOI":"10.3390\/diagnostics12061359"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.4067\/S0717-95022013000300053","article-title":"Discovering Craniofacial Patterns Using Multivariate Cephalometric Data for Treatment Decision Making in Orthodontics","volume":"31","author":"Ruz","year":"2013","journal-title":"Int. J. Morphol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/17\/1840\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:42:09Z","timestamp":1760110929000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/17\/1840"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,23]]},"references-count":65,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["diagnostics14171840"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14171840","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,23]]}}}