Use of dimensions in posterior dentition for sex estimation in forensic contexts: A systematic review and meta-analysis

Objective: This study assessed the validity of dimensions in posterior dentition for sex estimation in forensic contexts.Design: A systematic review was established following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). After assessing the risk of bias and methodological quality with the QUADAS-2 system, the data were subjected to statistical tests for a meta-analysis of diagnostic accuracy and I2 to verify the heterogeneity.Results: The search resulted in 15 studies that underwent qualitative testing, all were selected for quantitative analysis. The papers included: the mesiodistal of the upper first molar, lower first molar, and upper second molar, and the buccolingual of the upper first molar and upper second molar. The results showed that sensitivity and specificity rates were lower with the mesiodistal diameter, with rates of 0.577 for the lower first molar, 0.674 for the upper first molar, and 0.698 for the upper second molar, while the rates were higher with the buccolingual diameter, with 0.724 for the upper first molar, and 0.743 for the upper second molar. The power to estimate sex is greater for males than for females. High heterogeneity was detected among the studies of almost all dimensions, except sensibility for the lower first molar and specificity for the upper second molar. Conclusions: None of the dimensions reached an accuracy of & GE;80%, however, so they are not a reliable method for sex estimation in forensic practice.