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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 3  |  Page : 243-248

Assessment of velar morphological variants as gender determination tool in kanpur population: A digital cephalometric study


1 Department of Oral Medicine and Radiology, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
2 Consultant, Oral Medicine and Radiology, Purba Bardhaman, West Bengal, India
3 Department of Public Health Dentistry, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
4 Dental Surgeon and Consultant, Oral Medicine and Radiology, Department of Dental Surgery, Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi, Jharkhand, India
5 Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India

Date of Submission15-Jun-2022
Date of Acceptance10-Oct-2022
Date of Web Publication14-Nov-2022

Correspondence Address:
Rahul Srivastava
Department of Oral Medicine and Radiology, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_89_22

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  Abstract 


Background: The posterior fibromuscular part of the palate that attaches to the hard palate is what is often referred to as the soft palate. To distinguish between sexes, this research measured the velar for length, breadth, and morphological diversity. Materials and Methods: One hundred and fifty boys and girls, ages 15–25, had digital lateral cephalograms obtained. Using the taxonomy proposed by You et al., we categorized velar morphology into six different types and conducted an in-depth analysis of each. The resting length of the soft palate may be seen as a straight line stretching from the back of the nose to the tip of the uvula. It was also determined how wide the soft palate really is. IBM SPSS statistics 21 was used for the statistical analysis. The mean, the standard deviation, and the percentage distribution were used to describe the data. To ensure that the data were normally distributed, the Shapiro–Wilk test was run on them. Comparisons of clusters of discrete categories were made using the Chi-square test. To identify statistically significant differences between the sexes, we employed the independent Student's t-test. The mean length and width of different velar shapes of both genders were calculated using an analysis of variance test. Results: Type 2 was more common in males than in Types 1, 3, or 6. Form 6 was the rarest of the forms. Type 1 was more common among women than any of the other types, including Types 2, 3, and 6. The most frequent kind was Type 1. The veli of men are much longer and broader than those of females. Conclusion: In light of all the metric measurements from the current study, gender can be established from the length, width, and soft palate morphology.

Keywords: Cephalometric radiographs, gender determination, soft palate, velar morphology


How to cite this article:
Srivastava R, Mukherjee S, Pradhan D, Jyoti B, Mehrotra V, Singh P. Assessment of velar morphological variants as gender determination tool in kanpur population: A digital cephalometric study. J Dent Res Rev 2022;9:243-8

How to cite this URL:
Srivastava R, Mukherjee S, Pradhan D, Jyoti B, Mehrotra V, Singh P. Assessment of velar morphological variants as gender determination tool in kanpur population: A digital cephalometric study. J Dent Res Rev [serial online] 2022 [cited 2023 Jan 30];9:243-8. Available from: https://www.jdrr.org/text.asp?2022/9/3/243/361142




  Introduction Top


The soft palate is an important structural component.[1] Its rear line of fibromuscular taste receptors connects to the back line of the hard taste receptors (the hard sense of taste itself comprises three sections: the frontonasal cycle, two palatal cycles, and the crude sense of taste). Although the frontal region's mesoderm of the sensitive taste undergoes solidification to become the dorsal region's harsh taste, the reverse is not true.[2]

As the velopharyngeal area becomes more inaccessible, the clinical vision of the soft palate becomes increasingly challenging; additional diagnostic procedures are required for a comprehensive examination. No radiological examination of the soft palate is necessary since the superior surface may be seen using a flexible nasopharyngoscope, and the inferior surface can be evaluated directly.[3],[4]

You et al. used digital cephalometric analysis of the soft palate to construct a classification. Leaf- or lanceolate-shaped Type 1 soft palate, rattail-shaped Type 2s, butt-shaped Type 3s, straight Type 4s, s-shaped Type 5s, and rounded Type 6s are all possible variations (crook shape).[5] Certain velar forms have been proven to be more common in certain Chinese and Indian ethnic groups than in others. According to Agrawal et al.'s research, the “rattail” is the most common kind among the people of Madhya Pradesh, India. A North Indian subpopulation's most common velar morphology was “leaf,” according to research by You and Verma et al.[5],[6],[7]

Niu et al. observed that “leaf” was the most prevalent kind in a standard Chinese sample. The craniofacial and velopharyngeal dimensions of Asian, African-American, and Caucasian people have been shown to vary from one another, according to the available research.[8]

The lateral skull view is the best for evaluating the soft palate since it shows both the hard and soft tissues clearly. However, various radiographic techniques such as lateral skull views and other AP views are used for the evaluation of hard and soft tissue of the palate, pharyngeal walls, and uvula, but lateral cephalometry is the best for sagittal plane assessment. Therefore, one of the most used screening radiographs for sagittal plane assessment is the lateral cephalogram due to its low cost and high frequency of use.[3],[9] The purpose of this research was to determine whether or not the velar's length, breadth, and morphological diversity may be used to distinguish between sexes.


  Materials and Methods Top


The current investigation was carried out by researchers in the field of oral medicine and radiology. Institutional Ethical Committee of (letter no.:02/IEC/RDCHRC/2020-21/02 dated February 14, 2020). Each participant signed a written consent form after being fully informed. The following formula was used to determine the sample size:

Where p1 = 0.65 (65%) proportion of most frequent velar shape (Leaf) in males

P2 = 0.35 (35%) proportion of most frequent velar shape (Leaf) in females

e = 0.5(p2/p1), the proportion ratio considered to be clinically significant

Type I error, α = 5%

Type II error β = 20% for setting power of study 80%

Data loss factor = 10%

The sample size is calculated to be n = 147 for each gender

Using a convenience sampling strategy, researchers obtained digital lateral cephalograms from 300 people (150 males and 150 females) in the outpatient department, with participants' ages ranging from 15 to 25. Using a convenience sampling method, we collected 300 samples in total. All of the research participants had typical speech development and showed no signs of a cleft palate, other abnormalities, or neck or head fractures. Kodak Carestream Health INC, Model No. CS8000C, Made in France, November 2013, was used to capture the lateral cephalograms (tube voltage: 60–90 kV, tube current: 2–15 mA, tube focal point: 0.5 mm, total filtration: >2.5 mmEq. Al, and exposure period: 0.10–14.9s). Digital X-ray and imaging software, Trophy Dicom 6.4.0.4, were used to capture the pictures. The size of the pharyngeal airway route may also change depending on where the head is placed. To negate the possibility of these side effects, patients were instructed to stand during cephalogram exposure with their heads held high and the Frankfort horizontal plane parallels to the floor. The technique followed the guidelines for human experimentation laid forth in the Helsinki Declaration of 1975. After instructing each subject to swallow once to clear their mouth and pharynx of saliva, they were instructed to close their mouths tightly to position their upper and lower teeth in driven impediment and to relax their oropharyngeal muscular build, resulting in a more natural position and a more accurate design of the lip, for the purposes of the cephalometric radiographs. A well-informed lecturer in maxillofacial radiography inspected each and every one of the radiographs. The resting length of the sensitive sense of taste may be addressed by drawing a straight line from the back of the nose to the tip of the uvula. The whole scope of that deftly developed sense of taste was also evaluated. Velar morphology was investigated and evaluated in six morphological forms on the lateral cephalogram according to the classification suggested by You et al. [Figure 1].
Figure 1: Velar morphology according to the classification suggested by You et al

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Statistical analysis

Utilizing IBM SPSS Statistics v21 (IBM Corp., 2012), IBM SPSS Statistics for Windows, Version 21.0 was used to analyze the data for this article (Armonk, NY, USA: IBM Corp.). The mean, the standard deviation, and the percentage distribution were used to describe the data. To ensure that the data were normally distributed, the Shapiro–Wilk test was run on them. The Chi-square test was used to evaluate the similarities and differences between sets of discrete categories. The mean length and breadth of various velar forms were determined between sexes using an analysis of variance test, while gender-based comparisons were determined using an independent Student's t-test. For a significance level of P = 0.05, all results were judged to be significant.


  Results Top


In the present study, 300 subjects (150 males and 150 females) were examined to determine the morphological variants and forms of soft palate found in lateral cephalograms [Table 1].
Table 1: Gender distribution of the study participants (n=300)

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[Table 2] and [Graph 1] show the comparison of velar shapes among the study participants depending upon gender. Out of 150 males, Type 2 (rattail) was the most common type observed in 59 males (19.7%), followed by Type 1 (leaf type) observed in 50 males (16.7%), Type 3 (butt-like) observed in 23 males (7.7%), and Type 6 (crook-shaped) observed in 18 (6%) males. Unfortunately, no males were identified to have velar morphology Types 4 (straight line) or 5 (S-shape). The average velar length for male individuals was 32.65 mm, while the average velar breadth was 9.97 mm.
Table 2: Comparison of velar shapes among the study participants depending upon gender

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Out of 150 females, Type 1 (leaf type) was the most common type observed in 68 subjects (22.7%), followed by Type 2 (rattail) observed in 41 subjects (13.7%), Type 3 (butt-like) observed in 23 subjects (7.7%), Type 6 (crook-shaped) observed in 14 (4.7%) subjects, and Type 4 (straight line) observed in 04 subjects (1.3%). No female subject was found having Type 5 (S-shape) velar morphology. The mean velar length was measured and found to be 27.99 mm in females and the mean width was 7.94 mm [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6].
Figure 2: Type 1 leaf-shaped soft palate

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Figure 3: Type 2 rat-tailed soft palate

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Figure 4: Type 3 butt-shaped soft palate

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Figure 5: Type 4 straight line-shaped soft palate

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Figure 6: Type 6 Crook-shaped soft palate

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Soft palate morphological differences between sexes were statistically significant (χ2 = 10.290, P = 0.001).

Efforts were undertaken to evaluate the velar dimensions of males and girls. [Table 3] displays the statistically significant differences between the sexes in terms of the average velar length and breadth (in millimeters). We found that there is a statistically significant difference between the sexes in terms of soft palate length, with men typically having longer palates by 4.66 mm (P = 0.001).
Table 3: Gender-wise comparison of mean velar length and width (mm)

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There was a statistically significant difference (P = 0.001) between the sexes in terms of mean width, with males having a broader frame on average than women. When comparing men and females, guys consistently have larger soft palates in terms of both length and breadth.


  Discussion Top


The correct apposition of the soft palate to the posterior and lateral pharyngeal walls (velopharyngeal closure) is an important function of the soft palate. The soft palate and its surrounding structures may be evaluated morphometrically in terms of depth and height in the midsagittal plane with the use of a lateral cephalogram.[10] Lateral cephalogram is an important diagnostic method for the assessment of maxillofacial hard and soft tissues and for nasopharynx examination. It is advantageous since it is affordable, noninvasive, compatible with tests such as computed tomography, and can be carried out with minimal radiation.[11],[12]

The soft palate and the structures surrounding it have undergone extensive dimensional analysis studies, particularly the length and width of the velar. Variation in the length and breadth of the velar, among other aspects of the soft palate, has been largely overlooked up until recently.

Participants were between the ages of 15 and 25 for this research to guarantee that their pharyngeal structures had fully matured.[13] Classification of the soft palate based on its appearance proposed by You et al. was included in this study.[5] Some research also indicates that the size of the pharyngeal airway channel might be affected by the patient's head position. Since these side effects were undesirable, individuals undergoing cephalogram exposure were instructed to stand with their heads held high and the Frankfort horizontal plane parallels to the floor.

In research looking at velar morphological variations, Kumar and Gopal found that the leaf-shaped soft palate was the most common variety (40%), followed by the rattail shape (28%). Aside from the sex differences, they saw in the velar type, they also discovered a considerable morphological difference in the soft palate.[14] The research by Verma et al. indicated that morphological velar Type 1 was the most prevalent (48.7%), followed by Types 2 (31.0%), 4 (8.7%), 5 (4.7%), and 3 (4.0%). Type 6 was the least common (3.0%).[7] The anatomy of the soft palate was studied by Hussain et al., who looked into how it changed with age and between sexes. There was a statistically significant gender gap in the prevalence of soft palate morphologies, with Type 1 being the most prevalent in both sexes.[15] Males were more likely to have Type 1 and females more likely to have Type 2 patterns, as revealed by Khaitan et al. in their research.[16] According to the findings of this research, Kind 2 (rattail) is the most prevalent type among men (leaf type). The female population mostly displayed Type 1 (leaf type), followed by Type 2 (rattail). Pepin et al. first described a hooked look of the soft palate; You et al. (1999) classified this appearance as a distorted form (S-shape or Type 5). This variation was not seen in the current investigation.[5],[17] Type 6, also known as a crook-shaped soft palate, is seen in an extremely small percentage of the population (4.7%). The results matched those of You et al. (1.5%), Kumar and Gopal (3%), and Guttal et al. (6.5%).[5],[14],[18]

No other variant of soft palate morphology was noted in the present study, in addition to the six forms described by You et al.

Soft palate morphological variance, dimensional variations, and proportional differences were analyzed by Guttal et al. in a study of Indian ethnic groups. The length and breadth of the velar were measured, and men were found to have noticeably larger velar dimensions than women.[18] According to the research of Nagaraj et al., men have longer and wider soft palates than women do.[19] Khaitan et al. also found that men typically had a longer soft palate than women.[16] According to research done by Li et al., the male has a greater vertical velar length than the female.[20]

Literature on the morphological evaluation of the soft palate is really limited, and we have seen that using a digital cephalogram can be a quick and affordable way to evaluating the same. Until You et al. suggested a categorization for morphological varieties of the soft palate, the various morphological variants of the soft palate were mostly overlooked. You et al. observed six types of morphological variants according to their lateral cephalometric characteristics.[5] We can comprehend the variety of velar morphology in the median sagittal plane better with the aid of the classification. We found that normal people presented the soft palate in a variety of ways by looking at the image of the soft palate on lateral cephalometry.

By using cephalometric techniques, Kollias and Krogstad were able to investigate morphological changes over time and discover no gender differences. The researchers looked at how the uvulo-glossopharyngeal morphology of men and women changed over the course of 30, 20, and 10 years.[9] According to research by Santosh et al., who looked at how the velar morphology changes with age and how soft palate length and density alter, there is a considerable difference between the ages of preadults and adults. In men, the soft palate was more longer and thicker.[10] In this research, a comparison of men and females was made in terms of velar length and breadth, and the results showed that males had a longer and wider soft palate than females. To add insult to injury, men had significantly larger length and breadth of all six soft palate forms compared to females. Therefore, the soft palate (velar) serves several crucial purposes in the head and neck.[21],[22]

Limitations and future implications

The present state of knowledge has certain caveats. Because of the limited size of the sample used in the present investigation, larger longitudinal studies are needed to investigate the evolution of the velar ridge over time.

Understanding the age at which sexual dimorphism of velopharyngeal measurements becomes evident requires more research on the impact of race and sex on the development rates of velopharyngeal structures.


  Conclusion Top


In this work, digital lateral cephalograms were used to depict the various morphological forms of the soft palate. None of the study's participants had a straight line or an S-shape, whereas rattail and leaf forms were the most prevalent ones for men and females, respectively. Both the length and breadth of the velar in men were found to be substantially greater than in females. Based on the current study's metric measures, it was concluded that gender may be determined by the length, breadth, and shape of the soft palate. As a corollary, it is suggested that similar research be performed, but with a greater number of participants.

Ethical statement

The current investigation was carried out by researchers in the field of oral medicine and radiology. Institutional Ethical Committee of Rama Dental College Hospital and Research Centre with Approval letter no.: 02/IEC /RDCHRC/ 2020-21/02 dated February 14, 2020.

Acknowledgements

The authors would like to thank all the participants who volunteered for the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
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