|Year : 2020 | Volume
| Issue : 1 | Page : 8-11
Gender determination using velar morphology
Aishwarya Sanjay Awati1, Naveen Srinivas2, Praveen Ramdurg2, Surekha Puranik3
1 Intern, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
2 Reader, Department of Oral Medicine and Radiology, PMNM Dental college and Hospital, Bagalkot, Karnataka, India
3 Professor and Head, Department of Oral Medicine and Radiology, PMNM Dental college and Hospital, Bagalkot, Karnataka, India
|Date of Submission||21-Nov-2019|
|Date of Acceptance||20-Dec-2019|
|Date of Web Publication||16-May-2020|
Dr. Naveen Srinivas
Department of Oral Medicine and Radiology, PMNM Dental College and Hospital, Bagalkot, Karnataka
Source of Support: None, Conflict of Interest: None
Aim: Aim of the study was to assess the various shapes of soft palate and determine the gender using velar morphology. Material and Methods: The study sample comprised of Digital Lateral cephalograms of 120 normal individuals which consisted of 60 males and 60 females between the age group of 11 to 45 from the department of Oral Medicine and Radiology PMNM Dental College and Hospital Bagalkot. The velar morphology was examined and classified into 6 types according to you et al, the associated velar length, velar width was measured. The results obtained were subjected to a statistical analysis to find the association between variants of soft palate with gender. Results: Six types of velar morphologies were observed. In this study leaf shape (type 1) had highest incidence rate among the subjects i.e; 50%, followed by rat tail (type 2) i.e; 27.5%. S shaped showed the lowest incidence. Velar length and width was found significantly greater in males than females. Conclusion: It was found that gender determination can be done using length, width and morphology of the soft palate.
Keywords: Lateral cephalogram, velar length, velar width
|How to cite this article:|
Awati AS, Srinivas N, Ramdurg P, Puranik S. Gender determination using velar morphology. Indian J Oral Health Res 2020;6:8-11
|How to cite this URL:|
Awati AS, Srinivas N, Ramdurg P, Puranik S. Gender determination using velar morphology. Indian J Oral Health Res [serial online] 2020 [cited 2020 Sep 29];6:8-11. Available from: http://www.ijohr.org/text.asp?2020/6/1/8/284440
| Introduction|| |
Soft palate is a posterior fibromuscular part of the palate, which is formed by three components of frontonasal process – two palatal processes and the primitive palate which fuse together to form palate. The hard palate is formed by intramembranous ossification in the mesoderm of palate, whereas the soft palate is formed in the posterior region where the ossification does not occur.,
Soft palate separates the nasopharynx and oropharynx; soft palate is made up of muscles- tensor veli palatini, levator veli palatini, palatoglossus, palatopharyngeus and musculus uvulae (musculus uvulae is only intrinsic muscle of soft palate).
Soft palate performs normal functions such as deglutition, phonation, and respiration. It also plays an important role in maintaining velopharyngeal competence that is approximation of soft plate with the pharyngeal wall.
Since soft palate is anatomically positioned posteriorly, the inaccessibility of velopharyngeal region makes it difficult for clinical examination, and hence, alternative methods of examination are necessary to examine the soft palate.
Evaluation of soft palate on lateral cephalogram is an easy, inexpensive, and readily available method. Six morphological variations were observed in a study by You et al.: Type 1: Leaf-shaped; Type 2: Rat tail; Type 3: Butt like; Type 4: Straight line; Type 5: S-shaped, and Type 6: Crook shaped by observing the image of the velum on lateral cephalograms.
The purpose of the study is to investigate the length, width, and variation of morphology of the velar to differentiate males and females.
| Materials and Methods|| |
The samples comprised digital lateral cephalograms of 120 normal individuals which consisted of 60 males and 60 females aged 11–45 years from the Department of Oral Medicine and Radiology, PMNM Dental College and Hospital, Bagalkot. All the radiographs were taken using a Kodak 8000C (tube voltage 60–90 kV, tube current 2–15 mA, tube focal spot 0.5 mm, and total filtration >2.5 mmEq. Al with an exposure time of 4–14 s).
Morphology of the velar on lateral cephalogram was examined and evaluated into six morphological shapes according to You et al., namely Type 1: Leaf-shaped; Type 2: Rat tail; Type 3: Butt like; Type 4: Straight line; Type 5: S-shaped, and Type 6: Crook shaped as shown in [Figure 1].
|Figure 1: Six morphological shapes according to You et al, namely Type 1: Leaf-shaped; Type 2: Rat tail; Type 3: Butt like; Type 4: Straight line; Type 5: S-shaped, and Type 6: Crook shaped|
Click here to view
The velar length was determined by measuring the straight distance from the posterior nasal spine to the lower end of uvula of the resting soft palate.
The velar width was determined by measuring the thickest area of velar anterior-posterior dimension.
The measurements were carried out for each digital radiograph using Kodak Dental Imaging Software 220.127.116.11 Kodak software (Atlanta, USA) as shown in [Figure 2].
|Figure 2: Image of a lateral cephalogram showing the soft palate. To measure length and width of the soft palate|
Click here to view
Lateral cephalograms of patients between the age range of 11–45 years having normal speech and function were included in the study.
Patients with cleft palate, recent extractions, orthognathic surgeries, orthodontic treatment, fracture of maxillofacial complex, osseous lesions involving palate, oral submucous fibrosis, scleroderma, and other systemic diseases were excluded from the study.
| Results|| |
Statistical analysis was performed using Statistical Package for the Social Sciences (Newyork USA).
Descriptive analysis includes expression of study parameters in terms of mean and standard deviation.
Chi-square test was used to compare the age and velar shapes distribution among the study subjects based on gender.
Independent student t-test was used to perform gender-wise comparison of mean velar length and width (in cm) based on different shapes.
ANOVA test was used to compare the mean length and width (in cm) between different velar shapes in males and females.
Step-wise discriminate analysis was used to determine variables that discriminate between males and females.
Level of significance was set up to <0.05.
In this study, leaf shape (Type 1) had the highest incidence rate among the subjects, i.e., 50%, followed by rat tail (Type 2), i.e., 27.5%.
S-shaped showed the lowest incidence.
Type 1 was commonly seen in males and Type 2 seen in females.
Velar length and width were found significantly greater in males than females.
The mean length found in male subjects is 3.15 cm whereas in female subjects is 3 cm; similarly, the mean width found in male subjects is 0.87 cm whereas in females is 0.77 cm.
The length and width of all the six types of soft palate were significantly increased in males when compared to females.
| Discussion|| |
Cephalometric radiographs are easily available and cost-effective, and they have relatively good assessment of soft tissue and its surrounding structures, so it is a commonly accepted technique for evaluation of soft palate in both normal individuals and in those with cleft palate and obstructive sleep apnea syndrome (OSAS). The morphological variation of the soft palate may be a new explanation for surgical failure and the soft palate might be repaired in various patterns.
Miles et al. (1995) concluded that the measurements on cephalogram such as minimal pharyngeal airway space, thickness of soft palate, and hyoid bone position reliably identified, irrespective of quality of radiographs or individual tracing of the radiograph.
Leaf shape (Type 1) had the highest incidence rate among the subjects, i.e., 50%, which is in accordance with You et al., Verma et al., Elkunchwar et al., Kruthika et al., Bhambri et al., Santosh, et al. Khaitan et al., Nagaraj et al., Smriti et al., and Kumar and Gopal.
On comparison between males and females, Type 1 was commonly seen in males and Type 2 seen in females, which is in accordance with Khaitan et al. and Smriti et al as shown in [chart 1] and [Table 1].
|Table 1: Comparison of velar shapes distribution among the study subjects based on gender using chi square test|
Click here to view
In this study, it was noted that velar length and width were significantly greater in males than in females (as shown in [Table 2]), which was in agreement with the study done by Kruthika et al., Nagaraj et al., Khaitan et al., and Li et al..
|Table 2: Gender wise comparison of mean velar length and width (in cm) using independent Student's t-test|
Click here to view
Further, the length and width of all the six types of soft palate were significantly increased in males when compared to females.
A study conducted by Lin et al. concluded that OSAS is common in males than females. This may be due to increased length and width of soft palate in males which causes airway obstruction, leading to sleep apnea.
| Conclusion|| |
Type 1 was most commonly seen in males and Type 2 in females. The length and width of all the six types of soft palate were significantly increased in males when compared to females. This study was contrary to the studies conducted by Garg and Kapoor, Samdani et al., and Praveen et al., who found Type 2 rat tail more common. The sample size of the particular study is less, and hence, further studies with an increased sample size have to be carried out. It was found that gender determination can be done using length, width, and morphology of the soft palate.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
You M, Li X, Wang H, Zhang J, Wu H, Liu Y, et al
. Morphological variety of the soft palate in normal individuals: A digital cephalometric study. Dentomaxillofac Radiol 2008;37:344-9.
Samdani D, Saigal A, Garg E. Correlation of morphological variants of soft palate and types of malocclusion: A digital lateral cephalometric study. J Indian Acad Oral Med Radiol 2015;27:366-71. [Full text]
Rubesin SE, Rabischong P, Bilaniuk LT, Laufer I, Levine MS. Contrast examination of the soft palate with cross sectional correlation. Radiographics 1988;8:641-65.
Raja Lakshmi C, Ayesha Thabusum D, Bhavana SM. An innovative approach to evaluate the morphological patterns of soft palate in oral submucous fibrosis patients: A digital cephalometric study. Int J Chronic Dis 2016;2016. doi: 10.1155/2016/5428581.
Khaitan T, Pachigolla R, Uday G, Balmuri PK, Chennoju SK, Pattipati S. Digital cephalometric analysis illustrating morphological variation of the soft palate. J Indian Acad Oral Med Radiol 2015;27:532-8. [Full text]
Miles, Peter G; O'Reilly, Maria and Close, John. The reliability of upper airway landmark identification [online]. Australian Orthodontic Journal 1995;14:3-6.
Verma P, Verma KG, Kumaraswam KL, Basavaraju S, Sachdeva SK, Juneja S. Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: A digital cephalometric study. Imaging Sci Dent 2014;44:193-8.
Elkunchwar G, Gulve N, Nehete A, Shah K, Aher S. Evaluation of airway in different types of soft palate according to growth pattern. IOSR J Dent Med Sci 2018;17:53-8.
Kruthika SG, Rohit B, Ramaprakasha B, Krishna NB, Venkatesh GN. Diverse morphologies of soft palate in normal individuals: A cephalometric perspective. J Ind Acad Oral Med Radiol 2012;24:15-9.
Bhambri E, Ahuja V, Ahuja S, Bhambri G, Choudhary A, Sukhija S. The association between soft palate shape and Need's ratio in various sagittal skeletal malocclusions: A digital lateral cephalometric study. Int J Orthod Rehabil 2018;9:8-13. [Full text]
Santosh VK, Singh P, Pagare SS. Normative soft palate dimensions and morphology in a subset of Indian population: A digital cephalometric study. Indian J Oral Health Res 2015;1:48-51. [Full text]
Nagaraj T, Goswami RD, James L, Sreelakshmi N, Veerabasavaiah BT, Shruthi R. A radiographic assessment of morphologies of soft palate: A retrospective study. J Med Radiol Pathol Surg 2016;3:1-4.
Smriti K, Pai KM, Vineetha R, Pentapati KC. Radiographic evaluation of soft palate morphology and correlation with gender on lateral cephalograms. World J Dent 2015;6:147-9.
Kumar K, Gopal S. Morphological variants of soft palate in normal individuals: A digital cephalometric study. J Clin Diagn Res 2011;5 Suppl 1:1310-3.
Li G, Wang H, Ba K, Yang ZY, Li MX, Liu YY, et al
. Morphology of the soft palate in normal individuals when pronouncing: A digital cephalometric study. Hua Xi Kou Qiang Yi Xue Za Zhi 2011;29:136-8.
Lin CM, Davidson TM, Ancoli-Israel S. Gender differences in obstructive sleep apnea and treatment implications. Sleep Med Rev 2008;12:481-96.
Garg D, Kapoor D. Predominant shapes of soft palate in Chitwan district of Nepal: A radiographic study. Int J Contemp Med Res 2017;4:897-9.
Praveen BN, Sunitha A, Sumona P, Shubhasini AR, Syed V. Various shapes of soft palate: A lateral cephalometric study. World J Dent 2011;2:207-10.
[Figure 1], [Figure 2]
[Table 1], [Table 2]