Human identification by FSS system adapted to cephalometric radiographs

• The FSS system was adapted for cephalometric radiographs of the frontal sinus.
• Identification is possible and reliable by frontal and lateral cephalometric radiographs.
• Higher reliability of the proposed method was found using frontal and lateral cephalometric radiographs.

The aim of this study was to verify the applicability and reproducibility of the FSS system [8] adapted for frontal and lateral cephalometric radiographs of the frontal sinus for human identification purposes. Eighty lateral and frontal digital cephalometric radiographs from a private Dental Radiology service's database were evaluated. Evaluations were performed in a dimmed lighting room, using a 4.200 lux lightbox with mask, ultrafan paper and pencil with a 0.5 diameter tip. The sheet of paper was superimposed on the radiograph to obtain the outlines of the frontal sinus and two examiners made the drawings independently at two different times, with a minimum period interval between evaluations. To obtain the linear physical measurements of the frontal sinus, a digital pachymeter was used. Later, all the discrete variables were codded for the statistical analysis. All variables were tested by means of the Cohen's Kappa test. The intraexaminer agreement ranged from good to perfect (p < 0.001), while the interexaminer agreement ranged from regular to perfect (p < 0.001). The use of frontal and lateral cephalometric radiographs was found to be reproducible and reliable for human identification by an adaptation of FSS system.