Use of Lateral Teleradiography in Sex Estimation for Forensic Purposes: a Systematic Review.

Methods that use lateral teleradiography for sex estimation need to be discussed considering their feasibility and applicability in forensic cases. The aim of this study was to conduct a systematic review about the use of lateral teleradiography for sex estimation in adults. A search was conducted on Embase, PubMed/MEDLINE, Scopus, Lilacs, Scielo, and Web of Science databases. The search results were exported to Rayyan (https://www.rayyan.ai/). Subsequently, two independent reviewers applied eligibility criteria to select studies related to the topic, resulting in nine studies. Regarding the risk of bias, the checklist recommended by The Joanna Briggs Institute was applied. The risk of bias in all selected studies was considered low. However, a meta-analysis could not be performed, as there was no standardization in the way the data were presented. Regarding the included studies, it was noted that the samples came from six countries and that the studies presented methodological discrepancies regarding the measurements used in the analyses. As a result, the accuracy rates varied from 56.3% to 99.0%. It is concluded that lateral cephalometric radiography can support sex estimation in adults, especially in settings with limited resources. However, due to variations in measurement methods and landmarks across studies, future research should adopt standardized and more rigorous methodologies to strengthen its scientific validity.