Mandibular Canine Index(McI) Not an Accurate Tool for Gender Identification: Results from a Systematic Review and Meta-Analysis

Mandibular Canine Index(MCI) is being used by many researchers for gender identification, however the accuracy shows variations in the results. The aim of this review is to estimate the diagnostic accuracy of MCI in gender identification.

An electronic search of literature was carried out in pubmed MEDLINE database and Google scholar. 26 observational studies published from January 2000 to May 2016 in English were shortlisted using PRISMA guidelines. Study characteristics were entered in excel sheet and quality assessment was done using modified QUADAS 2. The diagnostic accuracy was assessed using sensitivity (males correctly identified) and specificity (females correctly identified) values.

37.9% percentage of the articles followed the Rao et al. guidelines in calculating MCI and rest modified the guidelines using mean of right and left canine width, right and left canine width separately and only right canine width. 25% of the studies showed high risk bias in patient selection and index test domain. In applicability, 50% of the studies showed high risk bias in patient selection domain. Overall summary measures of sensitivity was 0.65 and specificity 0.63. On subgroup analysis, high heterogeneity (I² >90%) was observed.

Few authors have already refuted the use of MCI in gender identification. The results of the present systematic review and meta-analysis showed lack of homogeneity in the data across the studies and concludes that MCI is not an accurate tool in gender identification.