Standardization and Evaluation of Mandibular Osteometric Parameters on Panoramic Radiographs for Forensic Age Estimation in South Indian Population: Development of a Prototype Digital Application Tool

<title>Abstract</title> <p>Introduction Mandibular morphometric parameters measured on panoramic radiographs have been widely investigated for forensic age and sex estimation because they exhibit age- and sex-related anatomical variations. However, evidence regarding their predictive value in South Indian populations remains limited. This study evaluated the reliability and forensic applicability of selected mandibular morphometric parameters for age and sex estimation in a South Indian population. Materials &amp; Methods A retrospective radiographic study was conducted on 600 panoramic radiographs of individuals aged 3–88 years retrieved from departmental archives. Participants were stratified into nine age groups. Six mandibular morphometric parameters—antegonial angle, antegonial depth, condylar height, coronoid height, superior mental foramen distance, and inferior mental foramen distance—were measured using standardized digital protocols. Multiple linear regression analysis was performed to develop an age prediction model, while independent t-tests were used to assess sex-related differences. Statistical significance was set at p &lt; 0.05. Results All mandibular parameters demonstrated significant age-related variations (p &lt; 0.05). Antegonial angle exhibited a significant negative association with age (B = − 0.104, p &lt; 0.001), and inferior mental foramen distance also decreased significantly with advancing age (B = − 0.061, p &lt; 0.001). Condylar and coronoid heights increased until early adulthood and subsequently declined with age. Males showed significantly greater condylar height, coronoid height, and antegonial angle than females (p &lt; 0.05). The regression model demonstrated moderate predictive performance for age estimation (R² = 0.36). Conclusion Mandibular morphometric parameters, particularly antegonial angle, coronoid height, and mental foramen-related distances, may serve as useful adjunctive indicators for forensic age and sex estimation. Although the proposed regression model provides moderate predictive accuracy, panoramic radiographic limitations preclude their use as standalone forensic markers. Further multicenter validation across diverse populations is warranted to improve generalizability and predictive performance. Clinical Trial Registration Not applicable</p>