Introduction: Sex determination of the juvenile skeleton before puberty time is a difficult task. Objectives: The objective of this study was to determine the accuracy of the hard palate measurements and the rugae patterns in determining the sex of the Egyptian children. Patients and Methodology: The study included 210 children of either sex aged 6-12 years old. Alginate impressions from the maxillary arches have been taken. We measured the hard palate length, width, and height by using a digital caliper. We also obtained palatal rugae patterns from the maxillary casts. The patterns included the rugae length, shape, direction, and unification. Results: The mean palatal length, width, and height were significantly higher in males than females (p<0.001), and they displayed a significant-good power in predicting male sex (area under the curves (AUCs) were 0.85, 0.87, and 0.80 respectively). The median number of curved rugae was significantly lower in males (p=0.002), while the straight shape rugae exhibited a significantly higher number in males than females (p=0.004). Binary logistic regression revealed a model with excellent (AUC=0.968) power and overall accuracy of 91.43% for sex identification. Conclusion: These findings indicate that the hard palate dimensions and the rugae shape could be used as complementary tools to determine the sex of the Egyptian children.
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