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Original Article

Cheiloscopy in gender determination: A study on 2112

individuals
Tim Peter Thermadam1, Laxmikanth Chatra2, Auswaf Ahsan3
Associate Professor, Department of Oral Medicine and Radiology, KMCT Dental College, Calicut, Kerala, 2Professor and Head
1

of the Department, Department of Oral Medicine and Radiology, Yenepoya Dental College, Mangalore, Karnataka, 3Professor
and Head of the Department, Department of Oral Medicine and Radiology, KMCT Dental College, Calicut, Kerala, India

A bstract
Background: Lip prints are seen to remain the same for an individual throughout his/her life. Cheiloscopy can be used
as an effective tool in the identification of the persons from pieces of evidence that may be left behind from lip prints.
Aim and Objectives: The aim of the current research was to evaluate the predominant lip groove pattern among Calicut population,
Kerala. Materials and Methods: The study involved 2112 individuals (1056 males and 1056 females) in the Department of Oral
Medicine and Radiology, KMCT Dental College, Calicut, Kerala. Lipstick was used to record the lip groove patterns and the patterns
were visualized by magnifying lens after the institutional ethical clearance and informed consent from the individual. Statistical
analysis was done using SPSS software 22.0. Results: Among the study population, Type 1’, Type 1, Type 4, and Type 5 were found
to be common lip groove patterns. Males showed predominance on Type 1’ and Type 1 lip groove patterns, whereas females
showed predominance on Type 4 and Type 5 lip groove patterns. The results were similar when analyzed on upper and lower lips
separately on males and females. Conclusion: Cheiloscopy is a reliable tool in personal identification and gender determination of
an individual. The geographical prevalence of lip groove patterns was reported in the current research and is added to the database
of the anthropological data. Studies in different geographical regions will add lip groove patterns on the database in the future and
henceforth the potential of cheiloscopy could be further utilized.

Keywords: Cheiloscopy, gender determination, lip print, personal identification

Introduction Identification in civil and criminal cases requires scientific evidence

and support. Cheiloscopy is the technique in which individuals
The identification of human beings is a process based on certain are identified based on the lip groove patterns.[4] It is possible
scientific principles.[1] There are many methods used in personal to identify the lip groove patterns as early as the sixth week of
identification rather than traditional methods for anthropometry, intrauterine life. Lip groove pattern once formed is permanent
age estimation, gender determination, differentiation by blood and does not change permanently following climatic variations,
groups, fingerprints, and DNA analysis. [2] The branch of pathology, minor trauma, inflammation, and infections.[5,6] The
dentistry that deals with the identification of individuals based salivary and sebaceous secretions from glands located at vermillion
on evidence in the court of law is termed forensic dentistry. It border aid in the formation of a latent lip groove pattern.[7]
includes rugoscopy, cheiloscopy, bite mark analysis, tooth prints,
radiographs, photographic study, and molecular methods.[3] Lip groove patterns aiding in criminal investigations have been
Address for correspondence: Dr. Laxmikanth Chatra, well documented.[8] It is an adjunctive mode of identification
Department of Oral Medicine and Radiology, Yenepoya Dental accepted in the court of law.[9]
College, Mangalore ‑ 575 018, Karnataka, India.
E‑mail: phd_omr@yahoo.com Cheiloscopy is a forensic investigative technique that deals with
Received: 22-11-2019 Revised: 05-02-2020 the identification of individuals based on lip groove patterns.[10]
Accepted: 12-02-2020 Published: 26-03-2020
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DOI: How to cite this article: Thermadam TP, Chatra L, Ahsan A. Cheiloscopy
10.4103/jfmpc.jfmpc_1046_19 in gender determination: A study on 2112 individuals. J Family Med Prim
Care 2020;9:1386-90.

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Thermadam, et al.: Cheiloscopy in gender determination

The pattern produced by lip grooves on mechanical surface is the remaining lipstick was cleaned on the lips with a tissue and
termed lip print.[11] Lip groove patterns are unique and do not washed properly.
change during the entire life of an individual and are invariable
and permanent.[12] In postmortem analysis, lip groove patterns Lip groove patterns were categorized into four regions
have to be obtained within 24 h of death to prevent any possible predominantly by dropping a perpendicular from the philtrum
postmortem mechanical degradation of lip mucosa.[1] of lips: upper right (UR) region, upper left (UL) region, lower
right (LR) region, and lower left (LL) region. The obtained lip
Apart from forensic medicine, particular types of lip print patterns groove patterns were carefully examined under the magnifying
have been associated with the occurrence of non‑syndromic lens. The analysis was done as per the Suzuki and Tsuchihashi
cleft lip with or without cleft palate and numerous studies are classification.[16,17] The classification is as follows: Type I: clear
underway to establish facts.[13] Parents of patients affected with cut grooves running vertically across the lips; Type I’: grooves
cleft lip and/or palate have been shown to have a particular are straight but disappear halfway instead of covering the
lip print pattern. The study of lip prints in understanding the entire breadth of the lip; Type II: grooves fork in their course;
inheritance of various congenital anomalies can, therefore, Type III: grooves intersect; Type IV: grooves are reticular; Type V:
be a useful tool in primary care of diseases. This provides a groves do not fall into any of the Type I to IV and cannot be
cost‑effective, noninvasive screening method to evaluate the differentiated morphologically.
occurrence of clefts in the offspring.
Statistical analysis
There are reported studies on the gender differences among The collected data was statistically analyzed using SPSS 22.0
the lip groove patterns of individuals. Lack of comprehensive software.
database is a major roadblock in the progression and
establishment of cheiloscopy as a distinctive supporting branch
in forensic dentistry.
Results
The results noted from the study were the following:
The aim of the current research is to determine the common lip Type I (61.5%), Type V (59.5%), Type I’ (56.4%), and
groove pattern among Calicut population, evaluate the variation Type IV (53.1%) form the predominant lip groove patterns in
in lip groove patterns and gender‑wise comparison of lip groove the four regions of lips in the population. Type III (24.7%) and
patterns. Type II (29.0%) form the least common lip groove patterns in
the four regions of lips in the population.
Methodology
Type  I’  (92.3%) and Type  I  (96.8%) lip groove patterns were
The study was carried out from January 2017 to January 2019
found to be predominant among all the regions of lips in males.
on 2112 individuals (1056 males and 1056 females) aged from
Type IV (93.7%) and Type V (55.6%) lip groove patterns were
15 to 60  years in KMCT Dental College, Calicut. Excluded
found to be predominant among all the regions of lips in females.
criteria are 1) persons with lip scar, 2) lip lesions, 3) lip congenital
deformities, and 4) persons with hypersensitivity to lipsticks.
2112 individuals comprising of 1056 males and 1056 females
were assessed for the lip groove patterns. Each individual lips
The study protocol and objectives were thoroughly explained
were divided into 4 regions: upper right, upper left, lower right,
to the participants and informed consent was taken from them.
and lower left. A total of 8448 lip regions (n = 8448) were assessed
The Institutional Ethics Committee of KMCT Dental College
for 6 types of lip groove patterns: Type  I, Type  I’, Type  II,
has approved the research.
Type III, Type IV, and Type V. Mean number of different types
of lip groove lines in each region of lips and standard deviation
Materials used to record the lip groove patterns were: red‑colored
is also assessed [Table 1].
lipstick, cellophane tape, white paper, and magnifying lens. Costa
and Caldas technique[14] was used to record the lip groove pattern.
Table 2 shows lip groove patterns among males. 1056 males were
assessed for their lip groove patterns. Each individual lips were
The individuals’ lips were cleaned with a wet tissue before
starting the procedure. The lipstick was gently applied to both
lips and the individuals were asked to roll the lips in a uniform Table 1: Lip groove patterns among males and females
manner from center to the corner of lips.[15] The individual was Lip Groove Patterns Number (n) (percentage) Mean±SD
asked to stop moving the lips during the procedure and to keep Type I 5195 (61.5) 3.60±0.33
the lips in relaxed state. The lip groove patterns were lifted by Type I’ 4766 (56.4) 3.25±0.35
cellophane scotch tape on upper lip from one side to another; Type II 2450 (29.0) 2.58±0.77
following which the tape was pasted on a white bond paper as Type III 2084 (24.7) 2.57±0.16
a permanent record. The same process was repeated for lower Type IV 4483 (53.1) 3.39±0.19
Type V 5033 (59.5) 2.22±0.79
lips. After pasting the lip groove patterns on the bond paper,

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Thermadam, et al.: Cheiloscopy in gender determination

divided into 4 regions: upper right, upper left, lower right, and upper lip and lower lip. Mean and standard deviation is also
lower left. A total of 4224 lip regions (n = 4224) were assessed for calculated [Table 4].
6 types of lip groove patterns: Type I, Type I’, Type II, Type III,
Type IV, and Type V. Mean number of different types of lip groove Lip groove patterns were taken for 1056 males and were assessed
lines in each region of lips and standard deviation is also assessed. for the presence of patterns separately in upper lip and lower lip.
Mean and standard deviation is also calculated [Table 5].
Table 3 shows lip groove patterns among females. 1056 females
were assessed for their lip groove patterns. Each individual lips Lip groove patterns were taken for 1056  females and were
were divided into 4 regions: upper right, upper left, lower right, and assessed for the presence of patterns separately in upper lip and
lower left. A total of 4224 lip regions (n = 4224) were assessed for lower lip. Mean and standard deviation is also calculated [Table 6].
6 types of lip groove patterns: Type I, Type I’, Type II, Type III,
Type IV, and Type V. Mean number of different types of lip groove Discussion
lines in each region of lips and standard deviation is also assessed.
Different prevalence of lip groove patterns has been reported
Lip groove patterns were taken for 2112  males and females worldwide. Cheiloscopy could be a useful adjunct in crime
and were assessed for the presence of patterns separately in scenes, mass disasters, and accidents. It is considered the most
important and advisable form of transfer of evidence.[5,18] Lip
Table 2: Lip groove patterns among males prints could be retrieved from glass, cigarette butts, clothes, food
material, etc., and it could be done by using aluminum powder
Lip Groove Patterns Number (n) (Percentage) Mean±SD
and magnetic powder.[19]
Type I 4089 (96.8) 4.36±0.38
Type I’ 3898 (92.3) 3.85±0.14
Type II 1242 (29.4) 2.65±0.89 The current research revealed a uniqueness of lip groove pattern
Type III 1086 (25.7) 2.43±0.28 and predominance of Type IV and Type V patterns among
Type IV 527 (12.5) 0.58±0.38 females and Type I’ and Type I patterns among males. Costa
Type V 2685 (63.6) 2.20±0.76 and Caldas[14] and Kumar et al.[12] stated that lip groove patterns
can be used as a potential aid in gender determination which is
in accordance with the results of current research. Lip groove
Table 3: Lip groove patterns among females patterns vary in different parts of lips and it reiterates the fact
Lip Groove Patterns Number (n) (Percentage) Mean±SD of uniqueness of lip groove patterns.
Type I 1106 (26.2) 2.84±0.24
Type I’ 868 (20.6) 2.65±0.22 According to other studies Type IV lip groove pattern was
Type II 1208 (29.0) 2.55±0.62 found to be predominant among Kerala population which is
Type III 998 (23.6) 2.70±0.87 in accordance with the predominant pattern among females
Type IV 3956 (93.7) 6.19±0.22 in the current research.[8,20] A cheiloscopic study on Rajasthan
Type V 2348 (55.6) 2.23±0.46
population revealed a significant difference among gender, which

Table 4: Lip groove patterns among upper and lower lips in males and females
Upper Lip Lower Lip
Lip groove patterns Number (n) (percentage) Mean±SD Lip groove patterns Number (n) (percentage) Mean±SD
Type I 2560 (60.6) 2.61±0.29 Type I 2476 (58.6) 3.09±0.35
Type I’ 2500 (59.2) 2.94±0.35 Type I’ 2454 (58.1) 2.93±0.35
Type II 1654 (39.2) 1.61±0.77 Type II 1492 (35.3) 1.57±0.76
Type III 1468 (34.8) 1.57±0.18 Type III 1522 (36.0) 1.55±0.14
Type IV 2354 (51.8) 2.62±0.20 Type IV 2434 (57.6) 2.62±0.18
Type V 2818 (66.7) 2.21±0.78 Type V 3096 (73.3) 2.22±0.80

Table 5: Lip groove patterns among upper and lower lips in males
Upper Lip Lower Lip
Lip groove patterns Number (n) (Percentage) Mean±SD Lip groove patterns Number (n) (Percentage) Mean±SD
Type I 1984 (93.9) 3.40±1.34 Type I 1972 (93.4) 4.31±1.41
Type I’ 2008 (95.1) 4.22±1.18 Type I’ 1996 (94.5) 3.21±1.17
Type II 970 (45.9) 1.65±0.90 Type II 936 (44.3) 1.60±0.89
Type III 872 (41.3) 1.43±1.29 Type III 884 (41.8) 1.42±1.28
Type IV 376 (17.8) 1.04±0.33 Type IV 442 (20.9) 1.07±0.42
Type V 796 (37.7) 1.18±0.75 Type V 1112 (52.7) 1.22±0.76

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Thermadam, et al.: Cheiloscopy in gender determination

Table 6: Lip groove patterns among upper and lower lips in females
Upper Lip Lower Lip
Lip groove patterns Number (n) (Percentage) Mean±SD Lip groove patterns Number (n) (Percentage) Mean±SD
Type I 576 (27.3) 1.82±1.23 Type I 504 (23.9) 1.86±1.24
Type I’ 492 (23.3) 1.66±1.01 Type I’ 458 (21.7) 2.64±1.02
Type II 684 (32.4) 1.56±0.63 Type II 556 (26.3) 1.54±0.61
Type III 596 (28.2) 1.71±0.92 Type III 638 (30.2) 1.68±0.82
Type IV 1978 (93.7) 4.20±1.23 Type IV 1992 (94.3) 4.17±1.22
Type V 2022 (95.7) 3.23±0.46 Type V 1984 (93.9) 3.22±0.45

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