Forensic Science International

89 (1997) 65–74

Logistic analysis of shovel and Carabelli’s tooth

traits in a Caucasoid population
a, b b c
John W. Hsu *, Peiling Tsai , Kehmin Liu , Donald Ferguson
a
Graduate Research Institute of Medicine, b Department of Anatomy, Kaohsiung Medical College,
Kaohsiung, Taiwan 80 708, ROC
c
Department of Orthodontics, Marquette University, Milwaukee 53233, WI, USA

Received 18 December 1996; accepted 14 May 1997

Abstract

Caucasoid populations differ from Mongoloids by having a high prevalence of Carabelli’s trait
and a low prevalence of shovel trait. This study was conducted to investigate the association
between the shovel and the Carabelli’s traits in a Caucasoid population. The research design
sought a Caucasoid population at Milwaukee of Wisconsin in United States. The Caucasoid group
selected for study was the European descendant. The effects of sex and age on Carabelli’s trait
were controlled in this investigation, as was the association between tooth size and Carabelli’s
trait. Results show that males were more likely to have Carabelli’s trait expressed on teeth than
females. The buccolingual diameter of Carabelli’s trait teeth was larger than that of teeth without
the trait. After adjusting for sex, age, and tooth size, the existence of the shovel trait decreased the
likelihood of having Carabelli’s trait which shows an significant effect.  1997 Elsevier Science
Ireland Ltd.

Keywords: Human tooth traits; Forensic science; Caucasoid; Mongoloid; Logistic regression

1. Introduction

Shovel trait incisors and Carabelli’s trait molars are dental features commonly used to
differentiate Caucasoid from Mongoloid populations (Fig. 1). Carabelli’s or shovel traits
have been used as critical indicators for several decades, and this has probably been
because they are simply observed in both living and skeletal materials and they can be

*Corresponding author.

0379-0738 / 97 / $17.00  1997 Elsevier Science Ireland Ltd. All rights reserved.
PII S0379-0738( 97 )00114-X
66 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74

Fig. 1. Cusp form of Carabelli’s trait (C) on upper right first molar and shovel trait (S) on upper right central
incisor.

used to show major ethnic differences in dentition [1]. Two features of Caucasoid dental
complex are a high frequency of Carabelli’s trait molars and a low frequency of shovel
incisors [2,3]. Although it might have been hypothesized that shovel incisors repress the
appearance of Carabelli’s traits, the preliminary positive association between these two
dental traits was found in a Mongoloid population [4]. However, the real association
between shovel and Carabelli’s traits has been still obscure in other populations. Shovel
traits are a combination of a concave lingual surface and elevated marginal ridges
enclosing a central fossa in the upper right central incisor teeth. Carabelli’s traits are
found on the lingual aspect of the mesiolingual cusp of the upper first molar teeth on
which the traits may take the form of a pit, fissure or cusp. Few studies have examined
the degree to which the existence of Carabelli’s trait in the molar teeth is influenced by
the existence of the shovel trait in the incisor teeth, although dental inter-trait studies
have been done before [5–11].
Considering the possible population differences in the manifestation of Carabelli’s
trait, we limited our investigation to a Caucasoid population. The Caucasoid people live
in Milwaukee area of Wisconsin in United States and are the descendants of Europeans
[12,13]. Besides reducing the impact of population differences, other possible factors,
such as sex and tooth size, which might affect the value for Carabelli’s trait and might
interfere with the influence of the shovel trait on Carabelli’s trait, have to be considered.
Although sex differences in the expression of Carabelli’s trait have been reported
[14–18], other authors have found no significant male-female differences in Carabelli’s
 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74 67

trait [19–23]. To control for potential differences caused by dimorphism, sex was
considered as a possible confounding variable in this investigation.
The association has been found between the increased maxillary molar tooth size and
the occurrence of Carabelli’s trait [21,24]. Tooth size is larger in Carabelli trait-positive
than in Carabelli trait-negative molars [25]. Because tooth size may be a confounding
variable in our analysis of Carabelli’s trait, we adjusted for tooth size. Our study
explores the statistical effects of confounding variables, such as demography and tooth
size, on Carabelli’s trait in a Caucasoid population, the American European at
Milwaukee in Wisconsin. After removing the effects of possible confounding factors,
this analysis may also seek to investigate the extent to which the shovel trait might affect
Carabelli’s trait.

2. Materials and methods

2.1. Measurement acquisition

One hundred and forty five subjects participated in this study. In order to reduce the
confounding effects of the admixture of race on Carabelli’s trait, subjects had to be
members of the American European at Milwaukee in Wisconsin. Tooth impressions
were taken and plaster models were made with rigid disposable trays and poured
immediately in dental stone to prevent distortion. To reduce the possible discrepancy
between deciduous and permanent dentitions, this study was restricted to permanent
teeth [23]. In order to avoid the decrease in observable characteristics caused by dental
caries and wear associated with advancing age, the subjects were also limited to
adolescents.
145 dental casts were used for morphological and metric inspections. Of this number,
142 could be appraised for upper right first molar and upper right central incisor
measurements. 3 casts were excluded due to inability to measure tooth size and traits.
There were no significant deviation in demography between the participating group
(142) and the nonparticipating group (3). In order to eliminate potential problems of
asymmetry, analysis was limited to traits and measurements of the right side of the
dentition [26–28]. If a tooth was missing or could not be precisely measured due to the
loss of measuring points through caries, restoration or attrition, the corresponding
contralateral tooth was not used as a proxy.
Several patterns of Carabelli’s trait have been classified and contain (a) no evidence of
Carabelli’s trait – smooth surface with the absence of pits or fissures, (b) pits or fissures,
(c1) cusp without free tip, and (c2) cusp with free tip [29]. Thereafter, more patterns of
Carabelli’s trait have been described, and even intermediate forms have been included
[22,30–32]. The nonmetrically categorical data of trait patterns have been dichotomized
into two types, including the existence and the nonexistence of Carabelli’s traits. The
presence or absence of Carabelli’s trait was recorded for the upper right first molar.
When there was any manifestation of the trait, cusp, fissure, or pit, the presence of
Carabelli’s trait was coded.
Many classifications of the shovel trait have been suggested and include (a) shovel –
68 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74

enamel rim distinct with an enclosed well-developed fossa, (b) semishovel – enamel rim
distinct but enclosed fossa shallow, (c) trace shovel – traces of enamel rim which can
not be classed as semi-shovel, and (d) no shovel – no perceptible trace of rim or fossa
[33]. Upper right central incisor teeth were examined by using this system of grouping
and the modified classifications [31,32,34]. These categorical figures were also dich-
otomized into two groups, including the existence and the nonexistence of shovel traits.
When rim or fossa could be observed the shovel trait-positive incisors were coded.
The tooth size of upper right first molars of permanent teeth for each dental cast was
measured by a sliding electronic digital caliper with 0.01 mm resolution. Tooth size
variables included mesiodistal and buccolingual diameters. The measurements of
mesiodistal and buccolingual diameters followed Seipel [35] and Moorrees et al. [36].
Mesiodistal diameter was measured as the greatest distance between the approximate
surfaces of the crown with a sliding caliper parallel to the occlusal and vestibular
surfaces of the crown. When a tooth was rotated or malposed in relation to the dental
arch, the measurement was taken between the points on the approximate surface of the
crown at which place it was judged that normal contact should have occurred with
neighbouring teeth. Measured with a sliding caliper held at right angles to the
mesiodistal diameter of the tooth, buccolingual diameter was measured as the greatest
distance between the labial or buccal surface and the lingual surface of the tooth crown.
To decrease inter-observer errors, mesiodistal and buccolingual crown dimensions of
upper right first molars were measured directly on the cast by a single well-trained
examiner. A significant test-retest reliability (r.0.94, P,0.001) was found. Diameters
were measured three times and the average value was recorded for each diameter. The
morphological traits were classified independently by another examiner, whose incorrect
percentage of trait classification was less than 4%.

2.2. Statistical analysis

The means and proportions for confounding variables were computed for the teeth
with vs. without Carabelli’s trait. Multivariate logistic regression was used in this
comparative dichotomy analysis between the two groups by using the SAS / STAT
computer program [37]. We employed logistic regression, which has become the
standard method of analysis in cases where the dependent outcome variable, such as
presence or absence of Carabelli’s trait, is dichotomous or discrete [38]. Because of the
possible variation of dental size and morphology, age was controlled for in this
investigation. In addition to sex, the diameters of teeth were also controlled for in the
analysis to explore the differences in Carabelli’s traits of upper right first molars
between presence and absence of shovel traits of upper right central incisors. This
logistic method enabled the comparison between presence and absence of the shovel trait
for the differences in Carabelli’s trait, while controlling for the effects of independent
variables such as sex, age, and size of upper right first molars simultaneously. Tests for
inference allowed a type 1 error rate of 5%. The odds risk and 95% confidence interval
of odds risk were calculated. Odds risk is a measure that shovel trait is associated with
Carabelli’s trait. An upper and lower 95% confidence limit of odds risk not containing
the value of one was defined as a significant odds risk.
 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74 69

Table 1
Confounding factors controlled in multivariate logistic regression
Factors No Carabelli’s Carabelli’s
trait trait
(N539) (N5103)
Sex (% male) 17.95 37.86
Age (mean years) 14.03 14.72
MD URM1 st (mean mm)a 10.19 10.35
BL URM1 st (mean mm)b 11.11 11.41
a
MD URM1 st : Mesiodistal diameter of tipper right first molar.
b
BL URM1 st : Buccolingual diameter of upper right first molar.

3. Results

One third (32.39%) of the sample were male subjects. Of all samples, 72.54% had
Carabelli’s trait in the upper right first molars, and of male subjects, 84.78% had this
traits. However, only 66.67% of female teeth had Carabelli’s trait. The means and
proportions of confounding variables of teeth with vs. without Carabelli’s trait are shown
in Table 1. The coefficients and the significance of independent variables in multivariate
logistic regression are shown in Table 2. Significant differences were found between
males and females for Carabelli’s trait. No age difference was observed between
presence and absence of Carabelli’s traits (P.0.05). A tooth exhibiting Carabelli’s trait
tooth was significantly more likely to be in males than in females (P,0.001).
Table 1 and Table 2 listed the possible confounding variables to be controlled for in
the analysis. Regarding tooth size, the total studied sample had mean6standard
deviation of mesiodistal and buccolingual diameters of 10.3160.48 mm and 11.3360.55
mm, respectively. After adjusting for the confounding variables, the mean buccolingual
diameter of the tooth with Carabelli’s trait was significantly larger than that of the tooth
without Carabelli’s trait (P,0.05). On the other hand, the mean mesiodistal diameter of
the tooth with Carabelli’s trait was slightly larger than that of the tooth without

Table 2
Estimates and standard errors in multivariate logistic regression: Carabelli’s trait vs. no Carabelli’s trait
Factors Log odds Statistical c
significance
Estimate Standard error
Sex 1.53 0.29 ***
Age (years) 0.34 0.22 ns
MD URM1 st (mm)a 0.41 0.31 ns
BL URM1 st (mm)b 0.64 0.28 **
Presence of shovel trait 21.17 0.27 ***
a
MD URM1 st : Mesiodistal diameter of upper right first molar.
b
BL URM1 st : Buccolingual diameter of upper right first molar.
c
Significant difference between with and without the Carabelli’s trait measurements, ** P,0.05, *** P,0.001.
ns: not significant, P.0.05.
70 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74

Table 3
The association between shovel and Carabelli’s traits a
Groups No Carabelli’s Carabelli’s Odds 95% P
trait trait risk confidence
(N5103) (N539) interval
Shovel 65 32
0.31 0.18–0.53 ,0.001
No shovel 38 7
a
Statistical significance was determined by logistic regression controlling for the effects of sex, age, as well as
both mesiodistal and buccolingual diameters of upper right first molars.

Carabelli’s trait, but it was not statistically significant after adjusting for sex, age, and
buccolingual diameters (P.0.05).
The presence of the shovel trait in the upper right central incisors predicted the
existence of Carabelli’s trait in the upper right first molars obviously less often than the
absence of the shovel trait did (odds risk, 0.31. 95% confidence interval, 0.18–0.53;
P,0.001) (Table 3). Of all nonshovel trait teeth in the Milwaukee Europeans, 84.44%
had Carabelli’s trait teeth. Carabelli’s trait teeth was found in 74.71% of all shovel trait
teeth in the Milwaukee Europeans.

4. Discussion

Morphologically nonmetric dental traits have been presumed to be quasi-continuous,

or treated as continuous variables in prior studies. Generally, the real trait expression
intervals have been unequally classified into several categories, but equally continuous
intervals have been assumed to apply. Further, incorrect percentages for several types of
dental trait classifications have ranged from 22% to 56% [39]. Finally, the classification
criteria of Carabelli’s traits have been variably set into different categories by different
authors. For example, the ‘‘pit’’ feature has been given different values or degrees in
different classifications. Some investigators have viewed ‘‘groove’’ and ‘‘cusp’’ as
independent categories, but some have had categories for ‘‘cusp’’ in contact with
‘‘groove’’ or ‘‘cusp’’ with no contact. Another method, assuming the threshold
mechanism, has dichotomized the nonmetric dental traits into present and absent groups
to view dental traits as entities [21,32,33,40–44]. On the basis of these prior studies,
dicliotomization reduces possible classification bias and has another trait entity implica-
tion.
Carabelli’s trait was found sexually dimorphic in Milwaukee Europeans in this study.
Similar findings have occurred elsewhere [14–18], but these are in contradiction with
some other studies [19–23]. It appears difficult to conclude that sex differences exist in
Carabelli’s trait. However, we note that these previous studies are not completely
comparable due to varying sample sizes and different methods of analysis. The effects of
confounding variables such as mesiodistal and buccolingual diameter have been rarely
removed. These methodological deficiencies in other investigations may have led to
contradictory findings. Certainly such analytic shortcomings influenced us to use
 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74 71

multivariate methods in our own analysis, which then identified the existence of
significant sexual difference.
Among Milwaukee Europeans, after adjusting for sex and age, significant differences
are present in buccolingual, but not in mesiodistal diameters. Such differences have been
observed elsewhere [25,45,46]. De Terra [45] and later Dahlberg [46] suggested that
Carabelli’s cusp is an adaptation that enlarged the occlusal surface of the first molars in
the buccolingual dimension as compensation for evolutionary reduction in the length
(mesiodistal diameter) of the maxillary molar row. Another study reported that
Carabelli’s cusp is related to larger first molars overall, and not especially with an
increase in the buccolingual diameter [21]. The opinion from the evolutionary perspec-
tive has been that Carabelli’s trait might be a primitive structure that tends to disappear
with molar reduction in all hominoid evolutionary lines [25,47,48]. A functional
argument for the existence of Carabelli’s trait has been the proposal that it may be a
structure that resists excessive biomechanical stresses on the first molar [49]. According
to the results of the present study, which shows that smaller first molars tend to have
fewer occurrences of Carabelli’s traits, we supported that developmentally Carabelli’s
trait is a disappearing structure while first molar gets smaller in a Caucasoid population.
That Carabelli’s trait serves a structural function needs further biomechanical ex-
perimentation to test.
Populations derived from Europe, such as American whites, have a low frequency of
shovel trait and a high frequency of Carabelli’s trait [1,33,50]. On the other hand, shovel
trait occurs almost universally, and occurs particularly frequently in all Mongoloid
groups, including Chinese, Taiwan aborigines, Eskimos, and American Indians [2,3,33].
Carabelli’s trait is less commonly found in these populations [1]. The literature shows
that Caucasoid and Mongoloid population frequencies differ remarkably in the expres-
sion of Carabelli’s trait on the upper right first molar and shovel trait on the upper right
central incisor teeth [1,51,52]. As a consequence of this, shovel and Carabelli’s traits
have been regarded as dental markers of Mongoloid and Caucasoid ancestry. Under-
standing the real interaction between these two prominent dental markers is therefore of
biological, and anthropological value.
Comparably, little attention has been paid to the outcome of multivariate analyses of
the effect of shovel trait on Carabelli’s trait, though many papers have examined dental
traits in Caucasoid populations [30,50,53,54]. By confining our study to the Milwaukee
Europeans only, we show that after adjustment, the presence of the shovel trait tends to
decrease the likelihood of Carabelli’s trait by a factor of point nineteen. We have found
the negative impact of the shovel trait on Carabelli’s trait after proper data adjustment in
a Caucasoid population which were different from the positive interaction, using similar
analytical method, between these two dental makers in a Mongoloid population [4],
which has anticipated analogous developmental relationship between shovel and
Carabelli’s traits. Given the negative association found in the present study, the
decrement of Carabelli’s traits is related to the increment of shovel traits. Accordingly, a
distinct developmental relationship between these two traits would be contemplated.
Moreover, the negative association between these two dental traits may be hypothesized
as a common characteristic in the Caucasoid population that needs further studies to
prove.
72 J.W. Hsu et al. / Forensic Science International 89 (1997) 65 – 74

Different models which include genetic and environmental factors for the mani-
festation of Carabelli’s trait have been reported [14,21,55]. It is likely that in addition to
the environment, genes play a major role in the association between Carabelli’s and
shovel traits [4]. Therefore, the negative association between shovel and Carabelli’s
traits in the Caucasoid population may be explained by that besides the different
environment, the different genes cause the different interaction between these two dental
traits. Nevertheless, this assumption also needs to be verified with family studies.
Although the generalization of the intensity of the effect of shovel trait on Carabelli’s
trait seen in Milwaukee Europeans to other populations may be limited, this study also
promotes a method to investigate the influence of shovel trait on Carabelli’s trait entity
in other populations, which are necessary.

Acknowledgments

We are grateful to Dr. Larry Steinrauf for his comments and Dr. S. Chang for his
statistical advice in this study and also to Mr. Paul Hsu. for his preparation of the
materials and manuscript.

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