Anthropological and radiographic comparison of vertebrae for identification of decomposed human remains

This case study demonstrates the importance of involving an anthropologist in forensic situations with decomposed remains. Anthropological consultation was used in conjunction with the comparison of antemortem and postmortem radiographs to establish positive identification of unknown, decomposed remains. The remains had no traditional identifying features such as fingerprints or dental. Through anthropological analysis, it was determined the decedent was male, between 20 and 23 years at time of death and c. 5'2' tall. This information allowed for a presumptive identification and a request for antemortem radiographs. The missing person was identified comparing the spinous processes of the cervical and thoracic vertebrae between ante- and postmortem radiographs.     

Shadow positioning technique: a method for postmortem identification

Radiology is increasingly being used as a means of postmortem identification. We have devised a shadow positioning technique by which a postmortem radiograph of a skeletal part can exactly duplicate an antemortem radiograph, thus, faciliating identification by comparison of the antemortem and postmortem radiographs. The antemortem radiograph can be of any skeletal part and taken in any position.     

Computed dental radiography used to reproduce antemortem film position

Visual comparison of conventional antemortem and postmortem dental radiographs is often included in forensic identification. Ten forensic cases employing dry mandibular and maxillary bones and a dry study skull were exposed using the CDR digital dental X-ray system developed by Schick Technologies, Inc. Exposures of 0.08s at 10 mA and 70 kVp were taken with an INTREX intraoral dental X-ray unit. Digital radiography has the ability to produce an image instantaneously, allowing an operator to retake an incorrectly aligned radiograph almost immediately. It gives the forensic scientist a simplified method for reproducing antemortem radiographic position more efficiently and often with greater accuracy than conventional radiography.     

Root Morphology and Anatomical Patterns in Forensic Dental Identification: A Comparison of Computer‐Aided Identification with Traditional Forensic Dental Identification*

Abstract: An online forensic dental identification exercise was conducted involving 24 antemortem–postmortem (AM–PM) dental radiograph pairs from actual forensic identification cases. Images had been digitally cropped to remove coronal tooth structure and dental restorations. Volunteer forensic odontologists were passively recruited to compare the AM–PM dental radiographs online and conclude identification status using the guidelines for identification from the American Board of Forensic Odontology. The mean accuracy rate for identification was 86.0% (standard deviation 9.2%). The same radiograph pairs were compared using a digital imaging software algorithm, which generated a normalized coefficient of similarity for each pair. Twenty of the radiograph pairs generated a mean accuracy of 85.0%. Four of the pairs could not be used to generate a coefficient of similarity. Receiver operator curve and area under the curve statistical analysis confirmed good discrimination abilities of both methods (online exercise = 0.978; UT‐ID index = 0.923) and Spearman’s rank correlation coefficient analysis (0.683) indicated good correlation between the results of both methods. Computer‐aided dental identification allows for an objective comparison of AM–PM radiographs and can be a useful tool to support a forensic dental identification conclusion.     

Dental identification by comparison of antemortem and postmortem dental radiographs: influence of operator qualifications and cognitive bias

Dental forensic identifications based on comparison of antemortem and postmortem radiographs provide effective and reliable evidence. There are no standardized procedures for assessing similarities between different types of dental radiographs (e.g. orthopantomograms, bitewings, and periapical radiographs), and the operator's subjective judgment can considerably affect identification. The purpose of this study is to evaluate the potential influence of experts' qualifications, training, and cognitive bias on the accuracy of identification. Seventy-eight differently qualified and experienced experts underwent an identification test. The expert sample was composed of 10 specialists in emergency care (ER), 10 specialists in legal medicine (ML), 20 pregraduate dental students (STU), 12 dentists (DENT), 20 dentists educated in forensic odontology (DENT-TRA), and 6 experienced forensic odontologists (FOR). The simulated cases required participants to assess the possible matching of 42 postmortem intraoral radiographs with 16 antemortem panoramic radiographs. Accuracy and specificity for the different operator groups were as follows: ER, 0.76-0.70; ML, 0.76-0.88; STU, 0.89-0.82; DENT, 0.87-0.97; DENT-TRA, 0.88-0.92; and FOR, 0.97-1. As evidenced by high rates of accuracy and repeatability, the most experienced forensic odontologist consistently outperformed operators less or differently educated and trained, especially for difficult cases. In our sample, the dentists who received additional education in forensic odontology did not necessarily perform better than dentists who had not received this additional education. Some cognitive bias, mainly the so-called observer effect, emerged as a possible source of outcome variability among the operator groups.     

Positive Dental Identification Using Tooth Anatomy and Digital Superimposition

Dental identification of unknown human remains continues to be a relevant and reliable adjunct to forensic investigations. The advent of genomic and mitochondrial DNA procedures has not displaced the practical use of dental and related osseous structures remaining after destructive incidents that can render human remains unrecognizable, severely burned, and fragmented. The ability to conclusively identify victims of accident and homicide is based on the availability of antemortem records containing substantial and unambiguous proof of dental and related osseous characteristics. This case report documents the use of digital comparative analysis of antemortem dental models and postmortem dentition, to determine a dental identification. Images of dental models were digitally analyzed using Adobe Photoshop^TM software. Individual tooth anatomy was compared between the antemortem and postmortem images. Digital superimposition techniques were also used for the comparison. With the absence of antemortem radiographs, this method proved useful to reach a positive identification in this case.     

Skeletal identification using the frontal sinus region: a retrospective study of 39 cases

The importance of identification using the frontal sinus has been previously demonstrated in case reports. In this study, 39 cases of identification using frontal sinus comparison from the Ontario Chief Coroner's Office were reviewed and differences between antemortem and postmortem radiographs examined. All cases involved decedents older than twenty years. Three cases were rejected due to poor antemortem and postmortem film quality. One subject had no frontal sinus. Thirty-five cases provided conclusive postmortem to antemortem pattern matches. Sixteen cases also yielded metric (quantitative) matches. Duration between antemortem and postmortem radiographic examinations, age, gender, and cause of death did not affect the ability to obtain a match. This is the largest study undertaken on actual cases and demonstrates the validity of frontal sinus pattern matching for forensic identification.     

Briefly unidentified: a study of a peculiar source of identification.

In May of 1992, unidentified human remains were received at the C.A. Pound Human Identification Laboratory, University of Florida, Gainesville, Florida for identification. The decedent was identified as a white female in her early sixties between 62 and 63 in. in stature. Significant trauma was observed at various skeletal sites. The identity of the decedent was meant to be obscured due to the decapitation of the head and removal of the lower arms including the hands. Examination of the clothing revealed that the first initial and last name of the decedent had been written in ink inside the label of the underpants. Subsequently, this information was matched with missing persons reports. Identification of the decedent was confirmed by comparison of antemortem and postmortem radiographs.     

Digital dental radiographic identification in the pediatric, mixed and permanent dentitions.

The purpose of this paper is to investigate the utility of digital dental radiographic superimposition in the various stages of development of the human dentition. Digital, computer assisted dental identification is a means of identification which allows the spatial relationships of the root and support structures of the teeth to be compared one to the other. The technique has not been tested in patients with developing dentitions. Dental radiographs from patients in the pediatric, mixed and permanent dentition stages of development, simulating "antemortem" and "postmortem" radiographs, were digitized using a flat field radiograph scanner. Anatomic features were used as points of comparison utilizing image editing software whereby anatomic sections were digitally cut from the antemortem image and compared to the same anatomic locations on the postmortem image to assess for points of concordance. The technique was applied to 25 cases within the primary dentition, 25 cases within the mixed dentition and 25 cases within the permanent dentition. Results showed that this was a viable technique within both the pediatric and permanent dentition although it was of little value within the mixed dentition.     

The reliability of digitized radiographs for dental identification: a Web-based study

In the era of Daubert and other judicial rulings pertaining to the acceptability of forensic evidence, it is increasingly important that experts are able to testify that their methods have been scientifically tested and that error rates and other factors relating to reliability have been published. The purpose of this study was to determine the reliability of digitized radiographic comparisons for the purposes of dental identification. Participants with various forensic backgrounds and experience levels were passively recruited to the website. Ten forensic identification cases composed of antemortem and postmortem dental radiographs were supplied to examiners using a bespoke website. Participants responded to the cases on two occasions after a one-month washout interval using the ABFO conclusion levels for forensic identifications. A total of 115 first attempts and 87 matched second attempts were received. Of the total responses, 72% were dentally trained respondents who had completed at least one forensic identification case; of these, 38% were experienced forensic dentists who had completed more than 25 identifications. Data relating to accuracy, intra- and inter-examiner agreement, and the effect of case difficulty are presented. Mean accuracy was 85.5% for all cases, with the experienced forensic dentists obtaining a 91% success rate. The inter-examiner agreement on the negative identification cases was classified as poor. The data suggest that dental identifications resulting from the comparison of postmortem and antemortem radiographs are valid, accurate, and reliable when undertaken by experienced odontologists.     

Personal identification based on radiographic vertebral features

Personal identification of human remains constitutes about 10% of the normal caseload of any forensic medicine practice. Identification can be achieved by a variety of methods, one of which is the comparison of antemortem and postmortem radiographs. There are numerous accounts of cranial and dental radiographic features useful for identification, whereas the availability of postcranial radiographs and especially plates that depict the vertebral column is less widespread among the forensic community. The authors here review the various vertebral features instrumental in positive identification that can be identified on radiographs of the spine.     

Craniofacial identification by comparison of antemortem and postmortem radiographs: two case reports dealing with burnt bodies

Two cases of positive identification of burnt bodies by radiographic comparison are reported. They emphasize that antemortem radiographs of the head are an important but sometimes overlooked source of information which can frequently provide useful objective data for comparison purposes. A positive identification can easily be achieved by medical examiners through visual comparison of the antemortem with the postmortem cranial and facial structures, even of bodies severely damaged by fire. In these bodies the radiographs of the skull can graphically depict structures which are often unique to the individual, such as the frontal sinus pattern and the morphology of dental restorations. However, the process of identification through radiographs is appropriate only in burnt bodies in which antemortem radiographs of the alleged deceased are available for comparison and unique craniofacial structures are still present on the body in a well-preserved state or at least not completely destroyed by fire, depending on the extent of the burn injury. Matching of corresponding features seems preferable to other methods of personal identification such as skull-photo superimposition, morphometric analysis, and/or other computer-aided methods since these techniques need trained personnel, as well as expensive equipment which is not invariably available in the medical examiner's office or department of anthropology.     

Skeletal identification by radiographic comparison: blind tests of a morphoscopic method using antemortem chest radiographs

This study investigated the value of antemortem (AM) and postmortem (PM) radiographs of the claviculae and C3-T4 vertebrae to identify skeletons of missing U.S. soldiers from past military operations. In total, 12 field-recovered skeletons and AM chest radiographs of 1460 individuals were used. For each skeleton, examiners analyzed an array of AM chest radiographs (up to 1000 individuals) and attempted to identify the correct PM/AM radiographic match. When examiners were able to compare all images within a single test, only true-positive identifications were made. When AM radiographs were presented one-at-a-time, in sequential order, and without examiners having knowledge of array size, erroneous identifications resulted but they were almost exclusively made by untrained examiners (accuracy = 35% vs. 90% for trained examiners). This study demonstrates the value of chest radiographs for the identification of disarticulated and even eroded skeletons, but only when methods are wielded by trained examiners.     

Comparative dental radiographic identification using flat panel CT

A skull without lower jaw was found and brought in for identification. It was suspected to be that of a man reported missing five years ago. An undated antemortal dental chart and two dental films of the 1st and 2nd dental quadrants, both taken about 4 years before the man went missing, were available for comparison. The method of choice in solving the identity question was comparative dental radiography. Despite numerous attempts, it was not possible to obtain radiographs of the upper jaw that duplicated the X-ray beam angulation of the antemortem dental films. The skull was thus scanned with a multislice computed tomography (MSCT) scanner, and virtual radiographs with the desired angulation were generated from the data with the maximum intensity projection (MIP) technique. The resulting virtual radiographs could, however, not be used for superimposition with the antemortem radiographs because of their poor resolution and the occurrence of artifacts caused by metallic dental fillings. The upper jaw was therefore scanned again, this time with a high resolution eLU-CT (eXplore Locus Ultra flat panel CT). The resulting eLU-CT datasets were visualized with the MIP technique and yielded virtual radiographs that could be compared with the antemortem radiographs. Positive identification could be assumed with near certainty after dental features could be matched in the superimposition of antemortem and postmortem radiographs. In the presented case, eLU-CT was used for the first time for a comparative dental radiographic identification.     

Radiographic human identification using bones of the hand: a validation study

The 1993 Supreme Court case Daubert v. Merrell-Dow Pharmaceuticals, Inc. underscores the importance of validating forensic science techniques. This research examines the validity of using posterior-anterior radiographs of the hand to make positive identifications of unknown human remains. Furthermore, this study was constructed to satisfy the requirements of Daubert's guidelines of scientific validity by establishing a standard methodology for hand radiograph analysis, testing the technique, and noting rates of error. This validation study required twelve participant examiners from the forensic science community, working independently, to attempt to match 10 simulated postmortem radiographs of skeletonized hands to 40 simulated antemortem radiographs of fleshed cadaver hands. The overall accuracy rate of the twelve examiners was 95%, while their collective sensitivity and specificity were 95% and 92%, respectively. However, the accuracy of each examiner was related to the amount of radiological training and experience of the observer. Six Ph.D. forensic anthropologists and four experienced forensic anthropology graduate students correctly identified all the matches. Participant examiners noted bone morphology, trabecular patterns of the proximal and middle phalanges, and distinctive radiopaque and radiolucent features as the anatomical features that aided the identification process. The hand can be an important skeletal element for radiographic positive identification because it contains 27 individual bones for comparative analysis.     

Personal identification by radiographic comparison of vascular groove patterns of the calvarium

A case of forensic identification utilizing the vascular grooves within the skull is presented. The case is unique in that the antemortem radiographs were from childhood, rendering useless the more standard points of comparison. Calvarial vascular grooves represent unique points of comparison when the only available premortem radiographs were obtained during childhood, especially when one is attempting to identify children (living or dead).     

A Radiographic Study on the Utility of Cranial Vault Outlines for Positive Identifications

A standard method for positive identification is the use of antemortem and postmortem radiographic comparisons. The purpose of this research is to test the visual accuracy of antemortem and postmortem radiographic comparisons of cranial vault outlines and to evaluate their uniqueness using geometric morphometric methods. A sample of 106 individuals with varying levels of education and forensic case experience participated in a visual accuracy test. Of the 106 individuals, only 42% correctly assigned all of the radiographs, with accuracy rates ranging from 70 to 93% for each radiographic comparison. Vault shape was further examined using elliptic Fourier analysis, and paired t‐tests were computed on the first 10 principal components accounting for 100% of the variance, which found no significant differences. The visual accuracy test and elliptic Fourier analysis shows that vault outlines may not be unique enough for positive identifications when used as a sole indicator.     

Associated postmortem dental findings as an aid to personal identification.

The use of the unique features of the human dentition to aid in personal identification is well accepted within the forensic field. Indeed, despite advances in DNA and other identification methodologies, comparative dental identifications still play a major role in identifying the victims of violence, disaster or other misfortune. The classic comparative dental identification employs the use of postmortem and antemortem dental records (principally written notes and radiographs) to determine similarities and exclude discrepancies. In many cases the tentative identification of the individual is unknown and therefore antemortem records cannot be located. In such a situation a dental profile of the individual is developed to aid the search for the individual's identity. With such a profile a forensic odontologist can identify and report indicators for age at time of death, race (within the four major ethnic groups) and sex. In addition to these parameters the forensic dentist may be able to give more insight into the individual. This paper outlines, for the non-expert, some of the additional personal information that can be derived from the teeth of the deceased, and which may assist in their ultimate identification.     

The use of thoracolumbar and hip joint dysmorphism in identification

A case of roentgenographic identification of a deceased person is presented. Comparison of antemortem and postmortem radiographs of the vertebral column and hip joint, for the purpose of identification, was based on the deceased medical history, and the fact the deceased was endentulous, and fingerprint comparison was not feasible. Evaluation of anatomical variants, due to the effects of degenerative disease, provided positive identification in a visually unidentifiable deceased person.