法医牙科学研究进展CSCD

法医牙科学是法医学与口腔医学的交叉学科,通过科学地收集、检测、评价牙科证据而为司法实践提供有法律效力的证明资料。本文从年龄推断,性别推断,种族、职业及生活习惯推断,个体识别,家庭暴力或虐待行为判定等方面对法医牙科学的应用现状进行综述,并对其未来应用进行展望,希望对法医牙科学体系进行不断的补充和完善,使其在法医学甚至司法实践中更好地发挥作用。     

Antemortem dental records: attitudes and practices of forensic dentists

This study was designed to provide insight concerning the attitudes and practices of forensic dentists regarding antemortem dental records reviewed for purposes of dental identification. Forensic dentists were invited to participate in a 10 item survey. The majority of the respondents reported a considerable amount of experience in dental identifications of the deceased. Sixty-six percent reported having suspected dental negligence or fraud in their antemortem record reviews. Only 17% believe that a forensic dentist should report suspected dental negligence, while 31% agree that dental fraud should be reported. Their response to additional issues addressed in the study suggests diversity in the practices and attitudes of forensic dentists in the use of antemortem dental records. In conclusion, opening a dialogue among practicing forensic dentists may lead to a standardized set of recommendations by the appropriate societies in the forensic dental community.     

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.     

基于Citespace的法医临床学研究发展历程分析

目的运用Citespace软件对法医临床学相关文献绘制知识图谱、进行可视化分析,探究该学科领域研究热点和动态发展,梳理鉴定难点脉络。方法汇总CNKI收录《中国法医学杂志》《刑事技术》《法医学杂志》《中国司法鉴定》刊登的法医临床学相关论文,利用Citespace分析其关键词、研究热点、基金资助、作者、发文机构及所在地等。结果法医临床学作为法医学分支学科之一,近年来呈现的科研成果部分获基金资助,多由开设法医学专业的院校完成;随着科研理论、技术方法推陈出新,法医临床学鉴定标准、版本也得以构建、更迭、完善,鉴定体量位居法医"四大类"之首。结论作为最具中国特色的法医学分支学科,法医临床学研究着重服务司法实践、以期用成果技术反哺鉴定,实现学术、实践的交流、转化。通过Citespace知识图谱可视化分析学科发展历程,有助于回溯此间规律,提示未来研究方向,提升鉴定业务水平,为持续增强法医临床学学科影响力提供借鉴。     

The response of relatives to medicolegal investigations and forensic autopsy

Relatives of deceased persons, on whose body a forensic autopsy had been performed at the Institute of Forensic Science, Bern, Switzerland, were interrogated by a questionnaire. The aim was to investigate the attitude of relatives toward medicolegal investigation procedures in general and toward forensic autopsy in particular. A great majority of the relatives showed a positive or indifferent attitude toward a forensic autopsy. They showed a great interest in autopsy results and wished to be informed. It was concluded that information given before the autopsy is important for better understanding and can, if properly given, improve the relatives' acceptance and collaboration regarding forensic investigations. By contrast, a lack of information before the autopsy and about the autopsy results can cause further suffering on behalf of the bereaved. A forensic autopsy can be of great benefit for relatives and can help them to cope with a tragic loss.     

A “concrete” identification in a dismemberment case

Homicide perpetrators can use concrete as a means to conceal their victims. When concrete encasement is encountered in the forensic field, albeit rarely, it is often coupled with postmortem dismemberment. This method of obscuring the evidence presents unique investigative obstacles, specifically related to identification. Various approaches to obtaining fingerprints from decedents encased in concrete have been suggested and implemented over the years. The presented case is that of an initially unidentified 44-year-old male, who was subject to postmortem dismemberment and concrete encasement. Meticulous excavation techniques facilitated preservation of evidence and an anatomical reconstruction of the body. These techniques enabled inspection of the incision sites of the dismembered remains during the postmortem examination. Identifiable jewelry and tattoos were noted at autopsy. Further, the resulting concrete molds could be utilized to obtain fingerprints. These prints were used to ultimately identify the decedent.     

新冠肺炎等传染病与法医学鉴定评述

新冠肺炎致死或引发的其他法律纠纷可能涉及法医学病理解剖或者法医临床学鉴定。在日常法医学解剖中时有遇到因传染性疾病死亡患者的尸体,法医鉴定机构及鉴定人应当有风险识别意识,充分认识到在解剖、检查这类尸体时的被传染风险。法医鉴定人需要采取充分有效的防护措施。由于新冠肺炎属于新型传染性疾病,相关研究成果、信息资料更新快,鉴定中的信息参考要慎重选择。同时本文对因传染性疾病死亡患者的尸体解剖中常见的职业伦理、知情同意、保险理赔和环境保护等问题进行讨论。     

Forensic evaluation of occupational marks in establishing identity—A case report

The livings have responsibilities for the dead; and in particular, civilized societies recognize the need for identity both during life and at death, particularly in circumstances when an unknown body is summoned for medico-legal autopsy. There are numerous tools for identification of an unknown body which includes visual identification, fingerprints, medical prostheses, odontological techniques, DNA fingerprints and to include in the list is the occupational marks over the body sustained during the course of his or her profession. The medico-legal investigators should possess comprehensive knowledge of such occupational marks, which aid in identification. We are highlighting a case of rare entity, where a forensic evaluation of occupational marks was done to establish the identity of an unknown elderly male, who committed suicide by ligature hanging.     

A case of suicide disguised as natural death.

A case report describing the suicide of a physician classified initially as a natural death. Faced with the vehement protest of the family of the deceased the magistrate decided to request a 'preventive' forensic autopsy. Forensic investigations revealed the cause of death as being a pentobarbital intoxication and the circumstances favoured the hypothesis of a genuine suicide. This case illustrates that the tendency of magistrates to request or not an autopsy is related to their experience or intuition.     

Unidentified bodies/skulls found in Danish waters in the period 1992-1996.

In the period 1992-1996 a total of 89 unidentified bodies/skulls found in Danish waters were investigated at the three University Institutes of Forensic Medicine in Denmark. Males constituted 79% of the total material. Open water was the finding place in half the cases, about one-fourth was found on shore and another fourth in a harbor basin. Totally 73 bodies and one skull were identified. Danes constituted 57% of the material. Almost all non-Danes originated from countries with borders to the waters surrounding Denmark. The cause of death was in 71% stated as presumably/possibly drowning, in 5% as severe lesions (precipitation) and in 25% it could not be solved. The manner of death was in non-Danes most often stated as an accident (56%), and according to this the finding place in non-Danes most frequently was the open water (66%). In Danes suicide predominated (71%) and the finding place in Danes was almost equally distributed among open water, shores and harbors, respectively. Among the totally 74 identified cases, 83% of the total material, an initial suggestion of the identity based on effects found on the body was possible in 43 cases (58%). The final identification was performed by means of forensic dental examination in total 58 cases (78%), in Danes in 93% and in non-Danes in 59%. In the remaining 16 cases one or more of the following contributed to the final identification: information about dental condition, clothing, personal papers, X-ray photos, jewelry, tattoos/scars and fingerprints. The importance of a close collaboration between the police, the forensic pathologist and the forensic dental expert in order to reach a fair number of positive identifications is emphasized.     

Collection of post mortem data: DVI protocols and quality assurance

In many countries forensic odontologists are members of the Disaster Victim Identification (DVI) team. As part of their post mortem (PM) tasks work on the incident site may include securing and preserving the dental material and evidence before transport to the mortuary. In the autopsy room the main aim is to register the PM dental status. Photographs and radiographs are essential documentations in addition to a conventional registration of the dental status. Abbreviations in the registration may be used if agreed with the ante mortem (AM) team. Dental age estimation may be an aid in the sorting process and especially in victims without previous dental treatment. Interpol has a form set as part of their DVI manual. Forensic odontologists working in pairs and checking each other will act as quality assurance (QA) as suggested by International Organization for Forensic Odonto-Stomatology (IOFOS). Direct entry into the computer program as part of the registration in the autopsy room may save time and manpower.     

窒息死亡的法医病理学分析

目的探讨窒息死亡的法医病理学特点。方法对四川大学华西法医学鉴定中心1982年10月1日～2006年9月30日所作160例窒息死亡尸体剖验病理材料进行统计分析。结果窒息死亡案例占整个法医学检案的9.9%,年龄:30～39岁的死者占整个研究对象的29.4%,平均年龄为31.25岁。性别:男性103例,女性57例。男女比例1.81∶1。死亡方式:意外死亡最多(63.1%),其次为自杀(24.4%)和他杀(12.5%)。死亡原因:缢死最多(21.9%),其次为CO中毒(17.5%)、溺死(16.25%)等。医疗纠纷共计39例,均为新生儿窒息,主要发生在乡镇医院和县级医院(76.92%)。结论加强法制教育,提高安全隐患意识等是减少窒息死亡的重要手段。提高城乡医疗水平,加强窒息急诊抢救的临床技能是防止窒息引起医疗纠纷的关键。     

Estimation of stature and determination of sex from radial and ulnar bone lengths in a Turkish corpse sample

Determination of sex and estimation of stature are important aspects of forensic identification of an unknown individual. In the absence of pelvis the sex is assessed from long bones and cranium as they both provide high accuracy in sexing. The present study is an attempt to assess sex and stature from long bones of the forearm using recently deceased forensic cases in Istanbul, Turkey. The sample is composed of 80 males and 47 females with an average age of 36 and 30 years, respectively. Length measurements from the radius and ulna were obtained by exposing the epiphyseal ends of the long bones in a fashion similar to dry long bones. Discriminant function statistics showed a sex determination accuracy as high as 96%. Regression analysis was used in stature estimation from these two bones. Ideally osteological remains are necessary to make standards for osteological identification. These materials are not always easy to obtain and those available seem to be less ideal when they do not represent a current population. Forensic anthropologists therefore should develop techniques that utilize autopsy remains.     

Archived or directly swabbed latent fingerprints as a DNA source for STR typing

Former studies [Nature (1997) 387, Electrophoresis 20 (1999) 2870, P. Van Renterghem, D. Leonard, C. De Greef, Progress in Forensic Genetics, Vol. 8, 2000, p. 501, J. Forensic Sci. 45 (3) (2000) 687] have shown that even a single skin contact, documented by a latent fingerprint, can transfer enough DNA for a genetic analysis. It was proven in these studies that it is possible to swab fingerprints from surfaces [Nature (1997) 387, Electrophoresis 20 (1999) 2870, P. Van Renterghem, D. Leonard, C. De Greef, Progress in Forensic Genetics, Vol. 8, 2000, p. 501] and use them as a DNA source. Usually, however, discovered fingerprints are removed with scotch tape and placed on evidence cards for further investigation.In this study, we tried to assess the potential use of latent fingerprints as a DNA source for STR typing. The materials (magnetic powder, soot powder and scotch tape) used for visualization and archiving fingerprints in Germany were tested for their PCR inhibitory characteristics. Then, fingerprints were placed on clean glass surfaces, visualized and tested for their usefulness as a DNA source.Obtained DNA was quantified and tested in an STR system. Partly it proved possible to type fingerprints taken directly from the surface as well as fingerprints removed from the surface with scotch tape.     

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.     

Fatal suffocation by rubber balloons in children: mechanism and prevention

The increase in the use of photographs on individual identification credentials such as driving licences, credit cards, security passes and passports has led, for the purpose of criminal activities, to the falsification of genuine documents bearing photographs of the perpetrating criminal. These photographs may be used as valuable physical evidence when compared with known photographs of a suspect as they form somewhat of a signature of the suspect that is left behind on the evidence. The comparison of ID photographs requires the cooperation of two predominantly visual disciplines; forensic photography and morphological anatomy. This paper describes a photographic technique which allows accurate anatomical measurement and tracing of facial features, which allows direct physical comparison of ID document images.     

Identification of a skeleton using DNA from teeth and a PAP smear.

Identification of unknown living or deceased persons using dental treatment records is an established forensic technique. However, some cases remain unidentified, especially when antemortem dental records are not available for comparison to postmortem dental records. Cytological smears have been previously reported to be potential sources of DNA reference samples which can be compared to DNA recovered from found human remains. The case described here involves an adult skeleton which exhibited extensive, complex dental restorative treatment. A putative identification of the found skeleton as a missing woman was established using circumstantial evidence found at the scene. However, it became important to establish a positive identification using reliable scientific methods. When it was discovered that antemortem dental records were not available because the treatment was completed in another country and the treating dentist could not be found, cytological smears stained with Papanicolaou (PAP) stain obtained from the putative decedent's medical records were used as a reference DNA sample. DNA was recovered from the teeth of the skeleton using cryogenic grinding. Comparison of the genotypes resulted in the conclusion that the DNA originated from the same source. The use of PAP smears in this way is seen as a valuable resource in cases where positive identification using traditional dental and medical records is not possible.