Expert Disagreement in Bitemark Casework*

Abstract: Bitemark cases continue to raise controversy due to the degree of expert disagreement which is frequently seen. Using a case mix of 49 bitemark cases from 2000 to 2007 each injury was independently assessed for its forensic significance using a previously described bitemark severity scale. Following the assessment, the mean value for the bites was categorized according to the crime type, the degree of expert agreement, and the judicial outcome. Results suggest that bitemarks found in child abuse cases have statistically significantly lower forensic value than those in other crime types, that bites where there is mutual agreement between experts will have higher forensic value than those where there is disagreement at trial, and that cases in which DNA has provided an exoneration will demonstrate similar quality to those where a conviction was secured. Forensic odontologists should carefully assess bitemark evidence and ensure that it meets certain minimums in relation to the presence of class and unique features before undertaking an analysis.     

A web-based survey of odontologist's opinions concerning bitemark analyses

Within the field of forensic dentistry, the detection, collection, and analysis of bitemarks remains one of the most contentious areas. Attempts at the production of consensus documents have produced documents such as the ABFO's Guidelines for Bitemark Evidence Collection. Despite this, the range of differing analysis techniques, allied with a varied opinion base on the robustness of bitemark conclusions has led to polarized views within the profession. The purpose of this study was to survey forensic dentists to obtain their views on a number of crucial components of bitemark theory and contentious areas within the discipline. Using a web-based survey, 14 questions were asked of respondents. Seventy-two odontologists completed the survey, with 38% being of Diplomate status, 10% had completed 20 or more bitemark cases, and 20% between 10 and 20 cases, 91% of respondents believed that the human dentition was unique, with 78% believing that this uniqueness could be represented on human skin during the biting process. Seventy percent believed that they could positively identify an individual from a bitemark, and 22% stated that the statistical tool, the product rule, should be applied to bitemark conclusions. Over half of the odontologists used overlays for bitemark analysis. with a digital method of production the most popular. The implications of these and other findings are discussed.     

Reality bites--A ten-year retrospective analysis of bitemark casework in Australia

Criticism of forensic science, particularly that of bitemark analysis, has become increasingly common in the last decade. Much of the criticism directed at forensic odontology cites cases where miscarriages of justice have occurred when erroneous, over-confident or even false bitemark evidence has been tendered by odontologists. Despite Australia's own experience with such cases in the past, it is postulated that this does not represent the true nature of bitemark analysis as practiced by odontologists today-at least in this country. A review of 119 cases from the last 10 years confirms that 'identification' of a suspect is rarely, if ever, offered, and that conclusions reached by odontologists with respect to bitemark analysis are generally conservative. However, the results of this study also indicate that in a small but significant proportion of cases, there is still some tendency to reach conclusions that could be considered over-confident when considering the overall quality of the physical evidence offered. It is suggested that odontologists should avoid making conclusive remarks regarding the origin of the mark, or the identification of a perpetrator, when such comments are realistically precluded, given the low evidentiary value of the mark itself.     

The barriers to achieving an evidence base for bitemark analysis

Forensic dentistry is the union of two scientific disciplines, both of which are undergoing a renewed scientific rigor. In forensic science the advent of the Daubert ruling has required that judges assess the forensic value of 'expert testimony' ensuring that techniques, methodologies and practices are not only commonly accepted (as was the previous hurdle during the Frye era) but that error rates, assessment of reliability and validation studies are published to support their use. This new degree of judicial scrutiny has been mirrored in the field of dentistry itself, where organisations search and summarise randomised controlled trials in order to recommend best practice and devise clinical care pathways that are firmly grounded in proven scientific research. Despite the obvious drive from both of these professions, forensic dentistry, and in particular the sub-discipline of bitemark analysis, has been remarkably slow to address the obvious deficiencies in the evidence base that underpins this element of forensic science. Reviews of the literature reveal that the vast majority of published works are case reports, and very little primary literature exists. This paper reviews those studies that have assessed aspects of bitemark analysis including the crucial issue of the uniqueness of the human dentition; the application of transparent overlays and the application of statistical probabilities in bitemark conclusions. There are numerous barriers to undertaking high quality research in the field of bitemark analysis, the most important of which is the use of a gold-standard that is acceptable both in terms of diagnostic research but is also forensically relevant. If bitemark analysis is to continue to play a role in the judicial process then there is an urgent need for high quality studies that meet the levels of forensic and scientific scrutiny applied to other disciplines within the criminal justice system. Studies are required to determine not that the human dentition is unique, but how this asserted uniqueness is represented on human skin and other substrates. The error rates associated with the analysis of bitemarks are required on a procedural level as well as an individual practitioner basis and scales and interpretative indices of bitemark severity and forensic significance should be validated and introduced into common use.     

Expert Interpretation of Bitemark Injuries—A Contemporary Qualitative Study

This study attempts to characterize the nature of disagreement among odontologists in determining the fundamental properties of suspected bitemark injuries. Fifteen odontologists were asked to freely comment on six images of supposed bitemarks. Qualitative analysis using a grounded theory approach revealed that practitioner agreement was at best fair, with wide‐ranging opinions on the origin, circumstance, and characteristics of the wound given for all six images. More experienced practitioners (>10 years) tended to agree with each other less than those who had 10 years or less experience in forensic odontology. The differences in opinions can be at least partly accounted for by the inconsistent nature of approaches used by different practitioners in assessing bitemark evidence. The results of this study indicate that more definitive guidelines as to the assessment of bitemarks as patterned injuries should be developed to ensure the highest possible level of practitioner agreement.     

The scientific basis for human bitemark analyses--a critical review.

This article presents a discussion of the scientific basis for human bitemark analyses. Using a review of the literature, the major areas of contention within the field are assessed: including the accuracy of bitemarks on skin, the uniqueness of the human dentition, and analytical techniques. The review revealed a lack of valid evidence to support many of the assumptions made by forensic dentists during bitemark comparisons. The new level of judicial scrutiny of such scientific evidence is likely to emphasise this lack of knowledge upon which bitemark analysis relies. The authors call for a more scientific and evidence-based approach to forensic dental research.     

Three‐Dimensional Comparative Analysis of Bitemarks*

Abstract: Historically, the inability to accurately represent bitemarks and other wound patterns has limited their evidentiary value. The development of the ABFO #2 scale by Krauss and Hyzer enabled forensic odontologists to correct for most photographic plane distortions. The technique presented here uses the ABFO #2 scale in conjunction with the evolving technologies of laser scanners and comparative software commonly used by the automobile industry for three‐dimensional (3D) analysis. The 3D software comparison was performed in which measurements were analyzed of the normal distance for each point on the teeth relative to the bitemarks. It created a color‐mapped display of the bitemark model, with the color indicating the deviation at each point. There was a correlation between the bitemark and the original teeth.     

The relevance of the evolution of experimental studies for the interpretation and evaluation of some trace physical evidence

In order for trace evidence to have a high evidential value, experimental studies which mimic the forensic reality are of fundamental importance. Such primary level experimentation is crucial to establish a coherent body of theory concerning the generation, transfer and persistence of different forms of trace physical evidence. We contend that the forensic context, at whatever scale, will be specific to each individual forensic case and this context in which a crime takes place will influence the properties of trace evidence. It will, therefore, be necessary in many forensic cases to undertake secondary level experimental studies that incorporate specific variables pertinent to a particular case and supplement the established theory presented in the published literature. Such studies enable a better understanding of the specific forensic context and thus allow more accurate collection, analysis and interpretation of the trace physical evidence to be achieved.This paper presents two cases where the findings of secondary level experimental studies undertaken to address specific issues particular to two forensic investigations proved to be important. Specific pre-, syn- and post-forensic event factors were incorporated into the experimental design and proved to be invaluable in the recovery, analysis and in achieving accurate interpretations of both soil evidence from footwear and glass trace evidence from a broken window.These studies demonstrate that a fuller understanding of the specific context within which trace physical evidence is generated and subsequently collected, as well as an understanding of the behaviour of certain forms of trace physical evidence under specific conditions, can add evidentiary weight to the analysis and interpretation of that evidence and thus help a court with greater certainty where resources (time and cost) permit.     

Statistical Evidence for the Similarity of the Human Dentition

Abstract: Recent scrutiny of forensic science has focused on unreliability of expert witness testimony when based on statements of individuality. In bitemark analysis, assumptions regarding uniqueness of the dentition have been based on use of the product rule while ignoring correlation and nonuniformity of dental arrangement. To examine the effect of these factors, two separate sets of scanned dental models (n = 172 and n = 344) were measured and statistically tested to determine match rates. Results were compared to those of a prior study. Seven and 16 matches of the six anterior lower teeth were found in the respective data sets. Correlations and nonuniform distributions of tooth positions were observed. Simulation tests were performed to verify results. Results indicate that given experimental measurement parameters, statements of dental uniqueness with respect to bitemark analysis in an open population are unsupportable and that use of the product rule is inappropriate.     

Comparison of simulated human dermal bitemarks possessing three-dimensional attributes to suspected biters using a proprietary three-dimensional comparison

The infliction of a bite is a four-dimensional space–time event that is ideally analyzed with three-dimensional (3-D) technology. Comparison of 2-D images (photographs) of a bitemark with a 3-D replica of a suspect's dentition is challenging. The authors present a technique that produces 3-D images of indented marks and dentitions for comparisons. Study models and corresponding dental-wax bites were digitized by 3-D scanning, and comparison overlays were generated using DentalPrint^© software. The effectiveness of the method was analyzed by determining the area under receiver operating characteristic (ROC) curve and the sensitivity, specificity and 95% confidence interval (CI) for each cut-off point. An area under the ROC curve of 0.953 (SE = 0.029; 95% CI = 0.893–0.985) and high sensitivity and specificity values were obtained for 104 comparisons made by an expert examiner, who correctly identified 92.3% of matching dentitions and 98.7% of non-matching dentitions. This technique can be considered a highly accurate method of bitemark analysis, although indentations must be present in the injury, limiting the cases that can be resolved. A comparative study of the same dentitions using 2-D bitemark photography confirmed the superiority of the new approach.     

Digital enhancement of sub-quality bitemark photographs.

Digital enhancement software was used to enhance bitemark photographs. This enhancement technique improved the resolution of the bitemark images. Lucis was the software program utilized in this study and case applications. First, this technique was applied on known bitemark images to evaluate the potential effectiveness of this digital enhancement method. Subsequently, Lucis was utilized on two separate unsolved cases involving enhancement of bitemark evidence. One case involved a severely beaten infant with a bitemark on the upper thigh. The second case involves a bitemark observed on the breast of a female sexual assault strangulation victim. In both cases, bitemark images were significantly improved after digital enhancement.     

Detection strategies for feigned psychopathology: test development and effects of criminal charge simulation design on response styles

Feigned psychopathology detection strategy is needed for forensic settings in Thailand. This initial Thai version of the symptoms validity test (SVT-Th) was developed based on two global detection strategies including unlikely and amplified detection strategies proposed by Rogers. The participants were collected from populations of nonclinical undergraduate students and clinical psychiatric patients. Results of Study 1, confirmatory factor analysis (CFA) were used to determine the factor structures of the SVT-Th. The results of CFA supported 2-factorial model as proposed by Rogers. The SVT-Th was found to possess a high degree of internal consistency. Using a simulation designed in Study 2, the experimental group was asked to feign psychopathology to avoid criminal prosecution of homicide charges (simulator undergraduate students). The findings were compared with two control groups who were asked to reply to the questions honestly (honest undergraduate students and honest psychiatric patients). The results indicated that the SVT-Th were significantly distinguishable in the experimental group (classified as feigned response style) from the control groups (classified as honest response style). The area under the ROC curve showed high accuracy classification. The ROC curve determined the optimal cutoff score, sensitivity and specificity for the SVT-Th.     

Biomechanical Factors in Human Dermal Bitemarks in a Cadaver Model*

Abstract: In bitemark analysis, the forensic odontologist must consider how the biomechanical properties of the skin contribute to distortion of the bitemark. In addition, one must consider how the bitemark can be distorted by postural movement of the victim after the bite has occurred. A fundamental review of the architecture and biomechanical properties of the dermis is described and evaluated through bites made on cadavers. In order to assess distortion, 23 bites from a single characterized dentition were made on un‐embalmed cadaver skin. Bite indentations were photographed. Following various body manipulations they were re‐photographed in different positions. Hollow volume overlays of the biting dentition were constructed, and metric analysis of the dentition and all bitemarks was completed. The overall intercanine, mesial to distal, and angle of rotation distortion was calculated. Of the 23 bites made, none were measurably identical, and in some cases, dramatic distortion was noted.     

Problem-based analysis of bitemark misidentifications: the role of DNA

The dental literature concerning bitemark methodology is surprisingly thin and sorely lacking in rigorous scientific testing. Contra to this fact, the bitemark legal caselaw is surprisingly strong and is used as a substitute for reliability testing of bite mark identification. In short, the Judiciary and the Prosecutors have loved forensic odontologists. This paper will focus on the author's participation as a Defense expert over the last seven years in over 50 bitemark prosecutions and judicial appeals. This sampling will act as an anecdotal survey of actual bitemark evidence. Certain trends regarding methods and reliability issues of odontologists will be discussed. Several of these cases have been later judicially overturned due to DNA analyses after the defendants were originally convicted. These diagnostic misadventures are being vocally discussed in the US media by news and legal investigators who are asking hard questions. The forensic dentistry community, however, is curiously silent. What actions are necessary by the profession to improve this assault on the 52-year tradition of bite mark identifications in the United States?     

Old dogs can learn new tricks--a new application of the ABFO #2 scale

In 1984 at its first Bitemark Workshop, the American Board of Forensic Odontology (ABFO) developed guidelines for the analysis of bitemark evidence. Prior to this, no standards had been established for the evaluation of bitemarks. The development of the ABFO #2 scale in 1987 gave the forensic odontologist a reproducible way to rectify and measure bitemarks that had been documented photographically. Primarily developed for the analysis of bitemark evidence, its use has expanded to encompass myriad forms of evidence. While the ABFO #2 scale can depict horizontal and vertical measurements, it is unable to depict depth accurately. The purpose of this paper is to show its successful application to three dimensions.     

Anatomical location of bitemarks and associated findings in 101 cases from the United States

The purpose of this paper is to update and confirm previous studies that examined the anatomical location of human bitemarks. This information is useful to forensic odontologists and pathologists, physicians, and coroners who must be familiar with the most likely locations of bitemarks. The data are also useful for those involved in bitemark research. Using the legal database "Lexis," 101 bitemark cases were identified from the United States Courts of Appeal. Cases were included in the study if they provided details concerning the bitemark, such as anatomical location, number of injuries, and information concerning the victim. Information on 148 bites was collated. These data are presented in tabular and graphical form to allow comparisons between males and females, victims and perpetrators, adults and children, and the crime types associated with human bites.     

Adherence of forensic odontologists to the ABFO guidelines for victim evidence collection

Certifying boards for different professions have the duty to help establish standards and guidelines for methodologies routinely performed within the discipline. For forensic dentists, this responsibility is placed upon the American Board of Forensic Odontology (ABFO). The purpose of this study was to examine whether board certified and noncertified forensic odontologists adhere to the ABFO Guidelines outlined in the collection of victim bitemark evidence. A questionnaire was developed to assess the compliance and attitudes towards the typical evidence collected, the photographic documentation, and the handling of the bite site injury. The results indicate the majority of the respondents in both representative groups routinely follow the guidelines set forth by the ABFO. The lack of personally photographing the bite injury on a consistent basis is an area of concern for all examiners. The photographic evidence is an instrumental part of the investigation and often cannot be utilized due to improper procedures being followed. The film type utilized, bite site impression techniques, and excision of any tissue samples remain an individual choice and vary significantly among each forensic odontologist.     

Clothing damage analysis in alleged sexual assaults--the need for a systematic approach

Clothing damage analysis is an integral part of the examinations carried out in sexual assault type cases. This analysis can be used to corroborate different versions of events and is at its most powerful in elucidating false allegation cases and consent cases. The purpose of this study was to determine to what extent people with varying levels of forensic awareness, experience and training could correctly carry out damage analysis. Two participant groups were asked to take part in this study. Group A ('forensic group') comprised participants at a forensic science conference, and Group B ('student group') comprised students undertaking a degree course in Forensic Science. Each group was given a practical workshop consisting of a lecture outlining common fabric types and general features observed in different damage types. Each participant was subsequently shown 25 pieces of 'damage' and asked to identify both the type of fabric construction (knit or weave) and the type of damage (cut, tear, rip, wear and tear). The ability to identify fabric construction and damage types varied within the two groups studied and across the groups. The forensic group performed better both in fabric and damage assessment than the student group. This paper suggests a systematic approach to clothing damage analysis to maximise the benefits that can be obtained from this area of forensic science and to minimise the subjectivity within the field.     

Violent and sexual offences: a validation of the predictive quality of the PCL:SV in Switzerland

Used to diagnose psychopathy, the Psychopathy Checklist: Screening Version (PCL:SV) is still rarely used in the German-speaking part of Europe. The aim of the present study was to conduct a first-time evaluation of the predictive validity of the PCL:SV for sexual and violent recidivism in the German language area. PCL:SV scores for 96 violent and sexual offenders in Switzerland were assessed. These assessments were based on data taken from the forensic psychiatric expert opinions. The scores were then compared to subsequent recidivism as shown in the official criminal records. ROC analysis indicated a cut-off score of 14 for maximized overall predictive accuracy. Consistent with various results from past research in North America and Europe, the PCL:SV yielded a satisfying predictive accuracy (ROC area=.69). This degree of accuracy demonstrates the PCL:SV's usefulness for risk assessment of sexual and violent delinquency in the Swiss cultural and German language area.     

Indication and limitations of using palatal rugae for personal identification in edentulous cases

To explore the availability and the limitations of using the palatal rugae pattern in forensic practice for personal identification in edentulous cases, we set up an experiment, which involved 48 patients who had both old and new complete dentures and we observed their rugae. First, we made 48 pairs of maxillary casts from their old and new dentures and a further 50 maxillary casts from complete dentures at random, to use as variables. All the initial impressions taken from the mucosal surfaces of complete dentures were made from alginate impression materials, and the maxillary casts were made from hard dental plaster. Secondly, all 146 casts were trimmed so that all the areas except for the rugae area were removed. Subsequently, 50 examiners were given the 48 casts from the old dentures and were then asked to compare them with the other 98 casts for possible matches. The case numbers, which matched correctly, were recorded. The median percentage of correct matches among the 50 examiners was 94%, despite variations in their experience with forensic identification, and this accuracy does not differ significantly from that in dentate cases, as described in previous publications. The median percentage of correct matches among the 48 cases was 90%. Analyzing the incidence of obtaining a correct match in each case revealed that there were three major misleading shapes that could give rise to a low rate of correct matches; (1) severely low and poorly demarcated eminences of rugae, (2) change of palatal height, and (3) non-complex rugae pattern. These features are mainly due to the shape of the edentulous palate itself and rarely due to the dentures, and could lead to difficulties in finding unique points for use in matching rugae patterns. The results suggest that an appropriate selection of cases, taking into consideration the above misleading shapes, may establish an increased rate of accuracy for identification with this method, thereby bringing the percentage of correct matches closer to 100% in edentulous cases, which is also the percentage of correct matches previously reported in dentate cases.