Comparative study of efficiency of dental methods for identification of burn victims in two bus accidents in Spain

This article deals with the usefulness and limitations of dental identification methods of human burn victims of two buses accidents in Spain. The first accident happened in Bailen in 1996 and involved 28 badly burned Spanish victims. In the second, in Illescas in 1997, 8 Japanese and 2 Spanish victims lost their lives. In both accidents, postmortem forensic procedures for identification were used, including external and internal examination, routine photographs, and dental examination. Dental identification was established in 57% of the cases in the Bailen accident and 80% in the Illescas accident. The success rate of dental identification varies considerably depending on the nature of the accident, the nationality and country of residence of the victims, the incidence of dental treatment, the availability of adequate dental records, and the degree of dental injuries. A discussion of procedures and methods for identification recommended when dealing with burn victims is included.     

A New Tool for Coding and Interpreting Injuries in Fatal Airplane Crashes: The Crash Injury Pattern Assessment Tool Application to the Air France Flight AF447 Disaster (Rio de Janeiro–Paris), 1st of June 2009

For investigation of air disasters, crash reconstruction is obtained using data from flight recorders, physical evidence from the site, and injuries patterns of the victims. This article describes a new software, Crash Injury Pattern Assessment Tool (CIPAT), to code and analyze injuries. The coding system was derived from the Abbreviated Injury Score (AIS). Scores were created corresponding to the amount of energy required causing the trauma (ER), and the software was developed to compute summary variables related to the position (assigned seat) of victims. A dataset was built from the postmortem examination of 154/228 victims of the Air France disaster (June 2009), recovered from the Atlantic Ocean after a complex and difficult task at a depth of 12790 ft. The use of CIPAT allowed to precise cause and circumstances of deaths and confirmed major dynamics parameters of the crash event established by the French Civil Aviation Safety Investigation Authority.     

Detection and classification of composite resins in incinerated teeth for forensic purposes

The great demand for esthetic restorations has resulted in placement of large numbers of composite resin fillings. The popularity of these materials is reflected in the quantity and variety of resin brands currently on the market. The ability to distinguish resin brands can aid in positive identification of burn victims, assuming that appropriate dental records exist. Scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) was used to characterize the structure and composition of 10 modern resins. The structure of each resin was unique to manufacturer, and elemental analysis allowed separation into distinct groups. These 10 resins were also placed in extracted teeth and incinerated at 900 degrees C for 30 min, simulating near cremation conditions. The resins were identifiable by SEM/EDS after incineration, and the elemental composition remained almost unchanged. The data produced are immediately useful for resin identification in forensics, and comparative analysis can be readily performed using standard equipment. This work represents the initial stage of database generation.     

Pediatric homicides related to burn injury: a retrospective review at the medical university of South Carolina

Many burn injuries are mistakenly referred to as "accidents" because they occur suddenly and seem unpredictable and uncontrollable; however, injuries often occur in predictable patterns. We reviewed all pediatric forensic cases referred to the Medical University of South Carolina Forensic Pathology Section over a 28-year period from January 1975 to December 2002. There were 124 cases with 121 fire-related fatalities and three scald fatalities. Ninety of the burn victims were in the 0-5-year age group. The manner of deaths showed 108 accidents and 12 homicides (four undetermined). Eleven of 12 burn-related homicides occurred at the home with all of the victims in the 1-8-year age group. The perpetrator of the home fire homicides was the mother in five cases and the sister in one case (two undetermined). Homicide involved a vehicle fire in one case in which the father caused an explosion with an accelerant. The three scald death perpetrators were the father, mother's boyfriend, and an aunt.This retrospective study and review of the literature may reveal patterns useful for evaluation of manner of death. By recognizing scene characteristics, potential perpetrators, and children at risk, we can better classify pediatric burn-related fatalities.     

西安“六.六”空难的法医学鉴定

本文报告了１９９４年６月６日，中国西北民航Ｂ—２１６０号客机在西安失事的法医学鉴定。机上乘员１６０人全部遇难、死难中，以撞击伤为主，主要死因为多脏器严重损伤、创伤休克、大出血。１６０名遇难者中，１３９人经体貌特征和遗物被确认，６例通过血型被认定，３例通过指纹被认定，其余通过牙齿被确认。本文还讨论了如死亡时间等空难中的法医学处理问题。     

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.     

Locard's Principle of Exchange,Dental Examination and Fragments of Skin

The transfer of materials between victim and perpetrator was first reported by Locard in the nineteenth century. While in recent years DNA testing has been very successful in matching biological material from crime scenes to perpetrators, the following cases demonstrate that other more time‐honored methods remain useful. Two cases of lethal assault are reported where the victims had bitten their assailants resulting in fragments of the perpetrators’ skin being wedged between their teeth which were discovered during post mortem oral examinations. As the fragments were able to be matched to injuries in the perpetrators, identification was established prior to confirmatory DNA testing. In case 1 a criminal conviction for manslaughter resulted, and in case 2 the identity of the assailant was confirmed. Examination of a properly exposed and illuminated oral cavity may provide useful evidence in assault cases. These cases represent an unusual dental variant of Locard's principle.     

Forensic dental training in the dental school curriculum

This article reviews the literature regarding forensic education in the dental school curriculum and describes an exercise in forensic identification of victims of a mass casualty. Radiographs were made of dentate human cadavers in the gross anatomy laboratory at the Southern Illinois School of Dental Medicine. The jaws were then removed to provide "wet specimens" for the exercise. Several restorations were performed on the cadaver teeth, after which radiographs of the dissected jaws were made. One author wrote up mock dental records for each of the victims. These records included the first set or "premortem" radiographs. Students participating in the exercise were provided with a plane crash scenario, the dental records of the passengers on the manifest, the dissected jaws, and the second set or "postmortem" radiographs. Students were expected to form three teams. The first two teams evaluated the ante-mortem and postmortem dental records. The third team compared the ante-mortem and postmortem records to arrive at identification. The purpose of the exercise was twofold. It introduced dental students to forensic dentistry and emphasized the need for complete and accurate record keeping in the dental office. Several factors lessened the realism of the exercise and made it difficult to reproduce in the future. These included the uniformity of the dental records and the destruction of cadaver material following the exercise.     

Identification via dental remains: Pan American Flight 759

Pan American Flight 759 crashed on takeoff from New Orleans International Airport on 9 July 1982. One-hundred-and-fifty-four persons lost their lives making this the second worst air crash in the United States. A dental identification team was assembled and began working the next morning. Ninety-three victims were positively identified by dental means and twenty-three other victims had strong supporting dental evidence as to their identities. The organization, method used, planning, and problem resolution concerning the dental team for this crash are presented.     

Color Stability of Dental Restorative Materials Submitted to Heat Sources,for Forensic Purposes

During postmortem examination of the dental arches of carbonized victims, dental restorative materials may be found. The aim of this study was to evaluate the effect of heat source action on the color stability of composite resin (CR) and glass ionomer cement (GIC) restorations, to discriminate between them and compare with antemortem dental data. Sixty bovine teeth (30 CR and 30 GIC) were prepared (6 × 6 × 2 mm) and separated into groups (n = 10). The color readouts were taken by spectrophotometer, before and after heat action (100°C, 200°C, 300°C), in an oven for 15 min. There were color alterations for all coordinates (ΔE, ΔL*, Δa* eΔb*) for both materials. GIC presented greater change. The authors concluded that it is possible to distinguish between the materials by the color changes analyzed by instrumental method, helping victim identification.     

The gander disaster: dental identification in a military tragedy

The authors record the contributions of dentistry to the identification of victims of one of the most significant disasters in aviation and U.S. military history--the December 1985 crash of a DC-8 charter airliner near Gander, Newfoundland (now known as Newfoundland and Labrador), Canada, which killed 248 Army personnel and 8 crewmembers. Most of the dental records of the military victims were destroyed in the crash, and, as a result, this loss hampered dental identification. Nevertheless, dental identification was the primary means of identification for many because a very high percentage of the bodies were severely burned and fragmented. Many phases of the U.S. identification efforts have been reported, but the dental-investigation aspects have been mentioned only in passing. Therefore, this article documents the dental team's organization, methodology, and a variety of remarkable problems that the team encountered.     

Clinical forensic examination findings and legal outcome in cases of suspected physical child abuse

Clinical forensic examinations performed at the Institute of Legal Medicine of the Hanover Medical School between 1999 and 2008 in cases of suspected physical abuse of children were analyzed retrospectively with special emphasis on the legal consequences. Altogether, 192 children (85 girls, 107 boys) with a median age of 4.4 years were examined. In 47 cases (24.5 %), the clinical forensic examination findings were interpreted as accidental injuries, birth traumas or unspecific findings. 29 victims (20.0 %) had suffered a shaken baby syndrome. Only part of the presented cases ended with conviction, which was more likely if the victims were aged between 7 and 11 years. Prison terms of 2 years and more were imposed only if the child suffered potentially or acute life-threatening injuries or if additional anogenital lesions were diagnosed indicating sexual child abuse.     

Distinct age-related differences among victims in cases of suspected child abuse

Evidence describing age-related differences among children with suspected physical and sexual child abuse is lacking. We describe findings in severe cases of suspected abuse. Cases with 756 children <15 years old were included during 2001–2013 at the Department of Forensic Medicine, Aarhus University, using forensic evaluation documents, medical records, and court proceedings. Eight percent of children <4 years old died from child abuse, 36% through violence resulting in death, and 64% by manslaughter, whereas 1% > 4 years old died, solely by manslaughter. External injuries were mainly located to head and torso in children <4 years old, changing to the upper and lower extremities in older children. Child sexual abuse was suspected in 52% of cases with living children <4 years old, 83% of children 4–7 years of age, 88% of children 8–11 years of age, and 93% of children >12 years old. Anogenital findings were mainly caused by other medical conditions in children <4 years old, hymenal clefts in the superior half of the hymenal rim were almost exclusively found in children between 8 and 11 years of age, whereas both superficial and complete hymenal clefts in the inferior half of the hymenal rim were found in children >12 years old. The present study describes age-related differences in victims of suspected child abuse. Fatal versus nonfatal child physical abuse and the significance of hymenal findings in child sexual abuse could be studied further.     

Four major disasters in Aquitaine,France: use of odontologic techniques for identification

The 4 mass disasters that have affected the Aquitaine region (France) in the previous 15 years are related through the specificity and the efficiency of dental methodology in identifying the victims. The results point to the decisive influence and the efficiency of dental methodology for identification of bodies that are burned or disfigured after an accident or a prolonged period in water.     

DNA Preservation in Skeletal Elements from the World Trade Center Disaster: Recommendations for Mass Fatality Management*,†

Abstract: The World Trade Center (WTC) victim identification effort highlights taphonomic influences on the degradation of DNA from victims of mass fatality incidents. This study uses a subset of the WTC‐Human Remains Database to evaluate differential preservation of DNA by skeletal element. Recovery location, sex, and victim type (civilian, firefighter, or plane passenger) do not appear to influence DNA preservation. Results indicate that more intact elements, as well as elements encased in soft tissue, produced slightly higher identification rates than more fragmented remains. DNA identification rates by element type conform to previous findings, with higher rates generally found in denser, weight‐bearing bones. However, smaller bones including patellae, metatarsals, and foot phalanges yielded rates comparable to both femora and tibiae. These elements can be easily sampled with a disposable scalpel, and thus reduce potential DNA contamination. These findings have implications for DNA sampling guidelines in future mass fatality incidents.     

Alleged Biological Father Incest: A Forensic Approach

Paternal incest is one of the most serious forms of intrafamilial sexual abuse with clinical, social, and legal relevance. A retrospective study was performed, based on forensic reports and judicial decisions of alleged cases of biological paternal incest of victims under 18 years old (n = 215) from 2003 to 2008. Results highlight that in a relevant number of cases: victims were female; the abuse begun at an early age with reiteration; the alleged perpetrator presented a history of sexual crimes against children; sexual practices were physically poorly intrusive, which associated with a forensic medical evaluation performed more than 72 h after the abuse, explain partially the absence of physical injuries or other evidence—these last aspects are different from extrafamilial cases. In conclusion, observations about paternal incest are likely to exacerbate the psychosocial consequences of the abuse and may explain the difficulty and delay in detect and disclose these cases. Few cases were legally prosecuted and convicted.     

Dental identification problems in the Abu Dhabi air accident

The forensic odontological examination of 112 victims in the 1983 air accident near Abu Dhabi is described with particular reference to the problems encountered in the age assessment of the 26 children, and serves to illustrate that dental identification in aviation accidents may be of only limited application in Asian victims. Following this accident, other means of identification had misguidedly been removed by the recovery teams. Of those identified, half were by dental means alone, but this amounted to only 6.24% of the total number of victims.     

Sharp Force Homicide in Denmark 1992–2016

Sharp force trauma is a common homicide method. The weapon is typically a knife, which is easily accessible and does not require special skills. We have analyzed all 471 sharp force homicides in Denmark during 1992–2016 with special focus on aspects that are relevant to forensic pathologists, including the distribution of wounds and organ injuries. Most homicides were committed inside with a kitchen knife. The front left thorax was the most common area to be affected by sharp force trauma. In 18.9% of the victims, there was only one sharp injury, the majority on the thorax. The most common trajectory for stab wounds was directly posterior with no deviation to the sides or up/down followed by directly anterior. The heart (including pericardium) and lungs (including hemo- and pneumothorax) had injuries in more than 75% of the victims. 67% of victims were males. Female victims had more sharp force injuries and defense wounds than male victims. Most females were killed in domestic homicides (73.7%), most commonly in partner killings (56.4%). In contrast, many male victims were killed in a setting of nightlife/intoxication (34.0%) most by a friend/acquaintance delivering a few stab wounds. The results clearly show strong sex differences in both victims and offenders. This could be useful for shaping policies and public opinion, and as a route for understanding the developments in interpersonal violence. In the narrow setting of death investigation, our results will provide an evidence-based approach to understanding the injury patterns in sharp force homicide.     

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.