Inquiry into the Scientific Basis for Bitemark Profiling and Arbitrary Distortion Compensation

Abstract: Prediction of dental characteristics from a bitemark (bitemark profiling) and arbitrary photographic distortion compensation are two practices proposed in bitemark analysis. Recent research on the effect of inherent skin tension properties in bitemark analysis suggests that these practices are subject to review. A biting apparatus was used to create 66 bitemarks in human cadaver skin. The bitemarks were photographed, sized 1:1, and evaluated with Adobe Photoshop^®. Metric/angular measurements and hollow volume dental overlays were employed. Distortion produced was calculated and assessed. Results showed distortional ranges were nonuniform both between bites, as well as within each bite. Thus, enlarging/decreasing the photograph uniformly would not correct the distortion that resulted. With regard to bitemark profiling, 38% of the bites created patterns that could be misleading if profiled. Features were present/absent that were inconsistent with the biter’s dentition. Conclusions indicate bitemark profiling and arbitrary distortion compensation may be inadvisable.     

Patterns of Variation and Match Rates of the Anterior Biting Dentition: Characteristics of a Database of 3D‐Scanned Dentitions

An understanding of the variability of the anterior human dentition is essential in bitemark analysis. A collection of 1099 3D laser scans of paired maxillary and mandibular arches were studied using geometric morphometric methods. Analyses were performed without scale (shape only) and with scale (shape and size). Specimens differing by no more than experimentally obtained measurement error were counted as matches, or as indistinguishable. A total of 487 maxillary (396 size preserved), 131 mandibular (83 size preserved), and one paired dentition (two size preserved) matches were found. Principal component analysis and partial least squares revealed interpretable patterns of variation and covariation in dental shape, principally dominated by variation in dental arch width. The sensitivity of match rate to assumed degree of measurement error was also determined showing rapid increases in match rate as measurement error increased. In conclusion, the concept of dental uniqueness with regard to bitemark analysis should be approached with caution.     

Dental shape match rates in selected and orthodontically treated populations in New York State: a two-dimensional study

Forensically identifying a suspect's dentition from a bitemark in an open population requires the supposition that every person's dental alignment is different. There have been few studies that have tested this claim. Four hundred and ten lower anterior dentitions from a selected population and 110 lower anterior dentitions from one that was orthodontically treated were measured using geometric morphometric analysis, allowing comparison of arch shape. Dental match rates of 1.46% and 42.7% of individuals were found in the respective populations, given an established measurement error. Orthodontic treatment had a strong effect on match rate suggesting that treated or naturally well-aligned dentitions may be indistinguishable. Sexual dimorphism was found to be only slightly significant. Principal shape variation in both populations was degree of arch curvature. Results of studying these populations show that dental matches can occur, and that statements of certainty concerning individualization in such populations should be approached with caution.     

Results of the 4th ABFO Bitemark Workshop--1999.

Thirty-two certified diplomates of the American Board of Forensic odontology (ABFO) participated in a study of the accuracy of bitemark analysis. Examiner experience as board-certified odontologists ranged from 2 to 22 years.Examiners were given sets of photographs (a cast in 1 case) of 4 bitemark cases and asked to report their certainty that each case was truly a bitemark and the apparent value of the case as forensic evidence. Participants also received 7 occluding sets of dental casts, 1 correct dentition for each case and three unrelated to any of the cases, and asked to rate how certain they were that each set of teeth had made each bitemark. Receiver operating characteristic (ROC) analysis resulted in an accuracy score of 0.86 (95% CI=0.82-0.91). Youden's index was used to determine a cutoff point for determining an accuracy score for each case. Accuracy scores were significantly correlated with bitemark certainty and forensic value (P<0.001 in both cases) but not with examiner experience (P=0.958). The use of individual ROC analysis with weighted Youden's index to calibrate individual accuracy was also demonstrated.     

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.     

The uniqueness of the human anterior dentition: a geometric morphometric analysis

The analysis of bitemarks has a significant bearing on forensic odontology and has attracted an increasingly sophisticated array of techniques in its evaluation. Two postulates underlie all bitemark analyses: firstly, that the characteristics of the anterior teeth involved in the bite are unique, and secondly, that this uniqueness is accurately recorded in the material bitten. Here, we investigate the question of the uniqueness of the anterior dentition. To do this, we use geometric morphometric techniques based on landmark and semilandmark data. The incisor and canine occlusal surfaces of 50 randomly selected orthodontic casts of young individuals (17-20 years) of both sexes form the material for this study. We analyzed the sizes of these teeth by means of landmark and semilandmark analysis to calculate Procrustes distances between tooth outlines. In order to analyze shape variation among individuals, we carried out principal components analyses on the partial warp scores. These are derived from Partial Procrustes coordinates aligned by means of thin-plate spline decomposition based on the bending energy matrix. The results indicate that there is no sexual dimorphism in the shape of the upper or lower arches. Plots of centroid size and first relative warps show less superposition among individuals than in shape analysis. This means that, when the size and shape are considered together, the difference between arches increases. Procrustes superimposition between the two individuals located most closely (0.0444) and the two most separated (0.1567) along the first axis of relative warp analyses show that individuals are not only differentiated by the relative position of their teeth but also by their arch shape. In conclusion, it appears that the incisal surfaces of the anterior dentition are in fact unique.     

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.     

A Test of Age Estimation Methods on Impacted Third Molars in Males

This study tests the relationship between third molar impaction and its concomitant effect on age estimation methods. Data were collected on radiographs of males analyzed in the Defense POW/MIA Accounting Agency Laboratory (n = 114). Radiographs of skeletonized individuals were scored for dental development, and age was assigned based on the appropriate ancestry‐based method. Differences between identified age and estimated dental age were assessed to determine whether molar impaction affected root development and age estimations. Results indicate that impacted teeth tend to be underdeveloped and result in age estimates that are too low. While these results are of note to anthropologists and odontologists performing dental age estimates, more work is needed to explore the effect of impaction on development among a more diverse sample.     

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.     

The Response of Skin to Applied Stress: Investigation of Bitemark Distortion in a Cadaver Model*

Abstract: Knowledge of distortional properties of skin is important in bitemark analysis. Thus, the response of skin to stress from bites was investigated. Four sets of models were created from the dentition of one individual. Anterior teeth were systematically removed to vary contact surface area. A biting apparatus was constructed with an integrated load cell. Forty‐six bites were created perpendicular to Langer lines on six cadavers. Rate of force application and bite pressure were controlled. Metric/angular measurement and hollow volume overlays were employed. Distortion produced by each dentition was calculated and assessed. Results showed that as teeth impressed loose tissue, mesial/distal distance increased, angles of rotation flattened, and inter‐canine distance lengthened. An opposite effect was seen in tight tissue. When the surface area of the dentition was reduced, a mixture of these effects was observed. Conclusions indicated that stiffness of the tissue was the most important variable in bitemark distortion.     

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.     

Age Estimation Based on Pulp Cavity to Tooth Volume Ratio Using Postmortem Computed Tomography Images

Pulp cavity size is known to decrease with age and can therefore serve as an indicator for age estimation. Here, we evaluated whether reconstructed images of multidetector‐row computed tomography (MDCT) acquired before forensic autopsy are useful for estimating age at death. Images of 136 mandibular first premolars obtained from bodies of known age at death were analyzed, and the volume of the regions corresponding to pulp cavity and that of the whole tooth were determined using a voxel counting function. The pulp cavity was clearly distinguishable from dental hard tissue on the reconstructed images when using a cutoff value of 1400 Hounsfield units. Regression analysis adjusted for sex showed that estimated age correlated significantly with the pulp cavity to tooth volume ratio (r = 0.76). MDCT is gaining more widespread use in forensic medicine, and analyzing dental images to obtain parameters for age prediction is a practical approach for postmortem identification.     

Testing a Novel 3D Printed Radiographic Imaging Device for Use in Forensic Odontology

There are specific challenges related to forensic dental radiology and difficulties in aligning X‐ray equipment to teeth of interest. Researchers used 3D printing to create a new device, the combined holding and aiming device (CHAD), to address the positioning limitations of current dental X‐ray devices. Participants (N = 24) used the CHAD, soft dental wax, and a modified external aiming device (MEAD) to determine device preference, radiographer's efficiency, and technique errors. Each participant exposed six X‐rays per device for a total of 432 X‐rays scored. A significant difference was found at the 0.05 level between the three devices (p = 0.0015), with the MEAD having the least amount of total errors and soft dental wax taking the least amount of time. Total errors were highest when participants used soft dental wax—both the MEAD and the CHAD performed best overall. Further research in forensic dental radiology and use of holding devices is needed.     

Computer‐aided Dental Identification: An Objective Method for Assessment of Radiographic Image Similarity*

Abstract: A pilot study evaluated a computer‐based method for comparing digital dental images, utilizing a registration algorithm to correct for variations in projection geometry between images prior to a subtraction analysis. A numerical assessment of similarity was generated for pairs of images. Using well‐controlled laboratory settings, the method was evaluated as to its ability to identify the correct specimen with positive results. A subsequent clinical study examined longitudinal radiographic examinations of selected anatomical areas on 47 patients, analyzing the computer‐based method in making the correct identification based upon a threshold level of similarity. The results showed that at a threshold of 0.855, there were two false negative and two false positive identifications out of 957 analyses. Based on these initial findings, 25 dental records having two sets of full mouth series of radiographs were selected. The radiographs were digitized and grouped into six anatomical regions. The more recent set of films served as postmortem images. Each postmortem image was analyzed against all other images within the region. Images were registered to correct for differences in projection geometry prior to analysis. An area of interest was selected to assess image similarity. Analysis of variance was used to determine that there was a significant difference between images from the same individual and those from different individuals. Results showed that the threshold level of concordance will vary with the anatomical region of the mouth examined. This method may provide the most objective and reliable method for postmortem dental identification using intra‐oral images.     

Yet another method for marking incisal edges of teeth for bitemark analysis

Over the years many methods have been proposed and presented for marking or "highlighting" the incisal edges of anterior teeth on a dental stone model -- one of the critical steps in production of transparent overlays for bitemark analysis. A method is presented here that is an extension and refinement of the "paint the edges" method shown at least as early as 1966 by Gustafson. This method uses "invisible ink" and ultraviolet illumination to produce a very high contrast image of the incisal edges of the teeth on the model. The advantages of this new method are that it is nondestructive, it does not leave visible marks on the models, operator subjectivity in selecting the portions of anterior teeth to be highlighted is reduced, and the author submits that this technique lends itself to easy construction of overlays using computer image-processing software such as Adobe Photoshop and ImageJ.     

Comparative Analysis of the Effects of Heat on the PCR‐Amplification of Various Sized DNA Fragments Extracted from Sus Scrofa Molars*

Abstract: This study examined the effects of heat on the amplification of DNA from the dental pulp of Sus scrofa molars and investigated the protection afforded to the pulp tissue by the dental enamel, alveolar process, and soft tissue of the head. Segments of defleshed maxilla and mandible encasing the first molar (n = 60) were subject to a range of temperatures for 15 min. Dental pulps were retrieved. Amplifications using three‐primer and four‐primer multiplexes showed no degradation of the largest fragment following exposure to 450°C. Amplifications in the three‐primer multiplex (283 bp) were successful following exposure to 525°C in maxillary samples only. This study revealed the enamel density of maxillary molars to be greater than mandibular molars in Sus scrofa. Following incineration of intact heads for 15 min (n = 10) and 1 h (n = 4) at an average temperature of 625°C, amplifications of the largest fragment (450 bp) were successful from both maxillary and mandibular teeth.     

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 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.     

DNA Identification of Commingled Human Remains from the Cemetery Relocated by Flooding in Central Bosnia and Herzegovina

The floods in Bosnia and Herzegovina in May 2014 caused landslides all over the country. In the small village of ?eri?i, near the town of Zenica, a landslide destroyed the local cemetery, relocated graves, and commingled skeletal remains. As the use of other physical methods of identification (facial recognition, fingerprint analysis, dental analysis, etc.) was not possible, DNA analysis was applied. DNA was isolated from 20 skeletal remains (bone and tooth samples) and six reference samples (blood from living relatives) and amplified using PowerPlex^® Fusion and PowerPlex^®Y23 kits. DNA profiles were generated for all reference samples and 17 skeletal remains. A statistical analysis (calculation of paternity, maternity, and sibling indexes and matching probabilities) resulted in 10 positive identifications. In this study, 5 individuals were identified based on one reference sample. This has once again demonstrated the significance of DNA analysis in resolving the most complicated cases, such as the identification of commingled human skeletal remains.