Jonestown tragedy revisited: the role of dentistry

The authors record the contribution of dentistry to the identification of victims of one of the most significant tragedies of the 20th century--the mass suicide of members of a religious cult, which initially resulted in 913 deaths and ultimately in 923. Though forensic dentistry played a significant part in identifying victims, the only report by members of the United States identification team did not examine dentistry's valuable role. Furthermore, the dental-investigation aspects have been mentioned merely in passing by the news media despite an infinite number of stories on the tragedy ranging from factual to expose. The dental team's organization, methodology, and significant contributions to forensic dentistry and a variety of remarkable problems that the team encountered and the lessons learned from them are documented in this paper.     

应用数字图像识别系统研究正畸治疗前后腭皱形态变化

目的利用腭皱数字图像识别系统对正畸治疗前后腭皱形态匹配正确率的分析研究,为法医学中同一认定提供理论依据。方法利用正畸患者治疗前后腭皱形态数字图像,通过腭皱数字图像识别系统对图像的特征进行提取并收录到腭皱数字库,运用Matlab软件完成对腭皱形态数字图像的信息匹配处理。结果正畸治疗前后,个体性检测匹配正确率各自都达到100%。正畸治疗前后腭皱形态匹配正确率为95.67%,配对检验结果 P0.05,具有统计学意义。结论腭皱形态具有高度的个体特异性,正畸治疗后腭皱形态会发生多种变化,但对同一认定的影响不大。腭皱形态识别为法医学同一认定提供一种新的方法和途径。     

Human Identification by Oral Prosthesis Analysis with Probability Rates Higher than DNA Analysis

Several techniques are used to perform an appropriate and reliable human identification. Forensic dentistry has achieved great relevance over the past years. The aim of this article is to report the method used for the identification of a male body found in the colliquative stage of putrefaction. The identification of the victim was succeeded confronting the dental findings found in the corpse with the data present on dental records provided by his dentist. The major elements for the identity′s recognition were a metal core and a prosthetic crown that were being fabricated. These elements associated with the dental records were compelling for the elucidation of the case, and a positive body identification was achieved with high levels of probability. In the present case, cadaveric analysis of stomatognathic system structures achieved a probability value higher than DNA identification techniques, emphasizing the importance of forensic dentistry.     

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.     

The USS Iowa disaster: success of the forensic dental team

The authors record the contributions of dentistry to the identification of the crew members who were in one of the most significant peacetime military accidents in U.S. Navy history-the April 1989 explosion in a gun turret on the battleship USS Iowa and the deaths of 47 U.S. Navy personnel. Dental identification was the primary means of identification for most because a very high percentage of the bodies were burned or fragmented. The dental-identification team's success was a direct result of its preparedness, its use of dental personnel with mass-disaster experience, and the overall excellent quality of the antemortem dental records. The dental-identification team's successful involvement in the USS Iowa tragedy was considered a model for success and therefore was instrumental in contributing to the development of the American Board of Forensic Odontology "Guidelines for the Development of a Disaster Dental Identification Team."     

The crash of LOT flight 007: dental identification

The authors record the contribution of dentistry to the identification of American victims of one of the most significant aircraft tragedies involving American athletes-the March 1980 crash of a Soviet-made Ilyushin 62 Polish jetliner and the deaths of 31 Americans including a 22-member U.S. amateur boxing team with several U.S. Olympic team candidates. Preparedness was a factor in the dental team's ability to resolve many notable and unexpected problems. Jurisdictional restraints that Polish authorities imposed on the U.S. investigative team hindered its efforts to identify American passengers. The team used dental and fingerprint methods of identification whenever possible and obtained further evidence from anthropologic methods, visual recognition, and personal effects. Dental readiness, organization, methodology, and lessons learned are documented in this paper.     

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。     

正畸治疗前后腭皱的法医同一认定研究

目的利用腭皱模型分析法评价腭皱形态的个体独特性及正畸治疗前后腭皱形态的稳定性,探索腭皱形态在法医齿科学个体识别应用中的可靠性。方法分别收集70例正畸治疗前、后的上颌模型。通过模型测量分析对腭皱形态及个体识别进行检测,包括数量、方向、形状及长度的变化和近、远中侧端点分别在近远中向及前后方向上的位移。同时对正畸治疗前、后及正畸治疗后与其复制后腭皱模型进行配对检测,计算其平均正确配对率(%)。结果 (1)正畸治疗后腭皱数量、方向、形状及长度均有变化,表现为长度变化(28.6%);分裂(4.3%);联合(2.9%);方向变化(1.4%);形状变化(1.4%)。并且治疗后腭皱远中端点的前后向位移变化占45.7%,近远中向位移占40%;而腭皱近中端在在前后向和在近远中向上位移变化分别为32.9%和17.1%。(2)正畸治疗前组及正畸治疗后组不同个体均未发现相同的腭皱模式。(3)正畸治疗前、后模型的腭皱平均正确配对率为92.19%。而治疗后模型与复制后模型的腭皱平均正确配对率是99.05%。结论腭皱形态具有高度的个体特异性,尽管正畸治疗后腭皱的形态有一定变化,但仍可作为一种新的方法应用于法医齿科的同一认定。     

Forced oral opening for cadavers with rigor mortis: two approaches for the myotomy on the temporal muscles

Forensic dentistry plays an essential role in personal identification procedures. An adequate interincisal space of cadavers with rigor mortis is required to obtain detailed dental findings. We have developed intraoral and two directional approaches, for myotomy of the temporal muscles. The intraoral approach, in which the temporalis was dissected with scissors inserted via an intraoral incision, was adopted for elderly cadavers, females and emaciated or exhausted bodies, and had a merit of no incision on the face. The two directional approach, in which myotomy was performed with thread-wire saw from behind and with scissors via the intraoral incision, was designed for male muscular youths. Both approaches were effective to obtain a desired degree of an interincisal opening without facial damage.     

A framework for estimating probability of a match in forensic bite mark identification

In forensic dentistry, a human expert typically does the comparison and identification based on bite marks. Unlike DNA analysis, however, there is no quantitative basis with which to assign a probability for this given match. This paper proposes a framework for empirically estimating the probability of such a bite mark match and reports on initial experimental results. The methodology involved collection of dental population data (3D dental casts and bite mark images), image analysis for quantitatively measuring the degree of match (based on chamfer distance), and performing a logistic regression analysis using the collected population data to estimate the probability of match from the calculated degree of match. The model correctly predicted 35 of the 42 matches and 585 of the 588 mismatches. The method also has potential for use in other forensic applications in which the assignment of quantitative probabilities is important.     

Age Estimation by Amino Acid Racemization in Human Teeth

Abstract: When an unidentified body is found, it is essential to establish the personal identity of the body in addition to investigating the cause of death. Identification is one of the most important functions of forensic dentistry. Fingerprint, dental, and DNA analysis can be used to accurately identify a body. However, if no information is available for identification, age estimation can contribute to the resolution of a case. The authors have been using aspartic acid racemization rates in dentin (D‐aspartic acid/L ‐ aspartic acid : D/L Asp) as an index for age estimation and have obtained satisfactory results. We report five cases of age estimation using the racemization method. In all five cases, estimated ages were accurate within a range ±3 years. We conclude that the racemization method is a reliable and practical method for estimating age.     

Identification through X-ray fluorescence analysis of dental restorative resin materials: a comprehensive study of noncremated, cremated, and processed-cremated individuals

Tooth-colored restorative materials are increasingly being placed in the practice of modern dentistry, replacing traditional materials such as amalgam. Many restorative resins have distinct elemental compositions that allow identification of brand. Not only are resins classifiable by elemental content, but they also survive extreme conditions such as cremation. This is of significance to the forensic odontologist because resin uniqueness adds another level of certainty in victim identification, especially when traditional means are exhausted. In this three-part study, unique combinations of resins were placed in six human cadavers (total 70 restorations). Simulated ante-mortem dental records were created. In a blind experiment, a portable X-ray fluorescence (XRF) unit was used to locate and identify the resin brands placed in the dentition. The technique was successful in location and brand identification of 53 of the restorations, which was sufficient to enable positive victim identification among the study group. This part of the experiment demonstrated the utility of portable XRF in detection and analysis of restorative materials for victim identification in field or morgue settings. Identification of individuals after cremation is a more difficult task, as the dentition is altered by shrinkage and fragmentation, and may not be comparable with a dental chart. Identification of processed cremains is a much greater challenge, as comminution obliterates all structural relationships. Under both circumstances, it is the nonbiological artifacts that aid in identification. Restorative resin fillings can survive these conditions, and can still be named by brand utilizing elemental analysis. In a continuation of the study, the cadavers were cremated in a cremation retort under standard mortuary conditions. XRF was again used to analyze retrieved resins and to identify the individuals based on restorative materials known to exist from dental records. The cremains were then processed and the analysis was repeated to determine whether restorative resins could be found under this extreme condition. Under both circumstances, sufficient surviving resin material was found to distinguish positively each individual in the study group. This study showed the utility of XRF as an analytical tool for forensic odontology and also the significance of the role of restorative resins in victim identification, even after cremation.     

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.     

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?     

Major incident response: collecting ante-mortem data

The Asian tsunami of 26 December 2004, which devastated coastal parts of more than 10 countries in and around the Indian Ocean caused over 200,000 casualties. People from more than 58 nationalities were amongst the victims and subsequently an international effort for disaster victim identification (DVI) was set up, coordinated by Interpol. DVI teams from more than 20 countries took part in the identification process which, because of the complexity of the situation, had to be conducted in an internationally agreed upon procedure. Standard operating protocols of post-mortem (PM) procedures were established for fingerprinting, forensic pathology, forensic odontology and DNA profiling and were crucial in the quality of the entire DVI process of the quickly decomposing bodies. A very important and underestimated part of the DVI process is the gathering of the ante-mortem (AM) data of the persons reported missing in their home countries. In the wake of this tsunami event it appeared to be even more problematic as entire families had died and information was difficult to obtain. As dentistry proved to be the most valuable identification mean--up to 85% of the cases--the AM dental records proved to be crucial elements for DVI. Standard operating protocols (SOP) were again established as to who, where, when and what information had to be collected by the dentists by the AM teams abroad. Transcribing the AM dental information by experienced forensic odontologists was another crucial element in the whole identification procedure as the information had to be loaded into the DVI System International (Plass Data, Holbaek, Denmark) for comparison with incoming PM data. The Interpol DVI Standing Committee thus recommends that forward planning, adequate funding, international cooperation and standardisation are essential to guarantee an effective response to any major mass disaster of this kind in the future.     

Organized dentistry and the pursuit of entry control

Organized dentistry spent nearly a century laboring to obtain control over entry into the profession. The first attempt, the American Society of Dental Surgeons, failed because the issue of using amalgam so split the Society that collective action became impossible. The second attempt, state licensing during 1870-1900, gave preferential treatment (automatic licensing) to dental school graduates and appeared at first to be the solution to the entry problem, given the small number of schools in operation. However, dental school entrepreneurs recognized a profitable opportunity, and the supply of dental schools expanded rapidly. Thus, in the third and final attempt at obtaining entry control, organized dentistry attacked the for-profit schools. The dental practice acts were amended to require all candidates to pass a licensing examination, provided first that they were graduates of a school considered "reputable" by the state board of dental examiners. Moreover, rising costs generated by increased school standards took the profit out of for-profit operation, and by 1930 such schools ceased to exist. However, the competitive nature of the 1930s made altogether clear that entry control was a necessary, but not sufficient, condition for the maximization of dentist profits, and thus organized dentistry began its turn inward, focusing on the competitive behavior of existing dentists.     

Analysis of scientific and pedagogical activities of Forensic Medicine Departments (courses) at higher medical schools in Russia

Pedagogical staff of departments (courses) of forensic medicine at higher medical schools of the Russian Federation, topics of research and pedagogical work at various faculties of higher school are analyzed. Forensic dentistry curriculum is suggested for students of dentistry faculties. New forms of forensic medical training are presented.     

Criteria of expert assessment of professional errors in dentistry

The most frequent errors in dental practice are analysed. Questionnaires, schemes and formula for objective assessment of medical documentation quality in dentistry are proposed.     

Drug liability litigation: toward better dental care

Seattle attorney Ann Pearl Owen reviews the proliferation of litigation involving dental anesthesia and drug liability, ties it to trends in dentistry and pharmaceutical manufacturing, and finds a positive role for trial lawyers.     

Intimate partner violence and physical health consequences: policy and practice implications

Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health services and unmet need for services, as well as strained relationships with providers. The body of IPV research has several critical gaps. There are almost no longitudinal studies of IPV and health. Most studies are clustered into a few specialties, with almost no research in the areas of allied health, dentistry, or management. A common definition of IPV is still not used. Finally, with some notable exceptions, there has been little success in moving the health care system to routinely screen women for IPV.