Forensic identification value of roentgen images in determining tooth-colored dental filling materials]

Identification of unknown bodies is mainly made by dental examination and comparison with accurate dental records. Therefore it is necessary to examine the jaws carefully and to locate every tooth-coloured dental restoration. Overlooking dental fillings can make positive identification impossible. The paper presented here evaluates the usefulness of radiographs to locate tooth coloured dental restorations. RESULTS: 40% of the dental materials tested here could not be detected radiographically with a sensitivity that is demanded. A radiographic examination is not sufficient and must be supplied by other techniques.     

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.     

Methods for identification of 28 burn victims following a 1996 bus accident in Spain

A car collided head-on with a bus containing 56 passengers plus the driver. A few seconds after the crash, the bus caught fire and 28 persons (15 male and 13 female) lost their lives. All the deceased were almost completely incinerated. To establish the identity of the victims, the judge in charge of the case designated a multidisciplinary Identification Commission. Postmortem procedures included a general external examination, routine photographs, dental examination, dental (intraoral and extraoral) and general radiographs (chest, ankle, etc.), and complementary biological methods for identification (e.g., DNA analysis). The antemortem information, including dental and medical records available, were transcribed onto the INTERPOL disaster victim identification forms. The detailed ante- and postmortem information were compared manually. In this disaster dental identity could be established in 57% of the victims, whereas dental evidence did not allow by itself the identification of 12 burned victims. Odontological examination and complementary radiographic procedures were found to be accurate, economic and rapid methods of identifying badly burned victims in this bus accident.     

The use of odontograms and panoramic roentgenography in personal identification]

Study of dental root surfaces prompted the authors to add to the routine odontogram 28 more maxillary surfaces and 22 mandibular surfaces, this making a total of 210 diagnostic signs. Employment of amplified panoramic roentgenography permitted the authors to detect specific features of the dental cavity, root canals, periodontal fissure structure, the presence of caries and its complications, inflammatory and systemic involvement, injury to the jaws and teeth. Visual examination of dental status and application of panoramic roentgenography will help improve forensic medical personal identification.     

Radiographic Recognition of Dental Implants as an Aid to Identifying the Deceased

Abstract:  This study was undertaken to determine if dental implants can be radiographically differentiated by company type to aid forensic identification of the deceased. Recognition of dental implants on intraoral radiographic images was assessed in a blind study using a radiographic examination guide to highlight differences between dental implants. Inter- and intra-examiner comparisons were conducted and a computer program (Implant Recognition System^®) was evaluated to see whether it improved the accuracy of implant recognition. The study found that dental implants could be radiographically differentiated by company type. The Implant Recognition System^® in its current form was of little benefit for radiographic assessment of dental implants for forensic odontologists. Prior knowledge of implant types, with a McNemar's statistical value of 92.9, proved to be most significant in identification.     

Detection of Tooth‐Colored Restorative Materials for Forensic Purposes Based on Their Optical Properties: An In Vitro Comparative Study

Victim identification using dental records involves antemortem and postmortem comparison of dental charts. Since dental restorations may be part of such records, identifying them accurately is critical. The objective of this study was to compare the diagnostic reliability and validity of two optical methods for identifying tooth‐colored restorations (digital imaging fiber optic transillumination (DiFOTI) using near infrared light, and fluorescence‐aided identification of restorations (FAIR)) with conventional diagnostic methods. Four examiners identified and charted tooth‐colored restorations in three sets of typodonts on the bench using conventional visual and tactile examination, DiFOTI (DIAGNOcam?) and FAIR. All examinations were repeated after 4 weeks. Both the sensitivity (95%) and specificity (97%) of the FAIR method were significantly higher than those for DiFOTI (82% and 82%) and for conventional inspection (71% and 82%). In conclusion, FAIR method performed better than conventional examination and DiFOTI, and was more reliable for identifying tooth‐colored restorations.     

The efficiency of an X-ray screening system at a mass disaster

This is a study to determine the efficiency and efficacy of using an X-ray security screening system to locate both dental fragments and other foreign objects that might be commingled with fragmented remains in a mass disaster. A controlled study by the Pennsylvania Dental Identification Team (PADIT) revealed that a manual examination of simulated body bags containing commingled dental parts and foreign objects by a team of trained forensic odontologists was very effective in locating dental fragments and in finding foreign objects. Although this was effective, it was not efficient, because it was very time consuming. With the use of an X-ray security screening system, the time factor could be reduced. This study also revealed that even though this sophisticated equipment could reduce the time factor in locating commingled dental and foreign objects, a forensic odontologist should be utilized to be most effective.     

Forensic stomatology as independent division of forensic medicine

A modern condition of identification with use of stomatological state is set out in details. Dissertations of research assistants and competitors of the department of forensic medicine were analyzed in connect with the problem of identification using anatomy, morphological and morphometrical peculiarities of tooth, dental arches, dental plates, oral cavity organs and others. A possibility of identification of sex, age, ethno-racial affiliation using peculiarities of structure of dental-jaw system was presented. A question connected with coverage of this problem in pages of "Forensic examination".     

Intelligent dental identification system (IDIS) in forensic medicine

This study reports the design and development of the intelligent dental identification system (IDIS), including its efficiency and reliability. Five hundred patients were randomly selected from the Dental Department at Police General Hospital in Thailand to create a population of 3000 known subjects. From the original 500 patients, 100 were randomly selected to create a sample of 1000 unidentifiable subjects (400 subjects with completeness and possible alterations of dental information corresponding to natural occurrences and general dental treatments after the last clinical examination, such as missing teeth, dental caries, dental restorations, and dental prosthetics, 100 subjects with completeness and no alteration of dental information, 500 subjects with incompleteness and no alteration of dental information). Attempts were made to identify the unknown subjects utilizing IDIS. The use of IDIS advanced method resulted in consistent outstanding identification in the range of 82.61-100% with minimal error 0-1.19%. The results of this study indicate that IDIS can be used to support dental identification. It supports not only all types of dentitions: primary, mixed, and permanent but also for incomplete and altered dental information. IDIS is particularly useful in providing the huge quantity and redundancy of related documentation associated with forensic odontology. As a computerized system, IDIS can reduce the time required for identification and store dental digital images with many processing features. Furthermore, IDIS establishes enhancements of documental dental record with odontogram and identification codes, electrical dental record with dental database system, and identification methods and algorithms. IDIS was conceptualized based on the guidelines and standards of the American Board of Forensic Odontology (ABFO) and International Criminal Police Organization (INTERPOL).     

The identification of a dismembered human body: a multidisciplinary approach

A criminal case was directed to a multidisciplinary forensic team for identification, concerning a victim whose head, having two gunshot wounds, had been separated by a sharp instrument and was recovered 6 months later. The purpose of this research was to determine the sex and age of the victim for human identification. Primarily, macroscopic examination of the skull, tooth, and DNA analysis was conducted for sex determination. A rough assessment of age was made from the skull based on anthropological findings, however a more definitive result of age estimation was determined utilizing dental morphology. The dental data showed an age range of 32-37 from the mineral examination and the formulation of microscopic measurements. The results obtained from the skull and dental analysis matched with the physical characteristics of the victim's body, the known personal data of this person, and with the superposition of the photos gathered by a formal request. Besides, the result of DNA profiling of the victim showed male gender and direct relationship with the victim's presumed wife and daughter. Generally, research on human identification consists of sex and age determination. The sex characteristics can be precisely proved from DNA tests. However, age can be estimated by skeletal, and dental analysis. In this case the performed sex and age analysis lead the research to the selective matching of the missing person's identity.     

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.     

A new system for computer aided dental identification in mass disasters

In recent years, several computer programs for dental identification in mass disasters have been developed. Unfortunately, it may be difficult to get access to such programs. The Norwegian police presently utilizes a text retrieval program, NOVA¹STATUS, for detection work. This program is based on the British STATUS ONE program, and it enables the user to find from a large pool of postmortem dental registration one or several sets containing specific information about one tooth or several teeth. The complete relevant set(s) can be displayed for visual examination and comparison. A coding system for dental information has been developed as well as a system for interrogating the computer. This system and its efficiency have been tested on a simulated small scale disaster where various well-known difficulties in dental identification were included.     

Three fatalities in flash fire with variable dental charring

The deaths of three teenagers in an automobile crash and flash fire are presented. The inability to draw valid conclusions about whether the victims were dead prior to the fire based on dental examination is discussed.     

An elliptical incised wound of the breast misinterpreted as a bite injury

Bite injuries upon homicide victims are most often initially identified by the forensic pathologist during the course of the autopsy examination. Following such recognition, the injury or photographs of the traumatized site are then referred to a forensic odontologist for his or her examination, further characterization, and subsequent comparison with any suspect's dentition. However, if the pathologist misidentifies an injury caused by another mechanism as a human bite, this mistake can potentially be perpetuated by the dental consultant, since relatively few dentists regularly examine traumatic injuries other than those arising from bites. To illustrate such an event, a case is presented involving an incised wound of the breast, which was originally identified as an avulsive bite wound. Detailed examination by two odontologic consultants confirmed the wound as having been caused by human teeth, and further, they related the "bite injury" to a specific individual. The bite injury interpretation represented the only scientific evidence implicating the suspect at a subsequent trial for capital murder. Later examination of the tissues and photographs by a forensic pathologist and another dental consultant revealed that the injury was not due to human dentition, but rather resulted from a sharp-edged instrument. These consultants conducted a unique experiment to reduplicate the injury and prove its causation. This information was presented to the jury during the suspect's trial and resulted in his acquittal on all charges.     

Studies of the chronological course of wisdom tooth eruption in a Japanese population

The importance of forensic age estimation in living subjects has grown over the last few years. In dental age estimation, tooth eruption is a parameter of developmental morphology that can be analyzed by either clinical examination or by evaluation of dental X-rays. In the present study, we determined the stage of wisdom tooth eruption in 549 male and 751 female Japanese subjects aged 14-26 years based on radiological evidence from 1300 conventional orthopantomograms. The results presented here provide useful data on the age of alveolar, gingival, and complete emergence of the third molars in the occlusal plane that can be utilized for forensic estimation of the minimum and most probable ages of investigated persons.     

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.     

Age estimation of unaccompanied minors. Part I. General considerations

In recent years many countries have experienced a sharp increase in the demand for forensic age estimates of unaccompanied minors. In many countries the age thresholds of relevance to criminal prosecution lie between 16 and 22 years. In line with recommendations issued by the Study Group on Forensic Age Diagnostics, for determining the age of live subjects a forensic age estimate should combine the results of a physical examination, an X-ray of the hand and a dental examination which records dentition status and evaluates an orthopantomogram. To assess the age of persons who are assumed to be at least 18 years old, an additional radiographic or CT examination of the collar bones is recommended. Forensic age estimates should take account of the ethnic origin and socio-economic status of the person under examination.     

Studies of the chronological course of wisdom tooth eruption in a Black African population

The importance of forensic age estimation in living subjects has grown over the last few years. In dental age estimation, tooth eruption is a parameter of developmental morphology that can be analyzed by either clinical examination or by evaluation of dental X-rays. In the present study, we determined the stage of wisdom tooth eruption in 410 male and 106 female Black South African subjects of known age (12-26 years) based on radiological evidence from 516 conventional orthopantomograms. Four eruption stages were determined (no emergence, alveolar emergence, gingival emergence, complete emergence). Statistical scores were determined for the individual stages separately for both sexes. The data presented here can be utilized for forensic estimation of the minimum and most probable ages of investigated persons.     

Reliability of the methods applied to assess age minority in living subjects around 18 years old. A survey on a Moroccan origin population

We present a review of a population of 114 immigrant Moroccan males for which an age estimation was requested. The subjects' real chronological age was confirmed by the Moroccan Embassy in Spain. The confirmed age range was between 13 and 25, with an average age of 18.1 years and a standard deviation of 2.03. The following tests were performed to arrive at the forensic estimation of age: general physical examination, carpus X-ray (Greulich and Pyle method) and dental orthopantomography to determine the degree of maturity of the third inferior molars (Demirjian's method). Carpus X-ray (skeletal age) was the most useful method, followed by Demirjian's method (dental age), as prediction factors of a chronological age of over or under 18. The combination of skeletal and dental age variables represented a significant improvement in the prediction of the chronological age of the subjects in this population, reducing the number of ethically unacceptable test errors to a minimum.     

The Role of Forensic Odontology in the Field of Human Identification

The profession of forensic odontology can make a significant contribution to the field of forensic science in the identification of people both dead and living. The opinion of this author is that this profession is often neglected. This article is a non-technical review of the basic methods that can be used to gather scientific evidence through the use of forensic odontology. Because of the uniqueness of bite patterns, bite marks can identify a person with enough accuracy to result in conviction by the courts. In cases where an unidentified body is skeletonized or visual identification or fingerprint identification is not possible, identification can be established by dental identification. In cases of mass disaster such as airplane crashes or fires, dental identification can be the most useful method not only of determining identity but also of determining the number of victims involved in the disaster. Dental examination can establish characteristics unique to an individual which can be useful as aids in establishing identity. There are several significant obstacles to overcome including lack of standardization and computerization before dental identification can be better utilized. Neglect by the dental profession and dental colleges of this contribution to science should be addressed.

[EDITOR'S NOTE: Dr. Kim is currently Chairman of the Department of Biomedical Dental Sciences, College of Dentistry, King Saud University in Saudi Arabia. Dr. Kim has also served as the Associate Editor on Forensic Dentistry for this journal for the past five years.—Editor.]