Can reallocation of rights help to avoid the Paretian Liberal Paradox?

The author is grateful to Christian Seidl for critical comments.     

Tooth eruption times of permanent teeth in male and female adolescents in Niedersachsen

The aim of this study was to determine the eruption times of permanent teeth, excluding third molars, in a defined area population of a country district in Lower Saxony. The authors investigated 2495 oral findings of 664 patients (male 315, female 349) in a longitudinal study. The minimum age was 3.00 years and the maximum age 24.00 years. The dental findings were collected over a period of about 20 years (1980-2002). The oral findings per child/adolescent were assessed between one and 16 times. The eruption times of teeth in females are earlier than those for the same teeth in males. Further, the permanent dentition in females is completed earlier than in males. The tooth eruption occurs symmetrically in both jaws. The comparison of both jaws revealed a slightly advanced eruption of the lower jaw teeth for both sexes. There is a noteworthy change in the eruption sequence of the teeth. In contrast to other reports we determined that the eruption of the canine proceeds the eruption of the second premolar. We found no acceleration of the dentition when compared to other reports and confirmed the rules of tooth eruption in man. Oral examination of teeth is a simple tool to calculate tooth eruption intervals. This first investigation on a population of Lower Saxony revealed a change in the eruption sequence of permanent teeth. The findings are relevant for dental treatment planning and should be reconfirmed at certain intervals.     

Eruption times of permanent teeth in children and adolescents of Paderborn, Westphalia, Germany

The eruption times of permanent teeth and the sequence of tooth eruption were investigated in 1535 individuals aged 3 to 24 years. Wisdom teeth were excluded from the evaluation. All individuals were inhabitants of Paderborn, Westphalia, Germany. The results were compared to results of other German studies on tooth eruption of the 20th century. The teeth emerged symmetrically in each jaw. However, teeth erupted earlier in the mandible than in the maxilla. Teeth erupted earlier in females than in males. The sequence of emerging teeth in the maxilla is identical in both sexes: first molar, central incisor, lateral incisor, first premolar, and canine, second premolar, second molar. The sequence of tooth eruption of the mandible is identical in both sexes but differs from the maxillary sequence: first molar, central incisor, lateral incisor, canine, first premolar, second premolar, second molar. Since the fifties of the last century the acceleration of teeth emergence has not increased in German studies on this subject.     

Assignment of a bite-mark on the victim's skin to the dentition of the perpetrator by means of anomalies in the number and position of the frontal teeth

This report is about a bite mark on the breast of a female corpse. The woman had been killed by ligature strangulation at the age of 76 years. The investigation of the dental casts of a suspected man showed some anomalies in the dentition and orthodontic variations. A comparison of the bite mark with these anomalies demonstrated the correspondence of several details. Consequently, the probability that the suspect was responsible for the bite mark was regarded as being very high. During the further investigations the suspect admitted the offence including the bite injury to the breast. The authors emphasize the importance of an exact photographic documentation as an indispensable prerequisite for an odontological comparison.     

Measuring the distance of the wisdom teeth from the occlusal plane as forensic-odontological method for chronological age determination

As part of an epidemiological study on tooth eruption it was attempted to define easily accessible criteria for age estimation in living human beings based on the distance of the wisdom teeth from the occlusal plane. 253 cast models of 149 female and 104 male patients were used for evaluation. Due to the great variability observed in the eruption of the wisdom teeth, only a small fraction of the total number of 10,924 cast models was suitable for investigation. Only teeth with the axis being perpendicular to the plane of occlusion during eruption according to radiological and clinical findings were included. After defining these inclusion criteria, the distance of the wisdom teeth from the plane of occlusion was determined and correlated to the age of the subjects. The results confirmed the known large variability concerning wisdom tooth eruption and did not show any reliable relation between age and distance values. Nevertheless, a remarkable finding that may be relevant for forensic odontostomatology was seen in one case where the lower wisdom teeth were taller than the occlusal plane, although the female patient was younger than 14 years. The upper molars were retained and root development was incomplete.     

Time of drug elimination in chronic drug abusers. Case study of 52 patients in a "low-step" detoxification ward

The elimination time of illicit drugs and their metabolites is of both clinical and forensic interest. In order to determine the elimination time for various drugs and their metabolites we recruited 52 volunteers in a protected, low-step detoxification program. Blood samples were taken from each volunteer for the first 7 days, daily, urine sample for the first 3 weeks, daily. Urine was analyzed using a fluorescence-polarization immunoassay (FPIA) and gas chromatography/mass spectrometry (GC/MS), serum using GC/MS. The elimination times of the drugs and/or their metabolites in urine and serum as well as the tolerance intervals/confidence intervals were determined. Due to the sometimes extremely high initial concentrations and low cut-off values, a few of the volunteers had markedly longer elimination times than those described in the literature. The cut-off values were as follows: barbiturates II (200ng/ml), cannabinoids (20ng/ml), cocaine metabolites (300ng/ml), opiates (200ng/ml). GC/MS detected the following maximum elimination times: total morphine in urine up to 270.3h, total morphine and free morphine in serum up to 121.3h, monoacetylmorphine in urine up to 34.5h, 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH) in urine up to 433.5h, THC-COOH in serum up to 74.3h, total codeine in urine up to 123h, free codeine in urine up to 97.5h, total codeine in serum up to 29h, free codeine in serum up to 6.3h, total dihydrocodeine (DHC) in urine up to 314.8h, free DHC in urine up to 273.3h, total and free DHC in serum up to 50.1h. Cocaine and its metabolites were largely undetectable in the present study.     

Mitral valve prolapse syndrome as cause of sudden death in young adults

Mitral valve prolapse syndrome (MVPS) is a relatively common disorder of the mitral valve and most cases take a benign clinical course. Only a subset of patients develop severe clinical symptoms such as arrhythmia, insufficiency of the mitral valve or infective endocarditis. As a consequence, sudden death might occur in these patients, thought to be caused by an arrhythmogenic event. By presenting six cases of sudden unexpected death in young female adults, we point at clinical and pathological data from the literature, which are of interest from the viewpoint of legal medicine. The incidence of MVPS in autopsy series has been reported to be about 4-5%, while clinical data hint at an incidence of about 2.5%. The presented cases suggest that even clinically benign cases of MVPS in young adults might result in sudden unexpected death. Such cases are not included in hospital based studies on the topic. This might lead to an underestimation of the fatal risk associated with the disease, even if sudden death might be a rare event in MVPS.