Description of restorative dentistry and its importance in forensic applications. This includes an introduction into forensic dentistry and its applications, historical aspects of forensic dentistry, specific applications of restorative dentistry and real accident case examples.
4. • IDENTIFICATION OF
RESTORATIVE MATERIALS
• Radiographs
• Chemical analysis
• Identification of Tooth
colored materials
• ADVANCES
• Computerized tomography
• Software's & databases
• CASE 1
• CASE 2
• CONCLUSION
• REFERENCES
5. DEFINITION
Application of a broad spectrum of sciences
& technologies to investigate situations & to
establish what occurred based on collected
evidence
Any science used for the purposes of the
law, & therefore provides impartial scientific
evidence for use in the courts of law
1http://en.wikipedia.org/wiki/Forensic_science
8. INTRODUCTI
ON
Crime scene investigators-
Gather evidence from scene
Crime scene
technician
Police
Medical
examiner
Forensic
odontologist
Examine these materials to
provide scientific evidence
4http://en.wikipedia.org/wiki/Forensic_science
Investigation and court
proceedings
9. APPLICATIO
NS
“That branch of forensic medicine which in the
interest of justice deals with the proper handling
and examination of dental evidence and with the
proper evaluation and presentation of the dental
findings.”
Keiser-Neilsen S. Bristol: John Wright and Sons; 1980. Person Identification by Means of Teeth.
Identification through dental records. Dental Abstracts Volume 54, Issue 2, March–April 2009, Pages 78
5
Identification of
found human
remains
Identification in
mass fatalities
Assessment of bite
mark injuries
Assessment of cases
of abuse
Civil cases involving
malpractice
Age estimation
10. APPLICATIO
NS
6
AGE ESTIMATION
• Eruption status
• Dental Wear
• Secondary Dentin
• Deposition of apical
cementum
• Radicular
Translucency
• Size of pulp chamber
• Studying the
mandible
BITEMARK ANALYSIS
• Involving skin /
inanimate objects
• Impressions made &
dental data obtained
• Electron Microscopy &
computer enhancement
aids analysis
MA Major, JN Stanley. Forensics, comparative anatomy, geometries,form and function. Wheeler’s Dental Anatomy, Physiology
11. APPLICATIO
NS
7
Identification of
human remains
Restorative
dentistry
MA Major, JN Stanley. Forensics, comparative anatomy, geometries,form and function. Wheeler’s Dental Anatomy, Physiology
Restorations are
individually
customized for each
patient
This uniqueness
enables the use of
restorative dentistry
to identify victims
12. ADVANTAGES
Teeth - Hardest
substance in the
body
Survive in most conditions
D.H. Ubelaker. Taphonomic applications in forensic anthropology. W.D. Haglund, M.H. Sorg (Eds.), Forensic Taphonomy—The Postmortem Fate of
Human Remains, CRC Press, Boca Raton (1997) 8
Restorations
• Fillings, RCT
• Crowns &
bridges
Enables identification of
unknown remains in a
straightforward & cost
effective manner
Size, Shape &
Arrangement of
teeth differs
No two humans have
identical dentition relative
13. DISADVANTAGES
Depends heavily on availability of antemortem
dental records
9
Poor quality am or pm dental records may result
in inability to establish identification
All teeth may not be recovered - loss of the
periodontal ligament or through postmortem
trauma
Fire - irreversible changes to both restorations &
teeth ,reduce amount of info available for the
comparison
Sweet D. Forensic dental identification. Forensic Sci Int. 2010 Sep 10;201-3.
More complicated
treatment
More chance of
correct identification
Youngsters often do
do not experience
decay and require
restorative
treatments
Absence of
restorations -
dependence by
forensic dentists on
morphological traits
for comparisons
Root curvature
Bone trabecular
patterns Pulpal
morphology &
stones,
Supernumerary
teeth
14. Dr. Joseph Warren,
1775
Killed during battle & buried by
in a mass grave. 10 months later
body was identified by a small
dentureDr. George
Parkman, 1849
Fragments of the maxillary jaw
were discovered at the
suspect’s residence. His dentist,
identified maxillary dentures
Adolf Hitler, 1945
1979, Theodore
“Ted” Bundy
Serial killer & rapist
This may have been the most
widely publicized case that
involved bite mark evidenceThe first recorded medico-legal
identification of a body using
dental means
This was the first time dental
evidence was used to convict a
murderer
Body burned buried, pieces of
mandible were found. Identity
confirmed when work matched
records kept by dentist
One of the most talked about
cases in forensic dentisry
Bruce-Chwatt RM. A brief history of forensic odontology since 1775. J Forensic Leg Med. 10
HISTORY
15. METHODS
Victims of violent
crimes
The most common role of the forensic dentist is the
identification of deceased individuals
11
Mass disasters
Sweet D, DiZinno JA. . Personal identification through dental evidence--tooth fragments to DNA. J
Calif Dent Assoc. 1996 May;24(5):35-42
Comparative dental
identification
Postmortem dental
profiling
16. POSTMORTEM DENTAL
PROFILING
When antemortem
dental records are
unavailable
12
Sweet D, DiZinno JA. . Personal identification through dental evidence--tooth fragments to DNA. J
Forensic dentist produces the postmortem
record
Assist in limiting population pool to which the
deceased is likely to belong
Info- age, sex
Ancestry,
background, socio-
economic status
Dietary habits
habitual
behaviours
dental/systemic
diseases
17. COMPARATIVE DENTAL
IDENTIFICATION
Human
remains
13
Sweet D, DiZinno JA. . Personal identification through dental evidence--tooth fragments to DNA. J
Tentative
identification by police
Antemortem
records obtained
from victim’s
dentist
Forensic dentist
produces the
postmortem
record
Forensic
comparison
18. CATOGARIES: By ABFO
Positive
identificatio
n
antemortem & postmortem data match in a
sufficient detail, no unexplainable discrepancies to
establish that they are from the same individual
Antemortem & postmortem data have consistent
features, but because of the quality of either
evidence, not possible to establish the identity
unambiguously
Available information is insufficient to form the
basis for a conclusion
14
Possible
identificatio
n
Insufficient
evidence
Exclusion The antemortem and postmortem data are clearly
inconsistent
Dostalova T, Eliasova H, Seydlova M, Broucek J, Vavrickova L . The application of CamScan 2 in
forensic dentistry. J Forensic Leg Med. 2012 Oct;19(7):373-80
19. PROCEDURES
Macrophotography of the
oral cavity
Dostalova T, Eliasova H, Seydlova M, Broucek J, Vavrickova L.. The application of CamScan 2 in forensic dentistry. J Forensic Leg
Med. 2012 Oct;19(7):373-80 15
X-ray examination
Intraoral examination
Number & type
of the teeth &
localisation
Presence of
filling –
material, size,
shape
Root canal
treatment
Fixed crowns,
bridges & RPD
Incorrect tooth
eruption
ectopical &
unerupted
teeth
Orthodo
anomaly –
open/cross
bite
Fractured
teeth & jaws
Shape of teeth,
abrasion,
attrition
Anatomical
anomaly -
torus
palatinus
20. RADIOGRAPHIC
EXAMINATION
Jahagirdar B. Pramod,1 Anand Marya,1 Vidhii Sharma1. Role of forensic odontologist in post mortem
person identification. Dent Res J (Isfahan). 2012 Sep-Oct; 9(5): 522–530
16
Crown and
root
morphology
Presence of
decayed,
missed, filled,
and fractured
teeth
Stages of
wound healing
in extraction
sockets
Degree of root
formation
Bone
trabecular
pattern
To determine cause of death
Evidence of bullets or foreign bodies in soft tissue
To determine faulty postmortem charting of teeth
Teeth may be wrongly numbered in postmortem
data- migration of adjacent teeth
21. UNIQUE
RESTORATIVE
DETAILS
17
Retentive pins &
Posts
• Type
• Location
• Length
Shades of tooth
coloured
restorative
materials &
Prosthetic teeth
Moulds of
prosthetic teeth
Casts
Removable
appliances
Implants
• Material
• Type
• Length
• location
Dostalova T, Eliasova H, Seydlova M, Broucek J, Vavrickova L . The application of CamScan 2 in
forensic dentistry. J Forensic Leg Med. 2012 Oct;19(7):373-80
Sweet D. Forensic dental identification. Forensic Sci Int. 2010 Sep 10;201-3
22. HIERARCHY OF
DENTAL FINDINGS
USED AS EVIDENCE
18
Prosthetic
appliances in 30%
of cases
Ante mortem teeth
extractions were
helpful in 25% of
the cases
Teeth restorations
were recorded in
20% of the
identified cases
Dental caries was
helpful in only 10%
of the cases
Brkić H, Keros J, Kaić Z, Cadez J. Hereditary and environmental dental findings in identification of
human remains. Coll Antropol. 2000 Jul;24 Suppl 1:79-83.
27%
3%
19% 1%
23. RADIOGR
APHS
Post-mortem
radiographs
Ante-mortem
radiographs
Hemasathya BA, Balagopal S. A study of composite restorations as a tool in forensic identification. J
Forensic Dent Sci. 2013 Jan;5(1):35-41.
ACCURATE
DUPLICATES
Shape of the composite
restoration is unique
Radiographic image can
be used for successful
identification
19
Amalgam & metallic restorations
has a unique radiographic
morphology
Can be readily identified in
both antemortem and
postmortem data
POST
MORTEM
ANTEMOR
TEM
Dental composites
24. Hemasathya BA, Balagopal S. A study of composite restorations as a tool in forensic identification. J
Forensic Dent Sci. 2013 Jan;5(1):35-41.
Wenzel A, Hintze H, Hørsted-Bindslev P. Discrimination between restorative dental materials by their
20
Various fillers, each having
varying degree of
radiopacity
Radiopacity of composites plays
significant
role in forensic dentistry- for
identification purposes
Dental composites
Possible to differentiate
between various restorative
materials their radiopacity
Amalgam, light-cured composite,
GIC, reinforced GIC
Filling materials could be distinguished
with a high probability in film, results may
be useful in forensic dentistry
RADIOPA
CITY
25. 21
Determine type of alloy,
composition of restorative
material
Scanning electron microscope
CHEMICAL
ANALYSIS
Electron probe microanalyzer
Dostalova T, Eliasova H, Seydlova M, Broucek J, Vavrickova L . The application of CamScan 2 in
forensic dentistry. J Forensic Leg Med. 2012 Oct;19(7):373-80
Zelic K, Djonic D. Forensic or archaeological issue: is chemical analysis of dental restorations helpful in
assessing time since death and identification of skeletonized human remains?. J Forensic Sci. 2013
Atomic emission spectroscopy
Material under
investigation
e-
Wavelength
characteristic of
particular element
26. S. Benthaus, A. DuChesne, B. Brinkmann. A new technique for the postmortem detection of tooth-
coloured dental restorations. International Journal of Legal Medicine. April 1998, Volume 111, Issue 3,
22
Increased the risk of overlooking
natural-coloured dental restorations –
Composite, Sealant, ceramic
Ultraviolet radiation with a peak emission at λ =
365 nm
TOOTH
COLOURED
Dyes- penetrate restoration slits & form
boundaries
Technique-preparation of natural dental hard
tissue by etching with 37% H₃PO₄, an indicator to
color roughened dental tissue but not polished
restoration material
Buccal surface of
left upper incisor,
with slits-
composite/enamel
crevices
Tooth after
preparation with
H₃PO₄ for 120 secs
& application of ink
Boundary of
restoration clear
cut
Fissure sealant
detection before ®
& after (L)
27. Organic matrix Filler particles
Different
manufacturers
Different fillers
Elemental composition
& microstructure
studied
Classified based on a
distinct chemical
signature
Presented as CLASS
EVIDENCE
CLASS EVIDENCE
Narrow down
possibilities
IdentificationElimination
23
FILLERS
Wenzel A, Hintze H, Hørsted-Bindslev P. Discrimination between restorative dental materials by their
radiopacity measured in film radiographs and digital images. J Forensic Odontostomatol. 1998
28. Kirchhoff S, Fischer F. Is post-mortem CT of the dentition adequate for correct forensic identification?:
comparison of dental computed tomograpy and visual dental record. Int J Legal Med. 2008
24
The gold standard for
identification
is the visual dental record
CT examination of an upper
jaw of a skull
Computed tomography (CT) as
valuable supportive tool
CT
Upper jaw of the skull
Corresponding CT in 2 different
views
ADVANTAGES
Possible to adapt direction of pm dental 3D-CT
to am X-rays at time of comparison
DISADVANTAGES
Streak artefacts resulting from metallic dental
works, decreasing the 3D image quality
Time consuming and costly
Identification can be performed by highly
trained and experienced personnel
29. Kirchhoff S, Fischer F. Is post-mortem CT of the dentition adequate for correct forensic identification?:
comparison of dental computed tomograpy and visual dental record. Int J Legal Med. 2008
25
DATABASES &
SOFTWARES
NCIC & INTERPOL -
Databases
Comparison of
dental records with
ones stored in
databases
Computer-aided comparison speeds up and refines the
search for the perfect “match”
Computer-based
dental chart matching
software
CAPMI
Toothpics®, WinID
30.
31. IDENTIFICATION OF A
CHARRED CORPSE
Remains of Human
burn victim of car
accident
Maxilla & mandible
enucleated with electric
saw to cut above the
apical area of the teeth
Anterior teeth underwent
a process of calcination,
loss crown structure
The posterior teeth were
sound
body of mandible was
carbonized, loss of hard
tissue due to fire
presence of fixed
orthodontic appliance-
brackets & bands
26AG Marco, AS Ricardo. Identification of a charred corpse through dental records.
32. IDENTIFICATION OF A
CHARRED CORPSE
Remains of
Human burn
victim of car
accident
Findings of the
macroscopic
examination of
dental forensic
analysis 27
Not referred for
examination
Amalgam restoration
Lost Ante mortem
AG Marco, AS Ricardo. Identification of a charred corpse through dental records.
33. IDENTIFICATION OF A
CHARRED CORPSE
Remains of
Human burn
victim of car
accident
Other dental
records sent for
forensic analysis
Lateral and frontal extra- and intraoral
photographs
Orthodontic analysis and tracings
Lateral radiograph of the head
Panoramic radiograph
Periapical radiograph of the area of
upper incisors
Periapical radiograph of the upper &
lower incisors
Dental casts of upper and lower arches
28AG Marco, AS Ricardo. Identification of a charred corpse through dental records.
34. IDENTIFICATION OF A
CHARRED CORPSE
Remains of Human
burn victim of car
accident
By comparing the treatment
performed on the upper right
lateral incisor - tooth #12)
Shape, contour &
site of restoration
compatible
F
O
R
E
N
S
I
C
C
O
N
F
R
O
N
T
A
T
I
O
N
Post-mortem
radiographs
Ante mortem
radiographs
Root and canal
shape compared-
positive
compatibility
Victim remains
29AG Marco, AS Ricardo. Identification of a charred corpse through dental records.
35. IDENTIFICATION OF A
CHARRED CORPSE
Human burn victim
of car accident
By comparing treatment of
upper right first molar (tooth
#16) which presented a fracture
in the palatal surface
same cavity
F
O
R
E
N
S
I
C
C
O
N
F
R
O
N
T
A
T
I
O
N
Post-mortem castAnte mortem cast
restoration shape was matched
to the dental casts
Victim remains
30Marco Aurélio Guimarães, Ricardo Henrique Alves da Silva. Identification of a charred
corpse through dental records. RSBO. 2011:Jul-Sep;8(3):345-51
36. STATE v. BLOM
May 26, 1999, 19-year-old
Kathlyn Poirier was
abducted
Suspect - Donald
Blom, repeat sex
offender
Among ashes
inside a fire pit
– bone??
Identified as
bone fragments
& a tooth
Lab analysis
31
http://caselaw.findlaw.com/mn-supreme-court/1402520.html
37. STATE v. BLOM
TOOTH 18
On August 27, 1991, he
had placed a 1-surface
occlusal amalgam cavity
filling in 18
Treated Poirier on May 12,
1999, less than two weeks
before the abduction
He “prepped” the
cavity with Dropsin,
cavity lining material
containing a large
amount of zinc
He replaced the existing
filling in 18 with another
amalgam filling, using
bonded acid-etch
technique and a 3M
bonding product known as
Rely X ARC
DENTIS
T 1 d
DENTIS
T 2 d
Poirier's dental radiographs of 1994 and 1997 were available to
make comparisons with radiographs of the recovered tooth and
jaw fragments
32
http://caselaw.findlaw.com/mn-supreme-court/1402520.html
38. STATE v. BLOM
Extra, distinctively
looking root.
which was used in an
earlier filling of Poirier's
tooth in 1991
Filled using the acid-etch
method
Also filled using the
acid-etch method
Recovered
toothd
Poirier's tooth
tooth
Similar looking extra
root.
Contained zirconium
and silicon on its
surface
Contained a small
amount of zinc
Same proportions
present in a bonding
agent used - Rely X ARC
Tooth structure,
physical characteristics
of the area filled
Similar
33
http://caselaw.findlaw.com/mn-supreme-court/1402520.html
39. Putrefac
tion
Fire
Burial
Submer
sion
Trauma
Chemicals
Lack of/ failure to locate
antemortem records
Failure of odontological
investigations
Dostalova T, Eliasova H, Seydlova M, Broucek J, Vavrickova L . The application of CamScan 2 in
forensic dentistry. J Forensic Leg Med. 2012 Oct;19(7):373-80
Dental care not freely
available
Dental documentation not
routinely practiced
Athorities & dental
practitioners not aware
40. • Murphy M, Drage N, Carabott R, Adams C. Accuracy and reliability of
cone beam computed tomography of the jaws for comparative forensic
identification: a preliminary study. J Forensic Sci. 2012 Jul;57(4):964-8.
• Keiser-Neilsen S. Bristol: John Wright and Sons; 1980. Person
Identification by Means of Teeth.
• Identification through dental records. Dental Abstracts Volume 54, Issue
2, March–April 2009, Pages 78
• D.H. Ubelaker. Taphonomic applications in forensic anthropology. W.D.
Haglund, M.H. Sorg (Eds.), Forensic Taphonomy—The Postmortem Fate
of Human Remains, CRC Press, Boca Raton (1997)
• Sweet D. Forensic dental identification. Forensic Sci Int. 2010 Sep
10;201-3
• Bruce-Chwatt RM. A brief history of forensic odontology since 1775. J
Forensic Leg Med. 2010 Apr;17(3):127-30
• Sweet D, DiZinno JA. . Personal identification through dental evidence--
tooth fragments to DNA. J Calif Dent Assoc. 1996 May;24(5):35-42
• MA Major, JN Stanley. Forensics, comparative anatomy, geometries,form
41. • Stimpson PG (1985) cited in Clark DH, Ruddick RF (1985) Post
mortem detection of tooth coloured dental restorations byultra violet
radiation. Acta Med Leg Soc (Liege) 35:278–284
• Dostalova T, Eliasova H, Seydlova M, Broucek J, Vavrickova L . The
application of CamScan 2 in forensic dentistry. J Forensic Leg Med.
2012 Oct;19(7):373-80
• Jahagirdar B. Pramod,1 Anand Marya,1 Vidhii Sharma1. Role of
forensic odontologist in post mortem person identification. Dent Res J
(Isfahan). 2012 Sep-Oct; 9(5): 522–530
• Sakoda S, Zhu BL. Dental identification in routine forensic casework:
clinical and postmortem investigations. Leg Med (Tokyo). 2000
Mar;2(1):7-14
• Kawakami T. Examination of the degree of agreement among dental
findings used for personal identification (Part 4)--Lapse of time
between features of dentition at time of death and those in the last
dental record. Nihon Hoigaku Zasshi. 1994 Jun;48(3):169-84.
• Hemasathya BA, Balagopal S. A study of composite restorations as a
tool in forensic identification. J Forensic Dent Sci. 2013 Jan;5(1):35-
41.
42. • S. Benthaus, A. DuChesne, B. Brinkmann. A new technique for the
postmortem detection of tooth-coloured dental restorations.
International Journal of Legal Medicine. April 1998, Volume 111, Issue
3, pp 157-159
Editor's Notes
This is especially important in law enforcement where forensics is done in relation to criminal or civil law,[1] but forensics are also carried out in other fields, such as astronomy, archeology, biology and geology to investigate ancient times.
This is especially important in law enforcement where forensics is done in relation to criminal or civil law,[1] but forensics are also carried out in other fields, such as astronomy, archeology, biology and geology to investigate ancient times.
Restorative dentistry is the study, diagnosis and integrated management of diseases of the teeth and their supporting structures and the rehabilitation of the dentition to functional and aesthetic requirements of the individual
INTERSECTION OF THE LAW AND THE SCIENCE OF DENTISTRY HAT IT HAPPENS WHEN DENTISTS ASSIST LAW ENFORCEMENT IN SOLVING CRIMES
due to the great resistance to the agents who provoke the destruction of the soft tissues in the corpses (putrefaction, traumatic, physical and chemical agents)
The vast number of possible combinations of characteristics (i.e., unrestored, filled, missing, etc.) in the human dentition (32 teeth) can give rise, in theory, to trillions of possible dental patterns that could allow the identification process to be quantified as reported in recent decades
Applications
Five areas are generally seen as the focus of forensic dentistry: establishing identification by comparing treatment records, radiographs, study casts, etc; comparing dental records to identify victims of mass fatalities; comparing suspects' teeth to bite marks found on a body or a food item at a crime scene; comparing bite marks or other patterned injuries when abuse is suspected; and providing evidence in cases of professional negligence, malpractice, malfeasance, or standards of care disputes. The principles involved spring from the basic skills used by dentists in providing clinical care. In fact, all dentists practice forensics daily as they identify previously unknown drug reactions, see signs of abuse, and keep good records on their patients. Good documentation testifies as to the kind of care being provided. For actual testimony in court, forensic odontologists prepare and sign a report detailing the ante mortem and postmortem records and submit an opinion as to how they compare.
due to the great resistance to the agents who provoke the destruction of the soft tissues in the corpses (putrefaction, traumatic, physical and chemical agents)
The vast number of possible combinations of characteristics (i.e., unrestored, filled, missing, etc.) in the human dentition (32 teeth) can give rise, in theory, to trillions of possible dental patterns that could allow the identification process to be quantified as reported in recent decades
dental patterns is their lower stability in a given population compared to mtDNA sequences, which are affected only by mutations and heteroplasmy. Dental patterns are closely related to dental health status, and this in turn depends on age (caries disease is accumulative) and birth cohort [11] and [12], because the current approach to dental treatment is different now (restorative era) compared to some decades ago (extractionist era). In forensic medicine it is difficult to estimate the chronological age and birth cohort of corpses
Young people today often do not experience decay and require restorative treatments in the same way and to the same extent as previous generations. The absence of dental restorations has meant a further dependence by the forensic dentists on morphological traits for comparisons [6]. Root curvature, bone trabecular patterns, pulpal morphology and stones, supernumerary teeth, etc. are now becoming increasingly important for the identification purposes since the absence of acquired dental traits can be a problem in some cases.
Interpretation of clinic- or hospital-specific abbreviations can present a significant problem for forensic dentists from other locations similar to the use of differing tooth nomenclature systems. Data recorded in foreign languages has also resulted in challenges for the forensic dentist [5]. And poor quality antemortem or postmortem dental records may result in an inability to establish identification. In the postmortem situation, all of the teeth may not be recovered as a result of loss of the periodontal ligament or through postmortem trauma. Fire can result in irreversible changes to both restorations and teeth, which can reduce the amount of information available for the comparison of records [7]. Despite these problems and challenges, teeth and dental traits are recognized as one of the most valuable individualizing features of the human body. Dentists are in an ideal position to provide the needed skill and expertise to identify human remains or living persons using these features
Mass disasters and other violent deaths often lead to major skull, face and jawbone mutilation and teeth fragmentation [13] and [14]. This report deals with the most frequent forensic situations: loss of the anterior teeth or loss of one complete arch. During the early stages of exposure to fire the cheeks and the tongue tend to physically protect the teeth. As the fire becomes hotter or lasts longer, the lips and cheeks tighten and harden, exposing the anterior teeth and resulting in their destruction [13] and [15], leaving only the posterior teeth for study. In some violent deaths the flat and irregular bones of the cranium and face burst, with subsequent loss of information from the upper or lower arches, or both
The utility of dental patterns in forensic dentistry
individuals with numerous and complex dental treatments are often easier to identify than those individuals with little or no restorative treatment
The first recorded medico-legal identification of a body using dental means is that of Dr. Joseph Warren
This was the first time dental evidence was used to convict a murderer
he first forensic dentist in the United States was Paul Revere who was known for the identification of fallen revolutionary soldiers.2-4 Dr. Joseph Warren, who suffered a severe head trauma during the war, was identified by the small denture that Paul Revere had fabricated for him.4 Through this identification, it was made possible for Dr. Warren to be buried with full military honors.2,3
Dr. George Parkman was a respected professor at Harvard University who also dealt with real estate and lending money.4 John Webster, a colleague of his at Harvard, who was a chemist, owed Dr. Parkman a considerable amount of money.4 One evening, Dr. Parkman failed to return home from dinner on November 23, 1849. John Webster’s laboratory was searched and a tea chest containing human remains was found. In the furnace, fragments of the maxillary jaw were discovered.4,5 At the trial for John Webster, Dr. Nathan Cooley Keep, Dr. Parkman’s dentist, identified the teeth as part of the maxillary and mandibular dentures he made three years earlier for the victim. This was the first time dental evidence was used to convict a murderer. This case is also a great example of how expert testimony was used in court.5
After the shooting of President Lincoln on April 14, 1865, John Wilkes Booth escaped and hid in a barn on a farm in Virginia.4,6 The United States Calvary found him there on April 26, 1865 and burned the barn.4,6 John Wilkes Booth exited the barn and was shot and killed.6 However there was rumor that Mr. Booth had escaped. Therefore in 1893, the body was disinterred and examined to verify that it was John Wilkes Booth.4,6 The family could not perform a visual identification, but the family dentist was able to recognize his work as well as a peculiar formation of the jaw he had noted in his records during a dental visit for the placement of a filling.6
Dr. Oscar Amoëdo returned to Cuba in 1889 after studying at New York Dental College. He was then sent as a delegate to the International Dental Congress in Paris in 1890.4 He decided to stay in Paris and became a dental instructor and teacher, eventually becoming a full professor. While in Paris, he wrote 120 scientific articles. A tragic fire at a charity event stimulated his interest in dental identification and the field of forensic odontology.7 While he was not involved with the identification of the victims from the fire, he knew many of the victims who survived and interviewed them. His accounts of the fire were presented in a paper at the International Medical Congress of Moscow and were published in English in 1897.7 Dr. Amoëdo wrote a thesis entitled “L’Art Dentaire en Medicine Legale”,8 which earned him a doctorate and served as the basis of his book by the same name published in 1898.8 The book he wrote was the first comprehensive text on forensic odontology and he is considered by many to be the “Father of Forensic Odontology”.4,8
After the end of World War II, there were rumors Adolf Hitler had escaped with his wife Eva Braun.4 Actually they had died together in 1945; however their bodies had been burned and then buried by Russian soldiers.4 Due to lack of ante-mortem and post-mortem records, it was a challenge to dispel the rumors they were still alive. Finally pieces of Hitler’s mandible were found that revealed remnants of a bridge as well as unusual forms of reconstruction to the mandible with evidence of periodontal disease.9 Adolf Hitler’s identity was confirmed when the work matched the records kept by his dentist, Hugo Blaschke.9
Several years after the assassination of John F. Kennedy, an English author named Michael Eddowes began raising suspicion concerning the identification of Lee Harvey Oswald.4 He believed the body buried in 1963 in Oswald’s grave was a Russian spy.4 Therefore, to set the record straight, the body was exhumed and positive identification of Oswald was made on October 4, 1981 with military ante-mortem dental records.10
In July of 1979, Theodore “Ted” Bundy was convicted of murder. This may have been the most widely publicized case that involved bite mark evidence. The exhaustive and specific nature of bite registries is to thank, at least in part, for Bundy’s incarceration. Ted Bundy was one of the most notorious serial killers in United States History. He could have been responsible for the deaths of as many as 36 young women from Florida to the state of Washington.11
natural / manmade
Forensic dentistry is an important sub specialty of forensic medicine which is contributing immensely in solving difficult criminal cases and in identification of individuals in mass disasters. The world has experienced many mass disasters like acts of terrorism, bombings, earthquakes, hurricanes, tsunami, railway accidents, air crashes and other transportation mishaps in the recent times.1 In these circumstances, exact identification of an individual becomes difficult as the bodies are charred or destroyed beyond visual recognition. Dental identifications have always played a key role in natural and man made disaster situations as the teeth and jaws resist extreme temperature conditions and can provide a valuable clue in identification of an individual. Disaster victim identification traditionally relies on the combined efforts of police, dentists and pathologists where ante mortem information from the missing persons are compared with post mortem data of the dead persons.2 In some of the cases, dental investigations may fail due to lack of proper ante-mortem records.3 The dental records such as casts, models, radiographs will be very valuable for comparing with post mortem records in cases of mass casualties.4 and
henever a human body or the remains of a human body are found, the police are called for further investigation. The police in turn may make a formal request to the dental authorities to help them identify the individual. At this point in time, a tentative identification is possible by considering the geographical location where the body was found, the physical features, the available wallet or driving license or any other personal belonging of the deceased individual. This tentative identification may help in narrowing the search for ante mortem records with which a possible identification may be established with a degree of certainty. [8] Dental identification of an individual can be made mainly by two methods namely
When antemortem dental records are unavailable and other methods of identification are not possible
When antemortem dental records are unavailable and other methods of identification are not possible, the forensic dentist can assist in limiting the population pool to which the deceased is likely to belong and thus increase the likelihood of locating antemortem dental records.2 This process is known as postmortem dental profiling. The information from this process will enable a more focused search for antemortem records. A postmortem dental profile will typically provide information on the deceased’s age, ancestry background, sex and socio-economic status. In some instances it is possible to provide additional information regarding occupation, dietary habits, habitual behaviours and occasionally on dental or systemic diseases.
Forensic anthropologists most often provide details of osteological studies, but forensic dentists can assist in the process.17-22 The determination of sex and ancestry can be assessed from skull shape and form. Generally, from skull appearance, forensic dentists can determine race within the three major groups: Caucasoid, Mongoloid and Negroid. Additional characteristics, such as cusps of Carabelli, shovel-shaped incisors and multi-cusped premolars, can also assist in determination of ancestry Figure 2.23 Sex determination is usually based on cranial appearance, as no sex differences are apparent in the morphology of teeth. Microscopic examination of teeth can confirm sex by the presence or absence of Y-chromatin and DNA analysis can also reveal sex.24, 25
Dental structures can provide useful indictors to the individual’s chronological age.22 The age of children (including foetuses and neonates) can be determined by the analysis of tooth development and subsequent comparison with developmental charts. Conclusions are usually accurate to approximately ±1.5 years. Charts such as those developed by Ubelaker graphically illustrate the development of the dentition from 5 months in utero to 35 years, illustrating the deciduous, mixed and permanent dentitions.2
natural / manmade
Congenital and acquired characteristics of the teeth are compared between the antemortem and postmortem records. Wear, acquisition of additional treatments, etc. over the period of time between the two records can mean that direct superimposition of one record over the other without discrepancy is not possible. Discrepancies may exist in forensic physical comparisons and still result in identification of the records as originating from the same person. But these discrepancies must be explainable through the passage of time or treatment, etc. [3]. As with all forensic physical comparison disciplines, if unexplainable discrepancies exist then the records cannot represent the same person
Forensic dentistry is an important sub specialty of forensic medicine which is contributing immensely in solving difficult criminal cases and in identification of individuals in mass disasters. The world has experienced many mass disasters like acts of terrorism, bombings, earthquakes, hurricanes, tsunami, railway accidents, air crashes and other transportation mishaps in the recent times.1 In these circumstances, exact identification of an individual becomes difficult as the bodies are charred or destroyed beyond visual recognition. Dental identifications have always played a key role in natural and man made disaster situations as the teeth and jaws resist extreme temperature conditions and can provide a valuable clue in identification of an individual. Disaster victim identification traditionally relies on the combined efforts of police, dentists and pathologists where ante mortem information from the missing persons are compared with post mortem data of the dead persons.2 In some of the cases, dental investigations may fail due to lack of proper ante-mortem records.3 The dental records such as casts, models, radiographs will be very valuable for comparing with post mortem records in cases of mass casualties.4 and
henever a human body or the remains of a human body are found, the police are called for further investigation. The police in turn may make a formal request to the dental authorities to help them identify the individual. At this point in time, a tentative identification is possible by considering the geographical location where the body was found, the physical features, the available wallet or driving license or any other personal belonging of the deceased individual. This tentative identification may help in narrowing the search for ante mortem records with which a possible identification may be established with a degree of certainty. [8] Dental identification of an individual can be made mainly by two methods namely
due to the great resistance to the agents who provoke the destruction of the soft tissues in the corpses (putrefaction, traumatic, physical and chemical agents)
due to the great resistance to the agents who provoke the destruction of the soft tissues in the corpses (putrefaction, traumatic, physical and chemical agents)
Details of restorative materials used; retentive pin or post type, location, and length; shades and moulds of prosthetic teeth; and notes
A new element for identification is the dental implant about unusual findings or treatments are but a few examples of traits that have been crucial to a successful outcome
tended to The molars appeared to be more frequently restored at a relatively younger age and more frequently missing in the elderly
Details of restorative materials used; retentive pin or post type, location, and length; shades and moulds of prosthetic teeth; and notes
A new element for identification is the dental implant about unusual findings or treatments are but a few examples of traits that have been crucial to a successful outcome
If the post-mortem radiographs are accurate duplicates of
ante-mortem radiographs of composite restorations, then
the shape of the composite restoration is unique and the
radiographic image can be used for successful identification.
This preliminary investigation was carried out with the
radiographs taken with absolute standardization. In real
The compound amalgam restoration has a unique radiographic morphology and can be readily identified in both antemortem and postmortem data
A variety of composite resins are available in
the market, each having varying degree of radiopacity.
The radiopacity of a composite restoration is an important
property which helps in assessment of marginal overhangs,
open gingival margins, interproximal caries, and recurrent
caries. The radiopacity of composites also plays a significant
role in forensic dentistry as it is very important for
identification purposes.[31-33] In this study, the composite
brand Tetric N-Ceram was used which has a radiopacity
of 400% aluminum.[34,35
life such exact ante-mortem and post-mortem radiographs
may not be possible due to factors like wear and fracture of
the restoration, change in dentition and radiological errors.
Further research can be done by conducting similar studies
in patients with long-standing composite restorations which
will mimic real-life situation.
The aim of this study was to investigate the possibility of differentiating between various dental restorative materials by means of their radiopacity. Ten extracted molars and ten canines/anterior teeth were selected for the study. In the molar group a class II cavity and in the canines/anterior teeth group a class III cavity were cut by airrotor. The cavities were coated with vaseline before filling with five molar- and three anterior tooth restorative materials in the following sequence: for molars: amalgam, light-cured composite, glass ionomer cement, reinforced glass ionomer cement and light-cured composite. After each filling sequence radiographs were taken of the teeth on conventional film (Ektaspeed Plus) and by two digital systems: a storage phosphor plate (Digora) and a ccd-based sensor (Sidexis). Density was measured in the films with a densitometer in three areas of "air", in three areas of the class II fillings and one area of the class III fillings. The same areas were measured in the digital images where the program calculated automatically the mean grey shade values. The density values obtained from the filling areas were taken as a proportion of the values obtained from the areas of "air". Statistically significant differences in material density when related to "air" density (Wilcoxon's test) were observed between all materials in film (p < 0.01 for molars and p < 0.02 for canines/anterior teeth). For Digora only half of the materials differed significantly which was also the case for the Sidexis system (none of the CF materials were significantly different). In conclusion, the molar filling materials could be distinguished with a high probability in film while the two digital systems were less reliable. The results may be useful in forensic dentistry
An electron microprobe (EMP), also known as an electron probe microanalyzer (EPMA) or electron micro probe analyzer (EMPA), is an analytical tool used to non-destructively determine the chemical composition of small volumes of solid materials. It works similarly to a scanning electron microscope: the sample is bombarded with an electron beam, emitting x-rays at wavelengths characteristic to the elements being analyzed. This enables the abundances of elements present within small sample volumes (typically 10-30 cubic micrometers or less) to be determined.[1] The concentrations of elements from boron to plutonium can be measured at levels as low as 100 parts per million (ppm). Recent improvements on EMPAs (e.g. the Cameca SX100 with five oversized PET crystals for trace element analysis) can accurately measure elemental concentrations of approximately 10 ppm.
produce excited atoms and ions that emit electromagnetic radiation at wavelengths characteristic of a particular element
Detection of silver-amalgam and gold restorations pre-
sents little difficulty to the forensic odontologist [4], but
anterior restorations are normally tooth-coloured. New
composite, compomere and ceramic filling materials imi-
tate the natural hard tissue as perfectly as possible in pig-
mentation and translumination.
Plastic fissure sealants are used in caries prophylaxis.
Jakobsen et al. [10] published a forensic case in which the
detection of such fissure sealants by scanning electron mi-
croscopy (SEM) was the only aid to positive identifica-
tion.
sed dyes that pene-
trate the restoration slits forming the boundary of the
restoration. The dye techniques are based on a discrep-
ancy and the existence of a gap between the filling mater-
ial and the hard tissue cavity. The absence of a gap means
that detection is not possible; therefore, perfectly polished
and well placed fillings cannot be recognized.
ooth-fillings consist of an organic matrix and an inorganic filler material. The organic matrix burns off, leaving the filler particles behind. This allows an analyst to identify a brand or at least brand group. Manufacturers use as many as fifty different filler types, any of which will show up brightly on a dental x-ray. Once identified as dental filling, the elemental composition and microstructure can be studied for its classification, based on a distinct chemical signature. While this is still class evidence (indicating one of a group) rather than uniquely identifying evidence, it does allow investigators to narrow down possibilities. Katie could at least be eliminated if it did not match her dental work.
The gold standard for identification of the dead
is the visual dental record
veral authors
emphasize computed tomography (CT) as valuable sup-
portive tool for forensic medicine
Due to dental overlays and corresponding artifacts, the definite periphery of the dental fillings/inlays was not accurately defined resulting in 2.9% incorrect and 64.1% false negative findings, especially synthetic inlays were hardly or not recognizable at all
The gold standard for identification of the dead is the visual dental record. In this context, several authors emphasize computed tomography (CT) as valuable supportive tool for forensic medicine. However, studies focusing on diagnostic accuracy of post-mortem computed tomography (PMCT) are still missing
nt J Legal Med. 2008 Jul;122(4):301-7. doi: 10.1007/s00414-008-0224-8. Epub 2008 Mar 12.
Ultra-high-resolution dual-source CT for forensic dental visualization-discrimination of ceramic and composite fillings.
Certainly, the major advantage of the CT
technique is the possibility to adapt the direction of post-
mortem dental 3D-CT to the ante-mortem X-rays at the
time of comparison
isadvantage in terms of streak artefacts resulting from
metallic dental works is still present decreasing the 3D
image quality
Obviously, a lot of time would be needed
just to scan one corpse for identification even though
performing a whole body post-mortem CT including dental
CT.
examiners
’ detailed documentation
of the single tooth or dental restoration is less precise and
hard to assess compared to classical dental radiographs
Experience
s a consequence,
CT-based identification should only be performed by highly
trained and experienced personne
The International Criminal Police Organization (INTERPOL) plays a number of significant roles in various aspects of criminal investigations, missing person files, human trafficking, smuggling of drugs and contraband, and other related crimes that extend across international boundaries. Created in 1923, the organization facilitates cross-border police cooperation and supports and assists all organizations, authorities and services whose mission is to prevent or combat international crime. At this time, 188 member countries make up the INTERPOL organization.enable faster, more accurate transmission of dental evidence and computer-aided comparison speeds up and refines the search for the perfect “match” – from CAPMI and Toothpics® to WinID
computer-based dental chart matching software
The most practical method by which masses of data can be compared is through use of computers ( circularization of dental records is futile will not trigger recall by a practising dentist unless dental coditions are extraordinarily unusual
The International Criminal Police Organization (INTERPOL) plays a number of significant roles in various aspects of criminal investigations, missing person files, human trafficking, smuggling of drugs and contraband, and other related crimes that extend across international boundaries. Created in 1923, the organization facilitates cross-border police cooperation and supports and assists all organizations, authorities and services whose mission is to prevent or combat international crime. At this time, 188 member countries make up the INTERPOL organization.enable faster, more accurate transmission of dental evidence and computer-aided comparison speeds up and refines the search for the perfect “match” – from CAPMI and Toothpics® to WinID
computer-based dental chart matching software
The most practical method by which masses of data can be compared is through use of computers ( circularization of dental records is futile will not trigger recall by a practising dentist unless dental coditions are extraordinarily unusual
The abduction was recorded on the store's videotape surveillance system, but the poor resolution of the images on the video did not allow the police to deteamong ashes inside a fire pit on Blom's property, searchers found fragments that appeared to be bone. These went to a lab for further testing. They were positively identified as bone fragments and possibly a tooth, which was sent to odontologists, experts in dental remains
rmine the abductor's identity with any certainty
forensic scientist in the Bureau of Criminal Apprehension's (BCA) microanalytical section testified that the tooth recovered from Blom's fire pit was consistent with a human tooth number 18 that had been treated with a dental amalgam that had been bonded to the tooth with Rely X ARC
Based on comparisons between the tooth and jaw-bone fragments found in the fire pit and Poirier's dental x-rays and medical records, the state's two forensic dentists testified that, to a reasonable degree of medical certainty, the tooth belonged to Poirier. The dentists' conclusions were based on the following findings:
(1) The recovered tooth and Poirier's tooth (lower left second molar, number 18) both had an extra, distinctively similar-looking root. Typically, tooth number 18 only has two roots.
(2) A comparison of Poirier's dental x-rays of 1994 and 1997 to x-rays of the recovered tooth and jaw fragments revealed various conformities in root size and shape, tooth structure, and physical characteristics of the area where the tooth was filled.
(3) The recovered tooth contained zirconium and silicon on its surface in roughly the same proportions present in a bonding agent used for a cavity filling called Rely X ARC, which bonding agent was used on Poirier's tooth for a cavity filling approximately two weeks before her disappearance and was only first introduced to the market approximately three months before it was used on Poirier's tooth.
(4) The recovered tooth contained a small amount of zinc, which was used in an earlier filling of Poirier's tooth in 1991.
(5) Both the recovered tooth and Poirier's tooth had been filled using the acid-etch method of cavity filling.
For many forensic dentists, the identification of found human remains will comprise the majority of their criminalistic work. However, there is rarely a typical dental identification. The resilience of teeth and their supporting tissues to peri- and postmortem assaults provides a wealth of information for those interested in the identity of the deceased. Chemical attack, burning, burial, submersion, and even severe head and neck trauma are all withstood by the dentition to an extent where identification is possible. The lack of a tentative identification or failure to locate dental or similar antemortem records is a more common reason for an odontological investigation to fail
Antemortem dental data is customarily available for patients in developed countries, but the absence of such data either in these countries for patients that do not seek dental care or in other under developed countries is the main reason why bodies cannot be identified using forensic dental means. Despite the significant role of forensic dentists in recovering the best possible postmortem data, some decedents will remain unidentified. This is primarily because of the absence of suitable antemortem data, but, unfortunately, this is sometimes due to poor quality records originating from the dental office. Another reason why cases remain unsolved is that dental records may not be kept over a long period of time, and thus will not be available after several decades when a body – the victim of a homicide that has remained unfound for many years, for example – may be discovered.
Dr Ashith B Acharya, whose DNA report played a vital role in the conviction of the four Delhi gang-rape accused
