Morphometric and Volumetric Evaluation of Maxillary Sinus as an Aid in Sex Identification in Forensic Odontology-A Cone-Beam Computed Tomography Study

Background:Various methods are used in forensic odontology for the purpose of sex and personal identification.Some of them include cheiloscopy,rugoscopy,mandibular measurements,and study of paranasal sinuses.In our study,we have used maxillary sinus as an aid in sex identification.For this purpose,we have evaluated the morphometric and volumetric measurements of the maxillary sinus using a 3-Dimensional imaging modality,Cone Beam Computed Tomography.Aims and Objectives:Sex and age identification are important in the process of identification of both the living and the dead.Hence,this transverse retrospective study was done to appraise the precision of the dimensions and volume of the maxillary sinus to aid in sex and age identification.Material and Methods:Eighty full Field of View(FOV)Cone-Beam Computed Tomography(CBCT)images were retrieved from the archives which were matched with age and sex.The maxillary sinuses on either side were measured mediolaterally in the axial section and supero-inferiorly in the coronal section.The volumetric analysis of the sinus was done in the sagittal section.The sex was classified using discriminant function analysis and the differences were compared using independent t-test.The differences with age were analyzed using one-way ANOVA.Results:Independent t-test was done for comparison of the sinuses between both sexes.Maxillary sinuses measurements were larger among the males both superior-inferiorly on either side(P<0.001)and mediolaterally on the right(P<0.049)showed statistically significant values.A significant correlation existed while comparing the maxillary sinus volume among both the sexes on either side(P<0.001 and<0.002 in the case of right and left respectively).On comparing the supero-inferior and mediolateral measurements and the maxillary sinus volume on either side among the various age groups,the values were statistically insignificant.Present study shows that the maxillary sinus measurements using Cone-beam computed tomography were diagnostic in the identification of sex but not in age estimation and can be used in forensic dentistry.

Forensic odontology in DVI:current practice and recent advances

Forensic odontology frequently plays a significant role in identification of the victims of multi-fatality disasters,but not in all.It depends on adequate dental remains surviving the disaster and on the availability of dental records to be successful.This paper describes current practice in the techniques of identification in forensic odontology and outlines recent advances that are moving into the mainstream.

Forensic odontology identification response to terrorist attacks in Paris November 2015

The terrorist attacks of November 2015 led to the immediate death of 129 victims admitted to the Legal and Forensic Medicine Institute of Paris,including 41 unidentified.During the Disaster Victim Identification(DVI)operations,22 bodies were examined by the postmortem(PM)dental team with the aim of establishing PM odontograms.At the same time,the dental expert in the antemortem(AM)unit collected a large number of dental files,progressively filtered as the list of missing persons became reduced.Feedback from these events has highlighted the difficulties of implementing the DVI chain principles in a legal framework,published the day before the attacks,and also the technical complexity of collecting dental data on a week end of terror.The return on experience after this event has represented a paradigm shift on previous methods of DVI in Paris and even more in France.Indeed,the victim identification procedure was redesigned,integrating new technical means such as a CT scan directly on spot,allowing the extraction of maxillofacial data as soon as possible in order to support the PM dental examination team.Moreover,the National Dental Council proceeded to the overall remodeling of the dental identification unit,which is composed of trained members,from local,regional and national aspects.These forensic experts are dedicated,at the request of the legal authorities,to DVI operations and deployed throughout the country capable of managing AM and PM data.This unit aims also to share experiences and awarenessraising among health professionals and investigators in order to optimize a better submission of AM elements and also to enhance the major interest of odontology as a primary identifier in disaster.

Recent Advances in Forensic Odontology:An Overview

Forensic odontology is a branch of forensic sciences that uses the skill of a dentist in personal identification during mass calamities,sexual assault,and child abuse to name a few.Forensic odontology is an evolving science and has a greater scope of development.Recent advances in the field of genetics and molecular biology have contributed to the rapid growth of forensic odontology.In case of a crime scene,forensic odontologists play a major role in investigating and interpreting dental evidence.Forensic odontologists utilize the knowledge of dentistry in bite mark analysis,fixation of identity in mass disasters,and age estimation.Thus,the duty and responsibility of forensic odontologists has increased in recent years.Therefore,practicing dentists and dental students should be made aware of the available newer technologies and its use in forensic dentistry.This article gives an overview of recent advances used in identification in forensic dentistry.

Platelet rich plasma(PRP)induces autophagy in osteoblast precursor 3T3-L1

Autophagy is an essential cellular homeostatic mechanism by which intracellular components are delivered into the lysosomes for degradation and recycling.Autophagy has been related with a diversity of pathological or physiological dentary processes such as bone remodeling,skeletal aging,osteoclastogenesis,osteoblastogenesis and different types of oral cancer.Platelet-rich plasma(PRP),isolated from autologous blood,is a plasma preparation containing a higher concentration of platelets which contains numerous different growth factors and cytokines that activate several cellular signaling cascades.The purpose of this study is to investigate the effect of PRP on autophagy stimulation in both osteoblast precursor 3T3-L1 and non-related osteoblastic cells.Our results showed that PRP can increase the number of autophagic structures in 3T3-L1 and HeLa(cervical cancer cells)cells.Moreover,we have determined by Western blot a rise in the lipidated form of the autophagic protein LC3(i.e.LC3-II)upon PRP treatment.Taken together,our results suggest that PRP is able to induce a strongly autophagy response in osteoblast precursor and,to a lesser extent,in non-related osteoblastic cells,suggesting that PRP could be a potential therapeutic tool for some autophagy-related diseases associated with bone homeostasis.

Left-Handed Students and Clinical Practice in Dentistry: Adaptations, Difficulties and Realities Experienced in the Academic Environment

Objectives: To verify the existence of difficulties throughout the course of dentistry clinical practices, identify musculoskeletal pain, and evaluate frequency and intensity of pain/discomfort (if existent) in different regions of the body, experienced by left- handed students in comparison to right-handed students of the odontology courses of the state of Rio Grande do Norte (Northeast Brazil). Methods: A general questionnaire was applied to identify left-handed students in a population of 750 students, enrolled in clinical courses. An adaptation of the Grad-Corllet Diagram and a specific questionnaire on clinical practices were applied to the selected students. Descriptive statistics was utilized to analyze data of the specific questionnaire, and Mann-Whitney statistics, chi-square or Fisher’s Exact tests (with a 5% significance level) were utilized for the Grad-Corllet Diagram, searching for an association be- tween discomfort/pain in different body regions and manual laterality. Results: All students presented higher percentage of pain in the lumbar and neck/cervical re- gions. However, left-handed students presented higher values, with statistical signifi- cance levels of p = 0.041 for lower back, p = 0.002 for neck and p = 0.003 for cervical region. Conclusions: The majority of left-handed students classified “moderate” the difficulty of working with equipment designed for right-handers. There was high frequency of musculoskeletal pain/discomfort, with relevant statistical results for left- handed students regarding intensity. It is suggested that the participating institutions evaluate the adoption of inclusion politics, re-adapt the infrastructure to include equipment designed for left-handers, and finally provide adequate work conditions for all students.

Morphologic,Radiographic,and Stereomicroscopic Evaluation of Teeth Subjected to High Temperatures:An In vitro Forensic Study

Background:To evaluate morphologic,radiographic,and stereomicroscopic changes of teeth when subjected to specific high temperatures in both direct heat and gradual heat and to compare the changes among two heat groups and also among different types of teeth.Materials and Methods:An in vitro study was conducted on 90 healthy extracted human teeth,in which the teeth were divided into two groups.Group 1(45)was subjected to direct heat and Group 2(45)was subjected to gradual heat.Group 1 and Group 2 were further subdivided into three subgroups(A)anteriors,(B)premolars,and(C)molars each consisting of 15 teeth.Teeth were subjected to temperatures of 200°C,400°C,600°C,800°C,and 1000°C in a muffle electric furnace.The color changes were noted using the Revised Munsell soil color chart and the radiographic and stereomicroscopic changes were evaluated.The results obtained were subjected to statistical analysis.Results:Teeth in direct heat showed more destructive changes at lower temperatures,i.e.,400°C and 600°C when compared to gradual heat where changes are observed at 600°C and 800°C.Among different types of teeth,anteriors and premolars showed more changes when compared to molars.Interpretation and Conclusion:It can be concluded that dental evidence may provide clues to solve the mystery in fire investigations as dental structures are the last to be destroyed under extreme conditions,whether temperature,acid,or putrefaction.

Personal identification and missing persons initiatives in Santa Catarina state,Brazil:forensic perspectives from 2019 to 2021

Santa Catarina is a small,developed,and relatively safe state in South Brazil.Despite having positive social economic indicators,it still faces multiple challenges regarding forensic practices for personal identification.The objective of this paper is to discuss the recent advances and current challenges in the region,from the perspectives of anthropological and dental postmortem human identification,missing persons,and disaster victim identification(DVI)from 2019 to 2021.The recent creation of a Forensic Anthropology Sector(SAF)in the state’s official forensic institution(Polícia Científica-PCI)has significantly improved identification of unidentified remains and optimised resources available for DNA analysis.However,SAF is still quite understaffed,which negatively affects the recovery of skeletal material,its preparation,and the time needed for filing reports.Santa Catarina has passed legislation for missing persons in 2015,4 years prior to the sanction of federal laws implementing the national policy for the disappeared.Nonetheless,a lack of integration between stakeholders remains a problem that PCI has tried to circumvent with the Conecta Programme,a multidisciplinary and integrated initiative between families of the missing persons,police agencies,and the Public Ministry.The programme aims to collect not only reference DNA samples,but also relevant anthropological and dental data.It also offers facial progression services in cases of disappearances that occurred many years ago.Despite a history of disasters in the state,PCI still needs to implement international DVI standards at an institutional level.Recent training on Phase 1 DVI procedures,integrated with other responding institutions,indicates better preparation for future disasters.There are many challenges ahead for Santa Catarina’s forensic institution and professionals that have yet to be addressed,but the overall situation on routine personal identification,missing persons initiatives,and DVI has improved over the last 2 years.

Comparing the accuracy of Demirjian and Nolla methods and establishing a new method for dental age estimation in northeastern Chinese children

Dental age estimation plays an important role in the field of clinic medicine and forensic medicine.The Demirjian and Nolla methods are common scoring methods for dental age estimation but there was no research about the comparison of accuracy of these two methods in northeastern Chinese children.Hence,in this study,we compared the accuracy of these two methods to explore more suitable method for our studied population.We collected 535 orthopantomograms from northern Chinese children aged from 6 to 15 years and divided them into training dataset and testing dataset according to the ratio of 7:3.The dental age of training dataset were estimated using Demirjian and Nolla methods,respectively.The results suggested that the mean differences of these two methods were 0.24 and−0.40 years,and mean absolute difference were 0.65 and 0.59 years.Then to further improve the accuracy of dental age assessment,the new improved formulas and dental age conversion tables were established after analyzing the relationship between the sum scores based on Nolla method and chronology age in training dataset.According to the new method used in testing dataset,the minimum value of mean difference(0.00)and mean absolute difference(0.49)were obtained,which are largely smaller than that of Demirjian and Nolla methods.The new developed method and dental age conversion scales may be more suitable dental age estimation method for northeastern Chinese children.

Can canines alone be used for age estimation in Chinese individuals when applying the Kvaal method?

Due to the secondary dentin formation,the dental pulp undergoes changes in shape throughout life.Based on this phenomenon,the Kvaal method has been applied to various populations for age estimation,and its usefulness has been verified.When applying the Kvaal method to Chinese subjects,we observed a relatively strong correlation between mandibular canines and age.This study notes the correlation between canines and chronological age and is the first to identify which canine is most closely related to chronological age.In addition,a new,simpler formula is determined based on canines according to Kvaal’s methodology.The radiographs of 360 individuals from northern China were selected,from which the widths and lengths of the pulp from four canines were measured according to the Kvaal method.Next,inter-and intra-observer reliabilities were analyzed in order to assess the repeatability of these measurements.The correlation between measurements and age was examined,and Chinese-specific age estimation formulae were derived.The results revealed that the ratios from the left maxillary canine exhibited the strongest correlation with age compared to the other canines,whereas the left mandibular canine showed the weakest correlation,which may contribute to the overall poor correlation of mandibular canines with age.What’s more,the formula derived from the left maxillary canine in this study displayed the highest coefficients of determination,and the formula derived from all canines showed the lowest residuals.Both of these formulae performed better than the Chinese-specific formula derived from six different types of teeth in our previous study,which had formerly possessed the highest coefficients of determination and the lowest residuals.Thus,we concluded that canines do play an important role in age estimation in the Chinese population,and the correlation between maxillary canines and chronological age is stronger than that of mandibular canines,although no distinct trend as to which side is better correlated with age was established.Going forward,we recommend the analysis of additional samples from different geographical regions and populations to further verify the importance of canines in age estimation.

The need for a complete dental autopsy of unidentified edentulous human remains

In December 2017,a decomposed unidentified body was found near the river Tronto in Teramo,Italy.The corpse was found without any identifying documents or specific personal belongings,except for a packet of cigarettes.The medical examiner determined a gastric perforation from the intake of hydrochloric acid to be the cause of death.A jar of muriatic acid found near the body led to suicide being considered the manner of death.The Penal Court in Teramo appointed two forensic odontologists to complete the postmortem assessment and collect dental data for personal identification.The corpse was found wearing a complete set of upper and lower dentures.The dental autopsy and 42 periapical X-ray images helped generate a biological profile of a man totally edentulous with upper and lower dentures,as well as an osteosynthesis with two plates and screws in the left ascending ramus of the mandible.In March 2018,the sister of a missing person reported the disappearance of her brother,and a presumptive identification was performed through visual recognition of the decomposed body.The sister confirmed the presence of two dentures and the location of the maxillo-facial surgery for the treatment of the fractured mandible.A complete dental autopsy was able to establish his identity without any DNA comparison needed.This case highlights the importance of performing a complete dental autopsy inclusive of dental radiographs,and its value in the identification of all unknown human remains even when totally edentulous.A complete dental autopsy should be performed in all cases of human identification.

Automatic detection of teeth and dental treatment patterns on dental panoramic radiographs using deep neural networks

Disaster victim identification issues are especially critical and urgent after a large-scale disaster.The aim of this study was to suggest an automatic detection of natural teeth and dental treatment patterns based on dental panoramic radiographs(DPRs)using deep learning to promote its applicability as human identifiers.A total of 1638 DPRs,of which the chronological age ranged from 20 to 49 years old,were collected from January 2000 to November 2020.This dataset consisted of natural teeth,prostheses,teeth with root canal treatment,and implants.The detection of natural teeth and dental treatment patterns including the identification of teeth number was done with a pre-trained object detection network which was a convolutional neural network modified by EfficientDet-D3.The objective metrics for the average precision were 99.1%for natural teeth,80.6%for prostheses,81.2%for treated root canals,and 96.8%for implants,respectively.The values for the average recall were 99.6%,84.3%,89.2%,and 98.1%,in the same order,respectively.This study showed outstanding performance of convolutional neural network using dental panoramic radiographs in automatically identifying teeth number and detecting natural teeth,prostheses,treated root canals,and implants.

Age estimation of individuals aged 5-23 years based on dental development of the Indonesian population

Dental development can be used to estimate age for forensic purposes.However,most of the currently available methods are less reliable for the Indonesian population due to population variability.This study presents a new method and evaluates other methods that utilize dental development to estimate the age of Indonesian people.Panoramic radiographs of 304 young Indonesian people aged 5–23 years old were analysed for deciduous tooth root resorption,permanent tooth calcification,and eruption.The extent of tooth root resorption was determined based on AlQahtani’s modified Moorrees et al.method.Tooth calcification was classified based on a modified Demirjian et al.method.Tooth eruption was evaluated based on AlQahtani’s modified Bengston system.The sequence of tooth root resorption,and permanent tooth calcification and eruption were grouped into 19 age categories(from 5–23 years old)in an atlas.The differences between males and females,between maxillary and mandibular teeth,and between right and left teeth were also analysed.There were minimal significant differences of tooth development between males and females,and between the right and left teeth(P>0.05),while the maxillary and mandibular dental development was significantly different(P<0.05).The newly developed atlas showed the development of the right side of maxillary and mandibular tooth of combined sex of Indonesian population.Another 34 panoramic radiographs of known-age and sex individuals from Indonesia were assessed using the newly developed Atlas of Dental Development in the Indonesian Population,Ubelaker’s Dental Development Chart,The London Atlas of Human Tooth Development and Eruption by AlQahtani,and the Age Estimation Guide-Modern Australia population by Blenkin-Taylor.Accuracy was assessed by comparing estimated age to actual chronological age using the Bland-Altmand test.Results show that the smallest range of error was found in the Atlas of Dental Development in the Indonesian Population(−0.969 to 1.210 years),followed by The London Atlas of Human Tooth Development and Eruption by AlQahtani(−2.013 to 1.990 years),the Age Estimation Guide-Modern Australia population by Blenkin-Taylor(−2.495 to 2.598 years),and the Dental Development Chart by Ubelaker(−2.960 to 3.289 years).These findings show that the Atlas of Dental Development constructed in this study performs better than the other three methods and presents greater accuracy of age estimation in the Indonesian population.

Digital reconstruction of fragmented tooth remains in forensic context

Forensic odontology majorly focuses on the identification of victims through the analyses of oral and para-oral structures.Exposure to high temperatures and trauma can occur in mass disasters and may lead to the fracturing and fragmentation of teeth.These fragments may become very fragile and easily damaged while handling.Conventional methodologies such as the use of transparent nail polish,hair spray,cyanoacrylate or adhesives have been used to stabilise the fragmented pieces.This study introduces a new and innovative digital technique that utilises three-dimensional surface scanning(3DSS)and rapid prototyping techniques to reconstruct fractured portions of the teeth.The results of qualitative congruency analysis suggest that over all variance of morphological error(0.0526±0.05)mm.These results imply that the reconstructed 3D model can be used for various morphometric analyses.

Assessment of Knowledge,Attitude,and Practice in Forensic Dental Anatomy and Histology among Dental Practitioners

Dental anatomy and histology is one of the fundamental subjects and a key to comprehend the act of dentistry.Dental features such as tooth morphology and variations in shape and size play a vital role in the area of forensic odontology.Forensic odontology is a challenging field that involves the application of such knowledge of dental sciences in the identification of deceased individuals.The aim and objective was to assess and evaluate the knowledge,attitude,and practice regarding dental anatomy and histology in forensic investigation among dental practitioners.A cross-sectional survey was carried out among 217 dental practitioners from Maharashtra who in their day-to-day life may experience instances of forensic interest.The information was collected through telephonic interview by means of a pretested,close-ended questionnaire.In our stud%the general awareness about forensic odontology was found to be more among MDS dental practitioners than BDS dental practitioners.Overall,there is a lack of adequate legal knowledge and forensic practices among the dentists of Mumbai and Nagpur.However,the practitioners did have a positive attitude toward the field and were keen to learn more about it.The study is the first of its kind to be conducted in Maharashtra state of India regarding dental anatomy and histology with respect to forensic odontology.The dental practitioners were also aware about the dental anatomy and dental histology with respect to forensic investigation.

Significance of Dental Records in Personal Identification in Forensic Sciences

Forensic odontology is a branch that connects dentistry and the legal profession.One of the members in the forensic investigation team is a dentist.Dentists play an important and significant role in various aspects of the identification of persons in various forensic circumstances.However,several dentists and legal professionals are quite ignorant of this fascinating aspect of forensic odontology.A need was felt to fill this gap.The dental record is a legal document possessed by the dentist and it contains subjective and objective information about the patient.A PubMed search and Google search were done for articles highlighting the importance of dental records in forensic sciences using the key words“forensic odontology,forensic dentistry,forensic dentists,identification,dental records,and dental chart”.A total of 42 articles relevant to the title of the article were found and reviewed.The present article highlights the role of dentists in forensic sciences,their possible contributions to forensics,and the various aspects of forensic dentistry,thus bridging the gap of knowledge between the legal and the dental fraternities.

Journey of DNA Evidence in Legal Arena:An Insight on Its Legal Perspective Worldwide and Highlight on Admissibility in India

DNA profiling is one of the powerful breakthroughs in forensics.This specialized technique has made the identification of an individual possible even by a tiny shred of tissue or drop of blood thus,has strongly revolutionized various criminal investigations.Rape,paternity,and murder cases are the type of criminal cases commonly solved by the use of this technique.It has been recently introduced to forensic odontology and is also used frequently.Although this is a powerful and reliable scientific technique but its forensic use is a major contribution to the debate on law reform.The application of DNA profiling in the criminal justice system,i.e.,the admissibility of DNA evidence in court of law is an important issue which is being faced by the courts and forensic experts worldwide today.Thus,a proper legal outlook is required while dealing with this kind of scientific evidence.Therefore,this review intends to make forensic experts/odontologists aware about the admissibility of DNA evidence in court,with a highlight on the laws related to the admissibility of evidence worldwide,having a special focus on the laws related to admissibility of evidence in Indian judicial system.For this review,the literature was overviewed from articles on DNA evidence and admissibility retrieved by searches on electronic databases such as Google,PubMed,and EMBASE from 1975 through July 2015.

Lip Traces in Forensic Science

Cheiloscopy is a study of lip prints which helps in the identification of humans based on lip traces.It is based on the fact that the pattern of lines on the red part of human lips is unique to each human being.The aim of the present study is to ascertain whether lip prints have the potential for assessment of sex of an individual from the configuration and to identify the most common pattern.Lip prints were collected and matched according to Suzuki and Tsushihashi's classification.The most common pattern found in female was Types I and?,while Type IV and Type V were predominant among males.Studies show that lip prints have a great potential to establish individuality,show gender variation,and remain unchanged forever.

Prediction of Facial Profile Based on Morphometric Measurements and Profile Characteristics of Permanent Maxillary Central Incisor Teeth

The computation of facial profile from dental morphometrics has been a subject of great interest in forensic odontology.The use of teeth to draw a profile and facial features is valuable in times of mass disasters when body remains are unavailable due to extreme destruction.This study aims to identify and evaluate applicable parameters in the permanent maxillary central incisors and the face of an individual.A correlation of these parameters establishes a mathematical equation that further charts a tooth‑facial profile table.Thirty soft and hard tissue landmarks on the face in the frontal and the lateral profiles(using standardized photographs)and seven landmarks on the facial/labial surface of the clinical crown of the permanent maxillary central incisor(using casts of the maxilla)were identified for the study.Based on these,a set of eight horizontal and seven vertical parameters on the face and four parameters on the tooth were created for the assessment.Internal and external correlations between the two were carried out and statistically analyzed.A logistic regression was made to predict the probability of the parameters most likely to be reproduced in the creation of the facial profile,based on tooth morphometrics.The results indicated a definite correlation between the facial and the tooth parameters.Among the multiple parameters,a definite correlation in the horizontal dimension could be established between the mouth width and the mesiodistal width(MDW)of the tooth.In the vertical dimension,a definite relationship existed between the crown height of the tooth and the width of the midface(zygoma‑mandible).There exist divergences in the correlation of tooth and facial parameters.