Journal of Forensic Odonto-Stomatology最新文献

A survey was conducted of the dental professional liability cases adjudicated (post-appeal) throughout the Brazilian territory during the years 2022 and 2023. Data was retrieved from the Jusbrasil website (www.jusbrasil.com.br), and the characteristics of the lawsuits were assessed and compared with those reported in previous studies. The query entered into the "case law search" field was "dental professional liability". An assessment was conducted of 472 rulings referring to 2022 and 447 rulings referring to 2023 in which the dentist was convicted in 61% and 68% of the cases, respectively. There was no increase in the number of cases between the years included in the assessment; however, an increase did occur in the number of cases when compared to that reported in another methodologically similar study. An expert's report was solicited by the court in 75% of the cases. The most frequently involved specialties were implant dentistry and prosthodontics, and there was a tendency toward an increase in lawsuits involving companies as opposed to individuals. The amounts awarded for moral and aesthetic damages ranged from US$ 299.00 to US$ 19,960.00. The highest mean value awarded for moral damages involved the specialty of oral & maxillofacial surgery and traumatology, whereas the lowest mean value was associated with restorative dentistry. The amount most frequently awarded in convictions across the two years included in the survey was US$ 1,954.00. The adoption of preventive measures can potentially reduce the number of new cases, convictions and financial losses resulting from civil liability lawsuits.

Background: Unilateral cleft lip and palate affects dental and skeletal maturation, leading to delays that impact treatment planning and forensic age estimation. Understanding the correlation between dental age, skeletal age, and chronological age is essential for clinical and medico-legal applications.

Aim: To evaluate and compare dental and skeletal age in non-syndromic unilateral cleft lip and palate patients with an age- and gender-matched non-cleft control group.

Materials and methods: This cross-sectional study included 216 individuals (108 unilateral cleft lip and palate cases and 108 controls), aged 7 to 18 years. Dental age was assessed using Acharya's modified Demirjian method on panoramic radiographs, while skeletal age was estimated using the Greulich and Pyle Atlas from left hand-wrist radiographs. Statistical analyses were conducted to compare dental age, skeletal age, and chronological age.

Results: Skeletal age was more delayed than dental age, with males experiencing greater delays than females. Males had a mean skeletal delay of 0.92 years (p < 0.001), and females had a delay of 0.90 years (p < 0.001). Dental age delay was 0.28 years in males (p = 0.016) and 0.21 years in females (p = 0.150, not significant). The most significant delays were observed between ages 10 to 14 years, with a peak skeletal delay of 1.04 years at age 10 in females (p < 0.001).

Conclusion: Skeletal age is more delayed than dental age, with males experiencing greater delays. These findings highlight the need for individualized treatment planning and reinforce the importance of cleft-specific age estimation methods in forensic and legal contexts.

Clinical significance: Accurate assessment of skeletal and dental age is essential for timely orthodontic and surgical interventions and for preventing age misclassification in forensic applications.

In forensics, dental age estimation is crucial, and literature has many methods for estimating dental age. London Atlas of Human Tooth Development and eruption method was developed on British and Bangladeshi populations in 2010, and there are likely to be differences between other populations.  Malaysian children have not yet been extensively tested for the method's applicability despite its universal acceptance and reliability. This research aimed to test the applicability of The London Atlas of human tooth development and eruption in children of the Malaysian population aged 4 to 16.99 years old. The study sample included 523 panoramic radiographs of healthy patients who had attended the Dental Paediatrics Department Hospital Tunku Azizah, Malaysia, between May 2019 and December 2019. The intra- and inter-observer errors were analysed by taking 53 radiographs and evaluating them over 14 days using the interclass correlation and Cohen's Kappa index. A paired t-test was used to compare chronological and estimated age ANOVA F-tests were used to establish if the difference is statistically significant between chronological and estimated age. The range of age estimation fell within a year due to the mean absolute difference of 0.60 years. The mean age for estimated age was 9.31±3.18 for the overall sample, 9.06±3.09 for males, and 9.60±3.27 for females. Paired t-test analysis showed the mean difference between chronological and estimated age of -0.0365 and was not statistically significant (p=0.240). The result also showed no statistically significant difference between the sexes. The difference between the chronological and estimated age was underestimated within minimal range, 0.002 years in males and 0.08 years in females. The London Atlas of human tooth development and eruption showed high accuracy in Malaysian children.

Sexual dimorphism is an important biological factor for sex estimation from skeletal remains in medicolegal identification. This study aimed to determine using a discriminant function analysis, whether specific maxillary linear and angular measurements performed in cone-beam computed tomography (CBCT) images may be useful to determine the sex in a Colombian population. The sample consisted of 212 CBCT scans acquired from 86 males and 126 females. The protocol included the assessment of 23 parameters, of which 16 were bilateral and seven were non-bilateral. An intra-observer variability test was performed to ensure data reliability and unpaired t tests were applied to determine between-group differences. Significant predictor variables were subjected to univariate and multivariate discriminant function analyses. A total of five non-bilateral and 14 bilateral measures were statistically significant. Univariate discriminant analyses produced a mean percentage of correct prediction after cross-validation ranging from 55.20% to 72.60% for non-bilateral and from 58.70% to 73.10% for bilateral maxillary variables. The association of variables in the multivariate models increased the percentages of correct sex prediction even after cross-validation up to 77.80% for non-bilateral and up to 77.40% for bilateral maxillary measurements. It was concluded that CBCT measurement of maxillary bone parameters may be applied as a complementary technique to discriminate the sex from human remains through discriminant function analysis methods in the Colombian population.

New complementary methods to aid in the rapid identification of human remains, particularly in cases involving multiple victims and heavily degraded bodies, are valued in the forensic field. In these circumstances, the properties and characteristics of teeth make them incredibly useful for human identification. Dental morphological traits, commonly studied in anthropology, exist in the population with varying frequencies, which makes them very informative. Thus, everyone has their own dental trait profile, that may manifest with greater or lesser frequency in the population. We propose a discriminative method by exclusion for the identification of individuals, based on the evaluation of dental traits, using intraoral 3D images. For this purpose, a group of 10 dental traits was chosen to obtain a personal profile in a population group of 76 individuals. Various scenarios were created to analyze different problem cases, by using matching-exclusion tables. Three individuals (problem cases) with dental trait profiles of very low (1/27703 individuals), medium (1/136 individuals), or high frequency in the population (1/42 individuals) were randomly chosen for the experiment. Using a conservative approach, the most likely candidate for positive identification was determined in eight steps for problem case 1, five steps for problem case 2, and two final candidates were identified in problem case 3, with only one achieving 100% similarity. In contrast, the less conservative approach identified the most likely candidate in four steps for case 1, three steps for case 2, and four steps for case 3. The rarest dental profile did not necessarily require fewer steps. Our work suggests that using the well-known dental morphological traits and recent 3D imaging technology could significantly improve the efficient triage and identification of victims, especially in cases of closed mass disasters.

Background: Despite the surging crime rates and diverse operating methods, identifying the perpetrators and suspects is challenging. Incorporating forensic odontology has expanded the scope of forensics. Over the years, saliva has become the hallmark of forensics. This study aimed to develop a scale for assessing the knowledge and awareness about the role of saliva in forensic odontology. The scale was developed sequentially according to the qualitative research methodology: formation of a conceptual framework, systematic development of an item pool and refinement of an item pool (focus group discussion, cognitive interviewing and pretesting). Then, the validity and reliability of the scale were tested.

Results: A conceptual framework was developed based on five constructs, which included forensic sciences, forensic odontology, crime investigations, salivary analysis and forensic genetics. A pool of 28 items was designed based on existing literature and refined through a focus group discussion involving the target audience and expert panellists. After validation by cognitive interview and pretesting, the scale was condensed into a pool of 23 items. Statistical analysis revealed a Cronbach's alpha of 0.8 (good reliability) and kappa value of 0.79, indicating a strong level of agreement.

Conclusion: The Salivary Analysis for Forensic Evidence scale is a valid and reliable tool that consolidates all possible constructs involved in assessing the role of saliva in forensic odontology.

Forensic age estimation is performed by assessing pulp chamber constrictions due to physiological age-related changes in dental radiographs; however, the estimated ages occasionally deviate from the actual ages. In particular, long-term steroid users tend to demonstrate pulp chamber constrictions in all teeth. Because this is uncommon among younger age groups, caution should be exercised when evaluating pulp chamber constriction. This study investigated the estimated ages of eight PSL users by applying the ratio of pulp area to total tooth area from canine radiographs. Patients in their 30-40s were examined at a dental outpatient clinic for the prevention or treatment of adverse events associated with the use of bisphosphonates to prevent steroidal osteoporosis, and radiographs were obtained. The pulp and tooth areas were measured and the estimated age was determined using regression formulas calculated from the canine teeth of the general study subjects of Japanese. The mean absolute error between the estimated ages and the chronological ages of the patients was 19.24 years for the upper canines and 17.69 years for the lower. Moreover, the root mean square error was 23.18 years for the upper canines and 20.00 years for the lower. The estimated ages were far from the actual ages of the steroid users. When estimating an unidentified individual's age, if the patient has pulp chamber constriction that is inconsistent with other forensic physical findings, this information may assist in predicting their medical background.

The age estimation of skeletal remains still represents a central issue not only for the reconstruction of the so-called "biological profile," but mostly for the palaeodemographic investigation. This research aims at verifying the feasibility of the adult age estimation method developed on living people by Pinchi et al. (2015 and 2018), for estimating the age at the death of 37 subjects from ancient populations found in two different Italian necropolis of archaeological interest (Mont'e Prama and Florence, X-IX century B.C and V-VI century A.D respectively). The method is conservative and based on a geometrical approximation of dental volumes of the upper central left incisors on CBCT scans. The statistical distribution of the age and errors followed the Bayesian approach proposed by Sironi et el. (2018) applying the "a priori" values according to the estimates/classification obtained with anthropological methods (morphological). Results show higher accuracy for Mont'e Prama remains than for the Florentine sample due to the different characteristics of the two ancient populations (estimates varying from 18.4 up to 28.7 years with a maximum error of 6,14 years for Mont'e Prama, and from 15.88 up to 43.37 years with a minimum error of 1 year up to a maximum error of 7,85 years for Florence). The method proposed and validated on modern living people can represent a reliable tool for estimating the age of ancient human remains with a significant palaeodemographic value for archaeologists/anthropologists. Mont'e Prama sample could be defined as a homogenous group of males aged around 20-30 years, probably warriors, soldiers, or athletes; Florentine sample as an inhomogeneous group of males and females from different families buried all together in a small area out of the city due to the probable occurrence of a special healthy emergency in the city.

The great advances in diagnostic and therapeutic skills of most sectors of medicine and dentistry have led to an increasingly greater demand from patients for accuracy, attention and diligence by healthcare workers. Dentistry is one of the branches most frequently involved in claims for damages from malpractice, especially in those sectors that are particularly costly and of significant aesthetic value. Aim of the study was to compare data of malpractice claims with those of other Authors to identify similarities and/or differences in the results and to increase epidemiological knowledge in the area of dental malpractice. This work is a descriptive study performed analyzing medical malpractice claims in which one of the Authors was nominated as court professional expert advisor from 2018 to 2022 in two of the biggest courts in Campania: Naples and Santa Maria Capua Vetere. Findings of great interest were the greater involvement of the pros-thetic and implant-prosthetic sector, the significant recurrence of clinical records deficiency and the high prevalence of claims made by female subjects. Also, there was a greater incidence of emergent damage confronted to the non-pecuniary personal injury (biological damage).

This study aims to compare the accuracy of Demirjian's and Cameriere's methods in determining adult age at the 18-year threshold using mandibular third molars in the Thai population. Panoramic radiograph images of 504 healthy subjects aged between 14 and 23 years were retrospectively collected. The developmental stages of mandibular third molars were evaluated using Demirjian's method, while the maturity index of mandibular third molars (I3M) was assessed using Cameriere's method. Comparing the development of the left and right mandibular third molars, slight differences were observed: the left side developed 0.06 stages faster (p = 0.01) and had an I3M 0.01 higher (p < 0.01). For the 18-year age threshold, Demirjian's Stage H demonstrated a specificity of 1.00 for both sexes on the left mandibular third molar, and 0.97 for males and 1.00 for females on the right. I3M < 0.08 yielded specificities of 0.84 for males and 0.93 for females on the left, and 0.82 for males and 0.91 for females on the right. Reducing the cut-off to I3M < 0.02 improved specificity to 1.00 for both sexes on the left side, and 0.96 for males and 1.00 for females on the right. Notably, using Demirjian's Stage H and I3M < 0.02, the probability of being over 18 years was 1.00 for females on both sides, and 0.96 for males on the left and 1.00 on the right. Our study recommends using an I3M cutoff of <0.02 for adult age assessment in the Thai population, as it achieves high specificity comparable to Demirjian's Stage H, with effective differentiation of adults.