Journal of Forensic Odonto-Stomatology最新文献

Objectives: The study aims to evaluate the pulp-to-tooth area ratio in permanent maxillary central incisors, lateral incisors, and canines for age estimation using three-dimensional cone beam computed tomography images.

Methods: Hundred cone-beam computed tomography (CBCT) images of patients aged between 12-70 years were retrospectively studied using NNT Viewer software version 13. Pulpal and teeth area were evaluated with the "area tool" in the acquired images in all three planes, and the pulp-to-tooth area ratio (PTR) was calculated with the measurements obtained. The reproducibility of intra-observer bias using paired t-tests was calculated.

Results: The coefficient of correlation (r) values of maxillary central incisors with age are -0.54, -0.623, and -0.50 in the axial, sagittal, and coronal planes respectively. The r values of maxillary lateral incisors are -0.05, -0.52, and -0.25 in the axial, sagittal, and coronal planes. The coefficient of correlation values (r) of maxillary canine with the age is -0.53, -0.62, and -0.49 in the axial, sagittal, and coronal planes. A strong correlation between chronological age and PTR in multiple sections of the maxillary incisors and canines (p-value <0.05) was observed.

Conclusion: The permanent maxillary central incisor and canine yielded promising results in predicting age. The predicted age derived by mid-sagittal sections was closer to the chronological age than the axial sections, which had the least predictability.

The activity of a dentist reveals itself in numerous aspects, and its regulation is determined by the Deontological Code of the Dental Association, which contains a set of rules that dentists are obliged to follow in the exercise of their profession. The regulation of this activity goes beyond following these precepts because, in the legal relationship that is established whenever an agreement is made with a patient to carry out the treatment deemed appropriate, a series of duties and obligations begin for each party, translated into a reciprocal contract, in which the non-compliance of one of them may result in a legal claim. The objective of this study was to research most court decisions delivered in this century, in Portugal, regarding the activity of dentists when faced with patient claims and to outline a framework that better allows us to understand the regulation of this activity within the scope of the contracts established with them. This includes identifying the patients' sex, the judicial instance, the area of dentistry, the location of the injury, the type of liability, the characterization of the obligation, the basis of responsibility, the alteration of biological assets, and the outcome of the action while also not neglecting the identification of trends and jurisprudential evolutions, should they arise. A survey of judgments from the Portuguese Superior Courts was carried out, which focused on decisions from the Supreme Court of Justice, Court of Appeal of Porto, Court of Appeal of Lisbon, Court of Appeal of Coimbra, Court of Appeal of Guimarães, and Court of Appeal of Évora. To understand the judgments analyzed in this study, a brief approach to various legal concepts and institutions of interest was conducted. A summary characterization of the factual basis of the injured party's claim and the legal framework applied, as well as subsequent decisions by higher courts regarding the activity of dentists, was also elaborated. It was impossible to identify any relationship between the field of dentistry and the characterization of the obligation and the basis of responsibility, nor between the outcomes of the actions and these two parameters mentioned. This is likely due to the small sample size, which, although limited, represented all available published superior court decisions in Portugal related to the proposed topic, and because there were different decisions for similar and identical factual situations due to the various scientific and social conceptions adopted by the courts being susceptible to other interpretations.

The life-altering effects of criminal trials necessitate providing reliable methods to distinguish adults (≥18) from minors (< 18). The present study aims to evaluate the accuracy of the third molar maturity index (I3M) introduced by Cameriere et al. (2008) in distinguishing adults from minors in the Iranian population. Panoramic radiographs of 800 Iranian individuals (400 males and 400 females) aged 14-23 were evaluated. The cut-off value of I3M=0.08 was analysed to determine whether the individual is younger or older than 18. All male or female subjects with I3M above 0.7 were below 18 years old. The cut-off value of 0.08 showed a sensitivity of 80.83% and 63.33% and a specificity of 88.12% and 93.12%, respectively, in males and females. The positive predictive values were 91.08% and 93.25%, and the negative predictive values were 75.40% and 62.87%, respectively, for males and females. The Bayes' post-test probability was 94% for females and 92% for males. 83.75% of males and 75.25% of females correctly classified as adults or minors. The most remarkable error rate occurred at 18 years old (67.5 % in females and 57.5% in males). By ROC curve analysis, the population-specific cut-off values of I3M 0.097 for males, 0.116 for females, and 0.099 regardless of sex, were acquired, which improved the sensitivity of discrimination between adults and minors (86.3%, 73.8%, and 78.1 %, respectively). The results showed that I3M is a reliable method for distinguishing between minors and adults in the Iranian population. This method provides a higher accuracy level in identifying individuals under 18 years old. Population-specific I3M cut-off values increased accuracy, sensitivity, and NPV, especially for females. The I3M method produced better results in diagnosing adult males than adult females and a higher accuracy level in identifying individuals under 18.

Background: Forensic age estimation is a procedure which utilises many methods to estimate the age of both living and deceased individuals, including those who have died in natural disasters or man-made catastrophes. The pattern and closure of spheno-occipital synchondrosis (SOS) fusion, along with subchondral ossification of the mandibular condyle, can be used to estimate age.

Aim and objectives: This study aims to estimate age using computed tomographic (CT) images of spheno-occipital synchondrosis fusion (SOS) and mandibular condylar cortication (MCC), and to correlate these findings with chronological age.

Materials and methods: The present study included 435 CT images of individuals aged 10-25 years. SOS fusion was assessed using a four-stage system, and MCC was assessed bilaterally using a three-stage system on the sagittal plane. Data on fusion stages and cortication types were entered along with chronological age, and then statistically analysed.

Results: SOS fusion stage 2 occurred at similar age in males (19.82 ± 2.67 years) and females (19.23 ± 2.93 years). Earlier fusion of other stages was observed in females by a mean age of 2 years. MCC was completed 1 year earlier in females, with statistically significant differences (p ≤ 0.001). When comparing cortication types and different fusion stages, only type II cortication showed statistically significant differences compared to different fusion stages (p ≤ 0.001).

Conclusion: Mandibular condylar cortication (MCC) and spheno-occipital synchondrosis (SOS) fusion were positively correlated with chronological age, suggesting that these parameters can be used as an adjunct method for age estimation.

Estimating the post-mortem interval (PMI) of human remains based on the histomorphology of dental pulp parameters is promising, but available evidence is scarce and sometimes contradictory without a scientific model. The aim of the study is to characterise the histomorphological changes of dental pulp associated with the decomposition of human remains by a qualitative and quantitative approach. The main aim is to establish a correlation based on post-mortem (PM) dental pulp histomorphology and the PMI, and whether pulp degradation could be an available medico-legal tool for PMI estimation beyond the first week after death (late PMI). The eligible sample consisted of 27 sound teeth from 16 healthy patients aged 16 to 72 years due to orthodontic or oral surgery treatment, to create PMI's simulating the death of the subject as the time elapsed from tooth avulsion. Data collected from patients (sex, date of birth, tooth position, date and hour of the avulsion, date and hour of pulp extraction) were anonymised in accordance with the requirements of Faculty of Dental Medicine of the University of Lisbon. The sample was divided into 9 groups of 3 teeth according to different PMI sets from T0 (baseline) up to 2 weeks (T0, 7, 12, 24, 36, 48, and 72 hours, 1 and 2 weeks). All the dental samples were stored at room temperature up to the time of pulp extraction and then prepared with haematoxylin and eosin stain. High-resolution microscopy was performed to obtain histological images. An operator performed the qualitative evaluation of blood vessels, collagen fibres, and the extra-cellular matrix (ECM) in PM pulps and measured the variation in cells/nuclei density by counting 6 different ROIs (Regions of Interest) for each pulp manually and automatically (quantitative analysis). Qualitative results showed that the degeneration of dental pulp appears 7 hours after death but histological changes in vessels, fibres, and ECM in PM dental pulp are characterised by high variability, consequently it is not possible to generalise the results for early PMIs. Quantitative measurements proved that cell count cannot be standardised due to the presence of superimposed layers of cells and nuclei fragmentation. Odontoblasts did not demonstrate evidence of cellular or nuclear lysis up to 14 PM suggesting their applicability in late PMIs. Future research will focus on late PMIs and different techniques of tooth preparation.

Background: Tooth wear is a non-pathological loss of hard tissues on the incisal and occlusal tooth surface. In archaeology, the loss of dental tissue through attrition is associated with living opportunities and habits, availability, characteristics and methods of food preparation. In forensics, tooth wear is used to estimate the dental age on cadavers.

Material and methods: For this study, we used an archaeological sample from two sample collections. In this study, tooth wear was compared in archaeological samples of well-preserved maxilla and mandible specimens (n=392) from Croatian coastal and continental populations from Late Antiquity (LA) and the Early Middle Ages (EMA). The computer system VistaMetrix 1.38 was used to analyse the abrasion and attrition of hard dental tissues. The Shapiro-Wilk and chi-square tests were performed for categorical data to test the difference between two historical periods and two geographical locations, while the Kruskal-Wallis test was performed for continuous data.

Results: There was a statistically significant difference in the proportion of tooth wear in total teeth area (P < 0.001) when comparing continental and coastal Croatia in LA and coastal Croatia between LA and EMA (P = 0.006 and P < 0.001, respectively). Samples from coastal Croatia from the LA period had the lowest percentage of tooth wear with a median of 8.35%, while samples from coastal Croatia from the EMA had the highest percentage of tooth wear with a median of 18.26%. Our results generally show greater tooth wear in the EMA period in male subjects.

Conclusion: The results of the tooth wear research obtained with the Vista Metrix software can contribute to the study of life circumstances and changes that the analysed population has experienced in its historical development.

Although dental patterns are unique, the use of bitemark analysis in personal identification remains controversial. To accurately reproduce and compare three-dimensional models of bitemarks and dental arches, intraoral three-dimensional scans, commonly utilized in clinical dental practice for precise and stable digital impressions, are recommended. This study aims to compare two different techniques for bitemark analysis: a digital method based on the superimposition of digital scans of dental patterns and lesions, and a visual method based on the physical superimposition of impressions and resin casts produced by 3D printing. A sample of 12 volunteers (6 males and 6 females) with a mean age of 26 years was collected as biters. Each subject was asked to bite on custom supports made from semi-rigid water bottles covered with imprintable dental wax. The dental arches and bitemarks were then recorded using an intraoral scanner and dental impressions. Scan superimposition analysis was conducted using CloudCompare software, while resin casts were printed using a 3D printer and physically superimposed on the bitemark impressions by a blind operator, who was not involved in sample collection, bite test execution, prior cast acquisition, or CloudCompare analysis. Both superimposition techniques relied on the selection of 10 corresponding landmarks (on canines and central and lateral incisors of the upper and lower arches) between the dental arches and impressions. The digital superimposition showed an average concordance of 92.5% for the upper arch landmarks and 85% for the lower arch landmarks, with an overall average concordance of 88.8% for both arches combined. In contrast, the visual analysis of resin casts showed an average concordance of 77.5% for the upper arch and 76.7% for the lower arch, with an overall average of 77.1% for both arches combined. In the analysis performed using CloudCompare, the maxillary arch demonstrated the best superimposition, with 4 landmarks (R0, R1, R2, R5) consistently overlapping. The digital analysis outperformed the visual analysis in all four quadrants, particularly in the upper right arch compared to the lower left arch, thereby supporting the integration of digital techniques in forensic applications. Further studies are necessary to validate the digital technique on a larger sample, including subjects with different dental characteristics, bite dynamics, and varying types of supports and substrates.

Background: Forensic Odontology developed as a discipline in 1898 with the publication of its first textbook; however, 126 years later, a standardised core curriculum for formal training in Forensic Odontology has yet to be decided. This website scoping review aims to provide information on three main distinct categories (and 17 subcategories): Availability, Content, and Quality of Forensic Odontology education globally. The information on formal education programmes was gathered by conducting a web search using 'Google Search' in English, Arabic, Spanish, and French languages between June and July 2022.

Highlights: Fifty-six programmes from 18 countries met the inclusion criteria. Of the 14 master's and 42 diploma programmes, only 7.14% provided information on their websites from all the subcategories investigated. The highest numbers of master's and postgraduate diploma programmes were identified in Europe (18 programmes), South America (15), North America (11) and Asia (7). A practical aspect was included by 10 master's and 12 diploma programmes' websites. Research integration in various forms was included by 11 master's and seven diploma programmes.

Conclusion: Programme providers and applicants must critically consider the quality of the programme being designed or applied to as there are currently no international training standards in Forensic Odontology. This study has developed an 'International Database of Forensic Odontology Programmes' (IDFOP).

Background: The study evaluates the feasibility of employing the radiographic visibility of the root pulp and periodontal ligament in mandibular molars for age estimation, particularly focusing on the 18 years of age threshold. This study additionally investigates the potential of root canal width reduction in mandibular molars, as a reliable method for forensic age estimation in living individuals.

Materials and methods: A cross-sectional study was conducted to assess the radiographic visibility of the root pulp (RPV) and the root canal width (RCW) of mandibular first, second, and third molars along with the radiographic visibility of the periodontal ligament (PLV) of mandibular third molars, in a sample of 403 individuals aged 16-25 years (220 males and 183 females). Data regarding age for different stages of RPV and PLV and various types of RCW were recorded and observed for sex-based differences. Results obtained were tabulated and descriptive statistics were applied to summarise the findings.

Results: Individuals over 18 years old were classified with higher accuracy using stage 3 of the RPV scoring system in all mandibular molars (first, second, and third) compared to stage 2, which was also effective for the second and third molars. This result held regardless of sex and side examined. Additionally, root canal width (RCW) assessment demonstrated that individuals with RCW types A, B, and C were more likely to be under 18 years old in both sexes. Conversely, individuals with RCW type U on the right side for males and the left side for females exhibited a higher likelihood of being above 18 years old.

Conclusion: The study suggests that the assessment of mandibular molars could potentially serve as an auxiliary tool in age estimation methods, particularly for approximating individuals around the 18 years of age threshold. Further investigation is warranted to explore the potential application of root canal width measurements in forensic age estimation.

Introduction: The aim of this study was to evaluate whether a forensic odontologist working remotely could accurately undertake forensic dental identifications using videos produced by non-dental forensic staff operating an intra-oral video camera (IOVC). The study's aims were to assess the accuracy and time taken to perform remote forensic dental identifications in this manner.

Materials and methods: Eight cadavers from the Centre for Anatomy and Human Identification (CAHID), University of Dundee, UK, were examined by a forensic odontologist via a traditional dental examination. Their dental condition was recorded to serve as ante-mortem records for this study. Videos of each dentition were produced using an IOVC operated by a medical student. Post-mortem records were produced for each dentition from the videos by a remote second forensic odontologist who was not present at the traditional dental examination. The ante-mortem and post-mortem records were then compared, and identification was classified as positively established, possible or excluded.

Results: Established identifications were positively made in all eight cases although there were some non-critical inconsistencies between ante-mortem and post-mortem records. Before the second opinion, 85.6% of the teeth per study subject were charted consistently. After the second opinion, the percentage of consistency increased to 97.2%. Each video on average was about 4.13 minutes in duration and the average time taken to interpret and chart the post-mortem dental examination at the first attempt was 11.63 minutes. The time taken to chart from the videos was greater than is typical of a traditional dental examination.

Conclusion: This pilot study supports the feasibility of undertaking remote dental identification. This novel "tele-dental virtopsy" approach could be a viable alternative to a traditional post-mortem dental examination, in situations where access to forensic dental services is difficult or limited due to geographical, logistical, safety, and/or political reasons.