Systematic review: oral and maxillofacial radiology as fundamental methods of virtual autopsy

Abstract Refusal of autopsy occurs for various reasons, including religious beliefs and the risk of infectious diseases such as coronavirus disease 2019. Dental autopsy involves invasive procedures, including incision and access openings in the oral cavity. Radiographic techniques can be used as an alternative to the conventional autopsy process in the field of forensic odontology, providing a non-invasive approach that does not involve tissue damage. The current study aimed to analyse the current status of the applicability of oral and maxillofacial radiology for virtual forensic odontological autopsy. A systematic review was conducted in accord with the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. The literature search was conducted from December 2021–October 2022 using the Pubmed, ScienceDirect, and SAGE Journals databases. Article selection was carried out by eliminating duplication, screening titles and abstracts, and reading the entire content of the article. A thematic analysis method was used to identify themes in the collected data. A total of 15 articles were included, and several uses of oral and maxillofacial radiography in virtual autopsy and forensic odontology were identified. Four techniques were identified that can be used for virtual autopsy in forensic odontology. The use of computed tomography (CT) scanning for virtual autopsy was reported in six articles, cone beam CT was reported in five articles, magnetic resonance imaging was reported in two articles, and multidetector CT was reported in two articles. In the studies included in this review, the identified oral and maxillofacial radiograph techniques that are used as the fundamental methods of virtual autopsy in forensic odontology are CT scanning (including multidetector CT), cone beam CT, and magnetic resonance imaging. The different methods of oral and maxillofacial radiography for virtual autopsy were identified as having advantages as well as limitations in their use in forensic odontology. Most of the included studies indicated that the virtual autopsy approach cannot yet stand alone as an identification method, but provides a useful adjunct for gathering dental evidence.