Partial amputation due to tongue bite in death-associated with eclampsia

Eclampsia is one of the most dangerous complications of pregnancy and has a high incidence in developing countries. It is characterized by coma and the occurrence of generalized tonic-clonic seizures in pregnant women with hypertension. Deep bites on the tongue and other orofacial injuries have been described as consequences of these seizures. We present a case of death associated with eclampsia in which the bite during the seizure episode caused almost total amputation of an enlarged tongue (macroglossia). The medico-legal value of this finding and the situation due to antecedent pathological conditions and lack of routine screening in pregnant women who may migrate legally or illegally to give birth with better medical care are discussed.

Automatic removal of soft tissue from 3D dental photo scans; an important step in automating future forensic odontology identification

The potential of intraoral 3D photo scans in forensic odontology identification remains largely unexplored, even though the high degree of detail could allow automated comparison of ante mortem and post mortem dentitions. Differences in soft tissue conditions between ante- and post mortem intraoral 3D photo scans may cause ambiguous variation, burdening the potential automation of the matching process and underlining the need for limiting inclusion of soft tissue in dental comparison. The soft tissue removal must be able to handle dental arches with missing teeth, and intraoral 3D photo scans not originating from plaster models. To address these challenges, we have developed the grid-cutting method. The method is customisable, allowing fine-grained analysis using a small grid size and adaptation of how much of the soft tissues are excluded from the cropped dental scan. When tested on 66 dental scans, the grid-cutting method was able to limit the amount of soft tissue without removing any teeth in 63/66 dental scans. The remaining 3 dental scans had partly erupted third molars (wisdom teeth) which were removed by the grid-cutting method. Overall, the grid-cutting method represents an important step towards automating the matching process in forensic odontology identification using intraoral 3D photo scans.

The effect of burning on dental tissue: A macroscopic and microscopic investigation

Teeth are considered unique as fingerprints for identification purposes. Their structure and resilience mean they can remain for thousands and millions of years withstanding extreme conditions, including burning. During burning, bones undergo carbonization at approximately 400°C and calcination at approximately 700°C. This study aimed to investigate the effects of carbonization and calcination on dental tissue. It involved nondestructive analyses of 58 extracted human teeth before and after burning, using x-ray diffraction, micro-CT, and high-resolution confocal microscopy. The results revealed that during carbonization, dentin volume decreased in two thirds of the sample, accompanied by crack formation and significant reduction in hydroxyapatite crystal size (p<0.001). During calcination, dentin volume decreased in all teeth, along with a significant deepening of the cracks (p<0.001), while enamel crystal size increased slightly. Initial changes in teeth occurred at lower temperatures than had once been assumed, as indicated by the cracks during carbonization, and there was up to a 36% decrease in dentin volume during calcination, which should be considered when measuring burnt teeth. The results of this research provide new insight into understanding dental tissue response to burning. Thus, dental remains may contribute to the knowledge needed to reconstruct anthropological and forensic scenarios involving burning.

Artificial intelligence in age and sex determination using maxillofacial radiographs: A systematic review

In the past few years, there has been an enormous increase in the application of artificial intelligence and its adoption in multiple fields, including healthcare. Forensic medicine and forensic odontology have tremendous scope for development using AI. In cases of severe burns, complete loss of tissue, complete or partial loss of bony structure, decayed bodies, mass disaster victim identification, etc., there is a need for prompt identification of the bony remains. The mandible, is the strongest bone of the facial region, is highly resistant to undue mechanical, chemical or physical impacts and has been widely used in many studies to determine age and sexual dimorphism. Radiographic estimation of the jaw bone for age and sex is more workable since it is simple and can be applied equally to both dead and living cases to aid in the identification process. Hence, this systematic review is focused on various AI tools for age and sex determination in maxillofacial radiographs. The data was obtained through searching for the articles across various search engines, published from January 2013 to March 2023. QUADAS 2 was used for qualitative synthesis, followed by a Cochrane diagnostic test accuracy review for the risk of bias analysis of the included studies. The results of the studies are highly optimistic. The accuracy and precision obtained are comparable to those of a human examiner. These models, when designed with the right kind of data, can be of tremendous use in medico legal scenarios and disaster victim identification.

Mandibular torus thickness associated with age: Postmortem computed tomographic analysis

Age estimation is an essential step in identifying human corpses. Several mandibular landmarks have been highlighted as skeletal sites for age estimation since aging causes morphological changes. Reports suggest that mandibular torus size may be associated with aging; however, thorough investigation has not been performed owing to the difficulty in measuring it. Therefore, this study aimed to determine the association between age and mandibular torus thickness using postmortem computed tomography data from Japanese corpses. This study included 2,792 corpses with mean (standard deviation) age of 58.0 (22.4) years (range, 0-101 years) and 67.6 % males. Further, 2,662 (95.3 %), 14 (0.5 %), 59 (2.1 %), and 57 (2.0 %) corpses were in the permanent, mixed, primary, and predental dentition periods, respectively. Multivariable analysis was performed to quantify the impact of age on mandibular torus thickness, adjusting for sex, height, weight, and occlusal contact status. The model also included an interaction term between age and occlusal status because of the potential effect modification by occlusion. Results of the multivariable regression analysis showed that mandibular torus thickness increased with age (the regression coefficients (95 % confidence interval) were 0.6 (0.2-1.0), 0.7 (0.3-1.0), 1.0 (0.6-1.4), 1.3 (0.9-1.7), 1.3 (0.8-1.8), and 1.1 (0.4-1.7) for age groups 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 years, respectively), especially in males with occlusal contact. A significant association between mandibular torus thickness and age, modified by occlusal status and sex, was identified. Therefore, data regarding the thickness of the mandibular torus and occlusal status may be useful for age estimation in human corpses.

Dental color measurement to estimate age in adults: a systematic review and meta-analysis

Age estimation is a major challenge in anthropology and forensic odontology laboratories, as well as in judicial settings, as one of the tools used in human identification. The aim of this study was to evaluate the usefulness of age estimation methods based on the accurate measurement of tooth color changes. A systematic review was carried out following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and in compliance with Cochrane criteria recommendations (PROSPERO registration number CRD 42022343371). An electronic search was performed in the following databases: Pubmed, Web of Science, Medline, Current Contents Connect, SciELO, KCI-Korean Journal Database, Derwent Innovations Index and Russian Citation Index. The search strategy yielded a total of 18 articles. A randomized meta-analysis model of the results for the CIE L*a*b* color variables stratified by age (less than 30 years, 30-60 years, 60 years and older) was performed with 9 of the 18 studies included in this systematic review. According to our results, sex and location of color measurement are the most influential factors in color estimation. All studies were carried out in healthy anterior teeth by spectrophotometry as the most commonly used method for color measurement, with CIE L*a*b* being the most commonly analyzed parameters. Studies based on age as a dependent variable showed R2 values between 0.28 and 0.56, being higher in ex vivo teeth. Studies based on age as an independent variable showed R2 values ranging from 0.10 to 0.48. The random model showed high heterogeneity for the L*, a* and b* parameters in all age groups, which is explained by discrepancies in age range and non-standardized conditions for color measurement. This systematic review highlights the need to protocolize age estimation studies that measure tooth color, in order to apply this method in different forensic settings.

Validity of postmortem computed tomography for use in forensic odontology identification casework

Forensic Odontology (FO) identification compares antemortem (AM) and postmortem (PM) dental datasets and is widely accepted as a primary identifier. Traditionally, a PM dental examination is undertaken in the same manner as a dental examination conducted for a living patient. Recently, the increased forensic application of computed tomography (CT) offers an alternative source of PM data. While charting from PMCT is widely accepted as less accurate, the impact on reconciliation is unknown. This study aims to determine if reconciliation outcome differs when PM dental data is collected from PMCT, compared with conventional PM examination. PMCT data was reviewed for 21 cases previously completed using conventional PM dental examination. Operators blinded to original identification outcomes charted from CT images before comparing to AM data to form an opinion regarding identity. Opinions formed were compared with original identification outcomes. Differences in PM dental charting between the two methods and the evidentiary value of AM and PM datasets were assessed to determine driving factors of differences in identification outcome. Compared to conventional PM dental examination, PMCT examination resulted in similar or less certain identification outcomes. Discrepancies in outcome were driven by the quality of AM and PM datasets rather than inaccuracies in charting from PMCT. Based on the results of this study, both conventional and PMCT methods of PM dental examination can reach similar identification outcomes. However, operators remained more certain in establishing identity when conducting conventional PM dental examinations especially when AM data was lacking.

Clinical comparative study on the accuracy of palatal rugae in models obtained by different impression materials and intraoral scanning

OBJECTIVE

Palatal rugae are frequently used in the evaluation of tooth movement after treatment in orthodontics and as a stable region in superimposition. It is important to note that the impression method and material used to record the rugae region affect the accuracy of the impression. The aim of this study is to compare the accuracy of palatal rugae, in three-dimensional (3D) by employing both conventional and digital impression methods.

MATERIALS AND METHODS

In this study, 22 patients (12 females, 10 males) mean age of 13.5 ± 1.7 years old were selected with complete permanent dentition. Three different impressions were taken from the maxillae of the patients: conventional impression using silicone rubber impression material, conventional impression using alginate impression material, and optical impression using an intraoral scanner. The impressions' digital data were analyzed by the GOM Inspect (Version 2018, Braunschweig, Germany), a 3D analysis software. The Root Mean Square (RMS) values of the total ruga region were evaluated in this software. The data were statistically analyzed using the Jamovi program. The Kruskal-Wallis test and Mann-Whitney U test were performed due to the non-normal distribution of the data.

RESULTS

There is no statistically significant difference between the comparison points of the right and left rugae's medial and lateral points and total rugae regions' RMS values. Although there was no statistically significant difference, the total RMS values of alginate and digital scan measurements showed closer results than the RMS values of silicone and digital scan measurements.

CONCLUSION

The study found that there was no statistically significant difference in the total RMS values of the ruga region between traditional and digital impression methods.

CLINICAL RELEVANCE

The treatment period in orthodontics is long. Different impression materials and methods can be used for diagnostic, mid-treatment, and final impressions. For superimpositions and treatment and post-treatment palatal ruga evaluations, traditional and digital impression methods are clinically acceptable and can be used as alternatives to each other.

Three-dimensional surface area analyses of developing maxillary second premolar root apices for age estimation using CBCT images

Three-dimensional surface area analyses of developing root apices for age estimation in children and young adults have shown promising results. The current study aimed to apply this three-dimensional method to develop a regression model for estimating age in Malaysian children aged 7 to 14 using developing maxillary second premolars. A training sample of 155 cone-beam computed tomography scans (83 Malays and 72 Chinese) was analysed, and the formula was subsequently validated on an independent sample of 92 cone-beam computed tomography scans (45 Malays and 47 Chinese). The results showed a strong correlation (r = 94 %) between the chronological age as a dependent variable and the predictor variables, including root surface area of the apex, sex, ethnicity, and root development status (open/closed apices). For this model, the predictor variables accounted for 88.4 % of the variation in age except sex and ethnicity. A mean absolute error value of 0.42 indicated that this model can be reliably used for Malaysian children. In conclusion, this study recognises the method of three-dimensional surface area analyses as a valuable tool for age estimation in forensic and clinical practice. Further studies are highly recommended to assess its effectiveness across different demographic groups.

Evaluation of Sexual Dimorphism Using Dental Dimensions - An Observational Study

Aim

In our study, we evaluated the gender dimorphism among dental measurements of selected people in a South Indian district.

Methodology

In our research, 500 participants between 17 and 25 years of age were included after taking their maxillary arch impressions. Utilizing Korkhaus compass and digital caliper, depth of palatal area as well as maxillary arch as a whole was done. T-test was done to initiate the comparative analysis between the palatal arch and complete maxillary arch depths where P < 0.05 was denoted significant statistically.

Results

It was recorded that complete maxillary arch depth measurements were increased in case of men as compared to women, whereas the measurements related to depth of the palatal arch were not statistically significant.

Conclusion

In our research, we found that complete maxillary arch depth can be utilized for gender segregation accompanied with other auxiliary methods. The mean value for both these measurements can be utilized as a standard measurement for advance research.

Evaluation of five methods to identify composite restorations in human teeth on a forensic purpose-an ex vivo comparative study

The use of tooth-colored composite resin materials in dentistry is increasing. As composite restorations appear similar to the natural tooth structure, their detection is becoming more challenging. The aim of this study was to compare five diagnostic methods for detection of dental restorations and to create reliable postmortem dental records for forensic purposes. A conventional examination method without a direct light source (CONV), with a dental loupe light (DL), Galilean loupes with a direct light source (GDL), a fluorescence-inducing device (FIT), and intraoral radiographs (RX) were compared. Dentists specializing in conservative dentistry or oral surgery and dentistry students participated. Regarding sensitivity, specificity, positive predictive value, and negative predictive value, FIT and RX showed significantly higher results than CONV, DL, and GDL. RX and FIT showed comparable results in identifying composite restorations but depending on their location. The combination of both methods may lead to even better results. In conclusion fluorescence-inducing devices show good results in identifying composite restorations and therefore should be considered as a standard tool in forensic examinations. Another advantage is their small size, low cost, and mobility. Good illumination and magnification devices are recommended to enhance performance during conventional examinations. Involving dentists specialized in conservative dentistry could contribute to dental identification.

Quantifying the potential of morphological parameters for human dental identification: part 1-proof of concept

In forensic identification, lack of eccentric characteristics of intact dentitions hinders correct ante-mortem/post-mortem (AM/PM) matching. It remains unclear which morphological dental parameters hold strong potential as identifiers. This study aimed to establish a method to quantify and rank the identifying potential of one (or a combination of) continuous morphological parameter(s), and to provide a proof of concept. First, a statistic was defined that quantifies the identifying potential: the mean potential set (MPS). The MPS is derived from inter-observer agreement data and it indicates the percentage of subjects in the AM reference dataset who at least need to be considered to detect the correct PM subject. This was calculated in a univariate and a multivariate setting. Second, the method was validated on maxillary first molar crowns of 82 3D-digitally scanned cast models. Standardized measurements were registered using 3D modeling software (3-Matic Medical 12.0, Materialise N.V., Leuven, Belgium): tooth depth, angles between cusps, distances between cusps, distances between the cusps, and the mesial pit. A random sample of 40 first molars was measured by a second examiner. Quantifying and ranking the parameters allowed selecting those with the strongest identifying potential. This was found for the tooth depth (1 measurement, MPS = 17.1%, ICC = 0.879) in the univariate setting, and the angles between cusps (4 measurements, MPS = 3.9%) in the multivariate setting. As expected, the multivariate approach held significantly stronger identifying potential, but more measurements were needed (i.e., more time-consuming). Our method allows quantifying and ranking the potential of dental morphological parameters as identifiers using a clear-cut statistic.

Age Estimation and Sex Determination Using Raman Spectra of Human Dentine

Objectives

This study aimed to determine the sex and estimate the age of individuals by analysing Raman spectra obtained from extracted teeth dentine.

Material and methods

A total of 25 male and 26 female extracted teeth were collected, disinfected, and fixed in auto acrylate before being cut near the cervical margin. The inclusion criteria were non endodontically treated teeth with the cervical third of the tooth crown preserved. The exposed dentine was recorded using a Raman spectrometer, with 100 scans per dentine site in the spectral range of 3500 to 200 cm-1 and a resolution of 4 cm-1. Background-corrected, normalized, and decomposed spectra were subjected to principal component analysis using MATLAB 2010 (The MathWorks, Natick, MA, USA). To assess age differences, prominent vibrational bands were observed and statistically analyzed, while sex differentiation employed the T-test on acquired data, exploring vibrational bands with significant intensity differences.

Results

The obtained results revealed a segmentation of spectra in the male sample group based on the age of teeth at extraction, with an accuracy of age estimation at 7.0048 years. A similar segmentation was observed in the female sample group, with an accuracy of 9.3863 years.

Conclusion

The recorded spectra were organized into datasets and analyzed with principal component analysis, demonstrating the feasibility of sex determination and age estimation using Raman spectra of teeth. Differences in classification accuracy between sexes may be attributed to hormonally-mediated differences in the biochemical composition of dentine between males and females. The findings of this study can provide valuable insights into methods for forensic and anthropological applications.

Influence of the amount of saliva deposition and time elapsed after deposition on bite mark analysis

Bite mark analysis is among the most interesting research fields in forensic odontology; however, it is limited by its dependence on the employed method as well as assessor subjectivity, particularly when using morphological analysis or DNA profiling. These limitations are due to differences in DNA collected from saliva adhering to a living or inanimate body, as well as differences in exocrine fluid secretion and deposition amount among individuals. This study aimed to analyze the effectiveness of DNA profiling when there are differences in the amount of saliva adhering to a living body and when time has elapsed since deposition. Most allele peaks could be identified in 1 µl of saliva, even 9 h after saliva deposition and examination. Consistent results were obtained following saliva deposition in an individual who had engaged in up to 9 h of free activity. The results of this study demonstrate the validity and reliability of DNA profiling for bite mark analysis and are extremely important as they can demonstrate the usefulness of the little information left by a suspect on a victim's body.

Maintenance of dental records and awareness of forensic odontology among pakistani dentists: a mixed-method study with implications for dental data repository

OBJECTIVE

Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan.

METHODOLOGY

This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly.

RESULTS

The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5-20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies.

CONCLUSION

Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices.

Assessment of sex and sexual dimorphism in children from Tamilnadu, India through odontometrics in primary dentition - a cross sectional study with discriminant function analysis

One of the crucial steps in the process of identification of human remains is sex determination of an unknown individual. Sex can be determined using the human skeleton, especially by examining the pelvis and skull. Odontometric analysis and assessment of sexual dimorphism of the human dentition has been less investigated, especially in primary dentition. Hence, this research was designed to verify the presence of sexual dimorphism through odontometric approach in paediatric population of Tamil Nadu, India. The present study was performed on 229 females and 244 males between 3 and 6 years of age. Linear measurements such as maximum mesio distal width, maximum bucco lingual width and clinical crown length were measured in all the primary teeth. Statistical analysis was performed using the Statistical Package for Social Science version 20.0 software (SPSS Inc., Chicago, IL, USA). Mann-Whitney-U test was used to check the statistical significance of the differences observed between males and females. Six equations were derived by discriminant function analysis for practical use. Sexual dimorphism existed in odontometric parameters of primary dentition. The maximum sexual dimorphism was observed in maximum bucco lingual width of 51 and maximum bucco lingual width of 75. The equations derived using discriminant function analysis yielded a jackknife accuracy ranging between 87.5% and 99.8%. These equations may be used to assess the sex from the children of Tamil Nadu, India.

3D-3D dentition superimposition for individual identification: A study of an Eastern Chinese population

Recently, 3D dental intraoral scanning technology has been developed rapidly and applied widely in everyday dental practice. Since 3D dental scanning could provide valuable personal information, it enabled researchers to develop novel procedures for individual identification through 3D-3D dentition superimposition. This study aimed to test the applicability of this method in an Eastern Chinese population and propose a threshold for personal identification. For this purpose, 40 volunteers were recruited, and the initial 80 (upper and lower) 3D intraoral scans (IOS) were collected. After one year, 80 IOS of these volunteers were repeatedly collected. In addition, the other 120 IOS of 60 patients were extracted from the database. The 3D models were trimmed, aligned, and superimposed via Geomagic Control X software, and then the root mean square (RMS) value of point-to-point distance between the two models was calculated. The superimposition of two IOS belonging to the same individual was considered as a match, and superimposition of two IOS belonging to different individuals was considered as a mismatch. Totally, superimpositions of 80 matches and 3120 mismatches were obtained. Intra- and inter-observer errors were assessed through the calculation of relative technical error of measurement (rTEM). Mann-Whitney U test verified possible statistically significant differences between matches and mismatches (P < 0.05). The rTEM of intra- and inter-observer repeatability analyses was lower than 4.7 %. The range of RMS value was 0.05-0.18 mm in matches and 0.72-2.28 mm in mismatches without overlapping. The percentage of accurate identification reached 100 % in blind test through an arbitrary RMS threshold of 0.45 mm. The results indicated that individual identification through the 3D-3D dentition superimposition was effective in Eastern Chinese population. Successful identification could be achieved with high probability when the RMS value of the point-to-point distance of two dentitions is <0.45 mm.

Cameriere's open apices methodology for dental age estimation in children: a scoping review from a Latin American perspective

Dental age estimation (DAE) is key to establishing an individual's identity, and this is relevant in minors. A widely used method for DAE in children is Cameriere's open apices (CAM). Despite its wide dissemination, there are no clear reports of its use in Latin American populations. A scoping review was conducted using a search strategy in the PubMed/MEDLINE database, Web of Science, and a complementary manual search. Only papers using CAM or its regression equation models for evaluating Latin American populations were included. Ten studies published between 2007 and 2020 responded to the search objective. Brazil was the country with the most studies using CAM (7/10), and the University of Macerata (Italy) was the most declared affiliation (6/10). Seven studies used the original CAM formula in populations from Brazil and Peru, while the European formula (EuCAM) was applied in Mexico, Colombia, and Brazil. Although the method underestimated the age values with acceptable error margins, the correction factor substantially improved the predictive power of the method. Some limitations of the method are highlighted. CAM and its variants can be useful for validation in Latin American settings, but attention to population structures and terminologies is suggested for future research.

Forensic odontology: Wrong convictions, "bad apples" and "the innocence files"

Forensic odontology (FO) provides expert testimony; however, new criticism has identified FO as one of the fields that must strengthen its scientific foundations. The recent Netflix documentary titled "The Innocence Files", featuring wrongful convictions, dedicates three of its nine episodes almost exclusively to bite mark identification (BMI), one of the most questioned tests performed by FO. Although most of the FO fields have an undoubted utility in forensic and juridical context, only BMI has been questioned in recent years; the derogatory expression "Junk science" is used continuously in the documentary almost as a synonym for FO. We present a scoping review of cases reported in the US National Registry of Exonerations in which FO was false or misleading forensic evidence (F/MFE) leading to wrongful convictions. Although in the 26 cases identified the only declared F/MFE was the BMI (excluding any other type of dental expertise), only in 2 cases (7.69%) was F/MFE the sole contributing factor, and in 4 cases (15.38%) there was F/MFE plus three additional factors. Official misconduct was detected in 19 cases (73.08%) and perjury or false accusation in 16 cases (61.54%). It has already been mentioned how dangerous it is to consider FO as synonymous with "bite mark identification", or even to publicly provide incorrect or decontextualized information. This review shows that erroneous convictions have been exclusively in the field of BMI, and that FO encompasses much more than just BMI. The relationship between the media and forensic sciences has been strained. The perspective of the new culture of risk management in forensics is also discussed.

Automatic sex estimation using deep convolutional neural network based on orthopantomogram images

Sex estimation is very important in forensic applications as part of individual identification. Morphological sex estimation methods predominantly focus on anatomical measurements. Based on the close relationship between sex chromosome genes and facial characterization, craniofacial hard tissues morphology shows sex dimorphism. In order to establish a more labor-saving, rapid, and accurate reference for sex estimation, the study investigated a deep learning network-based artificial intelligence (AI) model using orthopantomograms (OPG) to estimate sex in northern Chinese subjects. In total, 10703 OPG images were divided into training (80%), validation (10%), and test sets (10%). At the same time, different age thresholds were selected to compare the accuracy differences between adults and minors. The accuracy of sex estimation using CNN (convolutional neural network) model was higher for adults (90.97%) compared with minors (82.64%). This work demonstrated that the proposed model trained with a large dataset could be used in automatic morphological sex-related identification with favorable performance and practical significance in forensic science for adults in northern China, while also providing a reference for minors to some extent.

A Survey on forensic odontologists' activity in Italy during the COVID-19 pandemic

Few information on virus contagion at the beginning of the covid-19 pandemic led to severe restrictions in the dental and forensic activity in Italy, the introduction of procedural guidelines and implementation of preventive measures. A specific survey on Italian forensic odontologists (FOds) activity was conducted to investigate the COVD-19 pandemic impact on daily practices, the preventive measures adopted to manage the risks of contagion procedures performed on living and dead people and the possible peculiar cases that required the intervention of a medical examiner. A total of 122 FOds answered, mostly males over 46 years coming from northern Italy. The results highlight the lack of specific guidelines for the procedures on living people compared to those on the dead but the regulations for the daily clinical practice resulted more than sufficient: in fact, more than 80% of FOds adopted the preventive and safety measures provided for dental practices. The forensic activity significantly decreased during the initial period (more than 75%) and gradually normalized to pre-pandemic numbers in approximately 50% of cases after the implementation of the vaccination campaign. 13 cases of occupational contagion have been reported, most of them (more than 85%) in northern and central Italy. In two cases members of the dental staff sued the employer for responsibility in the contagion. The decrease of the overall ID activity during the pandemic time can be more likely attributed to the of the dental data than the real impact of the pandemic regulations. The use of telematic tools, such as teleconferences, for many procedures proved to be an important resource useful for application even in post-pandemic times.

Assessment of permanent teeth development in children with multiple persistent primary teeth

BACKGROUND

Persistent primary teeth (PPT) may occur due to various local factors, or it may develop due to general factors such as systemic diseases and syndromes. Since eruption and dental development are two different processes, it is important to investigate both processes to determine the actual cause of delayed tooth eruption. The study aimed to evaluate the dental development of a group of Turkish children with multiple PPT using the Willems dental age estimation method.

STUDY DESIGN

Digital panoramic radiographs of children and adolescents aged between 9 and 15 years were retrieved, assessed and categorized. A total of 80 radiographs of patients with more than one PPT were selected and matched with children without PPT. Dental age was calculated using the method of Willems et al. All analyses were conducted using the SPSS statistical software. The statistical significance was set at 0.05.

RESULTS

The permanent tooth development of children with multiple PPT could be delayed by 0.5-4 years compared to healthy ones. A strong positive correlation was found between the number of PPT and deviation for both females and males (p < 0.001).

CONCLUSION

In conclusion, we found that permanent tooth development of children with multiple PPT could be delayed compared to healthy ones. In addition, as the number of PPT increased, the difference between chronological age and dental age also increased, especially in males.

A casework study: The effect of the porcine digestive process on animal carcasses and human teeth

What happens if a human body is fed to pigs? Although a popular notion in the entertainment industry, no scientific published literature exists that documents this porcine feeding behaviour, nor, more importantly, what elements of the cadaver may survive such a process. A study conducted in 2020, born out of a casework enquiry, aimed to investigate the following two questions; Would pigs feed on a human body? And, if so, what could be recovered post feeding event? Kangaroo carcasses, porcine carcasses (as human analogues) and 90 human teeth were prepared, and fed, to two domestic pigs, in a variety of feed scenarios. Biological traces including bones, bone fragments, teeth and tooth fragments were recovered both post-digestion from the faeces of the pigs, as well as uneaten from the porcine enclosure. 29% of all human teeth were recovered from the study; 35% of which were recovered post-digestion from the faeces and 65% were recovered uneaten from the porcine enclosure, Of the recovered human teeth, 81% were deemed suitable for identification by a forensic odontologist. From the 447 bones recovered from the enclosure, 94% could be identified to a bone type and species. From all 3338 bone fragments recovered from the faeces of the pigs, none retained any morphological traits that would allow further intelligence to be generated. Overall, it was found that pigs will feed on human analogues and will consume soft tissue, bones, and human teeth. Biological traces in the form of bones, bone fragments, teeth and tooth fragments may be recovered both post-digestion from the faeces, or from the porcine enclosure. The biological traces can be used for identification of an individual via forensic odontology, identification of a species via forensic anthropology and may be suitable for DNA analysis. The outcomes of this study generated new avenues for investigation in the case and may be used to inform future operational resources.

Color change in teeth due to burning: Spectrophotometric analysis

Teeth are one of the most common skeletal elements for forensic identification purposes and also the strongest human tissue, making them resistant to high temperatures. Over the course of burning as temperature increases, teeth go through a process of structural change characterized by a carbonization phase (at approx. 400 °C) and calcination phase (at approx. 700 °C) that might result in complete enamel loss. The aim of the study was to quantify color change of enamel and dentin and to determine whether both tissues can be used for estimating burn temperature as well as to evaluate the whether these changes are visually perceptible. 58 human, permanent maxillary molars without restorations were burned for 60 min at either 400 °C or 700 °C in a Cole-Parmer StableTemp Box Furnace. The change in color was measured for the crown and root using a SpectroShade Micro II spectrophotometer to determine lightness (L*), green-red color (a*), and blue-yellow color (b*). Statistical analysis was performed using SPSS version 22. There is a significant difference between the L*, a*, and b* values of pre-burned enamel and dentin at 400 °C (p < 0.001). In addition, differences in dentin measures between 400 °C and 700 °C (p < 0.001), as well as pre-burned teeth and 700 °C (p < 0.001). The mean L*a*b* values were used to calculate a measure of the perceptible difference between colors (ΔE) revealing a highly perceptible color difference between the pre- and post-burn teeth for both enamel and dentin. There is a low perceptible difference between burned enamel and dentin was found. During the carbonization phase the tooth gets darker and redder and as temperature increases, teeth become bluer. Overall, as calcination occurs the tooth root color gets closer to a neutral gray palette. The results showed a highly perceptible difference indicating that for forensic purposes simple visual color evaluation can provide reliable information, and dentin color evaluation can be used in cases when enamel is missing. However, the spectrophotometer allows an accurate replicable measure of tooth color across various stages of the burning process. This has practical applications in forensic anthropology as a portable and nondestructive technique that can be used in the field regardless of the practitioner's level of experience.

The "hypopigmented" bitemark: a clinical and histologic appraisal

So-called "hypopigmented" bitemark patterns, commonly seen but not limited to dark skinned individuals, can be of value in forensic investigations. The process of aging bitemarks observed on skin is controversial and without guidelines. This report analyzes tissue obtained from the site of a hypopigmented bitemark using special histochemical stains for the identification of melanin pigment, and a panel of immunohistochemical markers to aid in the aging process. Histologic evaluation clearly showed that cellular changes in the hypopigmented area were indicative of wound healing that had taken place over a period of time. This validates the hypothesis that a hypopigmented bitemark is an indication of a wound inflicted some days previously. These findings have value in forensic investigations, particularly in cases of suspected long-term physical abuse.