Craniofacial reconstruction using a combined statistical model of face shape and soft tissue depths: methodology and validation

Analyzing 3D facial morphology: Insights from a comparative European and South African study on population affinity, sex, age, and allometry

Variable growth patterns and multifactorial mechanisms cause variation in facial shape. These differences in facial morphology pose challenges for craniofacial reconstruction. Three-dimensional (3D) imaging modalities are a valuable resource for examining these variations. In this study, we used geometric morphometric methods to evaluate the effects of population affinity, sex, age, and allometry on the variation and covariation of hard and soft tissue facial morphology matrices in a sample of French and white South African individuals. Seventy-six and 108 cone-beam computed tomography scans of white South African and French nationals, respectively, were retrospectively acquired. Three-dimensional anatomical structures (hard and soft tissue matrices) were extracted using MeVisLab© v. 2.7.1 software for dense landmarking of 43 craniometric, 50 capulometric, and 559 sliding landmarks. Geometric morphometric analyses were used to quantify shape differences attributed to population affinity, sex, age, and allometry and assess the covariation between hard tissue structures and soft facial tissues. Hard and soft tissue facial matrices were influenced by population differences, sexual dimorphism, and aging. Compared to sex and age, population affinity had the strongest influence on variation. In French individuals, all hard and soft tissue matrices were sexually dimorphic, except for the eyes and left external auditory meatus (EAM). In white South Africans, sexual dimorphism was observed for the mouth, midface, and left EAM. Significant shape differences were also observed for specific age groups. The underlying skull and overlying soft tissues were strongly associated with the nose and anterior nasal aperture (correlation, r2-PLS = 0.976), followed by the right ear and right EAM (r2-PLS = 0.875) and the left ear and left EAM (r2-PLS = 0.871) in white South Africans. For French individuals, relatively weak to moderate correlations were observed, and the covariation between matrices was nonsignificant, except for the association between the right ear and right EAM (r2-PLS = 0.499). The smallest covariation was observed between the mouth and midfacial matrix in both populations (South African: r2-PLS = 0.464; French: r2-PLS = 0.367), which was also nonsignificant. This study revealed that 3D imaging technology and geometric morphometric methods can accurately quantify and visualize facial morphology differences. These methods can also evaluate the association between skull structure and soft facial features.

The Doppelgänger effect? A comparative study of forensic facial depiction methods

This study attempted to assess the reproducibility of 2D and 3D forensic methods for facial depiction from skeletal remains (2D sketch, 3D manual, 3D automated, 3D computer-assisted). In a blind study, thirteen practitioners produced fourteen facial depictions, using the same skull model derived from CT data of a living donor, a biological profile and relevant soft tissue data. The facial depictions were compared to the donor subject using three different evaluation methods: 3D geometric, 2D face recognition ranking and familiar resemblance ratings. Five of the 3D facial depictions (all 3D methods) demonstrated a deviation error within ± 2 mm for ≥ 50% of the total face surface. Overall, no single 3D method (manual, computer assisted, automated) produced consistently high results across all three evaluations. 2D comparisons with a facial photograph of the donor were carried out for all the 2D and 3D facial depictions using four freely available face recognition algorithms (Toolpie; Photomyne; Face ++; Amazon). The 2D sketch method produced the highest ranked matches to the donor photograph, with overall ranking in the top six. Only one 3D facial depiction was ranked highly in both the 3D geometric and 2D face recognition comparisons. The majority (67%) of the facial depictions were rated as limited or moderate resemblance by the familiar examiner. Only one 2D facial depiction was rated as strong resemblance, whilst two 2D sketches and two 3D facial depictions were rated as good resemblances by the familiar examiner. The four most geometrically accurate 3D facial depictions were only rated as limited or moderate resemblance to the donor by the familiar examiner. The results suggest that where a consistent facial depiction method is utilised, we can expect relatively consistent metric reliability between practitioners. However, presentation standards for practitioners would greatly enhance the possibility of recognition in forensic scenarios.

Protocol for capturing 3D facial meshes for rhinoseptoplasty planning

OBJECTIVES

To present and execute a protocol for the capture of 3D facial images using photogrammetry through the open access software Blender and its add-on OrtogOnBlender (OOB) and to evaluate the compatibility of the 3D meshes generated with Computed tomography (CT) of the sinuses.

METHODS

Individuals >18 years old, candidates for Rhinoseptoplasty in a tertiary hospital, were submitted to a photographic session to perform the standardized protocol. In the session, divided into 3 phases, sequential photos were taken for processing the photogrammetry in the OOB and producing 3D meshes of the face. The photogrammetry reconstructions were compared with the reference mesh of the soft tissue surface of the Sinus CT scan to assess compatibility between them.

RESULTS

21 patients were included, 67% female. 3 photogrammetry meshes and 1 CT reference mesh were generated, which demonstrated matching compatibility, as most of the mean distances between cloud points were <1.48 mm. Phase 3 of the session with the highest number of photos (54.36 ± 15.05) generated the most satisfactory mesh with the best resolution.

CONCLUSIONS

The proposed protocol is reproducible and feasible in clinical practice, generated satisfactory 3D meshes of the face, being a potential tool for surgical planning and comparison of results. For the implementation of photogrammetry for use in 3D anthropometry, it is necessary to validate this method.

LEVEL OF EVIDENCE: 3

OCEBM Levels of Evidence Working Group.1 "The Oxford 2011 Levels of Evidence". Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653.

Facial reconstruction using 3-D computerized method: A scoping review of Methods, current Status, and future developments

Facial reconstruction (otherwise known as facial approximation) is an alternative method that has been widely accepted in forensic anthropological and archaeological circumstances. This method is considered useful for creating the virtual face of a person based on skull remain. Three-dimensional (3-D) traditional facial reconstruction (known as sculpture or manual method) has been recognized for more than a century; however, it was declared to be subjective and required anthropological training. Until recently, with the progression of computational technologies, many studies attempted to develop a more appropriate method, so-called the 3-D computerized facial reconstruction. This method also relied on anatomical knowledge of the face-skull relationship, divided into semi- and automated based computational method. The 3-D computerized facial reconstruction makes it more rapid, more flexible, and more realistic to generate multiple representations of faces. Moreover, new tools and technology are continuously generating fascinating and sound research as well as encouraging multidisciplinary collaboration. This has led to a paradigm shift in the 3-D computerized facial reconstruction to a new finding and new technique based on artificial intelligence in academia. Based on the last 10-years scientific-published documents, this article aims to explain the overview of the 3-D computerized facial reconstruction and progression as well as an issue relating to future directions to encourage further improvement.

Advancement in Human Face Prediction Using DNA

The rapid improvements in identifying the genetic factors contributing to facial morphology have enabled the early identification of craniofacial syndromes. Similarly, this technology can be vital in forensic cases involving human identification from biological traces or human remains, especially when reference samples are not available in the deoxyribose nucleic acid (DNA) database. This review summarizes the currently used methods for predicting human phenotypes such as age, ancestry, pigmentation, and facial features based on genetic variations. To identify the facial features affected by DNA, various two-dimensional (2D)- and three-dimensional (3D)-scanning techniques and analysis tools are reviewed. A comparison between the scanning technologies is also presented in this review. Face-landmarking techniques and face-phenotyping algorithms are discussed in chronological order. Then, the latest approaches in genetic to 3D face shape analysis are emphasized. A systematic review of the current markers that passed the threshold of a genome-wide association (GWAS) of single nucleotide polymorphism (SNP)-face traits from the GWAS Catalog is also provided using the preferred reporting items for systematic reviews and meta-analyses (PRISMA), approach. Finally, the current challenges in forensic DNA phenotyping are analyzed and discussed.

A Comparative Study of Different Schemes Based on Bézier-like Functions with an Application of Craniofacial Fractures Reconstruction

Cranial implants, especially custom made implants, are complex, important and necessary in craniofacial fracture restoration surgery. However, the classical procedure of the manual design of the implant is time consuming and complicated. Different computer-based techniques proposed by different researchers, including CAD/CAM, mirroring, reference skull, thin plate spline and radial basis functions have been used for cranial implant restoration. Computer Aided Geometric Design (CAGD) has also been used in bio-modeling and specifically for the restoration of cranial defects in form of different spline curves, namely C1,C2,GC1GC2, rational curves, B-spline and Non-Uniform Rational B-Spline (NURBS) curves. This paper gives an in-depth comparison of existing techniques by highlighting the limitations and advantage in different contexts. The construction of craniofacial fractures is made using different Bézier-like functions (Ball, Bernstein and Timmer basis functions) and is analyzed in detail. The C1,GC1 and GC2 cubic Ball curves are performed well for construction of the small fractured part. Any form of fracture is constructed using this approach and it has been effectively applied to frontal and parietal bone fractures. However, B-spline and NURBS curves can be used for any type of fractured parts and are more friendly user.

Using Computed Tomography (CT) Data to Build 3D Resources for Forensic Craniofacial Identification

Forensic craniofacial identification encompasses the practices of forensic facial approximation (aka facial reconstruction) and craniofacial superimposition within the field of forensic art in the United States. Training in forensic facial approximation methods historically has used plaster copies, high-cost commercially molded skulls, and photographs. Despite the increased accessibility of computed tomography (CT) and the numerous studies utilizing CT data to better inform facial approximation methods, 3D CT data have not yet been widely used to produce interactive resources or reference catalogs aimed at forensic art practitioner use or method standardization. There are many free, open-source 3D software packages that allow engagement in immersive studies of the relationships between the craniofacial skeleton and facial features and facilitate collaboration between researchers and practitioners. 3D CT software, in particular, allows the bone and soft tissue to be visualized simultaneously with tools such as transparency, clipping, and volume rendering of underlying tissues, allowing for more accurate analyses of bone to soft tissue relationships. Analyses and visualization of 3D CT data can not only facilitate basic research into facial variation and anatomical relationships relevant for reconstructions but can also lead to improved facial reconstruction guidelines. Further, skull and face surface models exported in digital 3D formats allow for 3D printing of custom reference models and novel training materials and modalities for practitioners. This chapter outlines the 3D resources that can be built from CT data for forensic craniofacial identification methods, including how to view 3D craniofacial CT data and modify surface models for 3D printing.

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

The field of facial plastic and reconstructive surgery is privy to a myriad of technological advancements. As innovation in areas such as imaging, computer applications, and biomaterials progresses at breakneck speed, the potential for clinical application is endless. This review of recent progress in the implementation of new technologies in facial plastic surgery highlights some of the most innovative and impactful developments in the past few years of literature. Patient-specific surgical modeling has become the gold standard for oncologic and posttraumatic reconstructive surgery, with demonstrated improvements in operative times, restoration of anatomical structure, and patient satisfaction. Similarly, reductions in revision rates with improvements in learner technical proficiency have been noted with the use of patient-specific models in free flap reconstruction. In the cosmetic realm, simulation-based rhinoplasty implants have drastically reduced operative times while concurrently raising patient postoperative ratings of cosmetic appearance. Intraoperative imaging has also seen recent expansion in its adoption driven largely by reports of eradication of postoperative imaging and secondary-often complicated-revision reconstructions. A burgeoning area likely to deliver many advances in years to come is the integration of bioprinting into reconstructive surgery. Although yet to clearly make the translational leap, the implications of easily generatable induced pluripotent stem cells in replacing autologous, cadaveric, or synthetic tissues in surgical reconstruction are remarkable.

Nose approximation among South African groups from cone-beam computed tomography (CBCT) using a new computer-assisted method based on automatic landmarking

Considering the high demand for the identification of unknown remains in South Africa, a need exists to establish reliable facial approximation techniques that will take into account sex and age and, most importantly, be useful within the South African context. This study aimed to provide accurate statistical models for predicting nasal soft-tissue shape from information about the underlying skull subtract among a South African sample. The database containing 200 cone-beam computer tomography (CBCT) scans (100 black South Africans and 100 white South Africans). The acquisition and extraction of the 3D relevant anatomical structures (hard- and soft-tissue) were performed by an automated three-dimensional (3D) method based on an automatic dense landmarking procedure using MeVisLab © v. 2.7.1 software. An evaluation of shape differences attributed to known factors (ancestry, sex, size, and age) was performed using geometric morphometric and statistical models of prediction were created using a Projection onto Latent Structures Regression (PLSR) algorithm. The accuracy of the estimated soft-tissue nose was evaluated in terms of metric deviations on training and un-trained datasets. Our findings demonstrated the influence of factors (sex, aging, and allometry) on the variability of the hard- and soft-tissue among two South African population groups. This research provides accurate statistical models optimized by including additional information such as ancestry, sex, and age. When using the landmark-to landmark distances, the prediction errors ranged between 1.769mm and 2.164mm for black South Africans at the tip of the nose and the alae, while they ranged from 2.068mm to 2.175mm for the white subsample. The prediction errors on un-trained data were slightly larger, ranging between 2.139mm and 2.833mm for the black South African sample at the tip of the nose and the alae and ranging from 2.575mm to 2.859mm for the white South African sample. This research demonstrates the utilization of an automated 3Dmethod based on an automatic landmarking method as a convenient prerequisite for providing a valid and reliable nose prediction model that meets population-specific standards for South Africans.

The masks of Lorenzo Tenchini: their anatomy and surgical/bioengineering clues

An academic, anatomist, and Lombrosian psychiatrist active at the University of Parma in Italy at the end of the 19th century, Lorenzo Tenchini produced ceroplastic-like masks that are unique in the anatomical Western context. These were prepared from 1885 to 1893 with the aim of 'cataloguing' the behaviour of prison inmates and psychiatric patients based on their facial surface anatomy. Due to the lack of any reference to the procedure used to prepare the masks, studies were undertaken by our group using X-ray scans, infrared spectroscopy, bioptic sampling, and microscopy analysis of the mask constituents. Results showed that the masks were stratified structures including plaster, cotton gauze/human epidermis, and wax, leading to a fabrication procedure reminiscent of 'additive layer manufacturing'. Differences in the depths of these layers were observed in relation to the facial contours, suggesting an attempt to reproduce, at least partially, the three-dimensional features of the facial soft tissues. We conclude the Tenchini masks are the first historical antecedent of the experimental method for face reconstruction used in the early 2000s to test the feasibility of transferring a complete strip of face and scalp from a deceased donor to a living recipient, in preparation for a complete face transplant. In addition, the layering procedure adopted conceptually mimics that developed only in the late 20th century for computer-aided rapid prototyping, and recently applied to bioengineering with biomaterials for a number of human structures including parts of the skull and face. Finally, the masks are a relevant example of mixed ceroplastic-cutaneous preparations in the history of anatomical research for clinical purposes.

Virtual reconstruction of paranasal sinuses from CT data: A feasibility study for forensic application

PURPOSE

The purpose of this study was to report the feasibility of computed modelization and reconstitution of the paranasal sinuses, before and after trauma, from CT data.

MATERIALS AND METHODS

We modeled and reconstructed the paranasal sinuses of two patients (A and B), before and after trauma, using two different softwares (3DSlicer^® and Blender^®). Both patients had different numbers and locations of fractures. The 3DSlicer^® software was used to create a 3D model from CT data. We then imported the 3D data into the Blender^® software, to reconstruct and compare the dimensions of the paranasal sinuses before and after trauma.

RESULTS

The 3 fragments of patient A and the 7 fragments of patient B could be repositioned in the pre-traumatic configuration. Distance measurements proved to be similar between pre- and post-traumatic 3D volumes.

CONCLUSION

After simple trauma, bone facial anatomy reconstruction is manually feasible. The whole procedure could benefit from automatization through machine learning. However, this feasibility must be confirmed on more severely fractured paranasal sinuses, to consider an application in forensic identification.

An overview of the latest developments in facial imaging

Facial imaging is a term used to describe methods that use facial images to assist or facilitate human identification. This pertains to two craniofacial identification procedures that use skulls and faces-facial approximation and photographic superimposition-as well as face-only methods for age progression/regression, the construction of facial graphics from eyewitness memory (including composites and artistic sketches), facial depiction, face mapping and newly emerging methods of molecular photofitting. Given the breadth of these facial imaging techniques, it is not surprising that a broad array of subject-matter experts participate in and/or contribute to the formulation and implementation of these methods (including forensic odontologists, forensic artists, police officers, electrical engineers, anatomists, geneticists, medical image specialists, psychologists, computer graphic programmers and software developers). As they are concerned with the physical characteristics of humans, each of these facial imaging areas also falls in the domain of physical anthropology, although not all of them have been traditionally regarded as such. This too offers useful opportunities to adapt established methods in one domain to others more traditionally held to be disciplines within physical anthropology (e.g. facial approximation, craniofacial superimposition and face photo-comparison). It is important to note that most facial imaging methods are not currently used for identification but serve to assist authorities in narrowing or directing investigations such that other, more potent, methods of identification can be used (e.g. DNA). Few, if any, facial imaging approaches can be considered honed end-stage scientific methods, with major opportunities for physical anthropologists to make meaningful contributions. Some facial imaging methods have considerably stronger scientific underpinnings than others (e.g. facial approximation versus face mapping), some currently lie entirely within the artistic sphere (facial depiction), and yet others are so aspirational that realistic capacity to obtain their aims has strongly been questioned despite highly advanced technical approaches (molecular photofitting). All this makes for a broad-ranging, dynamic and energetic field that is in a constant state of flux. This manuscript provides a theoretical snapshot of the purposes of these methods, the state of science as it pertains to them, and their latest research developments.

A facial reconstruction method based on new mesh deformation techniques

This article presents a new numerical method for facial reconstruction. The problem is the following: given a dry skull, reconstruct a virtual face that would help in the identification of the subject. The approach combines classical features as the use of a skulls/faces database and more original aspects: (1) an original shape matching method is used to link the unknown skull to the database templates; (2) the final face is seen as an elastic 3D mask that is deformed and adapted onto the unknown skull. In this method, the skull is considered as a whole surface and not restricted to some anatomical landmarks, allowing a dense description of the skull/face relationship. Also, the approach is fully automated. Various results are presented to show its efficiency.

Assessment of accuracy and recognition of three-dimensional computerized forensic craniofacial reconstruction

Facial reconstruction is a technique that aims to reproduce the individual facial characteristics based on interpretation of the skull, with the objective of recognition leading to identification. The aim of this paper was to evaluate the accuracy and recognition level of three-dimensional (3D) computerized forensic craniofacial reconstruction (CCFR) performed in a blind test on open-source software using computed tomography (CT) data from live subjects. Four CCFRs were produced by one of the researchers, who was provided with information concerning the age, sex, and ethnic group of each subject. The CCFRs were produced using Blender® with 3D models obtained from the CT data and templates from the MakeHuman® program. The evaluation of accuracy was carried out in CloudCompare, by geometric comparison of the CCFR to the subject 3D face model (obtained from the CT data). A recognition level was performed using the Picasa® recognition tool with a frontal standardized photography, images of the subject CT face model and the CCFR. Soft-tissue depth and nose, ears and mouth were based on published data, observing Brazilian facial parameters. The results were presented from all the points that form the CCFR model, with an average for each comparison between 63% and 74% with a distance -2.5 ≤ x ≤ 2.5 mm from the skin surface. The average distances were 1.66 to 0.33 mm and greater distances were observed around the eyes, cheeks, mental and zygomatic regions. Two of the four CCFRs were correctly matched by the Picasa® tool. Free software programs are capable of producing 3D CCFRs with plausible levels of accuracy and recognition and therefore indicate their value for use in forensic applications.

Growth Patterns and Individual Variation in Mid-sagittal Facial Soft Tissue Depth from Childhood to Adulthood

Previous studies have used longitudinal samples to investigate growth of the skeletal aspects of the face, although far less has been done on facial soft tissue. This study uses a larger sample than previous studies on the same data (Denver and Fels growth series) to explore covariation of bony and soft facial dimensions comprehensively from childhood to adulthood. A total of 1036 lateral cephalometric radiographs were digitized from 60 individuals, and distances between facial landmarks were measured using ImageJ. Multivariate analysis of variance (MANOVA) showed all bony facial landmark distances were significantly different (p > 0.05) between age groups; however, only half were significantly different between sexes. Further analysis showed the effect of age (calculated as eta-squared) explained a greater percentage of total variation (20%) than sex (15%). Overall, soft tissue changes between 0 and 19 years of age were small (<3 mm) and only some were correlated to underlying facial skeleton dimensions.

Automated facial recognition of manually generated clay facial approximations: Potential application in unidentified persons data repositories

This research examined how accurately 2D images (i.e., photographs) of 3D clay facial approximations were matched to corresponding photographs of the approximated individuals using an objective automated facial recognition system. Irrespective of search filter (i.e., blind, sex, or ancestry) or rank class (R₁, R₁₀, R₂₅, and R₅₀) employed, few operationally informative results were observed. In only a single instance of 48 potential match opportunities was a clay approximation matched to a corresponding life photograph within the top 50 images (R₅₀) of a candidate list, even with relatively small gallery sizes created from the application of search filters (e.g., sex or ancestry search restrictions). Increasing the candidate lists to include the top 100 images (R₁₀₀) resulted in only two additional instances of correct match. Although other untested variables (e.g., approximation method, 2D photographic process, and practitioner skill level) may have impacted the observed results, this study suggests that 2D images of manually generated clay approximations are not readily matched to life photos by automated facial recognition systems. Further investigation is necessary in order to identify the underlying cause(s), if any, of the poor recognition results observed in this study (e.g., potential inferior facial feature detection and extraction). Additional inquiry exploring prospective remedial measures (e.g., stronger feature differentiation) is also warranted, particularly given the prominent use of clay approximations in unidentified persons casework.

About Face: Matching Unfamiliar Faces Across Rotations of View and Lighting

Matching the identities of unfamiliar faces is heavily influenced by variations in their images. Changes to viewpoint and lighting direction during face perception are commonplace across yaw and pitch axes and can result in dramatic image differences. We report two experiments that, for the first time, factorially investigate the combined effects of lighting and view angle on matching performance for unfamiliar faces. The use of three-dimensional head models allowed control of both lighting and viewpoint. We found viewpoint effects in the yaw axis with little to no effect of lighting. However, for rotations about the pitch axis, there were both viewpoint and lighting effects and these interacted where lighting effects were found only for front views and views from below. The pattern of effects was similar regardless of whether view variation occurred as a result of head (Experiment 1) or camera (Experiment 2) suggesting that face matching is not purely image based. Along with face inversion effects in Experiment 1, the results of this study suggest that face perception is based on shape and surface information and draws on implicit knowledge of upright faces and ecological (top) lighting conditions.

A statistical shape model of the skull developed from a South African population

This paper discusses the development of a statistical shape model (SSM) of the skull from a South African population. A total of 16 skulls is used together with a reference from the Basel Face Model. A free-form deformation model is built using the reference model and the squared exponential kernel. The freeform model is used to establish dense correspondence across the skull sample and the in-correspondence skulls are then used to build an SSM. The validity of the SSM is assessed using leave-one-out cross-validation with its generality ranging between 1.47 mm and 1.84 mm and, the specificity ranging between 1.74 mm and 2.11 mm.

Craniofacial similarity analysis through sparse principal component analysis

The computer-aided craniofacial reconstruction (CFR) technique has been widely used in the fields of criminal investigation, archaeology, anthropology and cosmetic surgery. The evaluation of craniofacial reconstruction results is important for improving the effect of craniofacial reconstruction. Here, we used the sparse principal component analysis (SPCA) method to evaluate the similarity between two sets of craniofacial data. Compared with principal component analysis (PCA), SPCA can effectively reduce the dimensionality and simultaneously produce sparse principal components with sparse loadings, thus making it easy to explain the results. The experimental results indicated that the evaluation results of PCA and SPCA are consistent to a large extent. To compare the inconsistent results, we performed a subjective test, which indicated that the result of SPCA is superior to that of PCA. Most importantly, SPCA can not only compare the similarity of two craniofacial datasets but also locate regions of high similarity, which is important for improving the craniofacial reconstruction effect. In addition, the areas or features that are important for craniofacial similarity measurements can be determined from a large amount of data. We conclude that the craniofacial contour is the most important factor in craniofacial similarity evaluation. This conclusion is consistent with the conclusions of psychological experiments on face recognition and our subjective test. The results may provide important guidance for three- or two-dimensional face similarity evaluation, analysis and face recognition.

Facial surface morphology predicts variation in internal skeletal shape

INTRODUCTION

The regular collection of 3-dimensional (3D) imaging data is critical to the development and implementation of accurate predictive models of facial skeletal growth. However, repeated exposure to x-ray-based modalities such as cone-beam computed tomography has unknown risks that outweigh many potential benefits, especially in pediatric patients. One solution is to make inferences about the facial skeleton from external 3D surface morphology captured using safe nonionizing imaging modalities alone. However, the degree to which external 3D facial shape is an accurate proxy of skeletal morphology has not been previously quantified. As a first step in validating this approach, we tested the hypothesis that population-level variation in the 3D shape of the face and skeleton significantly covaries.

METHODS

We retrospectively analyzed 3D surface and skeletal morphology from a previously collected cross-sectional cone-beam computed tomography database of nonsurgical orthodontics patients and used geometric morphometrics and multivariate statistics to test the hypothesis that shape variation in external face and internal skeleton covaries.

RESULTS

External facial morphology is highly predictive of variation in internal skeletal shape ([Rv] = 0.56, P <0.0001; partial least squares [PLS] 1-13 = 98.7% covariance, P <0.001) and asymmetry (Rv = 0.34, P <0.0001; PLS 1-5 = 90.2% covariance, P <0.001), whereas age-related (r(2) = 0.84, P <0.001) and size-related (r(2) = 0.67, P <0.001) shape variation was also highly correlated.

CONCLUSIONS

Surface morphology is a reliable source of proxy data for the characterization of skeletal shape variation and thus is particularly valuable in research designs where reducing potential long-term risks associated with radiologic imaging methods is warranted. We propose that longitudinal surface morphology from early childhood through late adolescence can be a valuable source of data that will facilitate the development of personalized craniodental and treatment plans and reduce exposure levels to as low as reasonably achievable.

Forensic facial reconstruction: Nasal projection in Brazilian adults

The nose has a marked cognitive influence on facial image; however, it loses its shape during cadaveric decomposition. The known methods of estimating nasal projection using Facial Reconstruction are lacking in practicality and reproducibility. We attempted to relate the points Rhinion, Pronasale and Prosthion by studying the angle formed by straight lines that connect them. Two examiners measured this angle with the help of analysis and image-processing software, Image J, directly from cephalometric radiographs. The sample consisted of 300 males, aged between 24 and 77 years, and 300 females, aged 24 to 69 years. The proposed angle ranged from 80° to 100° in both sexes and all ages. It was considered possible to use a 90° angle from projections of the Rhinion and Prosthion points in order to determine the Pronasale position, as well as to estimate the nasal projection of Brazilian adults.

A regional method for craniofacial reconstruction based on coordinate adjustments and a new fusion strategy

Craniofacial reconstruction recreates a facial outlook from the cranium based on the relationship between the face and the skull to assist identification. But craniofacial structures are very complex, and this relationship is not the same in different craniofacial regions. Several regional methods have recently been proposed, these methods segmented the face and skull into regions, and the relationship of each region is then learned independently, after that, facial regions for a given skull are estimated and finally glued together to generate a face. Most of these regional methods use vertex coordinates to represent the regions, and they define a uniform coordinate system for all of the regions. Consequently, the inconsistence in the positions of regions between different individuals is not eliminated before learning the relationships between the face and skull regions, and this reduces the accuracy of the craniofacial reconstruction. In order to solve this problem, an improved regional method is proposed in this paper involving two types of coordinate adjustments. One is the global coordinate adjustment performed on the skulls and faces with the purpose to eliminate the inconsistence of position and pose of the heads; the other is the local coordinate adjustment performed on the skull and face regions with the purpose to eliminate the inconsistence of position of these regions. After these two coordinate adjustments, partial least squares regression (PLSR) is used to estimate the relationship between the face region and the skull region. In order to obtain a more accurate reconstruction, a new fusion strategy is also proposed in the paper to maintain the reconstructed feature regions when gluing the facial regions together. This is based on the observation that the feature regions usually have less reconstruction errors compared to rest of the face. The results demonstrate that the coordinate adjustments and the new fusion strategy can significantly improve the craniofacial reconstructions.

Correlation between average tissue depth data and quantitative accuracy of forensic craniofacial reconstructions measured by geometric surface comparison method

Accuracy is the most important factor supporting the reliability of forensic facial reconstruction (FFR) comparing to the corresponding actual face. A number of methods have been employed to evaluate objective accuracy of FFR. Recently, it has been attempted that the degree of resemblance between computer-generated FFR and actual face is measured by geometric surface comparison method. In this study, three FFRs were produced employing live adult Korean subjects and three-dimensional computerized modeling software. The deviations of the facial surfaces between the FFR and the head scan CT of the corresponding subject were analyzed in reverse modeling software. The results were compared with those from a previous study which applied the same methodology as this study except average facial soft tissue depth dataset. Three FFRs of this study that applied updated dataset demonstrated lesser deviation errors between the facial surfaces of the FFR and corresponding subject than those from the previous study. The results proposed that appropriate average tissue depth data are important to increase quantitative accuracy of FFR.

Toward DNA-based facial composites: preliminary results and validation

The potential of constructing useful DNA-based facial composites is forensically of great interest. Given the significant identity information coded in the human face these predictions could help investigations out of an impasse. Although, there is substantial evidence that much of the total variation in facial features is genetically mediated, the discovery of which genes and gene variants underlie normal facial variation has been hampered primarily by the multipartite nature of facial variation. Traditionally, such physical complexity is simplified by simple scalar measurements defined a priori, such as nose or mouth width or alternatively using dimensionality reduction techniques such as principal component analysis where each principal coordinate is then treated as a scalar trait. However, as shown in previous and related work, a more impartial and systematic approach to modeling facial morphology is available and can facilitate both the gene discovery steps, as we recently showed, and DNA-based facial composite construction, as we show here. We first use genomic ancestry and sex to create a base-face, which is simply an average sex and ancestry matched face. Subsequently, the effects of 24 individual SNPs that have been shown to have significant effects on facial variation are overlaid on the base-face forming the predicted-face in a process akin to a photomontage or image blending. We next evaluate the accuracy of predicted faces using cross-validation. Physical accuracy of the facial predictions either locally in particular parts of the face or in terms of overall similarity is mainly determined by sex and genomic ancestry. The SNP-effects maintain the physical accuracy while significantly increasing the distinctiveness of the facial predictions, which would be expected to reduce false positives in perceptual identification tasks. To the best of our knowledge this is the first effort at generating facial composites from DNA and the results are preliminary but certainly promising, especially considering the limited amount of genetic information about the face contained in these 24 SNPs. This approach can incorporate additional SNPs as these are discovered and their effects documented. In this context we discuss three main avenues of research: expanding our knowledge of the genetic architecture of facial morphology, improving the predictive modeling of facial morphology by exploring and incorporating alternative prediction models, and increasing the value of the results through the weighted encoding of physical measurements in terms of human perception of faces.

A spatially-dense regression study of facial form and tissue depth: towards an interactive tool for craniofacial reconstruction

Forensic Craniofacial Reconstruction (CFR) is an investigative technique used to illicit recognition of a deceased person by reconstructing the most likely face starting from the skull. A key component in most CFR methods are estimates of facial soft tissue depths (TD) at particular points (landmarks) on the skull based on averages from databases of TD recordings. These databases vary in their method of extraction, number and position of landmarks (usually sparse <100), condition of the body, population studied, and sub-categorization of the data. In this work a new dataset is presented in a novel manner based on 156 CT scans using a spatially-dense set (∼7500) of TD recordings to allow for a complete understanding of TD variation interpolating between typical landmarks. Furthermore, to unravel the interplay between soft-tissue layers, skull and facial morphology, TD and Facial Form (FF) are investigated both separately and combined. Using a partial least squares regression (PLSR) analysis, which allows for working with multivariate and spatially-dense data, on metadata of Sex, Age and BMI, different significant patterns on TD and FF variation were found. A similar, but with TD and FF combined, PLSR generated a model useful to report on both, in function of Sex, Age and BMI. In contrast to other datasets and due to the continuous nature of the regression there is no need for data sub-categorization. In further contrast, previous datasets have been presented in tabulated form, which is impractical for spatially-dense data. Instead an interactive tool was built to visualize the regression model in an accessible way for CFR practitioners as well as anatomists. The tool is free to the community and forms a base for data contributions to augment the model and its future use in practice.

Is post-mortem ultrasonography a useful tool for forensic purposes?

PURPOSE

To investigate the interest of post-mortem ultrasonography in the diagnosis of pathological background, and manner and cause of death.

METHODS

Post-mortem ultrasonography exams were carried out on 38 fresh human adult cadavers referred to the Department of Forensic Medicine and Pathology (Garches, France). Data obtained from ultrasonography were independently compared with further forensic autopsy findings.

RESULTS

Two important limitations relative to ultrasound utilization appeared: hyper-echoic abdominal and thoracic walls, with gas distension of the whole digestive tube and subcutaneous tissues (due to precocious putrefactive gas releasing); and difficulty in accessing lateral and posterior structures (i.e. liver, spleen, kidneys, lung bases, aorta) due to rigor mortis and evident non-compliance of the subject. Post-mortem diagnoses (moderate ascites, gallbladder stones, bladder globe, chronic kidney disease, cirrhosis, thyroid gland cysts and hypertrophy, intrauterine device), were strongly limited. False negative diagnoses comprised fatty liver, pleural effusion, thoracic aortic dissection, and focal organ and/or soft tissues lesions (for example, wounds or infarcts).

CONCLUSION

According to the results, post-mortem ultrasonography seems to have a very limited role for forensic purposes. Other post-mortem utilizations are cited, proposed, and discussed.

FACE-R--a 3D database of 400 living individuals' full head CT- and face scans and preliminary GMM analysis for craniofacial reconstruction

In the past, improvements in craniofacial reconstructions (CFR) methodology languished due to the lack of adequate 3D databases that were sufficiently large and appropriate for 3-dimensional shape statistics. In our study, we created the "FACE-R" database from CT records and 3D surface scans of 400 clinical patients from Hungary, providing a significantly larger sample that was available before. The uniqueness of our database is linking of two data types that makes possible to investigate the bone and skin surface of the same individual, in upright position, thus eliminating many of the gravitational effects on the face during CT scanning. We performed a preliminary geometric morphometric (GMM) study using 3D data that produces a general idea of skull and face shape correlations. The vertical position of the tip of the (soft) nose for a skull and landmarks such as rhinion need to be taken into account. Likewise, the anterior nasal spine appears to exert some influence in this regard.

Design of composite scaffolds and three-dimensional shape analysis for tissue-engineered ear

Engineered cartilage is a promising option for auricular reconstruction. We have previously demonstrated that a titanium wire framework within a composite collagen ear-shaped scaffold helped to maintain the gross dimensions of the engineered ear after implantation, resisting the deformation forces encountered during neocartilage maturation and wound healing. The ear geometry was redesigned to achieve a more accurate aesthetic result when implanted subcutaneously in a nude rat model. A non-invasive method was developed to assess size and shape changes of the engineered ear in three dimensions. Computer models of the titanium framework were obtained from CT scans before and after implantation. Several parameters were measured including the overall length, width and depth, the minimum intrahelical distance and overall curvature values for each beam section within the framework. Local curvature values were measured to gain understanding of the bending forces experienced by the framework structure in situ. Length and width changed by less than 2%, whereas the depth decreased by approximately 8% and the minimum intrahelical distance changed by approximately 12%. Overall curvature changes identified regions most susceptible to deformation. Eighty-nine per cent of local curvature measurements experienced a bending moment less than 50 µN-m owing to deformation forces during implantation. These quantitative shape analysis results have identified opportunities to improve shape fidelity of engineered ear constructs.

Is characterizing the digital forensic facial reconstruction with hair necessary? A familiar assessors' analysis

BACKGROUND

In the international scientific literature, there are few studies that emphasize the presence or absence of hair in forensic facial reconstructions. There are neither Brazilian studies concerning digital facial reconstructions without hair, nor research comparing recognition tests between digital facial reconstructions with hair and without hair. The miscegenation of Brazilian people is considerable. Brazilian people, and, in particular, Brazilian women, even if considered as Caucasoid, may present the hair in very different ways: curly, wavy or straight, blonde, red, brown or black, long or short, etc. For this reason, it is difficult to find a correct type of hair for facial reconstruction (unless, in real cases, some hair is recovered with the skeletal remains).

AIMS AND METHODS

This study focuses on the performance of three different digital forensic facial reconstructions, without hair, of a Brazilian female subject (based on one international database and two Brazilian databases for soft facial-tissue thickness) and evaluates the digital forensic facial reconstructions comparing them to photographs of the target individual and nine other subjects, employing the recognition method. A total of 22 assessors participated in the recognition process; all of them were familiar with the 10 individuals who composed the face pool.

RESULTS AND CONCLUSIONS

The target subject was correctly recognized by 41% of the 22 examiners in the International Pattern, by 32% in the Brazilian Magnetic Resonance Pattern and by 32% in the Brazilian Fresh Cadavers Pattern. The facial reconstructions without hair were correctly recognized using the three databases of facial soft-tissue thickness. The observed results were higher than the results obtained using facial reconstructions with hair, from the same skull, which can indicate that it is better to not use hair, at least when there is no information concerning its characteristics.

Pronasale position: an appraisal of two recently proposed methods for predicting nasal projection in facial reconstruction

This study examines two recently proposed methods for predicting nose projection from the skull, those developed by Stephan et al. (Am J Phys Anthropol 122, 2003, 240) and Rynn et al. (Forensic Sci Med Pathol 6, 2010, 20). A sample of 86 lateral head cephalograms of adult subjects from Central Europe was measured, and the actual and predicted dimensions were compared. Regarding nose projection (the anterior and vertical position of the pronasale), in general, the method of Rynn et al. (Forensic Sci Med Pathol 6, 2010, 20) was found to perform better and with less error variance than the method of Stephan et al. (Am J Phys Anthropol 122, 2003, 240), but the mean difference between the actual and predicted values did not exceed 2.2 mm (6.5% of the actual dimension) in most of the variables tested. The vertical dimensions of the nose were predictable with greater accuracy than the horizontal dimensions. Although the mean error of both methods is not great in practice and thus both methods could be considered to be "accurate," the real variance of error should not be overlooked.

The normal-equivalent: a patient-specific assessment of facial harmony

Evidence-based practice in oral and maxillofacial surgery would greatly benefit from an objective assessment of facial harmony or gestalt. Normal reference faces have previously been introduced, but they describe harmony in facial form as an average only and fail to report on harmonic variations found between non-dysmorphic faces. In this work, facial harmony, in all its complexity, is defined using a face-space, which describes all possible variations within a non-dysmorphic population; this was sampled here, based on 400 healthy subjects. Subsequently, dysmorphometrics, which involves the measurement of morphological abnormalities, is employed to construct the normal-equivalent within the given face-space of a presented dysmorphic face. The normal-equivalent can be seen as a synthetic identical but unaffected twin that is a patient-specific and population-based normal. It is used to extract objective scores of facial discordancy. This technique, along with a comparing approach, was used on healthy subjects to establish ranges of discordancy that are accepted to be normal, as well as on two patient examples before and after surgical intervention. The specificity of the presented normal-equivalent approach was confirmed by correctly attributing abnormality and providing regional depictions of the known dysmorphologies. Furthermore, it proved to be superior to the comparing approach.

Sexual dimorphism in multiple aspects of 3D facial symmetry and asymmetry defined by spatially dense geometric morphometrics

Accurate measurement of facial sexual dimorphism is useful to understanding facial anatomy and specifically how faces influence, and have been influenced by, sexual selection. An important facial aspect is the display of bilateral symmetry, invoking the need to investigate aspects of symmetry and asymmetry separately when examining facial shape. Previous studies typically employed landmarks that provided only a sparse facial representation, where different landmark choices could lead to contrasting outcomes. Furthermore, sexual dimorphism is only tested as a difference of sample means, which is statistically the same as a difference in population location only. Within the framework of geometric morphometrics, we partition facial shape, represented in a spatially dense way, into patterns of symmetry and asymmetry, following a two-factor anova design. Subsequently, we investigate sexual dimorphism in symmetry and asymmetry patterns separately, and on multiple aspects, by examining (i) population location differences as well as differences in population variance-covariance; (ii) scale; and (iii) orientation. One important challenge in this approach is the proportionally high number of variables to observations necessitating the implementation of permutational and computationally feasible statistics. In a sample of gender-matched young adults (18-25 years) with self-reported European ancestry, we found greater variation in male faces than in women for all measurements. Statistically significant sexual dimorphism was found for the aspect of location in both symmetry and asymmetry (directional asymmetry), for the aspect of scale only in asymmetry (magnitude of fluctuating asymmetry) and, in contrast, for the aspect of orientation only in symmetry. Interesting interplays with hypotheses in evolutionary and developmental biology were observed, such as the selective nature of the force underpinning sexual dimorphism and the genetic independence of the structural patterns of fluctuating asymmetry. Additionally, insights into growth patterns of the soft tissue envelope of the face and underlying skull structure can also be obtained from the results.

Facial soft tissue thicknesses of the mid-face for Slovak population

Forensic facial approximation is used as a tool for recreating the antemortem appearance of unknown dead and thus facilitates their identification. Several approaches to facial approximation are based on data on facial soft tissue thicknesses (FSTTs). The availability of sex-, age- and population-specific data contributes to the accuracy of the resulting facial approximation model. In this paper, first data set on FSTTs for a Central European population are presented. Soft tissue thicknesses of the mid-face were measured on 160 head CT-scans of 80 males and 80 females aged from 18 to 87 years. These CT-scans were made available after being a part of the diagnostic procedure concerning the paranasal sinuses of the patients. Basic descriptive statistics (i.e. mean, SD, median, range) for the FSTTs at 14 facial landmarks is reported separately by sex and age. Such information allows the forensic artist to choose the most suitable values for the FSTT considering the previous physiological and osteological analysis of the human remains.

An accuracy assessment of forensic computerized facial reconstruction employing cone-beam computed tomography from live subjects

The utilization of 3D computerized systems has allowed more effective procedures for forensic facial reconstruction. Three 3D computerized facial reconstructions were produced using skull models from live adult Korean subjects to assess facial morphology prediction accuracy. The 3D skeletal and facial data were recorded from the subjects in an upright position using a cone-beam CT scanner. Shell-to-shell deviation maps were created using 3D surface comparison software, and the deviation errors between the reconstructed and target faces were measured. Results showed that 54%, 65%, and 77% of the three facial reconstruction surfaces had <2.5 mm of error when compared to the relevant target face. The average error for each reconstruction was -0.46 mm (SD = 2.81) for A, -0.31 mm (SD = 2.40) for B, and -0.49 mm (SD = 2.16) for C. The facial features of the reconstructions demonstrated good levels of accuracy compared to the target faces.