Statistical Evidence for the Similarity of the Human Dentition

Evaluation of Bitemark Analysis's Potential Application in Forensic Identification: A Systematic Review

Bitemark analysis involves the examination of both patterned injuries and contextual circumstances, combining morphological and positional data. Considering the uniqueness of human dentition, bitemarks caused by teeth on skin or impressions on flexible surfaces could assist in human identification.

AIMS

to investigate the available literature systematically and evaluate the scientific evidence published over the past decade concerning the potential application of bitemark analysis in forensic identification.

METHODS

Two researchers meticulously searched electronic databases from January 2012 to December 2023, including Scopus, PubMed, Web of Science, and the Cochrane Library. Adhering to the PRISMA statement guidelines, this review employed appropriate medical subject headings (MeSHs) and free-text synonyms. Strict inclusion and exclusion criteria were applied during article retrieval.

RESULTS

The findings yielded controversial outcomes. Approximately two-thirds of the articles concluded that bitemark analysis is useful in forensic identification, while the remaining articles did not report statistically significant outcomes and cautioned against relying solely on bitemark analysis for identification.

CONCLUSIONS

The authors assert that bitemark analysis can be a reliable and complementary method for forensic identification, contingent upon the establishment and adoption of a universally accepted global protocol for data collection, processing, and interpretation. Undoubtedly, recent years have witnessed a notable increase in research focused on bitemark identification, driven by the goal of achieving quantitative, objective, reproducible, and accurate results.

Frontal Sinus Morphological and Dimensional Variation as Seen on Computed Tomography Scans

Frontal sinus variation has been used in forensic anthropology to aid in positive identification since the 1920s. As imaging technology has evolved, so has the quality and quantity of data that practitioners can collect. This study examined frontal sinus morphological and dimensional variation on computed tomography (CT) scans in 325 individuals for assigned sex females and males from African-, Asian-, European-, and Latin American-derived groups. Full coronal sinus outlines from medically derived CT images were transferred into SHAPE v1.3 for elliptical Fourier analysis (EFA). The dimensional data were measured directly from the images using the MicroDicom viewer. Statistical analyses—Pearson’s chi-square, ANOVA, and Tukey post hoc tests—were run in R Studio. Results indicated that 3.7% lacked a frontal sinus and 12.0% had a unilateral sinus, usually on the left (74.3%). Additionally, no statistically significant morphological clustering using EFA was found based on assigned sex and/or population affinity. However, there were statistically significant differences dimensionally (height and depth) when tested against assigned sex and population affinity, indicating that the interactive effects of sexual dimorphism and adaptive population histories influence the dimensions but not the shape of the frontal sinus.

Review of a forensic pseudoscience: Identification of criminals from bitemark patterns

The forensic sciences are a combination of laboratory procedures and physical comparisons of objects associated with victims, perpetrators, and crime scenes. The former is largely university-based protocols adopted by crime labs. The latter is predominantly pattern-matching tools originally developed by police examiners or experts deemed by courts to be relevant to forensic matters. These Court accepted experts bring their reasoning and conclusions into the legal arena. This subgroup of forensics has undergone significant scrutiny in regards to its history of exaggerated claims and weak scientific foundations. This paper addresses the rise and fall of bitemark pattern analysis (i.e. "matching" bitemarks in human flesh to human teeth) in the environment of opposing interests and agendas.

Epidermis and Enamel: Insights Into Gnawing Criticisms of Human Bitemark Evidence

Critics describe forensic dentists' management of bitemark evidence as junk science with poor sensitivity and specificity and state that linkages to a biter are unfounded. Those vocal critics, supported by certain media, characterize odontologists' previous errors as egregious and petition government agencies to render bitemark evidence inadmissible. Odontologists acknowledge that some practitioners have made past mistakes. However, it does not logically follow that the errors of a few identify a systemic failure of bitemark analysis. Scrutiny of the contentious cases shows that most occurred 20 to 40 years ago. Since then, research has been ongoing and more conservative guidelines, standards, and terminology have been adopted so that past errors are no longer reflective of current safeguards. The authors recommend a comprehensive root analysis of problem cases to be used to determine all the factors that contributed to those previous problems. The legal community also shares responsibility for some of the past erroneous convictions. Currently, most proffered bitemark cases referred to odontologists do not reach courts because those forensic dentists dismiss them as unacceptable or insufficient for analysis. Most bitemark evidence cases have been properly managed by odontologists. Bitemark evidence and testimony remain relevant and have made significant contributions in the justice system.

Three-dimensional analysis of the uniqueness of the anterior dentition in orthodontically treated patients and twins

Dental uniqueness can be proven if no perfect match in pair-wise morphological comparisons of human dentitions is detected. Establishing these comparisons in a worldwide random population is practically unfeasible due to the need for a large and representative sample size. Sample stratification is an option to reduce sample size. The present study investigated the uniqueness of the human dentition in randomly selected subjects (Group 1), orthodontically treated patients (Group 2), twins (Group 3), and orthodontically treated twins (Group 4) in comparison with a threshold control sample of identical dentitions (Group 5). The samples consisted of digital cast files (DCF) obtained through extraoral 3D scanning. A total of 2.013 pair-wise morphological comparisons were performed (Group 1 n=110, Group 2 n=1.711, Group 3 n=172, Group 4 n=10, Group 5 n=10) with Geomagic Studio^® (3D Systems^®, Rock Hill, SC, USA) software package. Comparisons within groups were performed quantifying the morphological differences between DCF in Euclidean distances. Comparisons between groups were established applying One-way ANOVA. To ensure fair comparisons a post-hoc Power Analysis was performed. ROC analysis was applied to distinguish unique from non-unique dentures. Identical DCF were not detected within the experimental groups (from 1 to 4). The most similar DCF had Euclidian distance of 5.19mm in Group 1, 2.06mm in Group 2, 2.03mm in Group 3, and 1.88mm in Group 4. Groups 2 and 3 were statistically different from Group 5 (p<0.05). Statistically significant difference between Group 4 and 5 revealed to be possible including more pair-wise comparisons in both groups. The ROC analysis revealed sensitivity rate of 80% and specificity between 66.7% and 81.6%. Evidence to sustain the uniqueness of the human dentition in random and stratified populations was observed in the present study. Further studies testing the influence of the quantity of tooth material on morphological difference between dentitions and its impact on uniqueness remain necessary.

Uniqueness of the anterior dentition three-dimensionally assessed for forensic bitemark analysis

The uniqueness of the human dentition (UHD) is an important concept in the comparative process in bitemark analysis. During this analysis, the incisal edges of the suspects' teeth are matched with the bitemarks collected from the victim's body or crime scenes. Despite playing an essential part to exclude suspects, the UHD contained in the involved incisal tooth edges remains an assumption on bitemark level. The present study was aimed, first, to investigate three-dimensionally (3D) the UHD within different quantities of dental material from the incisal edges; second, to test these outcomes in a bidimensional (2D) simulation. Four-hundred forty-five dental casts were collected to compose 4 study groups: I - randomly-selected subjects, II - orthodontically treated subjects, III - twins and IV - orthodontically treated twins. Additionally, 20 dental casts were included to create threshold groups on subjects from whom the dental impressions were taken at 2 different moments (Group V). All the dental casts were digitalized with an automated motion device (XCAD 3D^® (XCADCAM Technology^®, São Paulo, SP, Brazil). The digital cast files (DCF) were integrated in Geomagic Studio^® (3D Systems^®, Rock Hill, SC, USA) software package (GS) for cropping, automated superimposition and pair-wise comparisons. All the DCF were cropped remaining 3 mm (part 1), 2 mm (part 2) and 1 mm (part 3) from the incisal edges of the anterior teeth. For a 2D validation, slices of 1 mm, not including incisal edges (part 4), were also cropped. These procedures were repeated in Group V, creating specific thresholds for each of the study parts. The 4 study groups were compared with its respective threshold using ANOVA test with statistical significance of 5%. Groups I, II and III did not differ from the corresponding threshold (Group V) in all study parts (p > 0.05). Scientific evidence to support the UHD was not observed in the current study. Bitemark analysis should not be disregarded but considered carefully when the suspects present similar dental alignment and morphology, such as in orthodontically treated subjects and twins, respectively.

Three-dimensional validation of the impact of the quantity of teeth or tooth parts on the morphological difference between twin dentitions

BACKGROUND

The number of teeth involved in cases of bite-mark analysis is generally fewer in comparison to the number of teeth available for cases of dental identification. This decreases the amount of information available and can hamper the distinction between bite suspects. The opposite is true in cases of dental identification and the assumption is that more teeth contribute to a higher degree of specificity and the possibility of identification in these cases. Despite being broadly accepted in forensic dentistry, this hypothesis has never been scientifically tested.

OBJECTIVE

The present study aims to assess the impact of the quantity of teeth or tooth parts on morphological differences in twin dentitions.

MATERIAL AND METHODS

A sample of 344 dental casts collected from 86 pairs of twins was used. The dental casts were digitized using an automated motion device (XCAD 3D® (XCADCAM Technology®, São Paulo, SP, Brazil) and were imported as three-dimensional dental model images (3D-DMI) in Geomagic Studio® (3D Systems®, Rock Hill, SC, USA) software package. Sub samples were established based on the quantity of teeth and tooth parts studied. Pair wise morphological comparisons between the corresponding twin siblings were established and quantified.

RESULTS

Increasing the quantity of teeth and tooth parts resulted in an increase of morphological difference between twin dentitions. More evident differences were observed comparing anterior vs. entire dentitions (p < 0.05) and complete vs. partial anterior dentitions (p < 0.05).

CONCLUSION

Dental identifications and bite-mark analysis must include all the possibly related dental information to reach optimal comparison outcomes.

The uniqueness of the human dentition as forensic evidence: a systematic review on the technological methodology

The uniqueness of human dentition is routinely approached as identification evidence in forensic odontology. Specifically in bitemark and human identification cases, positive identifications are obtained under the hypothesis that two individuals do not have the same dental features. The present study compiles methodological information from articles on the uniqueness of human dentition to support investigations into the mentioned hypothesis. In April 2014, three electronic library databases (SciELO®, MEDLINE®/PubMed®, and LILACS®) were systematically searched. In parallel, reference lists of relevant studies were also screened. From the obtained articles (n = 1235), 13 full-text articles were considered eligible. They were examined according to the studied parameters: the sample size, the number of examined teeth, the registration technique for data collection, the methods for data analysis, and the study outcomes. Six combinations of studied data were detected: (1) dental shape, size, angulation, and position (n = 1); (2) dental shape, size, and angulation (n = 4); (3) dental shape and size (n = 5); (4) dental angulation and position (n = 2); (5) dental shape and angulation (n = 1); and (6) dental shape (n = 1). The sample size ranged between 10 and 1099 human dentitions. Ten articles examined the six anterior teeth, while three articles examined more teeth. Four articles exclusively addressed three-dimensional (3D) data registration, while six articles used two-dimensional (2D) imaging. In three articles, both imaging registrations were combined. Most articles (n = 9) explored the data using landmark placement. The other articles (n = 4) comprised digital comparison of superimposed dental contours. Although there were large methodological variations within the investigated articles, the uniqueness of human dentition remains unproved.

Patterns of variation and match rates of the anterior biting dentition: characteristics of a database of 3D-scanned dentitions

An understanding of the variability of the anterior human dentition is essential in bitemark analysis. A collection of 1099 3D laser scans of paired maxillary and mandibular arches were studied using geometric morphometric methods. Analyses were performed without scale (shape only) and with scale (shape and size). Specimens differing by no more than experimentally obtained measurement error were counted as matches, or as indistinguishable. A total of 487 maxillary (396 size preserved), 131 mandibular (83 size preserved), and one paired dentition (two size preserved) matches were found. Principal component analysis and partial least squares revealed interpretable patterns of variation and covariation in dental shape, principally dominated by variation in dental arch width. The sensitivity of match rate to assumed degree of measurement error was also determined showing rapid increases in match rate as measurement error increased. In conclusion, the concept of dental uniqueness with regard to bitemark analysis should be approached with caution.

Effect of systematic dental shape modification in bitemarks

Studies on human cadaver models have reported significant levels of distortion of bitemarks in skin, indicating that tooth characteristics are not reliably transferred and recorded in the bitten subject. Moreover, matches among the anterior biting dentition in open population studies have been found. This prompts the question as to what degree of difference in shape will distinguish one dentition from another as reflected in a bitemark. In order to understand how these variables appear on skin, 10 dental casts with systematic variations in tooth positions were produced. The height of the lateral incisors was systematically altered in 1mm increments up to 3mm and lateral incisor/canines were altered in facial/lingual displacement in 1mm increments up to 5mm. Each of the models was used to produce a series of 10 repeated bites, distributed over arms and legs of un-embalmed cadavers. Landmark-based geometric morphometrics were used for analysis of digital images of the bitemarks. Results indicate that alterations of height and displacement of particular teeth affected the position of impressions created by the adjacent teeth. Displacement of one lateral incisor/canine led to a relative shift in impressions of the central incisors and unaltered canines, while height alteration of the lateral incisors led to a shift in relative position of central incisors as recorded in the bitemark. The prominence of displacements was more pronounced in the bitemarks than in images of the dentition used to make the bites, thus the bitemarks tended to exaggerate the differences. It was found that a displacement of 5mm between teeth allowed for reliable distinction between bitemarks. No such threshold of distinction could be established for differences in height of teeth under these experimental conditions. The effect of distortion was more significant in the mandibular than maxillary arch, suggesting that the mandible exhibits higher variation than the maxilla, as impressed in skin. Numerous bitemarks also exhibited arch flattening, consistent with recent studies showing arch width as the principal variable in a bitemark.