Collection and recording of radiological information for forensic purposes

Insights from the 7th of October massacre: Forensic odontology in mass disasters

On October 7, 2023, an attack on Israel led to 1200 Israeli fatalities, creating a critical need for victim identification under challenging conditions of the remains, which ranged from fresh to severely burnt and fragmented. This study examines the role of forensic odontology within a multidisciplinary approach to disaster victim identification, a key element in handling mass casualty events. Ante-mortem dental data, obtained from various sources, were matched with postmortem information, such as full mouth X-rays and cone-beam computed tomography scans, utilizing dental identification software and visual comparison methods. A total of 970 victims were examined, leading to the successful identification of 166 individuals, representing 17 % of the overall identifications made through all scientific means. These findings emphasize the value of dental interventions and morphological features in forensic identifications, depicted in computed tomography-generated panoramic images which can provide an effective alternative to full mouth X-rays when direct oral access was restricted. These insights contribute to advancing forensic practices in response to complex mass disaster situations.

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.

Development of a radiographic technique for porcine head ballistic research

INTRODUCTION

The porcine model shows structural features comparable to that of humans and are routinely used within research, due to the ethical, legal, and practical use of post-mortem human samples. Methods for obtaining high quality and comparable reference data using standardised acquisition protocols are essential.

METHODS

The decapitated heads of three adult white sows were subjected to radiographic imaging before and after cranial trauma (9 mm, Heckler and Koch MP5). Digital radiographs were generated using a Siemens MULTIX TOP system with an Agfa digital detector, with foam blocks and sandbags as ancillary equipment. An iterative approach was adopted by the authors to generate reproducible radiographic views from two perpendicular angles. Specimens were kept at 5 °C and wrapped in polythene bags to reduce the impact of putrefaction.

RESULTS

Standardised head radiography technique was developed for superior-inferior and lateral views demonstrating porcine anatomy. Key parameters included: automatic exposure control for tube current (∼4 mAs), tube voltage of 73 kVp, 100 cm source to image receptor distance, and an anti-scatter grid. Slight variances in specimen morphology, developmental status, and soft tissue changes did not affect imaging outcomes.

CONCLUSION

The technique and positioning proposed in this study allows for the acquisition of high quality and reproducible radiographic images for comparable ballistic research datasets. Specimen positioning and centring of the primary beam may be applied across porcine breeds, although individual radiographic parameters may differ according to equipment specifications and specimen size.

IMPLICATIONS FOR PRACTICE

Development of a reproducible radiographic technique of porcine heads in forensic and veterinary research.

Automatic identification of individuals using deep learning method on panoramic radiographs

Abstract Background/purpose

The dentition shows individual characteristics and dental structures are stable with respect to postmortem decomposition, allowing the dentition to be used as an effective tool in forensic dentistry. We developed an automatic identification system using panoramic radiographs (PRs) with a deep learning method.

Materials and methods

In total, 4966 PRs from 1663 individuals with various changes in image characteristics due to various dental treatments were collected. In total, 3303 images were included in the data set used for model training. Vgg16, Vgg19, ResNet50, ResNet101, and EfficientNet models were applied for identification. The precision curves were evaluated.

Results

The matching precision rates of all models (Vgg16, Vgg19, ResNet50, ResNet101, and EfficientNet) were examined. Vgg16 was the best model, with a precision of around 80-90% on 200 epochs, using the Top-N metrics concept with 5-15 candidate labels. The model can successfully identify the individual even with low quantities of dental features in 5-10 s.

Conclusion

This identification system with PRs using a deep learning method appears useful. This identification system could prove useful not only for unidentified bodies, but also for unidentified wandering elderly people. This project will be beneficial for police departments and government offices and support disaster responses.

The biasing impact of irrelevant contextual information on forensic odontology radiograph matching decisions

The potential biasing effect of irrelevant context information on the forensic odontology method of radiograph-based identification has never been empirically investigated despite being a recognized problem in other forensic science disciplines. This study examines the effect of irrelevant context information on the probability judgment of match (JOM) of practicing forensic odontologist and dentist participants who were asked to match pairs of dental radiographs supplemented with irrelevant case information. The irrelevant case information contained domain task-irrelevant context information which varied in strength (strong or weak). It suggested either supportive or contradictory bias relative to the actual match status of the radiograph pairs. The dental radiographs consisted of verified match and non-match radiographs pairs sampled and de-identified from actual forensic cases. Changes in accuracy and JOM between supportive and contradictory contexts conditions revealed a contextual bias. Mixed model analysis showed that strong supportive context increased the odds ratio of correct decisions by a factor of 2.4 [1.23, 4.46]; p = 0.0097. Consistent with the biasing effect, the JOM score differences between strong supportive and contradictory irrelevant context information were 1.03 and 0.43 respectively for the non-match and match decisions. The direction of context suggestion (p = 0.0067), the radiograph match status (p = 0.014), and their interactions (p = 0.0061), were all found to impact the participants' decision. The weak context information was not strong enough to have a significant effect on accuracy or JOM scores. This study demonstrates that radiograph match judgment is affected and can be biased by strong irrelevant contextual information.

Specific oral and maxillofacial identifiers in panoramic radiographs used for human identification

Radiographically assisted dental identification is an important means for individual identification. Specific identifiers help to quickly filter some of the possible corresponding AM and PM images at the beginning. The study seeks specific oral and maxillofacial identifiers in panoramic radiographs. A total of 920 panoramic radiographs from 460 live patients were used. The most recent radiograph served as the surrogate post-mortem (PM) record of an unidentified person, and the earliest radiograph served as the ante-mortem (AM) record of the same person. We evaluated the following four groups of identifiers of the images: (1) dental morphology, tooth number, and position; (2) dental treatment and pathology; (3) morphological identifiers of the jaw; and (4) pathological identifiers of the jaw. The ratio of each identifier being identified simultaneously in the AM and PM databases was determined. Specific identifiers were defined as those that appeared at low frequency (ratio: 0%-0.250%). A total of 18 specific oral and maxillofacial identifiers were determined. The specific identifiers were a retained deciduous tooth (0.011%), S-shaped deflection of a tooth root (0.012%), distal deflection of tooth root (0.017%), inverted impaction (0.018%), malposition (0.038%), supernumerary teeth (0.061%), mesial deflection of tooth root (0.092%), microdontia (0.136%), buccal/lingual impaction (0.188%), cementoma (0.002%), hypercementosis (0.002%), continuous crown (0.004%), pulp calcification (0.023%), attrition (0.030%), residual root (0.106%), root resorption (0.137%), implant (0.156%), and osteomyelitis (0.002%). Identifiers of the teeth and jaw can be used for human identification, and dental identifiers are more specific than identifiers of jaw.

Forensic endodontics and national identity programs in India

National identity programs like Aadhaar in India can play an unique role in identification of an individual and has numerous beneficial applications for the government and the citizens. The biometric records of finger prints and iris provided in the database can be useful for the forensic purpose. In unfortunate incidence of disasters, accidents, and criminal cases such as severe burnings, the identification of the victims is possible through dental profiling where fingerprint matching is not possible. Endodontic treatment includes the radiography for diagnosis of the lesion, during working length determination, obturation, and various other procedures. The variations in tooth anatomy and morphology, post-endo restorations, root canal fillings, and sometimes, endodontic mishaps are recorded in these radiographs. This record can play an important role in identification of a person in case of unfortunate happenings. So, it is suggested to include dental profiling in National Identification programs, and the purpose of this article is to highlight the role of root canal procedures in dental profiling.

Comparison of air dose and operator exposure from portable X-ray units

This study was aimed at investigating and comparing exposure dose of workers and the surrounding workers. In addition, worker's exposure was also measure about lens and finger. Four intraoral portable X-ray units were evaluated. The stray radiations were measured using Pitman 37D and ionization chamber (Pitman). MyDosemini (ALOKA) was used for measurement of the finger exposure dose. Without the shield became high in anterior 0.5 m. Comparing the air dose for the four models used in this study showed a high tendency for the two NOMAD models. And using the shields, the images could be taken 4.6 times of the baseline at a maximum and 3.6 times on average. The finger radiation exposure dose was low with both of the NOMAD models, with no significant difference found. By setting the baseline value without a shield, finger radiation exposure when using a shield was lower than the detection limit for the D3000, and was reduced by approximately 94-96% for other three models. All models can photograph around 100 bodies, so it is considered that it is not necessary to switch out the operator considering the operation limit. But even if it does not reach the operation limit, the stochastic effects of radiation exposure can be increased as well as the deterministic effects of the operation limit. The operator and the surrounding workers seek to protect themselves. It is important to perform exposure management that takes into account the stochastic effects to the operator and the surrounding workers.

Personal identification with orthopantomography using simple convolutional neural networks: a preliminary study

Forensic dental examination has played an important role in personal identification (PI). However, PI has essentially been based on traditional visual comparisons of ante- and postmortem dental records and radiographs, and there is no globally accepted PI method based on digital technology. Although many effective image recognition models have been developed, they have been underutilized in forensic odontology. The aim of this study was to verify the usefulness of PI with paired orthopantomographs obtained in a relatively short period using convolutional neural network (CNN) technologies. Thirty pairs of orthopantomographs obtained on different days were analyzed in terms of the accuracy of dental PI based on six well-known CNN architectures: VGG16, ResNet50, Inception-v3, InceptionResNet-v2, Xception, and MobileNet-v2. Each model was trained and tested using paired orthopantomographs, and pretraining and fine-tuning transfer learning methods were validated. Higher validation accuracy was achieved with fine-tuning than with pretraining, and each architecture showed a detection accuracy of 80.0% or more. The VGG16 model achieved the highest accuracy (100.0%) with pretraining and with fine-tuning. This study demonstrated the usefulness of CNN for PI using small numbers of orthopantomographic images, and it also showed that VGG16 was the most useful of the six tested CNN architectures.

Automatic human identification based on dental X-ray radiographs using computer vision

A person may be identified by comparison between ante- and post-mortem dental panoramic radiographs (DPR). However, it is difficult to find reference material if the person is unknown. This is often the case when victims of crime or mass disaster are found. Computer vision can be a helpful solution to automate the finding of reference material in a large database of images. The purpose of the present study was to improve the automated identification of unknown individuals by comparison of ante- and post-mortem DPR using computer vision. The study includes 61,545 DPRs from 33,206 patients, acquired between October 2006 and June 2018. The matching process is based on the Speeded Up Robust Features (SURF) algorithm to find unique corresponding points between two DPRs (unknown person and database entry). The number of matching points found is an indicator for identification. All 43 individuals (100%) were successfully identified by comparison with the content of the feature database. The experimental setup was designed to identify unknown persons based on their DPR using an automatic algorithm system. The proposed tool is able to filter large databases with many entries of potentially matching partners. This identification method is suitable even if dental characteristics were removed or added in the past.

Forensic odontology in DVI: current practice and recent advances

Forensic odontology frequently plays a significant role in identification of the victims of multi-fatality disasters, but not in all. It depends on adequate dental remains surviving the disaster and on the availability of dental records to be successful. This paper describes current practice in the techniques of identification in forensic odontology and outlines recent advances that are moving into the mainstream.Key PointsForensic odontology plays a key role in mass disaster victim identification (DVI) when good-quality antemortem (AM) dental records are available.Images including radiographs, computerized tomography (CT) data and three-dimensional (3D) scan data are considered more reliable AM records than written dental charts and odontograms.Interpretation, transcription and comparison of dental datasets are complex processes that should be undertaken only by trained dental professionals.The future of forensic odontology DVI techniques is likely to include the use of 3D datasets for comparison.

Dental Patterns in Peruvians: A Panoramic Radiography Study

The dental pattern is defined as the combination of distinct codes assigned to describe specific tooth conditions including virgin, missing, and restored teeth that comprise the complete dentition or from discrete groups of teeth. This pattern can be then compared to the dentition of individual/s in an attempt to determine positive identification. The aims of the present investigation were to study and determine the diversity of dental patterns in Peruvian citizens based on a sample of panoramic radiographs. Digital panoramic radiographs of 900 adult Peruvian patients (450 female and 450 male) were evaluated to determine the dental patterns. The most frequent dental patterns found in the complete dentition, maxillae, upper-anterior and lower-anterior sextants were all-virgin-teeth (0.3%), all-extracted teeth (1.9%), all-virgin teeth (1%) and all-virgin-teeth (34.2% and 72.3%) respectively. The diversity was calculated by the use of the Simpson's diversity index, the resulting values for the full-dentition, maxilla and mandible were over the 99.8% value and were similar to those previously reported in the scientific literature. This study demonstrates the positive benefit of dental patterns in the process of identification. Additionally a combination of codes is proposed that could prove useful in cases where a better radiographic description is required.

A note on digital dental radiography in forensic odontology

Digital dental radiography, intraoral and extraoral, is becoming more popular in dental practice. It offers convenience, such as lower exposure to radiation, ease of storing of images, and elimination of chemical processing. However, it also has disadvantages and drawbacks. One of these is the potential for confusion of the orientation of the image. This paper outlines one example of this, namely, the lateral inversion of the image. This source of confusion is partly inherent in the older model of phosphor storage plates (PSPs), as they allow both sides to be exposed without clue to the fact that the image is acquired on the wrong side. The native software allows digital manipulation of the X-ray image, permitting both rotation and inversion. Attempts to orientate the X-ray according to the indicator incorporated on the plate can then sometimes lead to inadvertent lateral inversion of the image. This article discusses the implications of such mistakes in dental digital radiography to forensic odontology and general dental practice.