Dental autopsy for the identification of missing persons

The panoramic radiograph archive of the human craniological collection housed at the Human Anatomy Museum in Turin

The craniological collection at the Human Anatomy Museum of the University of Turin consists of 1090 skulls and 64 postcranial skeletons prepared mostly during the second half of the nineteenth century. The collection presents individuals of both sexes and of different age groups and includes 712 skulls of known age and sex and 378 of which only the sex is known. Most individuals are associated with a documentation that includes sex, age-at-death, dates of birth and a death certificate. The collection comes from several regions of Italy, between 1880 and 1915, received by the former Anatomical Institute of the University of Turin from city's prisons and hospitals. The whole craniological collection of known age was subjected to panoramic radiographs. The craniological collection combined with the panoramic digital X-ray images represents an important contribution in anthropology and forensic odontology, as there is now no craniological collection available in the world available from a radiological perspective, for investigating dental age assessment and sex dimorphism using radiographs as well as other research and teaching potentials.

The need for integrated research autopsies in the era of precision oral medicine

BACKGROUND

Autopsy has benefited the practice of medicine for centuries; however, its use to advance the practice of oral health care is relatively limited. In the era of precision oral medicine, the research autopsy is poised to play an important role in understanding oral-systemic health, including infectious disease, autoimmunity, craniofacial genetics, and cancer.

TYPES OF STUDIES REVIEWED

The authors reviewed relevant articles that used medical and dental research autopsies to summarize the advantages of minimally invasive autopsies of dental, oral, and craniofacial tissues and to outline practices for supporting research autopsies of the oral and craniofacial complex.

RESULTS

The authors provide a historical summary of research autopsy in dentistry and provide a perspective on the value of autopsies for high-resolution multiomic studies to benefit precision oral medicine. As the promise of high-resolution multiomics is being realized, there is a need to integrate the oral and craniofacial complex into the practice of autopsy in medicine. Furthermore, the collaboration of autopsy centers with researchers will accelerate the understanding of dental, oral, and craniofacial tissues as part of the whole body.

CONCLUSIONS

Autopsies must integrate oral and craniofacial tissues as part of biobanking procedures. As new technologies allow for high-resolution, multimodal phenotyping of human samples, using optimized sampling procedures will allow for unprecedented understanding of common and rare dental, oral, and craniofacial diseases in the future.

PRACTICAL IMPLICATIONS

The COVID-19 pandemic highlighted the oral cavity as a site for viral infection and transmission potential; this was only discovered via clinical autopsies. The realization of the integrated autopsy's value in full body health initiatives will benefit patients across the globe.

Identification of Skeletal Remains Using Genetic Profiling: A Case Linking Italy and Poland

Forensic genetics is a rapidly evolving science thanks to the growing variety of genetic markers, the establishment of faster, less error-prone sequencing technologies, and the engineering of bioinformatics models, methods, and structures. In the early 2000s, the need emerged to create an international genetic database for forensic purposes. This paper describes a judicial investigation of skeletal remains to identify the subject using various methods. The anthropological examination of the remains allowed identification of the Caucasoid (European) ethnic group, a height of 156 ± 4 cm, and an age between 47 and 50 years. The genetic profiles obtained from typing several microsatellites made it possible to evaluate the compatibility between the skeletal remains and the suspected decedent. To identify the remains, the two extrapolated genetic profiles were compared. The case described highlights the central role of forensic genetics in identifying skeleton remains by means of comparison.

Creating Awareness Regarding Forensic Odontology Among Non-Forensic Persons for Successful Dental Identifications

Visual Identification by next of kin is the most common method of identifying unknown bodies in India. However, this technique is unscientific and unreliable, especially if the remains recovered are decomposing, skeletonized, charred, mutilated, saponified. Primary identifiers recommended by higher authorities for scientific identification of unknown bodies include comparison of fingerprints, DNA, odontology or unique medical records such as implants. Forensic Odontology has played a major role in identifying victims of mass disasters around the world, and few examples of successful application of dental data in DVI situations include the South Asian Tsunami, 2004, Black Saturday bushfires, 2009, Australia, Christchurch earthquake, 2011, etc. However, the application of forensic odontology for positive identifications is extremely limited. A major reason for this is the unavailability and inaccessibility to quality dental records and ante mortem data. To improve the collection of ante mortem data, it is urgent that we create awareness among local on-ground investigating agencies, and stakeholders. For this purpose, an awareness campaign iDENTifyme from the University of Turin, Italy was launched in India in local languages, and has since successfully assisted in collection of ante mortem data for positive identification.

A literature review on dental autopsy - an invaluable investigative technique in forensics

Forensic odontology is a specialty of dental sciences that deals with dental evidence in the interest of the justice system. The science of autopsy has been developing from the ancient times even before the popularization of general medicine. The objective of a medico-legal autopsy is to identify significant clues for an ongoing forensic investigation. However, in certain circumstances, it is difficult to conduct an oral examination owing to the anatomic location of the oral cavity. The onset of rigor mortis after death poses further complications. Thus, skillful and sequential dissections of the oral and para-oral structures are required to expose the dentition. Dental autopsy includes incisions and resection of the jaw for the detailed examination of the oral cavity. The procedure involves various modes of examination, including visual and radiographic, which help in human identification in forensic investigation. The present paper provides an overview of the various methods of dental autopsy.

Oral Autopsy – Dental Surgeon’s Perspective

Background: Autopsy is routinely performed by the coroner in all medico-legal cases but the dental expertise is rarely sought. However, oral autopsy involving careful visual examination, imaging and laboratory methods can aid in solving the enigma associated with legal aspects of crime scene and death investigation. Aim: To illustrate the importance of oral autopsy during routine post-mortem examination. Data Sources: Pub-Med, Google Scholar search engines were used to extract the data. Conclusion: Oral autopsy performed as an adjuvant to regular autopsy procedure will definitely benefit in the legal investigation related to visually identifiable, decomposed, burnt or skeletonized corpse.

iDENTIfyme Informative Campaign: Raising Forensic Dental Identification Awareness in the Community

The identification of human remains can be performed visually through families and next-of-kin, but it is not advisable to rely only on visual recognition; instead, it is preferable to conduct a forensic comparison of antemortem and postmortem data for primary identifiers (fingerprints, DNA, and dental data). A dental autopsy is particularly valuable in the identification process of skeletonized, carbonized, saponified, and fragmented human remains. The principal challenge in the identification process is the search and collection of antemortem data. To this end, all dental information held on a missing person can represent a precious source of individualizing information that families should share with the police or investigating agencies after reporting a disappearance.

Dental Cingulum and Position of Fixed Orthodontic Appliance as Source of Morphological and Therapeutic Identifiers: An Unusual Case Report

Orthodontic records, such as photographs, radiographs, and dental casts, provide information useful for identification purposes because it may reveal important morphological, therapeutic, and pathological dental identifiers. Among these identifiers, the type and position of orthodontic appliances figure as distinctive tools for human identification. In this context, the present study aims to report an uncommon case of identification of a putrefied body, found near to a forest region in Brazil. The postmortem (PM) examination showed that the victim had part of a fixed orthodontic appliance installed in the maxillary and mandibular dental arches. To identify the body, relatives of the potential victim presented orthodontic examinations containing panoramic radiography and photographs of the orthodontic treatment. The body was identified based on the analysis of the radiographs and photographs that confirmed the presence of the orthodontic appliances observed PM. More specifically, the identification was supported by the analysis of bracket bonding position of the maxillary and mandibular incisors and the presence of distinctive morphological traits of the canines and incisors, as well dental roots observed radiographically. The present case highlights the importance of orthodontic records as a source of morphological dental identifiers for cases in which only unrestored teeth are available.