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Provides an overview of dental forensics. Reviews the following identification techniques: visual, fingerprints/footprints, radiological/medical, DNA, and dental. Describes identification processes/procedures for a mass disaster.
Dental Forensics
Branch of science that applies dental knowledge in civil and criminal investigations Internationally described as Forensic Odontology Includes not only dental identification but also involves mass disaster procedural management
Identification Methods
Visual Fingerprints/footprints Radiological/Medical DNA Dental
Visual
May not be possible due to disfigurement or fragmentation due to disaster trauma Least reliable due to emotional stress and subjective assessment required of family member
Fingerprints/Footprints
Severe fires or prolonged submersion may eliminate postmortem samples Civil fingerprint data has dramatically reduced Latent finger prints from victim personal property can be obtained, but difficult & time consuming
Radiological/Medical
Useful if victim has antemortem medical radiographs for comparison Medical records may document serial numbers from implanted prosthetic devices (joint, heart valve, etc.)
DNA
Becoming standard in military Civilian sector lagging behind Different protocols for identification
Legal precedents? Expensive! Takes longer to get results than other methods
Unique
Dental Identification
No two individuals have identical dentitions Dental care rendered is often unique Identification can sometimes be made from one tooth
Teeth most durable part of human body Remains after decomposition, fire, or trauma
Durable
Sections/teams
In-processing Photography Fingerprints Personal effects Pathology/Lab Anthropology Forensic Dentistry Mortuary Storage/Shipping
Pathology
Mortuary Processing
Forensic Dentistry
Anthropology Laboratory Shipping
Dental Charting
Entire team must be consistent Charting standards should be provided to every member for reference Universal numbering system preferred
Simple in nature Easily computerized
AF FORM 1802
AFIP FORM
Antemortem Charting
Antemortem Charting
AF FORM 1802
AFIP FORM
Two members of antemortem staff should review composite antemortem record as a QA check
Postmortem Identification
Nature of disaster determines amount of time involved with postmortem dental examination Depending upon condition of victim, usually involves
Preparation/dissection & cleansing Radiographs Exam & charting
Postmortem Identification
Facial dissection (note ** below)
Infrequent, but may be required with burned or traumatized remains Allows full access to oral cavity for exam and radiographs Reflects soft tissue surrounding oral cavity Does not remove maxilla or mandible from the body ** Dissection approved by Identification Center Chief before procedure **
Postmortem Identification
Facial dissection
Perioral incision & tissue removal Mandible sectioned & submylohyoid incisions Separate ramus and incise pterygoids Floor of mouth incision connecting all external incisions
Facial Dissection
Perioral incision
Reflects extraoral tissue over teeth
Facial Dissection
Perio oral incision
Will allow exposure of facial surfaces of teeth and posterior surface of mandible
Facial Dissection
Mandible sectioned & submentalmylohyoid incisions
Facial Dissection
Separate ramus and incise pterygoid musculature
Frees mandible from rigor mortis musculature tetani
Facial Dissection
Floor of mouth incision
Connects to all external incisions Frees mandible for manipulation to facilitate exam and radiographs
Postmortem Charting
Process begins with tooth #1
First examiner makes statement of findings Recorded by second examiner After completion of exam the process is repeated with examiner roles reversed
Postmortem Charting
Factors to be considered/recorded
Restorations Missing teeth
Antemortem or due to trauma
Prosthetic appliances
Note any unique features
Postmortem Charting
Accomplished on AF Form 1801 or AFIP Postmortem Form Mirror image of Antemortem Dental Record (AF Form 1802/AFIP Antemortem Form) Same charting and CAPMI/WinID symbols as antemortem record
Allows side-by-side comparison
AF FORM 1801
AFIP FORM
Postmortem Radiographs
Use digital radiography if available Portable 50 kvp unit adequate Practice safe shielding techniques If film-based, automated processor
Produces dry films ready for mounting
Only process one case at a time 4x4 gauze packs & Play-Doh to stabilize film/sensor during exposure
Postmortem Radiographs
Use double film packs Reduce exposure time for skeletinized remains Try to reproduce standard FMX All apices and occlusal/incisal edges represented in at least 1 image
More detailed & specific films/images may be taken if necessary
Postmortem Radiographs
Digital radiographs should be used if available All radiographs placed on one labeled CD for each postmortem record
Postmortem Radiographs
ARE A MUST!
Provides objective legal evidence
Dental treatment and anatomy unique Antemortem/postmortem comparison invaluable Unique alveolar/dental anatomy can establish identification if no restorations exist ID can be made on as little as one fragment or one tooth if unique anatomy or restoration present
Pentagon 9/11/01
WinID III program used on networked computers
References/Additional Resources
Cottone JA, Bernstein ML, Forensic Odontology, Boca Raton: CRC Press, 2010. Senn DR, Stimson PG, Forensic Dentistry, 2nd Edition. Boca Raton: Taylor & Francis, 2010. Stavrianos C, Kokkas A, Andreopoulos E, Eliades A, Applications of forensic dentistry: Part 1, Research Journal of Medical Sciences. 2010;4:179-186.