Download Dental human identification using bitewing

European Journal of Forensic Sciences
Case Report
www.ejfs.co.uk
DOI: 10.5455/ejfs.205492
Dental human identification using
bitewing radiographs: A case report
Rhonan Ferreira Silva1,2, Ademir Franco3, Fernando Fortes Picoli1,2,
Livia Graziele Rodrigues4, Roberta Gomes Resende5
Department of Forensic
Odontology, Federal
University of Goias,
Brazil, 2Department of
Legal Odontology and
Forensic Anthropology,
Scientific Police of Goias,
Brazil, 3Department of
Forensic Odontology,
Katholieke Universiteit
Leuven, Belgium,
4
Department of Forensic
Odontology, Federal
University of Goias,
Brazil, 5Department of
Oral Radiology, Brazilian
Association of Dentistry,
State of Goias, Brazil
1
ABSTRACT
The present study aims to illustrate the usefulness of bitewing radiographs in Forensic Odontology reporting
a case of positive human identification achieved through the comparison between ante-mortem and postmortem dental data. In 2014, a charred human body was referred for identification at the local medicolegal
institute. Maxilla and mandible were dissected, enucleated and cleaned for a proper exam. The ante-mortem
data consisted of 4 bitewing radiographs and a clinical dental file. The bitewing angulation was reproduced
post-mortem manipulating both dental arches, enabling a radiographic comparison of dental evidence. Positive
identification was obtained comparing specific morphological and treatment identifiers. The present study
highlights the importance of adequate management and storage of dental radiographs, which are potentially
useful for legal purposes.
Address for correspondence:
Rhonan Ferreira Silva,
Av. Universitaria, Esquina
com 1ª Avenida,
Setor Universitario,
Goiania, Goias, Brazil,
postal code: 74605-220.
E-mail:rhonanfs@terra.
com.br
Received: October 18, 2015
Accepted: November 18, 2015
Published: December 20, 2015
KEY WORDS: Forensic sciences, forensic odontology, bitewing radiology, human identification
INTRODUCTION
Dentists play an essential part in complex forensic scenarios,
such as the identification of putrefied and charred bodies as
well as skeletal remains, in which fingerprint analysis becomes
unfeasible [1]. Specifically in charred bodies, the anterior
teeth are often found fragile or destroyed after exposed to a
high temperature. However, the posterior teeth are mostly
preserved by the adjacent soft tissue, such as facial muscles,
buccal mucosa, and tongue [2,3].
Once the human teeth are preserved, they allow for the
registration of post-mortem (PM) data, which will be further
compared with ante-mortem (AM) data collected from dental
Eur J Forensic Sci
● Jul-Sep 2016 ●
Vol 3
● Issue 3
records of potential victims. Positive human identifications are
achieved when the dental identifiers registered PM match the
identifiers registered AM [4,5].
Considering that radiographic exams are constantly performed
for dental treatment purposes, forensics finds within dentistry
a large database for AM information [6-8]. Bitewing radiograph
arises as a technique used for detailed investigation of dental
crowns and alveolar bone of the posterior teeth. Consequently,
bitewings represent great AM/PM materials for dental human
identifications in the forensic casework. Based on that
the present study aims to report a case of positive human
identification achieved after the comparison of AM and PM
bitewing radiographs of an unknown charred victim.
31
Silva, et al.: Bitewings in forensic odontology
CASE REPORT
In 2014, a charred body found inside a burned-out car was
referred for cadaveric examination in the local medicolegal institute. The preliminary medical exam revealed
that the victim was an adult male deceased due to thermal
carbonization.
The victim presented charred hands hampering fingerprint
analysis, making a necessary dental identification. The dental
autopsy was performed with resection of maxilla and mandible
through the incision proposed by Luntz and Luntz [9], 1973.
The orofacial soft tissue was removed, and bones were cleaned
enabling to observe third molars; anterior teeth with charred
and fractured crowns; posterior teeth with non-metallic
restorations; and rotation of the mandibular right canine
[Figure 1].
In parallel, police investigations were conducted to retrieve
any AM data from potential relatives of the victim. The
investigations resulted in a clinical dental file and 4 bitewing
radiographs dated from 2011 [Figure 2]. PM bitewing
radiographs were performed reproducing the AM data, enabling
a comparative approach [Figure 3].
Outcomes of the AM/PM comparison consisted of morphological
and therapeutic similarities in 19 teeth. Five explainable
differences in 5 teeth were also detected [Table 1]. From
a qualitative scope, the comparison between radiographs
highlighted the anatomic pattern of non-metallic restorations
in the lower left first molar and in the lower right third molar.
Positive identification was achieved linking the deceased body
with the missing persons by dental evidence found in bitewing
radiographs.
DISCUSSION
The application and effectiveness of forensic odontology
for the identification of charred bodies are consolidated
and well supported in the scientific literature and forensic
practice [2-8,10,11], becoming considered by Interpol as a
primary method for human identification in mass disaster
environments [12].
a
Considering that the local medico-legal institute follows the
parameters of Interpol, dental identification was attempted
before DNA analysis, which was further considered not
necessary. Specifically, dental identification consists of a
comparative procedure, making necessary AM dental records
containing unique dental identifiers [2,3,5,8,10,11]. Currently,
panoramic and periapical radiographs figure as the most
common AM radiographic records due to their constant use for
treatment interventions in the dental routine [2,3,5,8,10,11].
Yet bitewings have more specific clinical importance [13] such
as: The exam of interproximal surfaces of the posterior teeth, in
operative dentistry; the exam of calculus deposits and alveolar
bone height, in periodontology; the exam of pulp nodules, in
endodontics; the exam of cervical adaptation of prosthetic
Table 1: Comparison between ante-mortem and post-mortem
identifiers and respective outcomes
Tooth*
AM (2011)
PM (2014)
Outcomes
13
#
14
#
15
#
16
#
17
#
18
#
23
#
24
#
25
#
26
#
27
#
28
#
33
#
34
#
35
#
36
#
37
#
38
#
43
#
44
#
45
#
46
#
47
#
48
Sound**
Caries (D)
Caries (M)
NM Class I
NM Class I
NM Class I
Sound**
Sound**
Sound**
NM Class I
NM Class I
NM Class I
Sound**
Sound**
Sound**
NM Class I
NM Class I
NM Class I
Sound**
Sound**
Sound**
NM Class I
NM Class I
NM Class I
Sound
NM (DO)
NM (MO)
NM Class I
NM Class I
NM Class I
Fractured crown
Sound
NM Class II
NM Class I
NM Class I
NM Class I
Fractured crown
Sound
Sound
NM Class I
NM Class I
NM Class I
Sound
Sound
Sound
NM Class I
NM Class I
NM Class I
SI
ED
ED
SI
SI
SI
ED
SI
ED
SI
SI
SI
ED
SI
SI
SI
SI
SI
SI
SI
SI
SI
SI
SI
#
AM: Ante-mortem, PM: Post-mortem, NM: Non-metallic restoration,
O: Occlusal surface, DO: Distal-occlusal surfaces, MO: Mesial-occlusal
surfaces, M: Mesial surface, D: Distal surface; SI: Similarities,
ED: Explainable differences, *FDI’s dental notation, **Considering
radiographically visible dental parts, #tooth number
b
Figure 1: Occlusal view of maxilla (a) and mandible (b) after resection
32
Eur J Forensic Sci
● Jul-Sep 2016 ●
Vol 3
● Issue 3
Silva, et al.: Bitewings in forensic odontology
From a legal scope, this information highlights the need
for major clinical attention with the technical process for
radiographic image acquisition, as well as the need for proper
storing and updating dental data.
Similarly to the other modalities of dentomaxillofacial
radiographs, bitewings have essential value as a source of
AM information for human identifications. However, this
technique seems to have major importance for the comparative
identification of charred bodies, once it registers the forensic
evidence found in dental crowns of the posterior teeth, which
are often found preserved in charred victims.
REFERENCES
1.
Figure 2: Ante-mortem bitewing radiographs dating from 2011
2.
3.
4.
5.
6.
7.
8.
9.
Figure 3: Post-mortem bitewing radiographs dating from 2014
crowns, in prosthodontics; and the exam of anatomic relation
between deciduous and permanent teeth, in pediatric dentistry.
The usefulness of bitewing radiographs for the identification of
charred bodies remains on the fact that bitewings allow for the
optimal visualization of the dental crowns of posterior teeth.
It directly converges with the fact that in charred bodies the
anterior dentition is commonly destroyed by thermal reaction,
and the posterior dentition is protected by the adjacent soft
tissue [11].
Eur J Forensic Sci
● Jul-Sep 2016 ●
Vol 3
● Issue 3
10.
11.
12.
13.
Senn DR, Weems RA. Manual of Forensic Odontology. 5th ed. Boca
Raton, USA: CRC Press; 2013.
Silva RF, Daruge E Jr, Pereira SD, Almeida SM, Oliveira RN.
Identification of charred corpse using dental records. Rev Odontol
Cienc 2008;23:90-3.
Silva RF, Chaves P, Paranhos LR, Lenza MA, Daruge E Jr. Use of
orthodontic records in human identification. Dent Press J Orthod
2011;16:52-7.
Silva RF, Ramos DI, Pereira SD, Daruge E, Daruge E Jr. Model cast:
Expertise relevance and forensic orientation for filling away. Rev
Assoc Paul Cir Dent 2007;61:381-4.
Silva RF, Nunes FG, Faria Neto JC, Rege IC, Daruge E Jr. Forensic
importance of panoramic radiographs for human identification. RGO
2012;60:527-31.
Gonçalves AS, Marcelino JC, Prado MM, Silva RF. Human
identification using PA radiographs of the maxillary sinus: Case
report. RBOL 2014;1:30-9.
Silva RF, Franco A, Saboia LR, Rodrigues LG, Gomes RR, Heit OJ.
Identification of a charred body through the radiographic morphology
of the frontal sinuses. Ann Forensic Res Anal 2015;2:1014.
Silva RF, Franco A, Picoli FF, Nunes FG, Estrela C. Dental identification
through endodontic radiographic records: A case report. Acta
Stomatol Croat 2014;48:147-50.
Luntz LL, Luntz P. Handbook for Dental Identification: Techniques
in Forensic Dentistry. 1st ed. Philadelphia, USA: Lippincott and Co.;
1973.
Silva RF, Prado MM, Oliveira HC, Daruge E Jr. How many point of
concordance are necessary to obtain a positive forensic dental
identification. Rev Odontol Univ Cid São Paulo 2009;21:63-8.
Silva RF, Prado FB, Agostini R, Kawagushi JT, Silva RF, Daruge E Jr.
Human identification based in dental radiographs. Rev Odontol Uniev
2008;10:97-100.
Interpol. Disaster Victim Identification Guide. Dundee: Dundee
University Press; 2014.
White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation.
6th ed. Amsterdam, Netherlands: Elsevier; 2009.
Source of Support: Nil, Conflict of Interest: None declared.
33