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7/25/2019 Rolul Dintilor in Identificare
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A look at forensic dentistry Part 1: The role of teeth in the determination of human identity
I A Pretty1& D Sweet2
Forensic dentistry lays a ma!or role in "ody identification
Se#eral methods of dental identification e$ist
D%A use in forensic dentistry
ase e$amles of dental identifications
Forensic dentistry can be defined in many ways. One of the more elegant definitions is simply
that forensic dentistry represents the overlap between the dental and the legal professions. This
two-part series presents the field of forensic dentistry by outlining two of the major aspects of the
profession: human identification and bite marks. This first paper examines the use of the human
dentition and surrounding structures to enable the identification of found human remains.
onventional and novel techni!ues are presented.
As we enter a new millennium' society is faced with fresh challen(es in e#ery concei#a"le area)
Desite leas in modern technolo(y' medical "reakthrou(hs and the (eo(rahical chan(es that the last
century has "rou(ht' crime still ersists in all asects of our li#es) *iolent and heinous acti#ities that
shatter the li#es of #ictims' their friends and families occur e#eryday) +ften' little can "e done to reair
such dama(e) The arehension and su"se,uent rosecution of the eretrator-s. is essential to
maintain law and order) Throu(h the secialty of forensic odontolo(y' dentistry lays a small "ut
si(nificant role in this rocess) /y identifyin( the #ictims of crime and disaster throu(h dental records'
dentists assist those in#ol#ed in crime in#esti(ation) Always art of a "i((er team' such ersonnel are
dedicated to the common rinciles of all those in#ol#ed in forensic casework: the ri(hts of the dead
and those who sur#i#e them)
The most common role of the forensic dentist is the identification of deceased indi#iduals)1Dental
identification takes two main forms) Firstly' the most fre,uently erformed e$amination is a
comarati#e identification that is used to esta"lish -to a hi(h de(ree of certainty. that the remains of a
decedent and a erson reresented "y antemortem -"efore death. dental records are the same
indi#idual) Information from the "ody or circumstances usually contains clues as to who has died)
Secondly' in those cases where antemortem records are not a#aila"le' and no clues to the ossi"le
identity e$ist' a ostmortem -after death. dental rofile is comleted "y the forensic dentist su((estin(
characteristics of the indi#idual likely to narrow the search for the antemortem materials)2
Dental identification of humans occurs for a num"er of different reasons -Ta"le 1. and in a num"er of
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different situations)0The "odies of #ictims of #iolent crimes'' fires'3motor #ehicle accidents and
work lace accidents'4can "e disfi(ured to such an e$tent that identification "y a family mem"er is
neither relia"le nor desira"le)5Persons who ha#e "een deceased for some time rior to disco#ery and
those found in water also resent unleasant and difficult #isual identifications) Dental identifications
ha#e always layed a key role in natural and manmade disaster situations and in articular the mass
casualties normally associated with a#iation disasters)6' 17' 11' 12/ecause of the lack of a
comrehensi#e fin(errint data"ase' dental identification continues to "e crucial in the 8nited
9in(dom)
to
omarati#e dentalidentification
any eole are
familiar with the
concet of dental
identification; it is fre,uently mentioned on tele#ision news) /ut the nuances and comle$ities of the
rocess are rarely understood) The central do(ma of dental identification is that ostmortem dental
remains can "e comared with antemortem dental records' includin( written notes' study casts'
radio(rahs' etc' to confirm identity) learly' indi#iduals with numerous and comle$ dental treatments
are often easier to identify than those indi#iduals with little or no restorati#e treatment) The teeth not
only reresent a suita"le reository for such uni,ue and identifyin( features' they also sur#i#e most
ostmortem e#ents that can disrut or chan(e other "ody tissues)2
Tyically' human remains are found and reorted to the olice who then initiate a re,uest for dental
identification) +ften a resumti#e or tentati#e identification is a#aila"le -ie wallet or dri#in( licence
may "e found on the "ody. and this will ena"le antemortem records to "e located) In other instances'
the (eo(rahical location in which the "ody is found or other hysical characteristics and
circumstantial e#idence' may ena"le a utati#e identification to "e made' fre,uently usin( data from the
missin( ersons< data"ase) Antemortem records are then o"tained from the dentist of record)
The forensic dentist roduces the ostmortem record "y careful chartin( and written descritions of the
dental structures and radio(rahs -Fi() 1.) If the antemortem records are a#aila"le at this time'
Table ": Table "
Full ta"le
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ostmortem radio(rahs should "e taken to relicate the tye and an(le of these)10=adio(rahs should
"e marked with a ru""er>dam unch to indicate antemortem and ostmortem to re#ent confusion
one hole for antemortem films and two holes for ostmortem films)
+nce the ostmortem
record is comlete' a
comarison "etween the two records can "e carried out) A methodical and systematic comarison is
re,uired' e$aminin( each tooth and surroundin( structures in turn) ?hile dental restorations fi(ure
si(nificantly in the identification rocess' many other oral features are assessed -Ta"le 2.' and these
lay an increasin(ly imortant role in those indi#iduals with minimal restorations) /ecause of the
ro(ressi#e decrease in dental caries' so>called non>restorati#e cases are likely to "ecome more
common)1
Similarities and
discreancies should
"e noted durin( the
comarison
rocess)1There are
two tyes of
discreancy' those that can "e e$lained and those that cannot) @$laina"le discreancies normally
relate to the time elased "etween the antemortem and ostmortem records) @$amles include teeth
e$tracted or restorations laced or enlar(ed -ie + amal(am that is now +D.) Fi(ure 2illustrates
e$laina"le discreancies) If a discreancy is une$laina"le' for e$amle a tooth is not resent on the
antemortem record "ut is resent on the ostmortem record then an e$clusion must "e made)
A ran(e of conclusions
can "e reached when
reortin( a dental
identification) The
American /oard of
Table #: Table #
Full ta"le
Figure ": $n example of postmortem dental charting
Full sie ima(e -177 9/.
Figure #: $n example of the comparison of postmortem and antemortem radiographs to determine identity.
The attern' shaes and sies of indi#idual dental treatments resent in one
record are comared with similar traits and characteristics in the other record)
In this case it was determined that the records ori(inated from the same erson)
This esta"lished a ositi#e identification) %ote that there are se#eral
discreancies resent' -e( endodontic treatment of teeth B= -. and B=3-3.
in the ostmortem record. "ut these can "e e$lained as a result of the time
inter#al "etween the two records and the additional dental treatments erformed
durin( this eriod
Full sie ima(e -23 9/.
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Forensic +dontolo(y recommends that these "e limited to the followin( four conclusions:13
Positive identification:The antemortem and ostmortem data match in sufficient detail' with no
une$laina"le discreancies' to esta"lish that they are from the same indi#idual)
Possible identification:the antemortem and ostmortem data ha#e consistent features "ut'
"ecause of the ,uality of either the ostmortem remains or the antemortem e#idence' it is not
ossi"le to esta"lish identity ositi#ely)
Insufficient evidence:The a#aila"le information is insufficient to form the "asis for a
conclusion)
Exclusion:the antemortem and ostmortem data are clearly inconsistent)
It is imortant to note that there is no minimum num"er of concordant oints or features that are
re,uired for a ositi#e identification) In many cases a sin(le tooth can "e used for identification if it
contains sufficient uni,ue features) @,ually' a full>mouth series of radio(rahs may not re#eal sufficient
detail to render a ositi#e conclusion)13The discretion of identification lies with the odontolo(ist who
must "e reared to !ustify the conclusions in court' surely the ultimate in eer>re#iew)Fi(ure
0illustrates a case of dental identification)
to
Postmortem dental
rofilin(
?hen antemortem
dental records are
una#aila"le and other methods of identification are not ossi"le' the forensic dentist can assist in
limitin( the oulation ool to which the deceased is likely to "elon( and thus increase the likelihood
of locatin( antemortem dental records)2This rocess is known as ostmortem dental rofilin() The
information from this rocess will ena"le a more focused search for antemortem records) A ostmortem
dental rofile will tyically ro#ide information on the deceasedeconomic status) In some instances it is ossi"le to ro#ide additional information re(ardin(
occuation' dietary ha"its' ha"itual "eha#iours and occasionally on dental or systemic diseases)
Forensic anthroolo(ists most often ro#ide details of osteolo(ical studies' "ut forensic dentists can
Figure %: &xample of a comparative dental identification case.
The "ody deicted in the ima(es is that of a si$teen>year>old female) She was
found encased in a water"ed frame after "ein( reorted missin( for o#er a year)
A #ictim of homicide' she "ecame mummified in the dry' cool conditions under
the "ed) The "ed' used fre,uently' was remo#ed when a lod(er left the
aartment and the "ody was disco#ered) Desite the condition of the soft
tissues the teeth remain in erfect condition) The antemortem and ostmortem
radio(rahs are shown "elow) A ositi#e identification' this case illustrates a
non>restorati#e case) %ote the mesiodens
Full sie ima(e -5 9/.
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assist in the rocess)14' 15' 16' 27' 21' 22The determination of se$ and ancestry can "e assessed from
skull shae and form) Cenerally' from skull aearance' forensic dentists can determine race within the
three ma!or (rous: aucasoid' on(oloid and %e(roid) Additional characteristics' such as cuss of
ara"elli' sho#el>shaed incisors and multi>cused remolars' can also assist in determination of
ancestry -Fi() .)20Se$ determination is usually "ased on cranial aearance' as no se$ differences are
aarent in the morholo(y of teeth) icroscoic e$amination of teeth can confirm se$ "y the resence
or a"sence of >chromatin and D%A analysis can also re#eal se$)2' 2
Dental structures can
ro#ide useful
indictors to the indi#idualadult a(es' erution dates of the teeth are hi(hly #aria"le and the actual
de#elomental sta(es of the teeth are more accurate) Third molar de#eloment is used "y some forensic
dentists to assi(n a(e to youn( adults althou(h dou"ts concernin( the accuracy of this techni,ue will "e
raised "y the ractitioner#aria"le
markers is in the ran(e of 1712 years) Some odontolo(ists ad#ocate the use of asartic acid
racemiation' claimin( an accuracy of years)25Additional methods include the use of S@>@DEA'
a method used to e$amine dentine in relation to a(e determination) A recent study from the 89
e$amined the use of root len(th in the determination of a(e in aediatric cases)26
The resence of erosion can su((est alcohol or su"stance a"use' an eatin( disorder or e#en hiatus
hernia while stains can indicate smokin(' tetracycline use or "etel nut
chewin()07' 01' 02' 00' 0' 0' 03' 04' 05' 068nusual wear atterns may result from ie stems'
Figure ': (a) *hovel-shaped incisors and (b) the usp of arabelli are both dental indicators for ethnicity
Full sie ima(e -21 9/.
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tml#B36http://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#B37http://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#B38http://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#B397/25/2019 Rolul Dintilor in Identificare
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ci(arette holders' hairins' caret tacks or re#ious orthodontic treatment)2' 7The ,uality' ,uantity and
resence or a"sence of dental treatment may (i#e an indication of socio>economic status or likely
country of residence -Fi() .)1 Fi(ure 3shows an e$amle of ostmortem dental rofilin()
If the ostmortem
rofile does not elicit
the tentati#e identity
of the deceased it may
"e necessary to
reconstruct the indi#idualyear>old missin( white male smoker
Full sie ima(e -0 9/.
Figure ,: The !uality and type of dental treatment may indicate an individuals country of residence:
a. Dental treatment of hi(h ,uality' which is consistent with %orth American
and @uroean standards) ". 8nusual dental treatments in#ol#in( the use of
ermanent acrylic and stainless steel crowns) This treatment was erformed in
=ussia
Full sie ima(e -27 9/.
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Dental materials ha#e ro#ided clues to assist identification) +ne of the authors -DS. has used S@>
@DE to identify the comosition of a (lass>ionomer restoration and then traced this "ack to a rison
where the fillin( was laced) Dental records secured the identification of the indi#idual) In another
case' it was ossi"le to identify 9e#lar fi"ers that had "een laced within a lower denture to reinforce
it) This rare rocedure ena"led an identification of the wearer who was a #ictim of homicide)
to
=ole of D%A in dental identifications
/ecause of the resistant nature of dental tissues to en#ironmental assaults' such as incineration'
immersion' trauma' mutilation and decomosition' teeth reresent an e$cellent source of D%A
material)4?hen con#entional dental identification methods fail' this "iolo(ical material can ro#ide
the necessary link to ro#e identity)5
?ith the ad#ent of the olymerase chain reaction -P=.' atechni,ue that allows amlification of D%A at re>selected' secific sites' this source of e#idence is
"ecomin( increasin(ly oular with in#esti(ators) omarison of D%A reser#ed in and e$tracted
from the teeth of an unidentified indi#idual can "e made to a known antemortem samle -stored "lood'
hair"rush' clothin(' cer#ical smear' "iosy' etc. or to a arent or si"lin()2
enomic /0$
Cenomic D%A is found in the nucleus of each cell and reresents the D%A source for most forensic
alications' -there are no nuclei' and hence there is no D%A' in red "lood cells). ?hen "ody tissues
ha#e decomosed' the structures of the enamel' dentine and ul comle$ ersist) It is necessary to
e$tract the D%A from the calcified tissues) In the authors< la"oratory' the cryo(enic (rindin( method is
emloyed -Fi() 4.)5Teeth reresent an e$cellent source of (enomic D%A) Indeed' the authors ha#e
found that e#en root>filled teeth suly sufficient "iolo(ical material for P= analysisG5
P=>"ased analysis
roduces a D%A
rofile that can "e
comared with known
antemortem samles or aternal D%A) Fi(ure 5illustrates a case usin( D%A from teeth to determine
the identity of found remains) The identification of indi#iduals is not the only use for dental D%A) The
techni,ue has allowed criminal in#esti(ators to link #ictims to crime scenes once the "ody has "een
Figure 1: ryogenic grinding is used to extract /0$ from calcified tissues such as teeth.
In a freeer mill a ferroma(netic lun(er is oscillated "ack>and>forth inalternatin( electric current) Bi,uid nitro(en is used to cool the samle' which
results in makin( it e$tremely "rittle and also rotects D%A from heat
de(radation) The tooth is reduced to a owder to increase surface area and
e$ose traed cells to "iochemical a(ents that release D%A into solution
Full sie ima(e -121 9/.
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remo#ed and incinerated)6
itochondrial /0$
In addition to (enomic
D%A' cells contain
mitochondrial D%A
-mtD%A.' the se,uence of "uildin( "locks of which can "e determined to assist in identification) The
main ad#anta(e of mtD%A is that there is a hi(h coy num"er in each cell caused "y the hi(h num"er
of mitochondria resent in most cells) This infers that in cases where (enomic D%A cannot "e
analyed' ossi"ly "ecause it is too de(raded' mtD%A may "e resent in sufficient ,uantity) In addition
to its hi(her coy num"er' mtD%A is maternally inherited)
7
This maternal inheritance attern confersthe same mtD%A se,uence' "arrin( mutations' uon si"lin(s and all their maternal relati#es) This has
imortant imlications for the identification of indi#iduals for which there is no antemortem
comarison samle) Althou(h mitochondrial D%A is still in its infancy in forensic casework' it is a
owerful techni,ue that is likely to "ecome commonlace in the future)
to
Dental identification in mass disasters
The identification of lar(e num"ers of casualties in mass disasters are comle$ and frau(ht with
haards' "oth hysically and emotionally)1' 2The identification rocess is fundamentally the same as
that in a routine comarati#e dental identification' "ut the inherent ro"lems are ma(nified)0Pro"lems
of "ody fra(mentation' mutilation' commin(lin( and incineration' idiosyncratic dental records from
numerous re(ions' oor workin( conditions and sycholo(ical stresses all confound the identification
rocess) The key to successful mass disaster identification is rearedness)any !urisdictions ha#e
dental identification teams and disaster lans in lace) ock disaster scenarios that hel dentists
reare for the disaster situation ha#e ro#en to "e successful)'
to
onclusions
Forensic dentistry lays a ma!or role in the identification of those indi#iduals who cannot "e identified
#isually or "y other means) The uni,ue nature of our dental anatomy and the lacement of custom
Figure 2: The use of /0$ from teeth to prove identity.
ircumstantial e#idence esta"lished the ro"a"le identity of a found human
skull) Antemortem dental records were not a#aila"le for comarison) edical
records re#ealed the a#aila"ility of a Pa -cer#ical. smear) Partial de(radationof D%A from teeth roduced a rofile at ei(ht (enetic loci) These were
comared with the D%A rofile o"tained from the Pa smear and esta"lished
that the samles ori(inated from the same source
Full sie ima(e -122 9/.
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restorations ensure accuracy when the techni,ues are correctly emloyed) In this "rief o#er#iew' the
authors ha#e shown the reader some of the traditional and ucomin( techni,ues in this fascinatin(
field)
to
Acknowled(ements
The authors (ratefully acknowled(e the su((estions of Dr Da#id 9ennedy of *ancou#er' anada with
resect to the su"mission of this article to the /ritish Dental Hournal) r) Pretty is suorted "y a (rant
from the Forensic Science Society -89.)
=ecei#ed 22 Decem"er 1666; Acceted 2 Huly 2777; Pu"lished online 1 Aril 2771)
to
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1)orlan( ? ) Dentistry
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2) Director' /ureau of Be(al Dentistry' 8ni#ersity of /ritish olum"ia' anada
orresondence to: D Sweet213>20 @ast all' 8ni#ersity of /ritish olum"ia' *ancou#er' /'
anada *3T 1
e>mail: dsweetOinterchan(e)u"c)ca
http://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#a2http://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#a2mailto:dsweet@interchange.ubc.cahttp://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#a2mailto:dsweet@interchange.ubc.ca