FORENSIC ODONTOLOGY

By : Shivika Chugh

 FORENSIC IS DERIVED FROM THE LATIN WORD FORUM WHICH MEANS COURT OF LAW ODONTOLOGYSTUDY OF TEETH DEFINED AS THAT BRANCH OF DENTISTRY WHICH ,IN THE INTEREST OF JUSTICE ,DEALS WITH THE PROPER HANDLING AND EXAMINATION OF DENTAL EVIDENCE,AND WITH THE PROPER EVALUATION AND PRESENTATION OF DENTAL FINDINGS

 FORENSIC DENTISTRY PLAYS A MAJOR ROLE IN IDENTIFICATION IN MAN MADE OR NATURAL DISASTER EVENTS THAT RESULT IN MULTIPLE FATALITIES THAT MAY NOT BE IDENTIFIABLE THROUGH CONVENTIONAL METHODS SUCH AS

 THE EARLIEST KNOWN EXAMPLE BY DENTAL MEANS DATES BACK TO 66 AD ELABORATE DENTAL RECORDS INCLUDING RADIOGRAPHS AND SPARE CROWNS IDENTIFIED THE BODY OF ADOLPH HITLER ,THE MOST HIGH PROFILE CASE OF DENTAL IDENTIFICATION IT RELIES ON SOUND KNOWLEDGE OF TEETH AND JAWS ,POSSESED BY DENTIST AND INCORPORATES DENTAL ANATOMY ,HISTOLOGY RADIOGRAPHY ,DENTAL

FORENSIC ODONTOLOGY DELVES INTO IDENTIFYING UNKNOWN HUMAN REMAINS THROUGH DENTAL RECORDS ,AND ASSISTING AT LOCATION OF MASS DISASTER ELICITING THE ETHNICITY AND ASSISTING IN BUILDING UP A PICTURE OF LIFESTYLE AND DIET OF SKELETAL REMAINS AT ARCHEOLOGICAL SITES DETERMINIG THE GENDER OF AN UNIDENTIFIED INDIVIDUAL AGE ESTIMATION OF BOTH THE LIVING AND DECEASED RECOGNITION AND ANALYSIS OF BITE MARKS FOUND ON VICTIMS OF ATTACK AND OTHER SUBSTANCES SUCH AS FOOD STUFF PRESENTING EVIDENCE IN COURT AS AN

PERSONAL IDENTIFICATION
IDENTIFICATION IS THE ESTABLISHMENT OF A PERSONS INDIVIDUALITY REQUIRED FOR LEGAL AND HUMANITARIAN REASONS HELP IN SETTLEMENT OF PROPERTY ,FACLITATE REMARRIAGE OF A SURVIVING SPOUSE AND ALLOW CREMATION OR BURIAL OF THE BODY ,ACCORDING TO RELAVENT RELIGIOUS AND CULTURAL CUSTOMS

TRADITIONAL METHODS VISUALLY RECOGNISING BODY PERSONAL PROPERTY SUCH AS CLOTHING ,JEWELLERY ETC VISUALLY IDENTIFYING THAT IS BURNT OR DECOMPOSED CAN BE A VERY TRAUMATIC EXPERIENCE FOR RELATIVES AND FRIENDS . THE BETTER OPTION IDENTIFICATION IS FORENSIC EXPERT TO ANALYSE PHYSICAL FEATURES PRESENT IN THE BODY

 PHYSICAL FEATURES ARE PRONE TO CHANGE OVER TIME ,FINGER PRINTS ARE EXCEPTIONS BUT LIKE OTHER SOFT TISSUE,UNDERGO POST MORTUM CHANGE BEING THE STRONGEST STRUCTURE PRESENT IN THE BODY DENTAL HARD TISSUES ARE RESISTANT TO POST MORTUM DECOMPOSITION

 MOREOVER MOST MATERIAL USED BY DENTIST FOR RESTORING TEETH ARE ALSO RESISTANT TO POST MORTUM DESTRUCTION THEREFORE THE USE OF DENTAL EVIDENCE IS THE METHOD OF CHOICE IN ESTABLISHING THE IDENTITY OF BADLY BURNT ,TRAUMATISED,DECOMPOSED AND SKELETONISED REMAINS

BASIS FOR DENTAL IDENTIFICATION

HUMAN DENTITION IS NEVER SAME IN ANY TWO INDIVIDUALS THE MORPHLOGY AND ARRANGEMENT OF TEETH VARY FROM PERSON TO PERSON TEETH ARE RELATIVELY RESISTANT TO ENVIRONMENTAL INSULTS AFTER DEATH

DENTAL IDENTIFICATION PROCEDURES

TWO FORMS: 1. COMPARITIVE IDENTIFICATION : COMPARING THE DEAD INDIVIDUALS TEETH WITH PRESUMED DENTAL RECORDS OF THE INDIVIDUAL 2. RECONSTRUCTIVE IDENTIFICATION (DENTAL PROFILING) : ATTEMPTS TO ELICIT THE ETHNICITY OR RACE ,GENDER , AGE AND OCCUPATION OF THE DEAD INDIVIDUAL UNDERTAKEN WHEN VIRTUALLY NO CLUE EXISTS.

COMPARITIVE DENTAL IDENTIFICATION

INCLUDES FOUR STEPS STEP 1:ORAL AUTOPSY STEP 2:OBTAINING DENTAL RECORDS STEP 3:COMPARING POST MORTUM AND ANTIMORTUM DENTAL DATA STEP 4:WRITTIN A REPORT AND DRAWING CONCLUSION

ORAL AUTOPSY
ALSO KNOWN AS NECROPSY OR POST MORTUM IT HAS A SYSTEMATIC PROTOCOL STARTING WITH CRITICAL EXAMINATION OF THE EXTERNAL FEATURES OF THE BODY SUCH AS GENDER, ETHNICITY ,BUILT, WOUNDS,SCARS ,TATTOOS AND BODY PIERCING. PHOTOGRAPHS,RADIOGRAPHS,FINGERPRI NTS, FINGER NAIL SCRAPING AND HAIR SAMPLE MAY BE OBTAINED ACCORDING TO

 ORAL EXAMINATION IS AN ESSENTIAL PART OF POSTMORTUM PROCEDURS A FORENSIC DENTIST WHO CONDUCT ORAL AUTOPSY SHOULD HAVE ADEQUATE KNOWLEDGE ABOUT COMMON POSTMORTUM FINDINGS SUCH AS RIGOR MORTIS ,LIVER MORTIS ,DECOMPOSITION AND POSTMOTUM ARTEFACTS RIGOR MORTIS MAY RENDER THE JAW AND THE USE OF MOUTH GAGS OR INTRA ORAL MYOTOMY IS ESSENTIAL FOR JAW SEPERATION

 Since teeth may be brittle in burned cases, they need to be reinforced with cyanoacrylate cements, polyvinyl acetate or clear acrylic spray prior to examination Access for radiology in incinerated bodies can be obtained by removing tongue and contents of floor of mouth in a tunneling fashion from beneath the skin The status of each tooth whether intact, carious , restored or missing should be carefully noted A thorough examination of soft tissue injuries, fracture and presence of foreign bodies is under taken and samples of hard and soft tissues may be obtained for further investigation All information pertaining to the body must be entered on to standard Interpol post-mortem form, which is color-coded in pink

OBTAINING DENTAL RECORDS FROM TREATING DENTIST, SPECIALIST, HOSPITAL RECORDS IN THE FORM OF DENTAL CHARTS RADIOGRAPHS,CASTS, AND/OR PHOTOGRAPHS

COMPARING POST-MORTEM &ANTE-MORTEM DENTAL RECORDS

FEATURES COMPARED INCLUDE TOOTH MORPHOLOGY AND ASSOSIATED BONY STRUCTURES, PATHOLOGY AND RESTORATIONS AN INDIVIDUAL WITH MULTIPLE DENTAL TREATMENT AND UNUSUAL FEATURES HAS A BETTER LIKELIHOOD OF BEING IDENTIFIED THAN SOMEONE WITH NO EXTRAORDINARY DENTAL CHARECTERISTICS COMPARISON SHOULD TAKE IN TO ACCOUNT QUALITY RATHER THAN QUANTITY

WRITING A REPORT AND DRAWING CONCLUSION

CONFIRMS IDENTIFICATION : MATCH EACH OTHER PROBABLE IDENTIFICATION : HIGH LEVEL OF CONCORDANCE BETWEEN THE TWO SETS OF DATA BUT,USUALLY ,WITH NO RADIOGRAPHIC SUPPORT POSSIBLE IDENTIFICATION :,EXPLAINABLE IDENTIFICATION BETWEEN THE ANTE AND POST-MORTEM DATA INSUFFICIANT INFORMATION : AVAILABLE ANTI&POS-MORTEM DATA ARE INSUFFFICIANT EXCLUDES IDENTIFICATION : ANTI&POST MORTEM DATA ARE CLEARLY INCONSISTENT

IDENTIFICATION IN DISASTERS
INVOLVES COMPARING HUNDREDS OR THOUSANDS OF ANTE &POST MORTEM DATA HUMAINS REMAINS IN SUCH EVENTS MAY BE HIGHLY FRAGMENTED , ONLY PART OF BODY MAY BE RECOVERED THE BODIES MAY BE INCINERATED OR COMINGLED i.e. PARTS OF TWO BODIES MAY BE MIXED

DENTAL SECTION FORENSIC DENTIST ARE USUALLY PART OF A TEAM OF IDENTIFICATION SPECIALIST THREE SUB SECTIONS
1.POST MORTEM UNITS 2.ANTE MORTEM UNITS 3.DENTAL COMPARISON IDENTIFICATION UNITS

POST-MORTEM UNIT THE LOCATION AT WHICH A BODY IS RECOVERED NOTED AND PRELIMINARY EXAMINATION OF MOUTH IS MADE TO EVALUATE THE ORAL CONDITION DEFINITIVE EXAMINATION AT MORTURY OF POST-MORTUM UNIT A PORTABLE DENTAL RADIGRAPHY UNIT SHOULD BE INSTALLED, TAKING PRECAUTIONS AGAINST RADIATION HAZARDS RESPONSIBLE FOR PROCESSING RADIOGRAPHS &MAY ALSO NEED ARRANGE FOR PHOTOGRAPHY OF TEETH TEETH AND JAW SPECIMEN MAY BE REMOVED FROM A BODY FOR THE CONVEININCE OF EXAMINATION

ANTE-MORTEM UNIT MOST DIFFICULT. THE MEMBERS NEED TO COLLECT AS MUCH AS INFORMATION AS POSSIBLE IN THE SHORTEST PERIOD OF TIME BEGINS WITH LOCATING THE DENTAL RECORDS OF THE VICTIMS COMMUNICATING WITH POLICE, DENTIST, AND RELATIVES OF THE VICTIMS ALL INFORMATION OBTAINED MUST BE TRANSFERRED ONTO THE STANDARD INTERPOL ANTE-MORTEM FORM THIS CONSTITUTE THE ANTE MORTEM COMPOSITE CHART

DENTAL COMPARISON AND IDENTIFICATION UNIT COMPARISON AND CONFORMATION OF IDENTIFICATION THE ANTE-MORTEM DATA ARE TAKEN INDIVIDUALLY AND COMPARED TO THE POSTMORTEM DATA THAT ARE SPREAD OUT (COMPUTER SOFTWARE DEVELOPED TO SIMPLIFY COMPARISON ) FINAL IDENTIFICATION SHOULD ALWAYS BE DONE BY DENTIST MANUALLY

IDENTIFICATION FROM DENTAL DNA

TEETH ARE EXCELLENT SOURCE OF DNA SINCE IT CAN RESIST EXTREME CONDITION PCR ALLOWS AMPLIFICATION OF EVEN HIGHLY DEGRADED DNA MAJOR ADVANTAGE IS THAT IF DECENDENTS ANTE MOTEM SAMPLE (HAIR FROM HAIR BRUSH, EPITHELIAL CELLS FROM TOOTH BRUSH OR BIOPSY)IS UNAVAILABLE ,THE DNA PATTEN MAY BE COMPARED TO A PARENT OR TO A SIBLING

EXTRACTION OF DENTAL DNA PULPAL TISSUE BEST SOURCE OF DENTAL DNA CRYOGENIC GRINDING FOR EXTRACTING DNA(COOLING THE WHOLE TOOTH TO EXTREMLY LOW TEMPERATURE,AND THEN MECHANICALLY GRINDING IT TO FINE POWDER)TOOTH WILL BE COMPLETELY CRUSHED ANOTHER METHODDRILLING OF THE ROOT CANALS, SCRAPING THE PULPAL AREA WITH A NOTCHABLE MEDICAL NEEDLE AND SUBSEQUENT FLUSHING OF THE TIISSUE DEBRIS

TYPES OF DNA TWO TYPES OF DNA 1)GENOMIC OR NUCLEAR DNA 2)MITOCHONDRIAL DNA (mtDNA)
EACH CELL HAS A HIGH COPY OF mt DNA ,ALSO EXCLUSIVELY INHERITED FROM MOTHER;NO CONTRIBUTION FROM FATHER THUS IDENTICAL mtDNA IS OBSERVED IN SIBLINGS, THEIR MOTHER AND MANY MATERNAL RELATIVES

THE PALATAL RUGAE IN IDENTIFICATION

USEFUL IN EDENTULOUS PERSONS RUGAE PATTERNS LIKE TEETH ARE CONSIDERED UNIQUE TO AN INDIVIDUAL RUGAE PATTERNS ON THE DECEDENTS MAXILLA OR MAXILLARY DENTURES MAY BE COMPARED TO OLD DENTURES THAT MAY BE REOVERED FROM THE DECEDENTS RESIDENCE,OR PLASTER MODEL FROM DENTAL OFFICE

CLASSIFICATION OF PALATAL RUGAE LYSELL MEASURED RUGAE IN ASTRAIGHT LINE FROM MEDIAL TO LATERAL AND CATEGORIZED AS -PRIMARY RUGAE (>5mm) -SECONDARY RUGAE(3-5mm) -FRAGMANTARY RUGAE (2-3mm) (RUGAE <2mm IS NOT TAKEN IN TO CONSIDERATION) THOMAS &KOTZE HAVE FURTHER DETAILED VARIOUS PATTERNS OF PRIMARY RUGAE BRANCHED ,UNIFIED , CROSSLINKED , ANNULAR , &PAPILLARY

ANALYSIS OF RUGAE PATTERNS THOMAS AND VAN WYK HAVE MANUALLY TRACED RUGAE PATTERN ON PHOTOGRAPHS OF PLASTER MODEL RECENTLY, LIMSON AND JULIAN HAVE DEVELOPED A COMPUTER SOFT WARE PROGRAM,RUGFP-ID MATCH(SAME PRINCIPLE OF FINGER PRINTING)

DENTAL PROFILING
WHEN ANTE-MORTEM RECORDS ARE NOT AVAILABLE INCLUDES A TRIAD OF INFORMATIONETHNIC ORIGIN , GENDER , AGE INFORMATION FROM THIS PROCESS WILL ENABLE A MORE FOCUSSED SEARCH FOR ANTE-MORTEM RECORDS

IDENTIFY ETHNIC ORIGIN FROM THE TEETH HUMAN RACES HAVE BEEN DIVIDED INTO THREE RACES CAUCASOID, MANGALOID AND NEGROID IT IS POSSIBLE TODAY TO IDENTIFY AN INDIVIDUALS ETHNIC ORIGIN BASED PURELY ON ONES DENTITION

GENETIC AND ENVIRONMENTAL INFLUENCE ON TEETH DENTAL FEATURES HAVE COMPLEX MODE OF INHERITENCE AND ARE COMBINATION OF HERIDITY AND ENVIRONMENTAL FACTORS TO WHICH PERSON IS EXPOSED SO DIFFERENT POPULATION SHOW CONSIDERABLE VARIATION DENTAL FEATURES IN POPULATION DIVIDED IN TO 1)METRIC(TOOTH SIZE) 2)NON METRIC(TOOTH SHAPE) :MORE HERITABLE&DEPENDABLE

NON METRIC DENTAL FEATURES

CROWN FEATURES : SHOVELLING,DOUBLE SHOVELLING,CUSP OF CAREBELLIS FEATURE,THREE CUSPED UPPER 2ND MOLAR,CUSP 5, CUSP 6,CUSP 7, WINGLING,FIVE CUSPED LOWER SECOND MOLAR, LOWER MOLAR GROOVE PATTERN,INTERRUPTION GROOVE, ENAMEL EXTENSION, ODONTOME, LETAREL INCISOR VARIATION, DISTAL ACCESSORY RIDGE, PREMOLAR ACCESSORY RIDGE, PREMOLAR ACCESSORY MARGINAL TUBERCLE, PREMOLAR LINGUAL CUSP, MESIAL MARGINAL TUBERCLE OF UPPER MOLAR, PARASTYLE, PROTOSTYLID

ROOT FEATURES :
TWO ROOTED UPPER PREMOLAR TWO ROOTED UPPER MOLAR TWO ROOTED LOWER CANINE TOMES ROOT THREE ROOTED LOWER MOLAR SINGLE ROOTED LOWER MOLAR

OF THESE NON-METRIC DENTAL FEATURES SOME HAVE HIGH FREQUENCY IN CERTAIN POPULATION AND OTHER UNCOMMEN Eg: SOUTH-ASIANS EXHIBIT 4 CUSPED LOWER SECOND MOLAR BUT FEATURES LIKE WINGLING ,SHOVELLING,Y GROOVE PATTERN TOMES PATTERN

SEX DIFFERENTIATION SECOND STEP CAN BE DETERMINED 1)SEXING FROM CRANIOFACIAL MORPHOLOGY AND DIMENSION 2)SEX DIFFRENCES IN TOOTH SIZE 3)DENTAL INDEX 4)SEX DETERMINATION BY DNA ANALYSIS 5)SEX DETERMINATION BY DNA ANALYSIS

Dental Age Estimation

Final step in dental profiling Estimation methods 1). Age estimation in prenatal, neonatal and early post natal child -by use of histologic technique (12 weeks before it is actually apparent on radiographs) -by radiograph-non invasive -neonatal line indicates a live births -by dry weight of mineralized tooth (at six month IU- 60mg, newborn-0.5g, six month post natal-1.8g)

2.Age estimation in children and adolescents -two events may be used eruption and tooth calcification -various methods a). Schowur and Masslers method: described 20 chronological stages of tooth development starting from 4 months IU until 21 years of age. It is based on histological section which permits direct comparison with radiographs b).Demirjans method: made use of a foreign system. Devolopment of Left side seven mandibular teeth was devided into 8 stages(A-H). Each tooth assigned a maturity score and total maturity score of all teeth is plotted on a chronologic age conversion table. Separate maturity score and age conversion table for both sexes.

c). Third molar in age estimation: A valuable indicator in the age 16-23 years. but questionable now a days due to great variation in genesis, position, morphology and time of formation. 3). Age estimation in adults challenging when compared to young age groups as numerous endogenous and exogenous fqactors, such as disease, nutrition, physical strain influences. a). Methods: Gustafsons method: based on morphological and histological changes of the teeth. Accessed regressive changes such as: .amount of occlusal attrition (A) .coronal secondary dentin deposition(S) .loss of periodontal attachment(P) .Cementum aposition at the root apex(C) .Root resorbtion at apex(R) .dentin translucency (T) Each of regressive changes have seven grades (0,0.5,1,1.5,2,2.5,3)

b). Dentin translucency: root dentin starts to become translucent during the third decade of life beginning at the apex and advancing coronally. Hence as age advances refractive index between intratubular organic and extra tubular inorganic material is equalized resulting in increased translucency of the affected dentin zone. Age= B0+B1X where B0 regression constant B1-regression coefficient X-length of translucency

C).Age Estimation from Incremental Lines Of Cementum

From acellular cementum incremental lines Made us of mineralized unstained cross-sections of teeth

D).Radiographic Method:
Used pulp size measurement of six teeth 521 125 421 124 Age = 129.8-316.4(M)-66.8(W-L)

 The measurement include several length and width ratios such as: pulp-root length P pulp-tooth length R pulp-root width at CEJ A pulp-root width at mid-root level C pulp-root width at mid-point between level C and A B mean value of all ratio including excluding T M mean value of width ratios B and C W mean value of length ratio p and R L Age = 129.8-316.4(M)-66.8(W-L)

Amino acid recemisation

Suggested a relationship between dentinal age and extent of aspartic acid recemisation in dentin. Aspartic acid undergo rapid rate of recemisation and get spontaneously converted from L-Aspartic acid to D-Aspartic acid with increasing age. Comparing D-L ratio age can be estimated.

CRIME INVESTIGATION
BITE MARKS:
A mark caused by teeth either alone or in combination with other mouth parts (Mc Donald). May be caused by humans or animals; may be on tissue, food items or other objects. Human bite broad, U-shaped somewhat circular or oval. Animal bite narrow in the anterior aspect , V shaped and elongated also morphology of the teeth is different.

Classification of bite marks

1.Cameron and Sims Classification Agents Humans Animals Materials skin,body tissue food stuff other materials 2.Mac Donalds classifications Tooth pressure mark Tongue pressure mark Tooth scrape mark

3. Websters classification Type I : the food item fractures readily with limited depth of tooth penetration e.g. hard chocolate Type II : fracture of fragment of food item with considerable penetration of teeth e.g. bite marks in apple and other firm fruits Type III : complete or near complete penetration of food item with slide marks e.g. cheese

Bite mark appearance

Type of injury Identifying The Injury As a Bite Mark a). Gross features: Circular or ellipticalwith central area of
ecchymosis b). Class features: Incisorrectangular Caninestriangular or rectangular Premolars and molars spherical or point shaped c). Individual features: Class features inter have characteristics such as fractures , rotation etc. Site of Bite Marks Females on breast, legs( inner part of thigh)-sexual assault Male children genitals-child abuse Adult Males finger, arms and shoulders-fight

 Preliminary questions Bite mark evidence collection from the victims

if criminal in nature, is reported to law enforcement agencies Steps: 1.Visual examination 2.Photography Orientation photographs close-up photographs 3.Saliva swab: WBC and sloughed epithelial cells, potential source of DNA

Bite mark investigation

4.Impression: Vinyl polysiloxane 5.Evidence collection from suspect: using a signed and informed consents or a court order (warrant) also include photograph, two casts, bite registration in centric occlusion and saliva swab from buccal vestibule

Bite mark analysis and comparison

Jaw movement Flexibility of bitten tissue Individual features of bite marks Metric analysis Computer software program

Conclusion Of Bite Mark Analysis

Positive identification Possible identification Excludes identification

Investigating Animal Bites

Characteristics of some vertebrate dentition fish conical, homodont, heterodont or polyphydont Reptiles homodont conical or only tricuspid teeth Venomous snake single row, palatal to this are two poison fangs containing canal or groove for venom release Non-Venomous two rows of maxillary teeth Mammals heterodont dentition, diphyodont also have accesssional teeth( permanent molar emerge posterior to deciduous teeth)

LIP PRINTS
Examination of lip print-cheloscopy Grooves an wrinkles visible on lips named as sulci, labiorum rubrorum and suppose to be individualistic so material evidence left at a crime scene similar to finger printsGrooves are heritable Lip prints classified as I) a) simple wrinkles straight line curved line angled line sine shaped curve b) compound wrinkles Bifurcated trifurcated anomalous

 II)type 1- clear cut vertical grooves that run across the entire lip type 1-similar to type 1 but not cover the entirely type 2- branched grooves type 3- intercepted grooves type4- recticular grooves type 5- grooves that can not be morphologically differentiated Invisible prints can be lifted using materials such as aluminum powder, magnetic powder DISADVATAGE 1.Trauma, pathosis, surgical treatment can affect the size and shape of the lip 2.The zone of transition close to vermilian border is extremely mobile so prints produced may differ depending on pressure applied and its direction

 Expert witness are those whose training, qualification or experience enables them to give an opinion on relevant matter where the ordinary person is not so enabled. To become dental expert to forensic dental expert need additional knowledge and experience

DENTIST AS AN EXPERT WITNESS