Rolul Dintilor in Identificare

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

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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

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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

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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#B39


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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


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

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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

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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

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9/14

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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)Haco" = F' Shalla B) Postmortem identification of the edentulous deceased: denture tissue

surface anatomy))J "orensic !ci1654; %#: 365472)

)?hittaker D 9)A Colour Atlas of "orensic Dentistr$) Saint>Bouis: arcourt' 1656)

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Odontostomatol1655; +: 2124)

4)Schwart T =' Schwart @ A' ieserski B' c%ally B' 9o"ilinsky B) haracteriation of

deo$yri"onucleic acid -D%A. o"tained from teeth su"!ected to #arious en#ironmental

conditions)J "orensic !ci1661; %+: 646667)

5)Sweet D' ilde"rand D) =eco#ery of D%A from human teeth "y cryo(enic (rindin()J "orensic!ci1665; '%: 11661272)

6)Sweet D H' Sweet ) D%A analysis of dental ul to link incinerated remains of homicide

#ictim to crime scene)J "orensic !ci166; '4: 01701)

7)utchison A' %ew"old H @' Potter S S' @d(ell ) aternal inheritance of mammalian

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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:[email protected]://www.nature.com/bdj/journal/v190/n7/full/4800972a.html#a2mailto:[email protected]

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