Forensic Odontology
Forensic Odontology
Forensic Odontology
absolutely necessary for the pedodontist as they are often the first one to deal with children.
DEFINITIONS
FORENSIC MEDICINE : branch of medicine wherein
the knowledge of medicine is applied to the knowledge of law in order to derive justice.(Rao,2000).
FORENSIC SCIENCE : is a study of physical
information connected with crimes or collection of evidences by scientifically examining the objects or substances involved in the crime.
FORENSIC ODONTOLOGY :
branch of dentistry which, in the interest of law, deals with the proper handling and examination of dental evidence and the proper evaluation and presentation of such evidence (keisler Neilson,1981)
HISTORICAL PERSPECTIVE Forensic dentistry began in 2500 BC, when the first evidence was found in the pyramid at Giza, Egypt , in a skull with a gold wire holding two molar teeth. The first text of a mass disaster on forensic dentistry was published in 1897 at Paris after the burn incidence at Bazaar de Charite. In 1967 , a 14 year old girl linda peacock had the bite mark along with other evidence which led to conviction of a young man.
MAJOR FIELDS
CRIMINAL
RESEARCH
Identification of an individual remains, where death is not due to suspicious circumstances. Mass disasters identification of victims of hotel fires, aircraft and other accidents. Craniofacial superimposition for identification
2 . Criminal Identification of persons from their dentition or teeth - living person - dead person Dealing with bite marks identification - foodstuff - on the assailant - the victim
3 . Research Academic training courses final year dental (BDS) and second year medical (MBBS) students.
PG training ( MD/ PhD- Forensic Medicine ).
DNA
Comparative Post mortem dental remains can be compared to antemortem dental records ( including written notes , study casts , photos , radiographs , etc.) to confirm identity.
Post mortem Dental profiling When antemortem dental records are unavailable, the forensic pedodontist can assist in limiting the population pool to which the deceased is likely to belong , thus increasing the likelihood of locating ante-mortem dental records.
Ageing Determination of age plays a significant role within forensic science, not only in identification of bodies but also in connection with crimes and accidents.
DNA and Dental identifications Comparison of DNA from the teeth of an unidentified individual can be made to a known ante - mortem sample ( stored blood, clothes, hairbrush, etc.) or to a parent or sibling.
THE ROLE OF PEDODONTIST MASS DISASTER CHILD ABUSE AND NEGLECT ACCIDENTAL &NON ACCIDENTAL TRAUMA DENTAL FRAUD AGE DETERMINATION BITEMARK EVIDENCE
DENTAL RECORDS
MASS DISASTER In the analysis of the incidences where children often become victims, the task of identification is very complicated. These cases can be systemically examined and identified skillfully by the dentist.
ACCIDENTAL AND NON ACCIDENTAL ORAL TRAUMA Dentist can play important role in examination of children who have sustained trauma involving oro facial structure via accident, negligence , malpractice or child abuse. A detailed and accurate examination supported with radiographs, tests, and photograph will be required by the enquiring agency as often these cases are challenged in the court.
Dental fraud
With the introduction of consumer protection act, the
dentist is required to examine patients carefully and records are to be maintained properly to defend himself if needed. Also records are to determine whether a treatment paid for by a third party has been actually performed or not.
Age determination
Age determination with the help of human dentition
lip. Thus lip print can be evaluated in identification of victims and suspects.
Poisoning
Most commonly associated with metallic taste and a
Dental records
Teeth
are unique in individuality, resistant to destruction and their record can be maintained well along with noting of developmental variations and appliances delivered if any to children. Thus routine findings of the patient if preserved can be used successfully for their identification.
INTRODUCTION
Dental evidence has become increasingly important
children of age group 11-15 years,while most of the male victims are in the age group 4-10 years.
DEFINITION
BITE MARK
A mark caused by teeth alone or in combination with other oral parts or consists of teeth marks produced by the antagonist teeth, which can be as two opposing arCh marks.
CLASSIFICATION
Bite marks are basically classified according to
causative agent(etiological factors), material bitten(Cameron and sims,1973 and McDonald,1974) and degree of biting(Whittaker et al,1989)
BITE MECHANISM (A) TOOTH PRESSURE: Marks caused by direct application of incisal edges of the anterior teeth or occlusal surfaces of posterior teeth. Marks depends on the force applied and degree of movement between the tissue and teeth. Pale area incisal edges Bruising margin of incisal edges Tooth mark pattern as an attack or defensive bite mark is seen most commonly in battered child syndrome.
(B) TONGUE PRESSURE Tooth pressure is caused when the material is taken into the mouth and pressed by the tongue against the teeth or palatal rugae.
This can leave a distinctive mark due to mechanism of
suck mark radiating linear abrasion pattern surrounding the central area and resembling a sunbrust.These are mostly found in sexually oriented assaults.
TOOTH SCRAPE
May be caused by teeth scraping across the surface of
skin. These marks are usually inflicted by anterior teeth. May appear as scratches or abrasions. If scratches,they might indicate a peculiarity of incisal edges and assist in identification.
Sex: females tend to bruise more easily than males and bite mark bruise persist longer in females because of more subcutaneous fat.
following categories:
Collection of evidence from victim photography Salivary swabbing Impressions Tissue sample
Collection of evidence from suspect Before collecting evidence from suspect,the dentist should ascertain that necessary search warrant court order or legal consent has been obtained,and should make a copy of this document as part of his/her records.
Transillumination: successful in enhancing low light energy images produced by interdental injection of chemically luminescent liquids.
Videotape analysis: with this advanced computer technique it is easy to anlayse a transparency
Superimposition technique : an image of the bite marks inflicted on the deceased child is compared with bite marks obtained from suspect for identification.
DNA fingerprinting: has been developed since 1980s as a molecular tool for genetic specification of an individual.
LIP PRINTS(CHEILOSCOPY)
Lip prints have been used as an identification aid in much
same manner as fingerprints. It is analogous to bite mark analysis. Of the many different types of lip prints,vertical,branched,intersected and reticular pattern are most commonly found. Minor differences have also been observed between the right and left sides and between upper and lower lips. .
CHEILOSCOPY.
LEGAL ASPECTS
Basic knowledge of legal aspects and practices pertaining to
of child abuse/neglect and existing related laws under the Draft Model Child Protection Act 1977,to protect himself and apply it correctly in child abuse/neglect cases.
Dentist should always follow the dont do or do always
principles.
legal responsibilities. Should keep legibly written, accurate case records. Records should be made in the presence of the patient. Additions or corrections should never be made to alter the original records. Should keep an up-to-date knowledge. Diagnostic tools like radiographs should always be used preoperatively and postoperatively. Should always be in consultation with legal/medicolegal expert to review insurance policies or any financial,legal matter.
helpful in the case, including physical evidence and comments obtained from questioning or interviewing. .
To remain objective toward all parties. To treat any dental injuries to establish and maintain a professional therapeutic
of this criminal act by understanding various issues related to child abuse and applying them at different level:
Primary level
Secondary level
Tertiary level
PRIMARY LEVEL
Greater attention needs to be given directed at screening
children at a higher risk of maltreatment. Greater use should be made of routine child health supervisory visit to explore psychological issues. Parents at risk for abusing their children are frequently very needy themselves , and being nurturant to their children is difficult. Therefore , they should be screened and counseled.
SECONDARY LEVEL
Secondary prevention concerns efforts directed to those who
are known or thought to be at a specially high risk for child abuse and neglect.
It is important that pedodontist recognizes his limitations and
capabilities and family functioning , thereby enabling them to more adequate care for their children and avoid possible maltreatment.
TERTIARY LEVEL
Refers to interventions after the condition is already
identified. still considered prevention because the goal is to prevent a recurrence of the condition or the potential negative sequelae. This treatment of abused child depends on the accurate identification of abuse and neglect. The pedodontist should ensure that child is referred to a designated child protection agency and childs situation is further evaluated.
Size of mandible Mandibular angle Frontal angle Palate Occipital condyle Teeth
Large and broad Large,rough outer surface Small Large and broad,u shaped Large Large,lower 1st molar,more often 5-cusped
Small and less broad Small, smooth outer surface Large Small, parabola like Small Small,more often 4cusped
INTRODUCTION
The determination of age plays a significant role within
forensic science,not only in identification of bodies but also in connection with crimes and accidents Age determination can be considered in two periods:
developmental period which the post Begins in utero and ends when developmental Dentition has reached maturity Period which extends from time of dental maturation to termination of life.
Gravimetric method
Histological approach
GRAVIMETRIC METHOD
In fetus or infant where teeth are not present in mouth,any
content of fetal and infantile teeth and relationship between the square roots of the weights of the ashed teeth and known age of subject can be determined.
This method appears to be reliable method.
HISTOLOGICAL APPROACH
In order to understand rationale of this technique,knowledge
number of teeth that are present in the dental arches and dentition to which they belong.
Radiographs would reveal the resorption of the roots of
primary teeth.
which begins during the first six months after birth in the case of incisors and canines, and ends with the completion of the roots of the second molar at about fifteen years.
Most common method used is visual supported with
radiographs.
of a tooth is more meaningful indication of dental maturation than the time of its clinical emergence.
Demerjian et al (1973) forumulated a new method
of age by reference to the radiological appearances of the seven teeth on the left side of the mandible.
Eight stages A TO H Have been defined from the first
of tooth development based on objective measurements such as crown height, apex width and root length.
Tounsend and Hammel (1999) proposed a method
estimation in a Belgian Caucasian population. It is a modification of Demirjian method (new tables for boys and girls with age scores directly expressed in years). Cameriere et al. (2006) published a mathematical formula for calculating dental age on teeth. The method is based upon measuring the completeness of apical development via a computer method and all studies to date show a very strong correlation to chronological age.
during post natal period the principal clues to the age of an individual . Gustafson (1950) introduced multifactorial histologic approach to the determination of age based on arbitary scale of points. - Secondary dentin formation; transparency in root formation from the apex appears to be directly related to chronologic age.
THANK YOU