The Importance of Blind Forensic Odontology Analyses.

Forensic odontology cases examined from 2012 to 2019 at the Defense POW/MIA Accounting Agency (DPAA) laboratory were reviewed. Five cases from World War II and the Korea War were selected. Three of the cases presented involve dental assemblages, which were built by previous analysts. Postmortem radiographic analyses at the DPAA laboratory of these cases were complicated by the use of an older version of a digital x-ray program and the assumption that teeth placed in the parent bone (maxilla and mandible) did not fully articulate due to the presence of debris at their root apices. Conflicting mitochondrial DNA test results for the submitted teeth and previously believed to be parent bone indicated these elements were not from the same individual. The remaining two cases are examples of how knowledge of findings from other disciplines may sway an opinion and could possibly lead to the rendering of erroneous opinions by the forensic odontologist. Having knowledge of previous examinations or results from other scientists, disciplines, and lines of evidence may lead to a bias in findings or opinions. If not careful, even the best-intended scientist may fall victim to a bias in their opinion/analysis. The forensic odontologist should perform all analysis in the blind, not knowing any information which may bias their opinion, and utilize current versions of digital x-ray software available and their tools when performing their examinations.

A Review of Proposed Positive Dental Identifications from the World War II Era.

In 1949, the American Graves Registration Service Pacific Zone proposed the identification of 27 sets of remains (skulls/crania/mandibles) based on comparisons with written dental records. All were denied, and the remains were buried as unknowns. In 2003 and 2015, the remains were exhumed by the DPAA. Currently, 26 individuals previously recommended for identification have been positively identified. The DPAA Science Director's opinion corresponded with 24 of their recommendations, while DNA excluded three. Caution should be taken by the forensic scientist when building assemblages through skeletal and dental articulation. The forensic odontologist must always consider variations in restorative care/extraction patterns and the possibility of documentation errors when reviewing/interpreting historical and current day dental records used for AM/PM comparisons. The odontologist should base their opinion on the strength of the antemortem/postmortem comparison, number and type of concordances, and distinct dental care and extraction patterns.

Healing alveolar sockets in skeletonized remains: A report on cases from one month to twelve months post-extraction.

The removal of a tooth is a common clinical procedure documented in an individual's dental record. A photographic and radiographic series of healing alveolar ridges/sockets are presented. The history of a documented extraction and a concordant finding of healing alveolar bone could assist in strengthening an association between a set of unidentified remains and an individual.

Radiopaque Images Resembling Obturated Root Canals.

The practice of endodontics, while not as common as today, was performed during the WWII era. Some of the materials used to fill canals during this time period include gutta-percha, calcium hydroxide, gold foil, and silver points. In this case study, fissures and fractures were present on the exposed root surfaces of the dental remains. Radiographs of the dental remains revealed canal systems similar to those obturated with a paste or semi-solid material. The root surface defects appear to be the access point for the radiopaque material. As demonstrated in the case presentation, the radiographic image suggestive of a treated canal may easily mislead the analyst. The analyst should be suspicious of a radiopaque artifact if no evidence of access is apparent and fissures/fractures are present on the root surfaces. The defects in the tooth structure may possibly be explained by the exposure to a wet or damp environment.

A Comparison of US and Japanese Dental Restorative Care Present on Service Members Recovered from the WWII Era.

The documentation of dental materials used in the USA during the WWII era is readily available, while references for the Japanese are minimal. It was therefore important to build a photographic database of Japanese restorative care which could be utilized as a comparison tool for the deployed odontologist. The dental restorative care of approximately 400 US and 100 Japanese sets of remains was evaluated. Both countries share many similar restorative techniques to include collared crowns, full-coverage restorations, cantilever bridge/pontics to close spaces; restorative materials such as amalgam, gold, and zinc phosphate (temporary) restorations; and removable prostheses. The dental restorative materials most commonly used by US dentists include the amalgam and silicate cement, while the full-coverage crown was the type of restoration most frequently seen on the Japanese remains. Silicates, porcelain and replaceable crowns, and partial-coverage prepared crowns were not observed on the recovered Japanese remains.

A Retrospective Review of Forensic Odontology Reports Written by the Joint POW/MIA Accounting Command Central Identification Laboratory for Remains Identified from the Korean War.

As of August 2014, the Joint POW/MIA Accounting Command has identified the remains of 1980 previously unknown U.S. service members; 280 were from the Korean War. To determine the accuracy and completeness of the available antemortem (AM) dental records, a review of the AM/postmortem (AM/PM) dental record comparisons from 233 Forensic Odontology Reports written in support of remains identified from the Korean War was performed. Seventy-two AM/PM comparisons resulted in exact dental chartings while 161 contained discrepancies which were explainable. Explainable discrepancies include undocumented treatment (103), incorrectly charted third molars as missing (82), differing opinions of specific molars present/missing (20), and erroneous treatment documentation and/or misidentification of teeth present/missing (22, other than molars). Reassessment has revealed varying levels of completeness for our available AM dental records, the need to thoroughly review our computerized comparisons, adjust our comparisons to include molar pattern variations/third molars, and updating our database comparison program.

A Comparison of Dental Chartings Performed at the Joint POW/MIA Accounting Command Central Identification Laboratory and the Kokura Central Identification Unit on Remains Identified from the Korean War.

During the Korean War, the Office of the Quartermaster General's Graves Registration Service (GRS) was responsible for the recovery, processing, identification, and repatriation of US remains. In January 1951, the GRS established a Central Identification Unit (CIU) at Kokura, Japan. At the Kokura CIU, postmortem dental examinations were performed by the dental technicians. Thirty-nine postmortem dental examinations performed at the CIU were compared to the findings documented in the Forensic Odontology Reports written at the JPAC Central Identification Laboratory (CIL). Differences were noted in 20 comparisons (51%). The majority of the discrepancies was considered negligible and would not alter the JPAC decision to disinter a set of unknown remains. Charting discrepancies that were considered significant included the occasional failure of the Kokura technicians to identify teeth with inter-proximal or esthetic restorations and the misidentification of a mechanically prepared tooth (i.e., tooth prepared for a restoration) as a carious surface.

The analysis of a World War I U.S. service member's dental remains recovered in France.

In October 2009, the grave of an unknown World War I (WWI) U.S. service member was exhumed in Rembercourt-Sur-Mad Village, in the Lorraine Region of France. The skeletal remains and material evidence were accessioned into the Joint POW/MIA Accounting Command's (JPAC) Central Identification Laboratory (CIL). The personnel records for the associated casualty were requested, received, and reviewed. A dental profile was present among the service member's personal information. There were multiple points of concordance between the dental records of the associated casualty, and the recovered dental remains to include eight restored teeth, 15 unrestored teeth, and three antemortem missing teeth. Distinctive restorations which compared favorably included a porcelain crown and multiple gold foil fillings. All lines of evidence (historical, material evidence/personal effects, anthropological, and dental) and the circumstances of loss compared positively with the associated casualty. On April 1, 2010, the previously unaccounted-for U.S. service member was positively identified and on June 23, 2010, was buried with full military honors at Arlington National Cemetery.

The search for, recovery, and positive identification of a Vietnam-era U.S. Army soldier.

In Quang Nam Province, then South Vietnam, on August 26, 1971, a convoy of United States Army armored patrol cars was returning to base at the end of the day. A rocket-propelled grenade struck one of the vehicles, and subsequently five of the soldiers were killed in action (KIA) while one was missing in action (MIA). After-action reports from eyewitnesses to the event described the MIA soldier as "vaporized" and his remains as "completely destroyed" since he had been seated on boxes of claymore mines, and the vehicle was said to contain white phosphorous as well. Search efforts nonetheless ensued for the MIA beginning 2 days after the attack and finally ending 29 years later when a U.S. Army search and recovery element (RE) discovered dental remains and a dental prosthesis which were used to identify the soldier positively.

A minimally destructive technique for sampling dentin powder for mitochondrial DNA testing.

The purpose of this paper is to present the horizontal sectioning technique used by odontologists at the Central Identification Laboratory to sample dentin for mtDNA analysis. From the perspective of DNA testing, anthropologists and odontologists at the Central Identification Laboratory work with ancient remains. In many instances, the lack of comprehensive antemortem records, the potential for fragmentation and commingling, and environmental exposure makes the use of traditional forensic identification techniques difficult or impossible. Teeth are highly resistant to environmental degradation and are an excellent source of mitochondrial DNA (mtDNA). This technique is simple, quick, and relatively conservative, allowing for preservation of the majority of the external portion of the tooth structure.

Recovery and identification of the victims of the Ehime Maru/USS Greeneville collision at sea.

This paper describes the recovery and identification of crew members lost during a collision at sea. On 9 February 2001, south of Honolulu, Hawaii, the Japanese fishing training boat, Ehime Maru was struck by the USS Greeneville (SSN 772), a Los Angeles-class fast attack submarine. Witnesses estimate that the vessel sank within 5-10 min after the collision. Nine of the 35 crew members remained unaccounted for after rescue procedures were completed. The U.S. Navy attempted the unprecedented procedure of moving the boat from a depth of 610 m (2000 ft) into shallower waters so that the missing could be located and recovered. Eight of the nine crew members were recovered and identified by their dental records.

The use of amalgam powder and calcium hydroxide to recreate a radiopaque image of a lost dental restoration.

Radiographs of dental restorations are highly reliable when used to identify postmortem dental remains. A problem exists if key dental restorations are missing or defective, which results in the loss of a comparative radiographic image. This article describes a simple method allowing the odontologist to quickly recreate a temporary radiopaque restoration. This article presents a method of using amalgam powder (radiopaque material) and calcium hydroxide (radiopaque material and transport medium for the amalgam powder) to recreate a radiopaque image on a tooth that has lost a dental restoration. Amalgam powder and calcium hydroxide is easily obtained (in any dental office), fairly clean, easy to manipulate, inexpensive, inert, stable, and able to be removed without damaging the dental remains. The amalgam powder/calcium hydroxide mixture can easily be re-shaped or modified to reflect the radiopaque image of the original restoration. Radiographic comparison of the "restored" dental remains to the antemortem radiographs is now possible. The use of this technique is presented in a case report.