Orthopantomography and INAIL assessment of dental injury. Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro.

The protection of workers' health is defended by the Italian Constitution, and sees its most extensive application in the work of the INAIL (Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro-National Institute for Assurance against Work-related Accidents). In the T.U. (Testo Unico-Complete Text of Legislation) 1124/1965, dental injury is compensated with fixed percentages for permanent impairment, depending on whether the prosthesis applied is effectual or otherwise. The INAIL's primary task of assigning the necessary treatment and recovering the claimant's occupational aptitude requires that it meets in full the cost of his dental rehabilitation. In Turin in 1981 a systematic procedure was set up for the provision and monitoring of the dental treatment received by the injured person. Legislation relating to prostheses has further widened the scope of dental treatment. To deal correctly with the legal medicine aspects of dental rehabilitation, the authors illustrate a working procedure which is based on the reading of radiological evidence in order to determine the prior situation, extent of injury, results of the treatment and evaluation of residual permanent injury.

Orthopantomography and the determination of majority age.

The problem of determining a subject's age to ascertain whether he can be criminally charged brings to prominence all the methods of investigation which can be used to define a person's biological age. The methodologies used to determine dental age still represent today the most sensitive means of arriving at this end. Researchers in Turin in 1980 elaborated an equational formula to determine a subject's presumable age by means of orthopantomography, basing the examination on the mineralization times of 4.5, 4.7, 4.8. After thorough checks carried out on sample groups of urban inhabitants, it was noted that the phases of mineralization of the 3rd molar can provide an answer to the judicial authorities' query as to whether the subject in question has come of age. The phase of mineralization of the 3rd molar is evaluated according to the table we have proposed during a previous conference and in another paper, which establishes 12 phases of mineralization. Focusing our attention on the final 12th phase, corresponding to the complete mineralization of the tooth roots, it was noted that this was present in 93 subjects, of whom 43 male and 50 female. A check of the personal data of these subjects revealed that for the male group age was between 6875 and 9396 days (between 18 years 10 months and 25 years 9 months), whereas for the female group age was between 6711 and 9275 days (between 18 years 4 months and 25 years 5 months). In other words, none of the subjects was found to be under 18 years of age.

[The thickness of the soft tissue of the face for person identification]. / Die Stärke des Weichgewebes des Gesichtes zur Personenidentifizierung.

A skull may give important information about race, sex, facial details and contribute, even without dental study, to personal identification in case of skeletal remains of unknown origin. It was shown by some authors that upon the cranial framework we may build bit by bit all soft tissues until details of physiognomy take shape and a reasonable reproduction of a living human head emerges. This work is based on the careful measurement of the tissue thickness of several cadavers' head and face in some chosen sites, to obtain mean values, which are the starting point for the restoration of physiognomy details. Collected data calculation gave four simple tables, with thickness mean values in millimetres. These tables successively determine groups according to age, sex and body condition.

[The problem of informed consent in dental treatment of the handicapped]. / Il problema del consenso nel trattamento odontostomatologico dell'handicappato.

The juridical and medical aspects of disability and the treatment of the disabled permitted by law are described with particular reference to the borderline situations most often encountered in dentistry, in order to highlight the fact that the implicit or explicit consent of the patient's legal representative must always be obtained.