Validation of reference data on wisdom tooth mineralization and eruption for forensic age estimation in living persons.

Estimation of dental age is an important part of forensic age estimation in living persons. As the quality of the values given in population-specific reference studies has a great impact on the estimation, the aim of this study was to validate reference data for wisdom teeth mineralization and eruption of a German population concerning the diagnosis of the age limit of 18 years in persons with known age. Mineralization and eruption was evaluated in 307 orthopantomograms of Central European subjects aged 17.5-18.5 years. Dental age was estimated using reference data and compared to chronological age. Statistical methods were used to analyze the differences and to propose adjusted reference values. Estimation of dental age relying on mineralization resulted in overestimations of 2 years on average in 76% of the males and 82% of the females. Using eruption, all men and 75% of the women were overestimated by up to 7 years. The differences between estimated and chronological age in both men and women were associated with the mineralization and eruption stage, respectively. The higher the stage, the higher was the risk of overestimation. The mineralization stages up to stage E were associated with underestimations. Using the proposed adjusted reference values resulted in more accurate estimations of dental age. Validation of reference values for dental age estimation showed great overestimations resulting in high error rates with numerous persons being younger than the estimated dental age. Adjustments are proposed which reduce differences between estimated dental age and chronological age.

A case of SUDEP in a patient with Dravet syndrome with SCN1A mutation.

A boy with a clinical history of pharmacologically resistant Dravet syndrome died suddenly after falling asleep. The autopsy concluded that the cause of death was sudden unexpected death in epilepsy (SUDEP). Postmortem molecular analysis of the SCN1A gene by multiplex ligation-dependent probe amplification (MLPA), high-resolution melting curve analysis (HRMCA), and sequencing revealed a frameshift duplication of adenosine at position 504. The incidence of this mutation is discussed as a potential cause of SUDEP.

Candida mediastinitis with aortic rupture after congenital heart surgery.

We describe the fatal course of a Candida albicans mediastinitis in a 4-year-old child after truncus arteriosus repair, leading to aortic rupture. The diagnosis was made by computer tomography and confirmed at exploratory sternotomy, with positive swab and blood cultures. After local surgical lavage, Amphotericin B therapy was started, but the child died due to aortic rupture 2 weeks later, despite negative blood cultures. The potential risk of aortic rupture with Candida mediastinitis after congenital heart repair exists, and combined aggressive surgical and medical treatment is essential. Guidelines for the diagnosis and therapy in pediatric patients with post-operative mycotic mediastinitis are required.

[The role of the dentist in modern forensic age determination]. / Die Rolle des Zahnarztes in der heutigen forensischen Altersschätzung.

The increase of international movements has led to a greater demand for forensic age estimation of foreigners without valid identification documents. Age estimation on living individuals is part of asylum and criminal proceedings. Age estimation has become also important within identification of victims, because of the fact of increasing natural disasters and events of terrorism. Therefore dentists are more and more appointed to this job. There are varieties of methods in age estimation. Dental examination and analysis of panoramic x-ray are usually used for dental age estimation.

Increased rate of Helicobacter pylori infection detected by PCR in biopsies with chronic gastritis.

Histology is considered a sensitive method for detection of Helicobacter pylori, in gastric biopsies. We investigated the diagnostic potential of qualitative nested (nPCR) and quantitative PCR (qPCR) for detection of H. pylori using different primers on 126 archived gastric biopsies with inflammation and correlated the inflammatory changes with the presence and density of bacteria. H. pylori was detected in 42.8% biopsies by histology and PCR, an additional 15 samples were positive exclusively by PCR: nPCR was positive in all histologically positive samples, but qPCR failed to detect H. pylori in 10 biopsies. The inflammatory score was significantly higher in biopsies positive for H. pylori only by PCR showed a significant higher inflammatory score compared with negative biopsies (mean of neutrophils score, 1.60 vs. 0.90, P < 0.01; mean of mononuclear cells score, 2.27 vs. 1.67, P < 0.01), whereas the inflammatory score was similar compared with biopsies positive for H. pylori by histology (mean of neutrophils score, 1.60 vs. 1.56, not significant; mean of mononuclear cells score, 2.27 vs. 2.20, not significant). A weak correlation between inflammatory score and the density of H. pylori detected by histology was observed. The mean values of H. pylori DNA were significantly higher in histologic-positive than in histologic negative biopsies. We have shown that PCR can detect H. pylori in about 20% of histologic-negative gastric biopsies, indicating the clinical relevance of H. pylori detection by PCR in biopsies with characteristic inflammatory changes.