Identificação odontológica post-mortem por meio de fotografias do sorriso: revisão de literatura / Post-mortem identification in Forensic Dentistry through smile photographs: a review of literature

A number of limitations can be encountered while determining human identity in complex cases. Furthermore, there is a great diffusion of digital photographs, especially with the use of smartphones, which gives value to the analysis of smile in forensic practice as a major or supporting human identification method. This is a literature review of forensic case reports using ante-mortem photographic images of the smile as a comparative method. The determination of a missing person's identity by means of ante-mortem photographic records of the smile is a viable method for the Forensic Sciences. This method has been commonly performed by making a direct comparison of ante- and post-mortem records or of their computerized overlapping, thereby constituting an important human identification tool.

Devido todas as limitações encontradas para estabelecer a identidade humana em casos complexos e com a grande popularização das fotografias digitais, especialmente com o uso dos smartphones, a análise do sorriso como método principal ou auxiliar de identificação humana torna-se de grande importância para a rotina pericial. Foi realizada uma revisão da literatura em busca de relatos de casos periciais que utilizaram imagens fotográficas antemortem do sorriso, como método comparativo. Constatou-se que o estabelecimento da identidade de um indivíduo desaparecido por meio de registros fotográficos de sorriso antemortem é um método viável para as Ciências Forenses, sendo realizado através de comparação direta ou da sobreposição computadorizada das imagens obtidas ante e pós-morte, constituindo ferramenta importante para a identificação humana.

Cheiloscopic Study among Monozygotic Twins, Non-Twin Brothers and Non-Relative Individuals.

This study aimed to investigate cheiloscopic patterns among monozygotic twins (MT), non-twin siblings (NTS) and unrelated individuals (UI). The sample consisted of 20 pairs of monozygotic twins (G1), 20 pairs of non-twin siblings (G2) and 20 pairs of unrelated individuals (G3). Lip thickness, commissures and grooves were evaluated and the latter were classified as: I - clear-cut vertical grooves; I' - incomplete vertical grooves; II - branched grooves; III - intersecting; IV - reticular grooves and V - undetermined, in 8 labial regions (sub-quadrants). The data were analyzed using descriptive and inferential statistics, with a 5% significance level. Concordance Correlation Coefficient (CCC) and Kappa coefficient, with a 95% confidence interval, were employed to check for agreement rates between G1, G2 and G3 pairs. There was a weak correlation for lip thickness (<0.90) in the total group, with higher values in G1 (CCC from 0.25 to 0.83 and from 0.34 to 0.86, upper and lower lips, respectively), followed by G2 (CCC from -0.03 to 0.70 and from -0.21 to 0.62, upper and lower lips, respectively) and G3 (CCC from -0.25 to 0.56 and from -0.38 to 0.34, upper and lower lips, respectively). With regard to labial commissures, Kappa statistic values were found to be 1.00 for G1, 0.45 for G2 and -0.24 for G3. As for the main groove pattern by sub-quadrant, Kappa values ranged from 0.48 to 0.87 for G1, from 0.17 to 0.59 for G2, and from -0.18 to 0.19 for G3. Monozygotic twins presented a relevant percentage of cheiloscopic agreements. Similarities were also found among NTS, while UI showed greater differences compared to their pairs, highlighting the influence of hereditary relationships on inherited cheiloscopic features.

Cheiloscopic Study among Monozygotic Twins, Non-Twin Brothers and Non-Relative Individuals

Abstract This study aimed to investigate cheiloscopic patterns among monozygotic twins (MT), non-twin siblings (NTS) and unrelated individuals (UI). The sample consisted of 20 pairs of monozygotic twins (G1), 20 pairs of non-twin siblings (G2) and 20 pairs of unrelated individuals (G3). Lip thickness, commissures and grooves were evaluated and the latter were classified as: I - clear-cut vertical grooves; I' - incomplete vertical grooves; II - branched grooves; III - intersecting; IV - reticular grooves and V - undetermined, in 8 labial regions (sub-quadrants). The data were analyzed using descriptive and inferential statistics, with a 5% significance level. Concordance Correlation Coefficient (CCC) and Kappa coefficient, with a 95% confidence interval, were employed to check for agreement rates between G1, G2 and G3 pairs. There was a weak correlation for lip thickness (<0.90) in the total group, with higher values in G1 (CCC from 0.25 to 0.83 and from 0.34 to 0.86, upper and lower lips, respectively), followed by G2 (CCC from -0.03 to 0.70 and from -0.21 to 0.62, upper and lower lips, respectively) and G3 (CCC from -0.25 to 0.56 and from -0.38 to 0.34, upper and lower lips, respectively). With regard to labial commissures, Kappa statistic values were found to be 1.00 for G1, 0.45 for G2 and -0.24 for G3. As for the main groove pattern by sub-quadrant, Kappa values ranged from 0.48 to 0.87 for G1, from 0.17 to 0.59 for G2, and from -0.18 to 0.19 for G3. Monozygotic twins presented a relevant percentage of cheiloscopic agreements. Similarities were also found among NTS, while UI showed greater differences compared to their pairs, highlighting the influence of hereditary relationships on inherited cheiloscopic features.

Resumo Este estudo teve como objetivo investigar o padrão queilocópico entre gêmeos monozigóticos, (GM), irmãos não gêmeos (NG) e os indivíduos sem herança genética em comum (SHG). A amostra foi composta por 20 pares de gêmeos monozigóticos (G1), 20 pares de irmãos não gêmeos (G2) e 20 pares de indivíduos sem grau de parentesco (G3). Foram avaliadas a espessura, as comissuras e os sulcos labiais, sendo os últimos classificados como: I - linhas verticais completas; I' - linhas verticais incompletas; II - linhas bifurcadas; III - linhas entrecruzadas; IV - linhas reticulares e V - padrão indeterminado, divididos em 8 regiões labiais (sub-quadrantes). Os dados foram analisados usando estatísticas descritiva e inferencial, com nível de significância de 5,0%. Para avaliar a concordância entre os pares G1, G2 e G3 foram utilizados o Coeficiente de Correlação de Concordância (CCC) e coeficiente Kappa, com intervalos com 95,0% de confiança. Em relação à espessura labial, verificou-se fraca concordância (<0,90) para o grupo total, sendo mais elevada entre os pares G1 (CCC de 0,25 a 0,83 e de 0,34 a 0,86, lábios superior e inferior, respectivamente), seguida de G2 (CCC de -0,03 a 0,70 e de -0,21 a 0,62, lábios superior e inferior, respectivamente) e G3 (CCC de -0,25 a 0,56 e de -0,38 a 0,34, lábios superior e inferior, respectivamente). Para a comissura labial, os valores de concordância Kappa foram 1,00 para G1, 0,45 para G2 e -0,24 para G3. No estudo do tipo sulcular principal por subquadrante, o Kappa variou de 0,48 a 0,87 para G1, 017 a 0,59 para G2 e -0,18 a 0,19 para G3. Gêmeos monozigóticos apresentaram um relevante percentual de coincidências. Semelhanças também estiveram presentes entre os NG, enquanto que os indivíduos SHG apresentaram maiores divergências em comparação com os seus pares, indicando a influência das relações hereditárias sobre as características queiloscópicas herdadas.

Avaliação da rugosidade superficial e análise morfológica de cimentos de ionômero de vidro: influência do armazenamento em saliva artificial / Evaluation of surface roughness and morphological analysis of glass ionomer cements: influence of storage in artificial saliva

Introdução: O desenvolvimento dos cimentos de ionômero de vidro (CIVs) proporcionou vantagens aos procedimentos restauradores diretos devido a suas propriedades, como adesão química à estrutura dentária e liberação de flúor. No entanto, o ambiente bucal pode promover condições capazes de alterar a superfície deste material. Objetivo: Avaliar a rugosidade superficial e a morfologia de superfície de quatro cimentos de ionômero de vidro (Ketac Molar Easy Mix, Vitremer, Vitro Molar e Maxxion), quando imersos em diferentes soluções de saliva artificial. Material e método: Dez amostras de cada material foram confeccionadas e a rugosidade superficial foi avaliada antes e após imersão em saliva artificial ácida e neutra, durante 28 dias, por meio de um rugosímetro (Surftest SJ - 40), e a análise morfológica deu-se através de microscopia eletrônica de varredura. Os valores médios de rugosidade foram submetidos aos testes de Kruskal-Wallis e de Wilcoxon, além do teste de Mann Whitney, com nível de significância de 5%. Resultado: Os valores de rugosidade foram maiores estatisticamente após a imersão em saliva ácida e neutra para todos os materiais, exceto o Vitromolar, que não apresentou diferença estatística entre as médias de rugosidade antes e após imersão em saliva neutra. O Maxxion R apresentou estatisticamente maiores valores de rugosidade quando comparado aos outros materiais após imersão em saliva neutra e ácida. Conclusão: A rugosidade superficial dos cimentos de ionômero de vidro aumentou após imersão em saliva neutra e ácida para a maioria dos cimentos estudados. A solução de armazenagem ácida promoveu aumento da rugosidade superficial para o Maxxion R e o Vitro Molar.

Introducion: The development of glass ionomer cements brought advantages to direct restorative procedures due to properties such as chemical adhesion to dental structure and fluoride release. Nevertheless, oral environment may provide conditions which can alter material surface. Objective: To evaluate surface roughness and surface morphology of four glass ionomer cements (Ketac Molar Easy Mix, Vitremer, Vitro Molar e Maxxion) when immersing on different artificial saliva. Material and method: Ten specimens of each material were fabricated and surface roughness was measured before and after immersion on neutral and acid artificial saliva for 28 days using a rugosimeter (Surftest SJ–40) and microscopy analysis by scanning electron microscopy. Roughness data were analyzed statistically by Kruskal-Wallis test, Wilcoxon test and Mann Whitney test, at 5% significance level. Result: Roughness values were statistically higher after immersion on neutral and acid artificial saliva for all materials, except for Vitromolar that did not presented no statistical difference between roughness values before and after immersion on neutral saliva. The Maxxion R presented statistically higher roughness values compared to all materials after immersion on neutral and acid artificial saliva. Conclusion: The superficial roughness of glass ionomer cement increased after immersion on neutral and acid artificial saliva for most of the materials. Acid storage solution promoted a greater increase in surface roughness after immersion of the specimens for Maxxion and Vitro Molar.

A queiloscopia na identificação humana: o papel da calibração / Cheiloscopy in human identification: the role of calibration

Introdução: Calibração é um processo metodológico que garante a reprodutibilidade observacional dos dados coletados pelo examinador, sendo, portanto, essencial em estudos de identificação humana. Objetivo: Demonstrar a importância do processo de calibração como parte dos procedimentos necessários a uma pesquisa queiloscópica (técnica de identificação através dos lábios). Material e método: Foram coletadas 20 impressões labiais, sendo a mesma dividida em oito subquadrantes, classificando-se o padrão sulcular (I ­ vertical completo; I' ­ vertical incompleto; II ­ bifurcados; III ­ entrecruzados; IV ­ reticulares e V ­ indefinidos). As impressões foram analisadas em dois momentos (intervalo de 8 dias) para medir a concordância por meio da estatística Kappa. Resultados: Os resultados indicaram concordância insatisfatória, sendo necessário repetir o processo com 20 impressões distintas. Na primeira calibração, obtiveram-se valores de Kappa entre 0,65 à 0,87 com concordância satisfatória (boa à perfeita) em sete das oito regiões analisadas. Apenas um subquadrante obteve Kappa regular (0,54). Na segunda calibração, todos os subquadrantes apresentaram valores de concordância boa à perfeita (0,75 à 1,00) existindo melhora de 75%. Conclusão: A Queiloscopia é uma técnica que exige atenção no quesito da classificabilidade, uma vez que a minuciosidade dos sulcos e subjetividade de predominância requerem calibração efetiva para que a confiabilidade da pesquisa seja mantida.

Introduction: Calibration is an step of the methodological process which ensures reproducibility of observational data collected by the examiner, being therefore essential in human identification studies. Objective: To demonstrate the importance of the calibration process as part of the procedures necessary to a cheiloscopy research (identification technique through the lips). Methods: Twenty lip prints were collected and each one was divided into eight subquadrants. Then, the pattern of grooves of each subquadrant was classified into one of the following patterns: I - complete vertical lines; I'- incomplete vertical lines; II ­ branched lines; III ­ crossed lines; IV - reticular lines; and V ­ undefined lines). The lip prints were analyzed twice, with an interval of 8 days between them, to measure agreement by Kappa statistics. Results: The results showed poor agreement, being necessary to repeat all the process with 20 different lip prints. In the first calibration, the Kappa values varied from 0.65 to 0.87 with a satisfactory reliability (good to perfect) in seven of the eight regions analyzed, but one subquadrant got regular Kappa (0.54). In the second calibration process, all subquadrants showed values of agreement good toperfect (0.75 to 1.00), implying an improvement of 75%. Conclusion: Cheiloscopy is a technique that demands attention in the classification of grooves patterns, since the thoroughness of the grooves and the predominance of subjectivity require calibration so that the research' reliability is maintained.

Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users.

The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user's perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws.

Odontometric analysis of molars for sex determination

Aim: To investigate the existence of sexual dimorphism between the first and second permanentmolars. Methods: A cross-sectional, observational, blind study using comparative and statisticaldescriptive procedures. The sample included 50 pairs of plaster casts from undergraduate dentalstudents (25 men/25 women) from the Federal University of Paraíba, João Pessoa/PB, Brazil,aged 20-26 years. Odontometric measurements of first and second maxillary/mandibular, right/left permanent molars were performed. Mesiodistal (MD) and buccolingual/palatal (BL/BP) widthsand the distance between the lingual cusps of corresponding molars in opposite quadrants, weremeasured. The data were analyzed by Student’s t test and ANOVA with Bonferroni (p≤0.05).Results: The crowns of all first molars were statistically larger in men than in women (p<0.05).Maxillary and mandibular left second molars (#27 and #37) did not differ in their MD widths (p=0.66,p=0.75), whereas mandibular left and right second molars (#37 and #47) showed statisticallydifferent BL widths (p=0.007 and p=0.008). As to the distance between the lingual cusps, only thefirst left-to-right mandibular molars (#36-46) showed no sex dimorphism (p=0.107). Conclusions:Molars are larger in males than in females. Individually, first molars demonstrated higher evidenceof sex distinction than second molars.

Influência da aplicação tópica de géis de flúor na rugosidade superficial de cimentos de ionômero / Influence of topical applications of fluoride of gels of the surface roughness of glass ionomer cements

Avaliar a morfologia de superfície de quatro CIVs (cimentos de ionômero de vidro) quando submetidos à ação tópica do flúor fosfato acidulado a 1,23% e gel de fluoreto de sódio neutro a 2%. Foram confeccionados 10 espécimes de cada CIVs (Ketac Molar Easymix, Maxxion R, Vitro Molar e Vitremer). Um ensaio de rugosidade foi efetuado antes e após aplicação tópica de gel de flúor. Os dados obtidos foram analisados através do teste de Tukey e do teste T. Os valores de rugosidade apresentados pelos materiais, segui a ordem descrescente: Maxxion>Ketac Molar Easy Mix> Vitro Molar. A aplicação tópica de flúor acidulado apresentou alterações de superfície nos materiais avaliados.

To evaluate the surface morphology of four glass ionomer cements when submitted to 1.23% acidulated phosphate fluoride topical application and 2% sodium fluoride. Ten specimens of each material (Ketac Molar Easymix, Maxxion R, Vitro Molar and Vitremer) were made. Surface roughness testing was made before and after topical application of fluoride. Data were analyzed statistically by Tukey’s test and T´s test. Maxxion presented the biggest variation on morphological standard after treatment with acidulated gel, continuing, in decreasing order, by Ketac Molar Easy Mix and Vitromolar. The topical acidulated fluoride presented surface alterations in all evaluated materials.

Safety and Tolerability of Essential Oil from Cinnamomum zeylanicum Blume Leaves with Action on Oral Candidosis and Its Effect on the Physical Properties of the Acrylic Resin.

The anti-Candida activity of essential oil from Cinnamomum zeylanicum Blume, as well as its effect on the roughness and hardness of the acrylic resin used in dental prostheses, was assessed. The safety and tolerability of the test product were assessed through a phase I clinical trial involving users of removable dentures. Minimum inhibitory concentration (MIC) and minimum fungicidal concentrations (MFC) were determined against twelve Candida strains. Acrylic resin specimens were exposed to artificial saliva (GI), C. zeylanicum (GII), and nystatin (GIII) for 15 days. Data were submitted to ANOVA and Tukey posttest (α = 5%). For the phase I clinical trial, 15 healthy patients used solution of C. zeylanicum at MIC (15 days, 3 times a day) and were submitted to clinical and mycological examinations. C. zeylanicum showed anti-Candida activity, with MIC = 625.0 µg/mL being equivalent to MFC. Nystatin caused greater increase in roughness and decreased the hardness of the material (P < 0.0001), with no significant differences between GI and GII. As regards the clinical trial, no adverse clinical signs were observed after intervention. The substance tested had a satisfactory level of safety and tolerability, supporting new advances involving the clinical use of essential oil from C. zeylanicum.

Prescrição medicamentosa: análise sobre o conhecimento dos futuros cirurgiões-dentistas / Prescription drug: analysis of the knowledge of future dentists

A prescrição racional necessita de adequadas noções de farmacodinâmica, farmacocinética, interações e efeitos adversos, regulamentação sanitária e uso de fontes de informação. É necessário que o medicamento seja prescrito adequadamente, na forma farmacêutica, doses e período de duração do tratamento e que esteja disponível de modo oportuno, a um preço acessível. Também o mesmo precisa responder sempre aos critérios de qualidade exigidos, que se dispense em condições adequadas, com a necessária orientação e responsabilidade, e, finalmente, que se cumpra o regime terapêutico prescrito, da melhor maneira possível. Concluímos que os futuros profissionais cirurgiões-dentistas se sentem inseguros com relação à prescrição de medicamentos.

Rational prescription needs adequate notions of pharmacodynamics, pharmacokinetics, interactions and adverse effects, health regulations and use of information sources. It is necessary for the drug to be prescribed appropriately, the pharmaceutical form, dose and duration of treatment, which is available in a timely manner, at an affordable price, and that always responds to the required quality criteria, which dispense under appropriate conditions, with appropriate guidance and accountability, and ultimately that meets the prescribed treatment regimen, the best possible way. We conclude that future professional dentists feel insecure regarding prescription drugs.