The effect of hydrochloric acid (HCl) on permanent molars: A scanning electron microscope (SEM) and energy dispersive X-ray spectroscopy (EDS) study.

It is well established that acid disposal is a potentially effective method used by criminal syndicates to hinder the identification of victims. This study documents the effects of continuous immersion in hydrochloric acid (HCl, 37%) on molars using macroscopic analysis, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). The goal of this study is to aid in distinguishing visually unrecognizable fragments of dental remains when drastic changes in morphology have occurred as a result of acid exposure. Macroscopic, SEM, and EDS analysis were conducted on seven maxillary molars before and after HCl treatment. Molars reduced in weight relative to the length of time immersed in HCl and the dissolution time was over 40 hours longer than reported in previous studies, at just over 66 hours. SEM and EDS analysis showed acid-treated teeth exhibited morphological patterns such as cracking and layering visible at high magnification. Calcium/phosphorous ratios fell within the expected range of 1.6-2.5, indicating that HCl-treated teeth are still identifiable as osseous or dental tissue even when not visually identifiable as teeth. This is the first study to present SEM images of molar cementum before and after immersion in HCl and to present EDS results. This information can assist researchers and investigators in determining the presence of dental tissue in a forensic context associated with acid disposal.

A new method for estimating time since death by analysis of substances deposited on the surface of dental enamel in a body immersed in seawater.

The present investigation was performed with the objective of developing a method to estimate how long a corpse had been immersed in water after death (the time since death). Accurate determination of the time elapsed since death may lead to identification of the place of drowning, and therefore, serves not only as a piece of information useful for determination of the cause of death but also leads to prompt identification of the body. The results showed that diatoms attached to the surface of dental enamel increased with prolongation of immersion time in water. Further, as the immersion time increased, the quantity of O, Si, Mg, K, Al, and S detected on the surface of dental enamel increased, while the quantity of the main dental components (Ca and P) that were detected gradually decreased. Based on these results, we calculated a regression formula to estimate the immersion time. Our method is considered to be a breakthrough technique for evaluating the time since death more objectively, compared to the conventional method of determination based on the degree of decomposition of the corpse.

Use of XRD and SEM/EDX to predict age and sex from fire-affected dental remains.

In fire scenarios, the application and accuracy of traditional odontological methods are often limited. Crystalline studies and elemental profiling have been evaluated for their applicability in determining biological profiles (age and sex) from human dentition, particularly fire- and heat-affected dental remains. Thirty-seven teeth were paired according to tooth type and donor age/sex for the analysis of crown and root surfaces pre- and post-incineration using X-ray diffraction (XRD) and scanning electron microscopy (SEM/EDX). In unburned crowns, carbon (C) content showed a positive correlation with age, whereas phosphorus (P) and calcium (Ca) contents showed a negative correlation with age. In unburned roots, C, P and Ca contents also showed significant changes that were opposite of those observed in the crowns. In relation to sex, females exhibited a higher C ratio than males, whereas males showed significantly higher levels of oxygen (O), P and Ca in unburned roots. Incineration resulted in an increase in the crystallite size that correlated with increasing temperature. No differences in hydroxyapatite (HA) crystallite size were found between age groups; however, unburned teeth from females exhibited a larger crystallite size than did those from males. The challenges of using XRD with a 3D sample were overcome to allow analysis of whole teeth in a nondestructive manner. Further studies may be useful in helping predict the temperature of a fire.

Competencias genéricas para la educación en odontología forense: pensamiento crítico y responsabilidad social / Generic skills for education in forensic dentistry: critical thinking and social responsibility

La Educación Basada en Competencias representa una estrategia de enseñanza-aprendizaje donde se busca que el estudiante logre un mejor desempeño en los entornos sociales cada vez más complejos a través del desarrollo de sus propias habilidades. Esto requiere que las instituciones educativas ofrezcan oportunidades curriculares que desplieguen Competencias Genéricas (CGs) transparentes y explícitas. Los desafíos contextuales de las ciencias forenses en general, y de la Odontología legal y forense en lo particular, han determinado una necesaria adaptación de sus contenidos conceptuales, procedimentales y actitudinales en la búsqueda de definición de sus campos específicos, desarrollo holístico de sus áreas de conocimiento, la adquisición de habilidades y experiencia, orientación hacia valores profesionales éticos, e integración de todos esos contenidos. Se presentan al Pensamiento Crítico y a la Responsabilidad Social como las CGs más idóneas para una educación focalizada en la Odontología legal y forense, como maneras de asumir el desafío de mejorar la calidad, consistencia y suficiencia de no sólo de futuros nuevos peritos sino también del profesional asistencial generalista, y se discute la trascendencia de formalizar estos aspectos según las realidades y paradigmas imperantes hoy en algunos países de habla hispana.

The competence-based training nowadays represents a strategy of teaching-learning, which supports the student to prepare him/her for better performance in the increasingly complex social environments through the development of their own skills. This model requires that educational institutions must offer curricular opportunities to develop explicit and transparent generic skills (GSs). The contextual challenges of forensic sciences in general, and of the legal and forensic dentistry in particular, have to determine a necessary adaptation of their conceptual, procedural and attitudinal contents to define their specific fields, holistic development of their areas of knowledge, the acquisition of skills and experience, orientation toward professional ethical values, and integration of all these contents. We present Critical Thinking and Social Responsibility as the more suitable GSs for a training focused on the legal and forensic dentistry. To take up the challenge to improve the quality, consistency and adequacy of not only of new future experts but also of the professional healthcare practitioner, and the significance of formalizing these aspects with the realities and prevailing paradigms today in some Spanish-speaking countries is discussed.

Spatial distribution analysis of strontium in human teeth by laser-induced breakdown spectroscopy: application to diagnosis of seawater drowning.

The diagnosis of drowning can be extremely difficult, especially when the typical morphological signs of drowning are not present, or when the body is in an advanced stage of putrefaction. The main aim of this work is to demonstrate the applicability of laser-induced breakdown spectroscopy (LIBS) to the diagnosis of seawater drowning. Ten teeth samples were selected from eight medico-legal autopsies. A Nd:YAG laser operating at its fundamental wavelength (1,064 nm) was used to generate microplasmas at the sample surface. Strontium (Sr) concentration in tooth samples has been found to be a key factor for the diagnosis of seawater drowning. Spectral differences between the dentin and the enamel were observed. Greater Sr abundance was located in the dentin, with relative standard deviations in the range of 30 to 35%. In addition, chemical images were generated to study the spatial distribution of Sr along the piece. In all cases, Sr content was higher when the cause of the individual death was drowning. A blind experiment was performed to exclude the possibility that the increase of Sr is due to passive diffusion in the blood. The detection of Sr as well as the determination of its distribution by LIBS in dentin seems to be a promising complementary tool for the diagnosis of death by seawater drowning.

Use of dental impression materials in the analysis of tool marks to identify causal elements / Uso de materiales de impresión dental para el análisis de marcas de corte para identificación de elemento causal

When faced with an element which is the suspected cause of a cut or lesion, dental casting can be made to compare characteristics observed on the surface of the tool mark with those found on the bones. There is a large variety of materials available on national and international markets to record and analyze marks or signs that an element leaves on any given surface (bite marks, tool marks on bones, finger prints, etc.), all of which are useful in forensic investigation (1). However, the unconventional application of odontological techniques and the use of materials such as alginate and silicone have been found useful recovering tool marks on bones, which allows the forensic scientist to clearly establish when an element was used to cause cuts and injuries in an individual. This technique has been applied in five cases of possible homicide with the use of a cutting element and, as a result, has generated highly accurate casts. It also shows that both materials are appropriate for this purpose, and although silicone offers greater detail in the impression, either material can be used depending on the commercial availability.

En caso de contar con el elemento debitado (con el que se sospecha se causó la lesión), se pueden generar impresiones con materiales de uso odontológico para comparar las características observadas en la superficie de corte de la herramienta con las encontradas en la estructura ósea. En el mercado nacional e internacional existe gran variedad de materiales para el registro y análisis de las marcas o señales que deja un elemento sobre una superficie dada (impresiones de estructuras bucales, marcas de herramientas en huesos, huellas dactilares, etc.), y son útiles en estudios forenses (1). Con la aplicación de técnicas odontológicas y el empleo de materiales tales como el alginato y la silicona, se observó que en esta aplicación no convencional es útil para tomar impresiones de marcas de corte sobre estructuras óseas, lo que a su vez permite establecer con claridad cuando un elemento dubitado ha sido utilizado para causar cortes y lesiones en un individuo. Esta técnica se aplicó en 5 casos de posible homicidio con empleo de elemento cortante y se encontró no solo la generación de improntas de alta fidelidad sino también que ambos materiales son apropiados para ello, y aunque la silicona ofreció mayor detalle en la impresión, cualquiera de los dos puede ser utilizado dependiendo de su disponibilidad comercial.

Dental status among fisher folk communities: a clinical study and its role in forensic dentistry

AIM: To assess the dental findings among fishermen communities residing in the coastal areas of Edakkad and Muzhappilangad, Kannur, Kerala, South India, and the feasibility of using these findings for identification of the subjects in forensic investigation. MATERIAL AND METHODS: Fifty males of age group 30-35 years were selected- two groups of 20 each from two fishermen communities and one control group of 10 from the non- fishermen population. The parameters included in the study were work procedure, smoking, tobacco chewing, alcohol consumption, attrition, cervical abrasion, macrodontia, incisal notching, dental caries and facial features. For statistical analysis was used chi-square test. RESULTS: All the parameters were significantly more in the study groups compared to the controls. CONCLUSION: Further research is suggested to identify other factors which may influence the outcome of forensic investigation.

Validation of X-ray fluorescence spectrometry for determining osseous or dental origin of unknown material.

Forensic anthropological examinations typically involve the analysis of human skeletal remains, but in cases where samples are very small and/or physically compromised, it may first be necessary to determine whether the material is even osseous or dental in origin. X-ray fluorescence spectrometry (XRF) is a technique that reveals the elemental composition of materials and is hypothesized to have utility in such cases. XRF analysis was conducted on a variety of tissues and materials in unaltered and altered (damaged) states. With few exceptions, osseous and dental tissues in unaltered and altered conditions contained characteristic levels of calcium and phosphorus, while other materials did not. Materials could be accurately identified as osseous or dental in origin based on the calcium and phosphorus levels identified by XRF, and we therefore conclude that XRF analysis is a valid and effective means of determining osseous or dental origin of unknown material.

Virtual and macroscopical studies of mummies--differences or complementarity? Report of a natural frozen Siberian mummy.

Since 2004, a multidisciplinary Franco-Russian expedition discovered in the Sakha Republic (Yakutiya) more than 60 tombs preserved by the permafrost. In July 2006, an exceptionally well-preserved mummy was unearthed. The coffin, burial furniture and clothes suggested a shaman's tomb. Multislice computed tomography (MSCT) was performed before autopsy with forensic and anthropological aims. Forensic study aimed to detect any lesions and determine the manner of death. Anthropological study aimed to determine the mummy's gender, age at death, morphological affinity, stature and body mass. She was female and virginity status was assessed. The radiological and forensic conclusions were compared. Imaging confirmed most autopsy findings, suggesting that death followed disseminated infection. MSCT could not formally exclude a traumatic death because close examination of the skin was difficult, but was superior to conventional autopsy in diagnosis of infectious lesions of the left sacroiliac joint and one pelvic lesion. Autopsy detected a post-infectious spinal lesion, misinterpreted on MSCT as a Schmorl's node. However, most conclusions of virtual and conventional anthropological studies agreed. Age at death was estimated around 19 years old. The morphology of the mummy was mongoloid. MSCT identified the craniometric characteristics as similar to those of the Buryat population. The deceased's stature was 146 cm and estimated body mass was 49 kg. MSCT demonstrated its great potential and complementarity with conventional autopsy and anthropological techniques in the study of this natural female mummy buried in 1728.

Esthetics and implantology: medico-legal aspects.

In recent years the high number of malpractice lawsuits in dentistry has attracted closer attention of dental practitioners to its medico-legal aspects. Implantology, in particular, presents many points of medico-legal concern connected with the difficulties inherent to dental procedures and objectives (both functional and esthetic), as well as full patient collaboration as an essential part of successful treatment. An accurate assessment of each case by the clinician is fundamental, especially in circumstances where esthetic considerations are preponderant as, for instance, in the frontal sectors. In such cases, the options of implantology or of a traditional fixed prosthesis need to be carefully weighed in light of the patient's anatomic condition. The patient should therefore receive complete information and be made fully aware of the risk of treatment failure, as well as possible complications, limits to the procedures, and the fact that successful outcome will also depend on her/his scrupulous observance of the practitioner's instructions. In short, the aim is to make the patient an active ''accomplice'' in treatment. To this end, the use of an extremely detailed information leaflet is strongly advised; after careful clarification of any doubts the patient may have, the patient's written informed consent should be obtained. Nevertheless, there is the risk that excessive intrusion of bureaucracy into medical procedures in defence of the practitioner against malpractice suits may hinder the principal aim of traditional medicine, i.e. to provide the best care for the patient through mutual trust fostered within the doctor-patient relationship.

Suporte básico de vida: diferencial no atendimento ou responsabilidade legal odontológica? / Support basic of life: differential in the service or legal responsibility odontologic?

O Suporte Básico de Vida, através de suas etapas de atendimento, permite que o profissional ou mesmo o leigo, ofereça uma chance de sobrevida nas situações em urgência e/ou emergência médica. Objetivos: descrever as etapas do Suporte Básico de Vida, enfatizando a importância da necessidade de treinamento contínuo dos profissionais de Odontologia; bem como citar a questão da responsabilidade legal prevista no Código de Ética dos mesmos. Considerações finais: situações de urgência e/ou emergência médica podem ocorrer no consultório odontológico; por isso é fundamental que o profissional de Odontologia conheça-as e saiba agir adequadamente, com o intuito de minimizar quaisquer efeitos deletérios que comprometa a qualidade da abordagem holística do paciente.

Basic Support of Life, through their sequential stages of service, allows that the professional or even the lay, offer a chance of in cases of medical urgency and/or emergency situations. Objectives: Describe the stages of the Basic Support of Life, emphasizing the importance of continuous training by dentistry professionals, as well as to emphasize the subject of the legal responsibility foreseen in the Code. Conclusion: medical urgencies/emergencies can happen in the odontologic clinic so it is important that the dentistry professional knows them and know how to act in all of them, with the intention of minimizing harmful effects that can commit the quality of the holistic approach in odontology clinic.

Responsabilidade civil do cirurgião-dentista: o pós-tratamento ortodôntico* / The dentist surgeon's civil responsibility: the orthodontic post-treatment

O objetivo deste trabalho foi investigar quais os procedimentos clínicos e as dificuldades do ortodontista no pós-tratamento ortodôntico (contenção e pós-conten-ção), verificando se as condutas adotadas satisfazem possíveis reclames de pacientes que já terminaram o tratamento corretivo, com base nas determinações do Código Civil e do Código de Defesa do Consumidor quanto ao relacionamento profissional! paciente. A literatura ortodôntica é controversa no que diz respeito a técnicas, tempo, estabilidade e dificuldades inerentes ao tratamento. Um questionário foi enviado pelo correio a todos os especialistas inscritos no CRO/PR; 95 deles enviaram respostas. A análise percentual das respostas obtidas demonstrou que 73,7% dos profissionais não têm consciência plena do tempo para reclamos à Justiça em relação ao tratamento odontológico. Não conhecem o Art.177 do Código Civil Brasileiro (83,2%). Adotam contrato (67%), fazem ressalvas (48%), porém não estão cientes da validade das mesmas (59%). A maioria (60%) considera a Responsabilidade Civil do ortodontista como de resultado. Nos casos de recidiva pós-contenção, 70% propõem retratamento ortodôntico. Perante a insatisfação do paciente com o resultado do tratamento ortodôntico, 55% dos profissionais responderam que procurariam, de qualquer forma, evitar que o mesmo impetrasse ação de ordem cível. O desconhecimento da Lei e a existência de controvérsias no pós-tratamento ortodôntico, podem estar levando o ortodontista a responder civilmente pelas movimentações dentárias e alterações neuromusculares que ocorrerem nessa fase...

Diet and age-at-death determinations from molar attrition. A review related to the low countries.

To elucidate the impact of diet on age-at-death determinations based on molar attrition a comparison was made between the established rate of attrition in three populations; a pre-mediaeval (British), a late mediaeval (Dutch) and a 17-18th century (Dutch) (western European). It appeared that the rate decreased dramatically during the overall time span and that this change was probably diet related and owing to the coarseness of foodstuffs. This result strongly indicated that molar age-attrition tables should only be used for age-at-death determinations if their application is restricted to a particular cultural period and diet.

Skeletal remains of Dr. Eugenio Antonio Berríos Sagredo.

It is often noted that even a well-designed osteological technique may not provide accurate results when applied to single forensic cases. Case studies are ideal to test if this concern is valid, and forensic anthropology is a testing ground for applying a population based standard to individual skeletal remains. Secondly, the increasing role anthropologists have played in forensic sciences has aided the medicolegal disciplines in a number of ways. For example, identification of skeletal remains is now more accurate than ever before. Many of these cases have brought perpetrators to court for justice. The purpose of this paper is to use osteological techniques to analyze skeletal remains and make a positive identification. The victim was found partially buried in the sand near El Pinar, Uruguay in 1995. The analysis indicated that the victim was a 45-year old, white, male who was about 170cm tall. Based on preliminary evidence that the victim might be Dr. Eugenio Antonio Berríos Sagredo, a digital superimposition was made using the victim's photograph and the unknown skull. This examination revealed that the skull corresponded consistently with the individual in the photograph. Results were supported by the fact that personal belongings, such as a medal and wrist watch, also pointed to the same individual. Dental records and radiographs when made available later also indicated the same identity. Dr. Berríos was accused of making nerve gas during the dictatorial regime of former Chilean President General Augusto Pinochet. It was also alleged that he made bombs that killed a Spanish diplomat in his laboratory and a Chilean diplomat in Washington, DC. Many complex techniques are often needed to make a positive identification and such was the case for this study. Because of the nature of anthropology as a holistic discipline, such complexity is an integral part of human biology and behavior and can be used successfully in the forensic sciences and medicolegal investigations.

Comparison of bitemarks left in foodstuffs with models of the suspects' dentitions as a means of identifying a perpetrator.

In a recent court case, a comparison was made between an impression of marks left in cheese at a murder scene and a set of study models of one of the suspects. The court was reluctant to accept the validity of the pattern-associated comparison that was used in the identification. This study compared marks made in cheese, butter and cooked potato with study models taken from volunteers. Pattern-associated comparison was the method used. Eighty pair-wise comparisons were made by two odontologists. The examiners correctly identified all the true matches from among the eighty comparisons as well as selecting the dental models for which there were no corresponding silicone impressions. In the absence of identifiable fingerprints or DNA samples, the method can be employed for matching left in foodstuffs to the dentitions of suspects.

[Professional, criminal and civil responsibility and the legal medical aspects of the performance of the dentist practicing local anesthesia and tooth extractions]. / Considerazioni sulla responsabilità professionale, penale, civile ed aspetti medico-legali sull'operato dell'odontostomatologo nella pratica dell'anestesia locale e delle estrazioni dentarie.

The paper affirms that the dentist can come up against severe complications while exercising his profession which expose him to charges outlined by the Penal and Civil Codes. The circumstances in which the operator's responsibility can be questioned during the use of local anesthesia and extraction are discussed.