Are deciduous upper molars and lower canines useful for sex estimation?

OBJECTIVE: This paper investigates whether deciduous upper molars and lower canines have sexual dimorphic features, exploring these teeth' dimensions and the presence of Zuckerkandl's tubercle and Carabelli's cusp on the first and second upper molars. DESIGN: We analyzed 64 pairs of dental plaster casts from 34 females and 30 males aged between 3 and 12 years. We measured the first and second deciduous upper molars and the lower deciduous canines (maximum mesiodistal and buccolingual length), and we registered the presence of the Zuckerkandl's tubercle and the Carabelli's cusp on the first and second upper molars, respectively. RESULTS: Regarding the differentiation between sexes using Carabelli's cusp and Zuckerkandl's tubercle, the classification was not independent of Carabelli's cusp presence only for tooth 65 (p = 0.035). In all other teeth, whether for Carabelli's cusp or Zuckerkandl's tubercle, their presence was similar for both sexes. There were statistically significant differences between sexes (p < 0.05) for the buccolingual measurements of both upper second molars, the first right upper molar, and the right canine. The developed model allowed for a 64.1% accuracy in sex estimation. CONCLUSIONS: The study suggests that while Carabelli's cusp and Zuckerkandl's tubercle in upper deciduous molars don't consistently differ between sexes, tooth size, particularly the buccolingual measurements of certain teeth, including upper deciduous molars and lower canines, may provide a more reliable criterion for sex estimation. The developed model depicted moderate accuracy, underscoring the need for a multifactorial approach when estimating sex from skeletal remains. It suggests that while dental features can contribute to sex estimation, they should be used in conjunction with other skeletal or molecular markers to improve accuracy.

Cheiloscopy in sex estimation: a systematic review.

This study aimed to conduct a systematic review to gather evidence to clarify if cheiloscopy can be used in sex estimation and identify the reasons behind the lack of consensus in the scientific community. The systematic review was performed following the PRISMA guidelines. A bibliographic survey was conducted in PubMed, Scopus, and Web of Science databases, restricted to articles published between 2010 and 2020. Studies were selected according to eligibility criteria, and then the study data were collected. The risk of bias in each study was assessed and applied as additional inclusion or exclusion criteria. The results of the articles eligible for analysis were synthesized using a descriptive approach. In the 41 included studies, several methodological flaws and variations between studies that contribute to the discrepancy in results were identified. The data gathered allowed us to conclude that there is no strong scientific evidence to support the use of cheiloscopy in sex estimation, as there is no specific pattern for each sex, which reduces the criminalistic interest of cheiloscopy in estimating this parameter.

Microbiology and postmortem interval: a systematic review.

This systematic review aims to learn if and how it is possible to use the human microbiome to indicate the time elapsed after death. Articles were searched on the PubMed database using predefined data fields and keywords; reviews, systematic reviews, and meta-analyses were excluded. The final selection included 14 papers (out of 144). The results indicated that the microorganisms present in the cadaveric island succeed predictably over time, with markers between the stages of decomposition constituting a potential innovative tool for postmortem interval (PMI) estimation. The human microbiome has the potential to be used for PMI estimation and may present advantages as microbes are present in all seasons, in all habitats, including the most extreme ones, and because microbial communities respond predictably to environmental changes.

Fluctuating asymmetry in third molar agenesis as an aid to estimate socioeconomic status.

Traditionally, dental identification techniques are used to establish identity or assist in reconstructing an individual's biological profile. However, other aspects of identity, namely socioeconomic status (SES), can be estimated through teeth. This work aims to evaluate the influence of SES on third molar agenesis in a Portuguese population. X-rays from 448 subjects (223 belonging to a high and 225 to a low socioeconomic status) were assessed and demographic data (age, sex) and dental history were registered. Frequencies and associations between the variables were analyzed using the chi-square test. For each group, differences between third molar agenesis were studied using the Wilcoxon test. The significance level was 5%. X-rays displaying at least one agenesis were more common in females (in both SES groups). Differences between socioeconomic status were found in female subjects' upper right and lower left third molars, with a higher frequency of agenesis in the lower SES group. Agenesis of lower third molars displayed fluctuant asymmetry in both groups, whereas agenesis of upper third molars was also present in the lower SES group. These results suggest that socioeconomic status can affect third molar agenesis prevalence, and fluctuant asymmetry seems more prevalent in the lower SES, as it affects all third molars.

Bisphosphonates and osteonecrosis of the jaws: Clinical and forensic aspects.

OBJECTIVE: This manuscript aims to provide a comprehensive review of the current knowledge in the pathophysiology, diagnosis, prevention, and other relevant clinical and forensic aspects of a potentially severe complication known as medication-related osteonecrosis of the jaw (MRONJ) while synthesizing state-of-the-art information on bisphosphonates and introducing a possible differential diagnosis. DESIGN: An extensive search was conducted in PubMed (U.S. National Library of Medicine) without a time or language constraint, focusing on the epidemiology, pathophysiology, risk factors, site specificity, signs and symptoms, differential diagnosis, prevention, and forensic aspects of MRONJ. All types of original articles, reviews, case reports, short communications, opinion articles, guidelines, and letters to editors were considered to produce a complete review on this subject. RESULTS: MRONJ prevention relies on a multidisciplinary approach and is critical since truly effective treatments are lacking. This therapeutic challenge is partly due to uncertainty regarding this condition's pathophysiology. Differential diagnosis of osteonecrosis of the jaws associated with krokodil abuse, one of the most dangerous and homemade psychoactive illicit substances, should be considered. CONCLUSIONS: Further research into the etiology and site specificity of MRONJ is encouraged, aiming to develop novel treatment prospects. Indeed, comprehending this would allow for increased efficacy and therapeutic options while emphasizing the importance of prevention. In addition, we advocate for greater consensus among the various societies regarding MRONJ's treatment and management.

Lipidic compounds found in soils surrounding human decomposing bodies and its use in forensic investigations - A narrative review.

Following decomposition of a human body, a variety of decomposition products, such as lipids, are released into the surrounding environment, e.g. soils. The long-lasting preservation in soils and their high diagnostic potential have been neglected in forensic research. Furthermore, little is known about the preservation, chemical transformation, or degradation of those human derived lipids in soils. To date, several studies identified various lipids such as long-chain free fatty acids and steroids in soils that contained decomposition fluids. Those lipids are preserved in soils over time and could serve as markers of human decomposition in forensic investigations, e.g. for estimating the post-mortem interval or identifying the burial location of a human body. Therefore, this review focuses on the current literature regarding fatty acid and steroid that have been detected in soils and associated with human body decomposition. After a short introduction about human decomposition processes, this review summarises fatty acid and steroid analysis applied in current case studies and studies related to taphonomic research. This review provides an overview of the available studies that have used fatty acids and steroids as identifiers of human decomposition fluid in soils in a forensic context and discusses the potential for developing this innovative field of research with direct application in a forensic context.

Are lip prints hereditary? A systematic review.

Hereditary lip prints have been studied by several researchers. However, the literature shows no consensus among the scientific community regarding this topic. Therefore, the aim of this study was to conduct a systematic review to gather evidence to clarify whether the surface structure of lip prints is hereditary and, consequently, if a familial relationship between individuals can be established through the analysis of lip prints. The systematic review was performed following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. A bibliographic survey was conducted in PubMed, Scopus, and Web of Science databases, restricted to articles published between 2010 and 2020. Studies were selected according to eligibility criteria, and then the study data were collected. The risk of bias of each study was assessed and applied as additional inclusion or exclusion criteria. The results of the articles eligible for analysis were synthesized by a descriptive approach. In the seven included studies, methodological variations, including the definition of similarity, that contribute to the heterogeneity of results were identified. The data gathered allowed to conclude that there is no strong scientific evidence to support the hypothesis of the existence of heredity in the surface structure of lip prints, since it was not proven that similarities between parents and children occur systematically in all families.

Socioeconomic differences in permanent teeth mineralization of Portuguese girls and boys from Porto, Portugal.

Purpose: Socioeconomic differences in dental maturation can be used to examine the impact of environmental factors on dental maturation. The purpose of this study is to assess socioeconomic differences in dental maturation of the seven permanent mandibular teeth (I1-M2). Methods: A total of 2114 panoramic radiographs of Portuguese children, adolescents and young adults were studied. The sample was divided into a high socioeconomic status (SES) (n = 925), and a low SES group (n = 1189). Ages ranged between 5 and 26 years. Demirjian's stages were used to assess the maturation of the seven mandibular teeth on the left side. Median-age of attainment of each stage and each tooth was calculated and compared between groups using binary logistic regression. Results: Low SES girls showed a consistent advancement in dental maturation across the entire dentition. Low SES boys, however, showed more often a delayed maturation relative to their high SES counterparts, but this pattern was not consistent and a clear socioeconomic difference seems to be absent in boys. Conclusions: While this study was not able to further explore the causes of the dental advancement in girls, it is hypothesized that it might be related to a higher prevalence of overweight/obesity, and possibly caries, in low SES girls, compared to the SES difference in prevalence in boys.

Historical, demographic, curatorial and legal aspects of the BoneMedLeg human skeletal reference collection (Porto, Portugal).

The BoneMedLeg research project was developed to address current research concerns related to the use of skeletal reference collections for forensic purposes. These concerns were partly addressed by amassing a new reference collection which incorporates unclaimed human remains sourced from two municipal cemeteries in the city of Porto, Portugal. Amassed between 2012 and 2014 the collection was developed with permission from and in partnership with the Municipality of Porto, in a manner that is similar to that of other skeletal reference collections in Portugal. Traditionally, municipalities have bequeathed human remains that are cleared from temporary primary and secondary burial plots at local cemeteries and deemed unclaimed, to museums and universities for research purposes. The BoneMedLeg collection currently includes a total of 95 individuals, of which only 81 are fully identified (38 males and 43 females), with ages ranging from 21 days to 94 years, and a mean age of about 62 years. Years of death range from 1969 to 2003, and years of birth from 1891 to 1969. Only about half of the individuals are documented as to cause of death, which includes a considerable diversity of etiologies, from oncological to cardiovascular system disorders, and also traumatic injuries. The collection is more representative of an unskilled working class and aged population, due to one of the main sourced cemeteries disproportionately serving more socioeconomic disadvantaged communities and reflecting the demographics of the city over the past 40 years. In addition to describing the history and curatorial process of the collection in detail, this paper also discusses its broad legal framework and potential biases in its profile and composition which can inform and help plan future research projects.

Physical Violence Against Children and Adolescents in Porto: A 5-Year Study.

The aim of the present study was to analyze the prevalence of physical violence against children and adolescents (PVCA) in a 5-year period in the city of Porto, Portugal. All forensic reports between 2009 and 2013 in the clinical services of the North Branch of the National Institute of Legal Medicine and forensic sciences were analyzed. Victims were classified according to sex, age, relationship with perpetrator, traumatic consequences of the event, and year of occurrence. Statistical analysis was performed using SPSS (Version 22.0). Continuous variables were described when appropriated frequencies were displayed. The association between variables was evaluated using chi-square, Fisher's exact test, or Kruskal-Wallis test, when appropriate and a logistic regression was performed. The margin of error for the statistical tests was 5.0%. A total of 2,148 occurrences were evaluated. Most subjects were male, and mean victim age was 13 years. The single most frequent perpetrator was an unknown individual, but most offenders were known to the victim. The majority site of injury was the face. The larger number of complaints of aggression maintained a similar frequency over the 5 years analyzed. A physical examination to confirm the reasons between the complaint and the type of aggression was performed and shown a high relationship. Adolescents were more susceptible to violence than younger children were. The most affected region was the face.

Evolution and Analysis of Cultural and Cognitive Factors Related With Domestic Violence Against Women.

Despite the occurrence of encouraging political and social changes in the past few years, many beliefs about women's role in intimate relationships persist, influencing their response to domestic violence (DV). This study aims to analyze the influence of recent policies against DV in Portugal, concerning particularly intimate partner violence against women and their perceptions about the victimization process. Two samples of women ( n = 126 each) reporting an aggressive act allegedly perpetrated by the current or former male partner were interviewed with a hiatus of 5 years (before and after some most relevant policy updates). Results suggest a positive influence of the recent policies against DV. Many significant and encouraging changes were found in the more recent women sample (S2) relatively to the first sample (S1) regarding their information, awareness, perceptions, and attitudes toward DV. They seem to show less tolerance and endurance to DV, placing responsibility on the offender, as well as seem more empowered to report. In S2, there was a decrease in the acceptance of violent behaviors as normal and of reasons to explain violence; the fears, shame, and helplessness about DV; the elapsed time between the beginning of the abuse and its report; and the prevalence of more severe types of physical abuse. In S2, there was an increase on the acknowledgment of DV as a crime, the number of reports in cases without cohabitation, the report of psychological abuses, and the feeling of safety and assurance while reporting.

Sex estimation using the mandibular canine index components.

The mandibular canine index (MCI) has been described as a suitable methodology for sex estimation in forensic scenarios but there are contradictory reports about its accuracy. Moreover, the two mandibular canine teeth must be available, which is not always a viable option. The aim of this study was to strip the MCI by analyzing the MCI itself and its components, in order to optimize its use for sex estimation. The mesiodistal dimensions of the mandibular canine crown and the mandibular canine arch width were measured in a sample of 120 cast models. Five predictor variables were considered in this study: the standard MCI, a variation of the MCI using the left canine, and MCI components (MD43, MD33 and D33-43). Multivariate binary logistic regression was performed using stepwise forward approach to select the most statistical relevant variables on the probability of a cast being from a female. The estimated probability was then analyzed with respect to performance in sex classification (ROC analysis and optimal cut-offs accuracy) and compared with the performance of the univariate variables. MCI43 and MCI33 presented the lowest performance (64.2% and 63.3% respectively), and the highest overall accuracy was attained using the MD43 and MD33 (85.8% in both cases). The multivariate logistic model obtained (using MD43 and MD33) exhibited the same accuracy as the logistic model based solely on MD43 (85.8%). Our results suggest that MD43 should be used instead of MCI for sex estimation.

Orofacial Injuries in Children and Adolescents (2009-2013): A 5-Year Study In Porto, Portugal.

The aim of this study was to verify the prevalence of acts of aggression to the head, face and neck towards victims of Physical Violence against Children and Adolescents (PVCA) who were examined at the National Institute of Legal Medicine and Forensic Sciences Delegation North (INMLCF-DN) in Porto, Portugal. A study was carried out on 2,148 complaints of physical aggression against children and adolescents (0 to less than 18 years old) occurred between 2009 and 2013 and which were retrieved from information about violence held on INMLCF-DN data files. Continuous variables were described and the association between them was verified by Chi-square or Fischer's Exact tests with 5% significance level. Within the 5-year timespan, 1,380 cases were identified with clinical relation with physical aggression. Most subjects evaluated were male adolescents and the most affected body region was the face, to which 747 injuries (24.7%) were recorded, with statistically significant association between sex and region (head and face). Victims in 15-17-year-old age group are more susceptible to violence than those in the 0-14-year-old age range. Dentists routinely examine the face, neck and skull, which make them the most appropriate health professionals to identify cases of aggression early.

Orofacial injuries in children and adolescents (2009-2013): a 5-year study in Porto, Portugal

Abstract The aim of this study was to verify the prevalence of acts of aggression to the head, face and neck towards victims of Physical Violence against Children and Adolescents (PVCA) who were examined at the National Institute of Legal Medicine and Forensic Sciences Delegation North (INMLCF-DN) in Porto, Portugal. A study was carried out on 2,148 complaints of physical aggression against children and adolescents (0 to less than 18 years old) occurred between 2009 and 2013 and which were retrieved from information about violence held on INMLCF-DN data files. Continuous variables were described and the association between them was verified by Chi-square or Fischer's Exact tests with 5% significance level. Within the 5-year timespan, 1,380 cases were identified with clinical relation with physical aggression. Most subjects evaluated were male adolescents and the most affected body region was the face, to which 747 injuries (24.7%) were recorded, with statistically significant association between sex and region (head and face). Victims in 15-17-year-old age group are more susceptible to violence than those in the 0-14-year-old age range. Dentists routinely examine the face, neck and skull, which make them the most appropriate health professionals to identify cases of aggression early.

Resumo O objetivo deste estudo foi verificar a prevalência de atos de agressão à cabeça, face e pescoço em relação às vítimas de Violência Física contra Crianças e Adolescentes (PVCA) que foram examinadas no Instituto Nacional de Medicina Legal e Delegação de Ciências Forenses Norte (INMLCF -DN) no Porto, Portugal. Um estudo foi realizado em 2.148 queixas de agressão física contra crianças e adolescentes [0 a menores de 18 anos] ocorridas entre 2009 e 2013 e que foram recuperadas de informações sobre violência mantidas em arquivos de dados do INMLCF-DN. Variáveis contínuas foram descritas para verificar a suas correlações foram usados os testes do Chi-Quadrado e o Teste Exato de Fisher em um nível de significância de 5%. Nestes 5 anos, foram detectados 1.380 casos que apresentam nexo clínico com agressão física. As vítimas mais acometidas eram adolescentes do sexo masculino, a região do corpo mais atingida foi a face com 747 das lesões (24,7%) registradas. Há significância estatística no teste do qui-quadrado de Pearson na relação de gênero com a cabeça e o rosto. Dentistas rotineiramente examinam o crânio, rosto e pescoço que os torna os profissionais mais adequados para identificar casos de agressão precoce. Os adolescentes são mais suscetíveis à violência do que as crianças menores de 12 anos.

Chronology of mineralization of the permanent mandibular second molar teeth and forensic age estimation.

Forensic age estimation frequently relies upon the chronology of mineralization of the third molar teeth. However, even when present, third molar teeth cannot always be used for estimating age in people who are classified as minors. Seconds molars develop earlier and in a more predictable way, and therefore are often more reliable for age estimation in this age group. This study aims to contribute to forensic age estimation using an age threshold of 14-years, studying the stages of development of permanent mandibular second molar teeth mineralization. 367 orthopantograms of a Portuguese population group, aged between 3 and 19 years, were studied. The stages of mineralization of mandibular permanent second molar teeth were studied following the classification stages proposed by Demirjian et al. Stage descriptive analysis was performed, and associations between age and stage were studied. A logistic regression to determine age over 14 years, using maturation stages and sex as a predictive variables, was made. A second sample was used for testing the model. The significance level was set at 5%. The model correctly classified 92.0% of cases overall. The equation was tested in the second sample, and the results showed that there were no statistical significant differences between the binary real age (i.e. age < 14 and age ≥ 14 years) and the estimated age (p = 0.109). The developed model is useful for age estimation using 14-years as a threshold. However, stage maturation analyses showed that stage F, in males, and stages G and H, in both sexes, lead to an estimated age with significant statistical differences from chronological age.

A new approach to sex estimation using the mandibular canine index.

Rao et al.'s mandibular canine index (MCI) is a simple odontometric method which uses the mandibular canine as the key to sex estimation. This index is defined as the ratio between the right canine mesiodistal dimension and the mandibular canine arch width. The aim of this study was to contribute to sex estimation using dental techniques by analysing the MCI efficiency, and to propose a new approach for its use. Measurements were taken from 120 plaster casts (70 females) in the 16-30 year age group. Although statistically significant sexual dimorphism was observed in both the mesiodistal dimension and the mandibular canine arch width, the MCI showed a low accuracy in sex classification (54.2% correct identifications). This accuracy was improved to 64.2% using receiver operating characteristics curve analysis. Yet, despite the better accuracy, these results reinforce the idea that the MCI may not be particularly useful in sex prediction, since it may not reflect the same degree of sexual dimorphism as its absolute measures.

The radiographic visibility of the root pulp of the third lower molar as an age marker.

PURPOSE: The aim of this work was to determine the usefulness of the visibility of the dental pulp in lower third molars in forensic age estimation. METHODS: Dental pulp visibility on lower third molars was assessed using a sample of 487 orthopantomograms. Intra and inter-observer agreement was determined using the Cohen's kappa test. A descriptive analysis of the stages according to age was done. The relationship between age and stage attainment was assessed using Chi square test and the strength and direction of the linear relationship between pulp visualization stage and chronological age was evaluated using Spearman rank order correlation (rho). Equations for predicting an age above 21 years were developed using logistic regression. The level of significance was defined at p < 0.05. RESULTS: The relationship between age and stage attainment had statistical significance for both sexes (p < 0.001). There was a medium positive correlation between the two variables for both genders (Spearman ρ = 0.420, p < 0.001 and Spearman ρ = 0.454, p < 0.001, for males and females respectively). The model built for age estimation successfully predicted age over 21 in 96.2% of the females and in 96.9% of the males. However, only 19.6 and 27.0% of predictions were accurate for the group that was younger than 21, for females and males, respectively. CONCLUSIONS: The accuracy of predictions for the group younger than 21 years of age was low, meaning that this methodology may not be suitable for age estimation. Still, stage 3 alone proved to be a suitable age marker for determining an age over 21 years.

Is Demirjian's original method really useful for age estimation in a forensic context?

PURPOSE: The suitability of Demirjian's method for forensic age estimation has been systematically questioned. The aim of this study is to further assess the reliability of Demirjian's original method in forensic age estimation using a sample of Portuguese children. METHODS: 564 panoramic radiographs of Portuguese boys and girls between 6 and 16 years of age were evaluated using Demirjian's method. Dental age (DA) was determined using the 50th percentile for the maturity score obtained for each age group. The mean difference between chronological age (CA) and dental age (DA) and the mean absolute difference between CA and DA were calculated for each age group. Paired t tests were used to test the statistical significance of mean differences between CA and DA. For each individual, a 94% confidence interval was calculated for estimated DA, using the 3rd and 97th percentiles in Demirjian's conversion tables. RESULTS: Chronological age was overestimated in boys, in every age group; mean differences between CA and DA were statistically significant, expect for age 7. In girls, chronological age was overestimated in the 10-15 year-old age group. The difference between CA and DA was highest in the 12 years olds for both sexes. The 94% confidence intervals did not include the true chronological age in all 6, 13, and 15 year-old girls, and all 14 and 15 year-old boys. Only a small portion of the individuals in the remaining age groups had their true chronological age falling within the probable age interval. CONCLUSIONS: Results show a systematic bias and consistent inaccuracy in estimating age from dental development using Demirjian's original method, making this methodology unsuitable for age estimation in the study sample. These results add to published evidence which suggests that Demirjian's method is not suitable and should be abandoned altogether for forensic age estimation purposes.

Human identification using dental techniques: A case report.

Dental identification of skeletal remains frequently relies on data comparison. Comparative dental identification is used to establish with a high degree of certainty that the remains of a corpse and a person represented by ante-mortem dental records are the same individual. There is no minimum number of concordant points necessary to perform a positive identification; rather, each case is unique and should be treated as such. In this paper, we present a report of a case in which positive identification was made by a paramolar tubercle in both upper first deciduous molars.