Facial soft-tissue thickness in children: A study of a CTBC Brazilian sample.

As an auxiliary method in the process of human identification, forensic facial approximation (FFA) is an important tool for identifying unknown human bodies whose remains do not present the necessary traceability to any antemortem data collection. Specific characteristics are necessary when addressing children aged between 6 and 10 years, who have little sexual differentiation and a mixed dentition. Due to the chronology of eruption of the permanent second molars in this population, it is not possible to measure facial soft-tissue thickness (FSTT) from specific landmarks such as supra and infra M2. The objective of this research was to report the method for measuring the average FSTT of 32 landmarks adapting the method for adults replacing the landmarks at the upper and lower second molars (Supra M2 and Infra M2) in children up to 10 years of age for a measurement using the deciduous second molars as reference. We found statistical differences for some points, considering the variables of age and sex, but with a maximum difference of 2 mm, which allows the use of a single FSTT table. The deciduous teeth can replace the reference of the thicknesses at the supra and infra M2 landmarks. In addition to the new FSTT data for children in Brazil, we concluded that the proposed adaptation to the deciduous M2 points can be applied to obtain soft-tissue data for 32 facial points.

Fluorescence-aided identification technique using a low-cost violet flashlight and rotatory instruments for dental trauma splint removal.

BACKGROUND/AIM: Removing resin composites used for bonding dental trauma splints may result in irreversible damage to the enamel. This in vitro study evaluated the influence of additional violet illumination and different bur types on damage caused to tooth enamel. MATERIALS AND METHODS: Fifteen maxillary models with four bovine incisor teeth were prepared. All models were scanned using a laboratory scanning system (s600 ARTI; Zirkonzahn). Six experimental groups (n = 10) were generated by two study factors: lighting type (three levels), (1) low-cost (5-7 US$) violet LED flashlight (LUATEK, LT 408); (2) VALO Cordless light curing unit (Ultradent) with black lens; or (3) without additional illumination; and rotatory instrument (two levels), (1) diamond bur or (2) multifluted tungsten-carbide bur. New scanning was performed after splint removal, and the generated files were superimposed on the initial scans using Cumulus software. The light emitted by both violet light sources was characterized by using integrating sphere and beam profile. A qualitative and quantitative analysis of enamel damage and two-way ANOVA followed by Tukey's post hoc was used at an α = 0.05. RESULTS: The use of low-cost violet flashlight that emitted the violet peak light at 385 nm and VALO Cordless with black lens at 396 nm resulted in significantly lower damage to the enamel surface than those in the groups without additional violet light (p < .001). An interaction between rotatory instruments and lighting was found. When no additional violet lighting was used, the diamond bur presented higher mean and maximum depth values. CONCLUSIONS: Fluorescence lighting facilitated the removal of remnant resin composite dental trauma splints, leading to less invasive treatment. The diamond bur resulted in higher enamel damage than that affected by the multifluted bur when no violet lighting was used. A low-cost violet flashlight is a useful fluorescence-aided identification technique for removing resin composite dental trauma splints.

Exigência do código da CID em atestado: embasamento legal e análise da jurisprudência atual / ICD code requirement in medical statement: legal basis and analysis of current jurisprudence

A Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID) é uma forma globalmente padronizada para fornecer informações cruciais sobre as doenças, suas causas e consequências, colaborando para criar políticas de saúde e laborais. Porém, sua divulgação compulsória por parte de profissionais da saúde pode expor o empregado e sua privacidade. Neste contexto, o objetivo desse trabalho é analisar as decisões publicadas nos últimos dez anos, julgadas em última instância pelo Tribunal Superior do Trabalho (TST) e o entendimento dos magistrados sobre o assunto, as leis utilizadas no embasamento e a distribuição dos processos com esse teor. Foi realizada uma pesquisa no site do TST com os termos "exigência" "CID" "atestado" "médico" entre os anos de 2012 e 2022. Foram encontradas 18 decisões, 94% delas das regiões Sul e Sudeste do país. Quase 70% são desfavoráveis à exigência da CID em atestados, tendo como base a Constituição Federal (CF), resoluções do Conselho Federal de Medicina (CFM) e o Código Civil (CC). Conclui-se que as decisões relacionadas à exigência do código da CID estão concentradas em tribunais do Sul e do Sudeste, sendo os anos entre 2015 e 2019 com o maior número de ocorrências. Há uma predominância pela não exigência do código da CID em 12 das 18 decisões, sendo o argumento mais utilizado o sigilo e privacidade garantidos pela CF e Códigos de Ética Médica e de Ética Odontológica. As que se mostraram a favor predominantemente citam a súmula 122 do TST

International Statistical Classification of Diseases and Health Related Problems (ICD) is the global standard for diagnostic health information, providing key information about diseases, their causes, and consequences, leading to improvement on public and labor health. Its disclosure may expose employers when required by employers. Based on this context, the aim of this study is to analyze decisions law decisions and judgments reports from the Federal Labor Court between 2012 and 2022, the understanding of judges on the subject, the basis and distribution of decisions in this matter. Research was conducted on Superior Labor Court of Brazil website, using the keywords in Portuguese "requirement", "ICD", "statement" and "medical" between 2012 and 2022. It was found 18 judgments, 94% from South and Southeast of Brazil. Almost 70% of them were against the requirement of ICD code in medical statement, basing their decisions on our Federal Constitution (FC), resolutions of the Federal Medical Council (FMC) and Civil Code (CC). In conclusion, the Brazilian Law understands that the employee's privacy when seeking for medical help is above the employer's requirement. It is believed the new General Data Protection Law (GDPL) may reinforce this common Legal Knowledge and help footing new orders

Artificial Intelligence for Detecting Cephalometric Landmarks: A Systematic Review and Meta-analysis.

Using computer vision through artificial intelligence (AI) is one of the main technological advances in dentistry. However, the existing literature on the practical application of AI for detecting cephalometric landmarks of orthodontic interest in digital images is heterogeneous, and there is no consensus regarding accuracy and precision. Thus, this review evaluated the use of artificial intelligence for detecting cephalometric landmarks in digital imaging examinations and compared it to manual annotation of landmarks. An electronic search was performed in nine databases to find studies that analyzed the detection of cephalometric landmarks in digital imaging examinations with AI and manual landmarking. Two reviewers selected the studies, extracted the data, and assessed the risk of bias using QUADAS-2. Random-effects meta-analyses determined the agreement and precision of AI compared to manual detection at a 95% confidence interval. The electronic search located 7410 studies, of which 40 were included. Only three studies presented a low risk of bias for all domains evaluated. The meta-analysis showed AI agreement rates of 79% (95% CI: 76-82%, I2 = 99%) and 90% (95% CI: 87-92%, I2 = 99%) for the thresholds of 2 and 3 mm, respectively, with a mean divergence of 2.05 (95% CI: 1.41-2.69, I2 = 10%) compared to manual landmarking. The menton cephalometric landmark showed the lowest divergence between both methods (SMD, 1.17; 95% CI, 0.82; 1.53; I2 = 0%). Based on very low certainty of evidence, the application of AI was promising for automatically detecting cephalometric landmarks, but further studies should focus on testing its strength and validity in different samples.

Facial soft tissue thickness in forensic facial reconstruction: Impact of regional differences in Brazil.

Forensic facial reconstruction aims to assemble and provide the appearance of a face over a skull, in order to lead to recognition of that individual, making possible the application of primary identification methods. The scientific literature presents facial soft tissue thickness (FSTT) tables for reference from a range of different geographic regions. However, the consensus on its importance or on how to use specific population data related to FSTT is not unanimous. Brazil is formed by geographic regions with diverse populations, which are reflected in facial features. This paper aimed to measure and compare FSTT of distinct Brazilian samples to ascertain the need for specific data sets for different regions. A specific protocol for cone beam computed tomography was used to standardize measurement, and it was applied in a sample of 101 subjects. The FSTT measurements of a Brazilian population from the Midwest Region was compared to a previous sample from Southeast, which was collected using the same protocol. High compatibility was observed when comparing the averages of FSTT among samples of these two different geographic regions. Regarding age groups, notable differences on the medium and inferior face were observed in females. Minor variances found are unlikely to affect the practice of forensic facial reconstruction. Facial features, such as eyes, lips, nose, and skin may also be relevant in the differentiation of people from these two areas in Brazil. Therefore, concerning the Southeast and Midwest Brazilian regions, the need to apply different data sets is unnecessary.

Reconhecimento facial na prática forense: uma análise dos documentos disponibilizados pelo FISWG / Facial recognition in forensic practice: an analysis of the documents made available by FISWG

O reconhecimento facial na prática pericial tem sido discutido e submetido a muitos questionamentos nos últimos anos. Esse fato decorre do avanço tecnológico e consequente aumento da demanda dos exames em imagens nos organismos policiais e periciais. No contexto internacional, o Facial Identification Scientific Working Group (FISWG) coordena um debate constante sobre o tema e aponta para as limitações e aplicação das técnicas envolvidas. O objetivo dessa revisão é de interpretar e sintetizar o conteúdo dos documentos disponibilizados pelo FISWG, introduzindo o tema àqueles que estão iniciando na prática do reconhecimento facial. Os documentos compreendem toda uma construção de conhecimento que se inicia na contextualização da técnica, apresentação de um código de ética, a padronização da nomenclatura e áreas anatômicas de interesse, características do treinamento, comunicação e indicação de fatores que influenciam no processo, tais como a idade e distorções de imagens. Sendo a área de interesse da Odontologia Legal, os profissionais dessa especialidade podem e devem estar preparados para exercer perícias dessa natureza

In forensic practice, facial recognition has been discussed and subjected to many questions in recent years. This fact is due to technological advances and consequent increase in the demand for imaging examinations by the police and forensic agencies. In the international context, the Facial Identification Scientific Working Group (FISWG) coordinates a constant debate on the subject and points to the limitations and application of the techniques. The aim of this review is to interpret and synthesize the content of the documents made available by the FISWG, introducing the theme to those who are starting in the practice of facial recognition. The documents comprise a full construction of knowledge that begins in the contextualization of the technique, presentation of a code of ethics, standardization of nomenclature and anatomical areas of interest, characteristics of training, communication and indication of factors that influence the process, such as age and image distortions. Being the area of interest of Legal Dentistry, professionals of this specialty can and should be prepared to practice expertise of this nature

Splint stiffness and extension effects on a simulated avulsed permanent incisor-A patient-specific finite element analysis.

BACKGROUND/AIM: Splinting is an important procedure after avulsion. However, the role of splint stiffness and extension is not fully understood. The aim of this study was to evaluate the effect of splint stiffness and extensions on the mobility and stress on an injured tooth under physiological biting load. MATERIALS AND METHODS: Three-dimensional (3D) finite element models were created from a cone beam computer tomogram of a patient with normal occlusion. An avulsion injury of the right central incisor was created with a 1000 N load application on the palatal of the injured tooth, causing increased socket width. Splints made from four materials were tested: 0.9 mm diameter wire-composite splint (WCS1), 0.4 mm diameter wire-composite splint (WCS2), 1.0 mm diameter nylon-composite splint (NCS), and a 2 mm high by 0.2 mm thick plastic strip composite splint (PSS). Three splint extensions (involving 6, 5, and 3 teeth) were evaluated. Mobility of the avulsed tooth and the maximum principal stress distributions in the adjacent teeth were calculated. RESULTS: The injured incisor tooth mobility was not affected by the splint extensions. The NCS and PSS stabilized the avulsed incisor but allowed, respectively, 10 and 20 times more mobility under horizontal loading than the WCS1, which inhibited most mobility, while the WCS2 allowed double the mobility compared with WCS1. The NCS and PSS allowed more tooth mobility, mainly in the extrusion direction. Splints were 2-3 times more effective in limiting mobility under intrusive loads than extrusive loads. High levels of stress were found at the base of the composite attachments in the adjacent incisors. CONCLUSION: Splinting an avulsed tooth to one or two teeth bilaterally using a nylon splint or a plastic strip is appropriate for tooth stabilization and should be recommended over the 0.4mm wire-composite splint, while the 0.9 mm orthodontic wire is too rigid and not recommended.

A evolução do código de ética odontológica brasileiro / The evolution of the Brazilian dental code of ethics

O Código de Ética Odontológica (CEO) brasileiro, instituído em 1957, regulamentou o exercício da Odontologia e da ética profissional. Desde então, foram instituídas mais sete versões do CEO que acompanharam as necessidades da profissão e evoluíram com a sociedade brasileira. No entanto, em tempos de quebra de paradigmas éticos é necessário resgatar a origem da filosofia comportamental que rege a profissão. Frente a isso, este trabalho teve como objetivo analisar versões antigas do CEO, comparando-as com a edição atual, avaliando os artigos já existentes, alterações e complementações. A comparação de suas versões permitiu melhor percepção das mudanças da regulamentação da profissão odontológica ao longo das décadas e seus motivos. A realização de uma avaliação de cada artigo buscou as alterações de texto, inclusões e exclusões em cada versão do CEO, dados que foram analisados qualitativamente. Perceberam-se grandes modificações referentes à publicidade e propaganda, honorários profissionais e penalidades e suas aplicações ao longo do tempo, o que leva à reflexão de que o relacionamento com o paciente, a liberdade do profissional e as suas obrigações no âmbito da Odontologia são questões que estão em constante evolução e que necessitam de atualizações devido à complexidade da sua temática.

Necropsia odontolegal: técnicas e vias de acesso com finalidade de identificação humana / Dental autopsy: techniques and access ways with human identification purpose

Introdução: A Odontologia Legal ocupa importante espaço dentre as Ciências Forenses, oferecendo seus conhecimentos específicos da Odontologia em prol da resolução de casos de natureza cível, criminal, administrativa e trabalhista. O avanço da Odontologia Legal está diretamente ligado à busca pela identificação humana, o que tornou possível a crescente presença do perito odontolegista nos Institutos Médico Legais (IMLs), oficializada pela Lei 5081/66. O objetivo deste trabalho foi apresentar, por meio de uma revisão de literatura, as principais técnicas de necropsia bucal com finalidade de permitir o exame de identificação humana, bem como as diferentes vias de acesso, desenvolvidas ou utilizadas pelos odontolegistas. As técnicas preconizam incisões em diversas regiões de cabeça e pescoço, com a remoção ou não dos maxilares e são selecionadas para serem utilizadas de acordo com o estado de degradação dos corpos e a necessidade de preservação das estruturas e tecidos faciais, já que em diversos casos, os cadáveres deverão ser devolvidos aos seus familiares para serem velados posteriormente. Conclui-se que o uso das técnicas de necropsia bucal é necessário para a análise detalhada dos arcos dentais, de onde são retiradas as informações post-mortem para, em seguida, serem confrontadas à documentação ante-mortem do cadáver. Essas técnicas devem ser escolhidas de acordo com a praticidade e agilidade do exame, mas sob os critérios do estado inicial do corpo e a necessidade estética final do procedimento

Forensic Dentistry plays an important role within the Forensic Sciences, offering its expertise in Dentistry for the resolution of cases for civil, criminal, administrative and labor. The advancement of Forensic Dentistry is directly linked to the search for human identification, which is made possible the growing presence of the forensic odontologist in the Medical Legal Institutes (IMLs), a right granted by the Brazilian Federal Law n. 5081/66. The objective was to present, through a literature review, the main techniques of oral autopsy, and the various access ways, developed and used by dental examiners in order to facilitate and expedite the identification of bodies. Such techniques recommends incisions in various regions of the head and neck, with or without removal of the jaws, and are selected according to the state of preservation of the bodies, and the need for preservation of facial tissues and structures since, in many cases, the bodies must be returned to their families later to be veiled. It is concluded that the use of oral necropsy techniques is necessary for a detailed analysis of the dental arches, where postmortem data can be acquired and then confronted to the documented antemortem data of the corpse. The techniques are chosen by a practical and less time consuming criteria, but under the initial state of preservation and necessity of final aesthetic variables

Ética odontológica: para onde devemos olhar em busca de soluções? / Ethics in dentistry: where should we look for solutions?

O presente trabalho tem como objetivo refletir sobre o momento da ética odontológica, comportamentos observados nas mídias sociais, e a influencia do mercado de consumo na Odontologia. Foi realizada uma análise em diferentes perspectivas temporais sobre a proposta de "flexibilização" do Código de Ética, o que significaria abrir normas que por princípio são fechadas, abdicando ou tirando de contexto alguns dos princípios norteadores da conduta do Cirurgião-dentista. Aditivamente, mostrou-se algumas possíveis saídas para as questões levantadas como a discussão em fóruns adequados com participação dentre outros de especialistas da área de ética, bioética e odontologia legal, além da criação de centros de pensamento (ou think tank) da Odontologia, e ainda pela formação continuada na área de ética profissional. Finalizando, justamente a ética foi elevada como solução, através da Disciplina de Ética, Deontologia e matérias correlatas tornando-se necessidade básica na formação de profissionais cientes de suas responsabilidades para com a saúde do ser humano e seu papel na sociedade.

The present study aims to reflect ethics in dentistry moment, behaviors observed in social media, and the consumer on dentistry market influence. Different temporal perspectives analysis was made about the proposal to "flexibilize" the Code of Ethics, which mean opening rules that are closed by principle, abdicating or taking out of context some dentist guiding principles. In addition, there were some possible solutions to the issues raised, such as the discussion in appropriate forum with specialists in ethics, bioethics and legal dentistry, as well as the creation of dentistry think-tanks, and continuing education in the area of professional ethics. Finally, ethics has been elevated as a solution through the Discipline of Ethics, Deontology and related subjects becoming a basic need in the training of professionals aware of their responsibilities towards the human health and its role in society.

Assessment of accuracy and recognition of three-dimensional computerized forensic craniofacial reconstruction.

Facial reconstruction is a technique that aims to reproduce the individual facial characteristics based on interpretation of the skull, with the objective of recognition leading to identification. The aim of this paper was to evaluate the accuracy and recognition level of three-dimensional (3D) computerized forensic craniofacial reconstruction (CCFR) performed in a blind test on open-source software using computed tomography (CT) data from live subjects. Four CCFRs were produced by one of the researchers, who was provided with information concerning the age, sex, and ethnic group of each subject. The CCFRs were produced using Blender® with 3D models obtained from the CT data and templates from the MakeHuman® program. The evaluation of accuracy was carried out in CloudCompare, by geometric comparison of the CCFR to the subject 3D face model (obtained from the CT data). A recognition level was performed using the Picasa® recognition tool with a frontal standardized photography, images of the subject CT face model and the CCFR. Soft-tissue depth and nose, ears and mouth were based on published data, observing Brazilian facial parameters. The results were presented from all the points that form the CCFR model, with an average for each comparison between 63% and 74% with a distance -2.5 ≤ x ≤ 2.5 mm from the skin surface. The average distances were 1.66 to 0.33 mm and greater distances were observed around the eyes, cheeks, mental and zygomatic regions. Two of the four CCFRs were correctly matched by the Picasa® tool. Free software programs are capable of producing 3D CCFRs with plausible levels of accuracy and recognition and therefore indicate their value for use in forensic applications.

Facial pattern analysis: critic review and collection of facial proportions in a brazilian sample using cone-beam computed tomography / Análise de tipos faciais: revisão crítica e coleta de proporções faciais em amostra de brasileiros utilizando tomografia computadorizada de feixe cônico

The classification of facial vertical patterns is a common practice among dentists of different specialties. It influences treatment planning and expected outcomes, but is usually carried out qualitatively. The aim of this study is to better understand vertical facial proportions, combining a critic review of the literature with the collection of data from 100 Brazilian adult sample in search of 3D quantitative parameters with the use of Cone-Beam Computed Tomography (CBCT) measurements. In Pubmed database, the following quoted phrases were used: "Facial pattern" AND "Facial Index" AND "Facial height Index" AND "Facial height" AND "Dolichofacial" AND "Brachyfacial" AND "Longface syndrome" AND "Short-face syndrome" in a 25 years interval (1990-2015). Study selection was performed searching for crucial facial features, commonly used to determine the facial pattern of a patient. In CBCT exams, 100 patients had facial features measured and classified by the three most reliable methods. The literature on the field can be very confusing, as the methods, landmarks and averages differed considerably. Most of the facial features researched had different values when the literature was analyzed and compared to our data. This indicates that ethnic, age and gender variations play an important whole in facial pattern diagnostic and should be taken in account when using general cephalometric approaches on diagnosis. With a group sorting method, combining the ratios between the anterior Facial height and the width, the anterior vertical proportion and the gonial angle divergence, and with anatomical landmarks we successfully correlated the sample to the qualitative description, as shorter faced patients to larger bi-zygomatic distances and less divergent gonial angles and longer faced patients with narrower and more divergent faces.

A classificação de padrões faciais verticais é prática comum entre Cirurgiões Dentistas de diferentes especialidades. Esta influencia o planejamento de tratamento e resultados esperados, no entanto, essa tarefa é frequentemente realizada de forma qualitativa. O objetivo deste trabalho foi compreender melhor as proporções verticais da face, combinando uma análise crítica da literatura com a coleta de dados de 100 adultos brasileiros na procura por parâmetros quantitativos em 3D, usando tomografias computadorizada de feixe cônico (TCFC). Na base de dado pubmed, a seguinte frase foi utilizada: "Facial pattern" AND "Facial Index" AND "Facial height Index" AND "Facial height" AND "Dolichofacial" AND "Brachyfacial" AND "Long-face syndrome" AND "Short-face syndrome" em um intervalo de 25 anos (1990-2015). A seleção dos estudos foi realizada procurando características faciais cruciais e métodos comuns para a determinação do padrão facial do paciente. Em exames de TCFC de 100 pacientes adultos, foram medidas as dimensões faciais foram registradas e os três métodos mais confiáveis e encontrados na literatura foram testados. A literatura sobre o assunto pode ser muito confusa, ao ponto de que os métodos, pontos de referência e médias variaram consideravelmente. Muitas das características pesquisadas tinham valores diferentes quando analisada a literatura em comparação com os dados dessa pesquisa. Isso indica que variações de etnia, idade e gênero tem papel importante no diagnóstico do padrão facial e deve ser levada em consideração quando utilizados padrões cefalométricos para diagnóstico. Com a metodologia de agrupamento, utilizando o índice entre a altura facial anterior e a largura, a proporção anterior da face e a divergência do ângulo goníaco, assim como os pontos cefalométricos selecionados, nós correlacionamos com sucesso a amostra com as descrições qualitativas como: os pacientes de face curta e as distâncias bi-zigomáticas e ângulos faciais menos divergentes, assim como os pacientes de face longa com faces mais estreitas e menos divergentes.

Guidelines for reproducing geometrical aspects of intra-oral radiographs images on cone-beam computed tomography.

Human identification requires comparison of individual traits of a person, depending on the availability and reproduction of antemortem (AM) records. If there is no presumed identity or AM exams are not available for comparison, the production of postmortem (PM) records is impaired. The purpose of this research is to describe and test standards to enable the comparison of antemortem periapical radiographs to images extracted from the manipulation of postmortem CBCT exams in multiple identification simulations in a randomized blind study. In a simulation, 20 CBCT images from dry skulls were used as PM records and 3 periapical radiographs (total of 60) that were randomized and blinded from the first examiner. In each case, an intentional incidence error of 10° was added in four different directions. Three points were selected in the AM radiograph, and the angle, linear measurements and proportion between these distances were collected. The AM data were used to mathematically find similar image geometry on a CBCT maximum intensity projection. Possible identification by superimposition was achieved in all cases, and statistical analysis proved the success in the reproduction of angular and length proportion using CBCT incidence manipulation. Significant reproducibility was also observed on intra- and inter-observer tests. In conclusion, the images extracted from CBCT could be compared to any periapical radiographs by superimposition, providing acceptable evidence to establish human identification. The application of this protocol is suitable for forensic practices with the high level of reproducibility and could be used as PM record when no AM records are available at the time of the exam.

Practical Application of Anatomy of the Oral Cavity in Forensic Facial Reconstruction.

The oral cavity's importance in defining the facial region makes it a primary feature for forensic facial reconstruction (FFR). The aim of this study is to construct a pattern of reference for dimensions and proportions of the lips and establish parameters that may help estimate the vermilion borders' height dimensions and the mouth's width. By means of cone beam computed tomography, divided into two samples: sample 1 (n = 322; 137 male, 185 female) verified the linear distances delimited by anatomical landmarks in soft tissue. The sample 2 (n = 108; 40 male, 68 female), verified the proportions among the height of the vermilion borders, width of the mouth, and linear distances between craniometric landmarks in hard tissues, both from a Brazilian database. The measurements were completed using OsiriX, and the results were analyzed by means of descriptive statistics at a level of significance of 5%. The height of the vermilion borders corresponded to approximately 26% of the width of the mouth. The width of the mouth increased over the course of time in men and remained stable in women. In men, a mean intercanine distance of 75% of the total mouth's width was found; for women, it was 80%. The parameters of the relations between soft and hard tissues in the oral cavity region presented that the distance between landmarks ID-SM (Infradentale-Supramentale) corresponded to 55% of the height of the vermilion borders of the mouth for both sexes, while the distance between landmarks PM-SD (Philtrum medium-Supradentale) corresponded to 85% in men and 88% in women. Mean values of 97% of the width of the mouth in women and 93% in men were attributed to the distance between the mentonian foramina. It was not possible to estimate the height of the labial vermilion borders by the bone measurements, FIs-Fli (Foramen incisivus superius-inferius) and NS-GN (Nasospinale-Gnathion). Profound knowledge of the anatomy and morphology of the oral cavity may contribute to increasing the precision of FFRs and help with human identification.

Forensic facial reconstruction: Nasal projection in Brazilian adults.

The nose has a marked cognitive influence on facial image; however, it loses its shape during cadaveric decomposition. The known methods of estimating nasal projection using Facial Reconstruction are lacking in practicality and reproducibility. We attempted to relate the points Rhinion, Pronasale and Prosthion by studying the angle formed by straight lines that connect them. Two examiners measured this angle with the help of analysis and image-processing software, Image J, directly from cephalometric radiographs. The sample consisted of 300 males, aged between 24 and 77 years, and 300 females, aged 24 to 69 years. The proposed angle ranged from 80° to 100° in both sexes and all ages. It was considered possible to use a 90° angle from projections of the Rhinion and Prosthion points in order to determine the Pronasale position, as well as to estimate the nasal projection of Brazilian adults.

Importância pericial dos sistemas de notação dental – revisão de literatura / Forensic importance of the dental notation systems – a review

Em algumas circunstâncias, o conhecimento de sistemas de notação dentais utilizados internacionalmente pode ser importante para a avaliação dos documentos odontológicos apresentados. O objetivo desse trabalho é revisar a literatura, exemplificando e descrevendo os principais sistemas,permitindo a sua identificação e compreensão. Com as informações apresentadas será possível atranscrição de prontuários que utilizem sistemas diferentes dos encontrados no Brasil. Devido àsemelhança entre os sistemas e sua utilização restrita aos profissionais da odontologia, recomenda-seque sempre seja avaliado o sistema presente nas documentações como etapa inicial. Também deve serdescrita, de maneira objetiva, qual a notação dental utilizada em laudos e pareceres.

In some circumstances, the knowledge of dental numbering that are in use internationally maybe useful when analyzing dental charts presented. The objective of this study is to review theliterature, to give examples and to describe the main numbering systems, allowing itsidentification and comprehension when necessary. With this information it will be possible toread and transcribe the dental records that present other numbering system than the onesfound in Brazil. Due to similarity between systems, and it’s restrict use by dental professionals, itis recommended that one always analyze the notation system as a first step. In addition, thesystem is in use should be clearly described, when writing forensic reports.

Human identification through frontal sinus 3D superimposition: Pilot study with Cone Beam Computer Tomography.

As a unique anatomical feature of the human body, the frontal sinus morphology has been used for identification of unknown bodies with many techniques, mostly using 2D postero-anterior X-rays. With the increase of the use of Cone-Beam Computer Tomography (CBCT), the availability of this exam as ante-mortem records should be considered. The purpose of this study is to establish a new technique for frontal sinus identification through direct superimposition of 3D volumetric models obtained from CBCT exam, by testing two distinct situations. First, a reproducibility test, where two observers independently rendered models of frontal sinus from a sample 20 CBCT exams and identified them on each other's list. In the second situation, one observer tested the protocol and established on different exams of three individual. Using the open source DICOM viewer InVesallius(®) for rendering, Mesh Lab(®,) for positioning the models and CloudCompare for volumetric comparison, both observers matched cases with 100% accuracy and the level of coincidence in a identification situation. The uniqueness of the frontal sinus topography is remarkable and through the described technique, can be used in forensic as an identification method whenever both the sinus structure and antemortem computer tomography is available.