Sex dimorphism according to the nasozygomatic triangle

Sex is one of the first features to be diagnosed in human identification, composing, with age, ancestry and stature, the so called "big four". Aim: The present study aimed to metrically analyze the sexual dimorphism in skulls of known age and sex from Rio Grande do Sul ­ Brazil. Methods: This was a crosssectional study of metrical analysis, which used a sample comprised of 209 human skulls (106 male and 103 female) older than 22 years old at the time of death, undamaged and without signs of trauma or abnormalities. The point nasion and the most superior points on the zygomaticotemporal sutures from each side were connected forming a triangle. This area was calculated using Heron's formula, and the results were submitted for statistical analysis. Results: All measurements showed significant values for sexual dimorphism. Through the area of the triangle, it was possible to determine sex with an accuracy of 83.97% for males and 83.50% for females. Conclusion: This simple method requires only a caliper, and still can be reliable for forensic human identification. It must be diffused and tested on other samples, and can be used as a good and inexpensive tool for experts in day-to-day practice

O Cirurgião-Dentista Clínico e a Identificação Humana: a Importância do Prontuário Odontológico / Dentists and Human Identification: the Importance of Dental Records

O processo de identificação humana envolve uma comparação de dados de um corpo que pode variar desde integridade corporal a graus avançados de destruição, como esqueletização, carbonização ou fragmentação. A partir dos dados disponíveis nos remanescentes encontrados, inicia-se uma busca por informações ante mortem de pessoas desaparecidas. O presente trabalho busca demonstrar a importância do prontuário odontológico no processo de identificação humana, pela riqueza de informações, e unicidade da arcada dentária. O arquivamento do prontuário para toda a vida do profissional tem seu fundamento legal no Código de Defesa do Consumidor. Um prontuário bem elaborado, organizado e arquivado, pode fazer a diferença entre identificar ou não um indivíduo. Este arquivamento, bem como o trabalho bem desenvolvido do odontolegista no processo de identificação do indivíduo falecido, constitui um serviço para o bem da população viva,isto é, para a família deste indivíduo, que não fará parte da estatística dos desaparecidos. Os documentos que compõem o prontuário odontológico são cruciais para a eficácia na identificação humana e possuem valor ético e jurídico.

Human identification involves comparing data from a body, ranging from structural integrity to advanced degrees of destruction, such as skeletonization, carbonization, or fragmentation. Data available in remains found trigger a search for ante-mortem information on missing persons. This work aims to demonstrate the importance of dental records in the human identification process, considering the richness of information within them and the uniqueness of human dental arches. The lifetime archiving of dental records has its legal basis in Brazil's Consumer Protection Code. However, we seek to demonstrate how a well-designed, organized, and filed medical record may play a key role in identifying or not an individual. The well-performed filing and forensic activity work in the identification process is a service for the living population; that is, for the family of the deceased individual who, if not identified, will be part of the missing persons statistics. Documents comprising dental records are fundamental for effective human identification, besides having ethical and legal value.

Identificação de vítima de afogamento por meio de documentação ortodôntica: relato de caso / Drowned victim identification through orthodontic documentation: Case report

Introdução: A identificação humana pelos arcos dentais é considerada uma forma segura para se obter um resultado, pois possuem unicidade no conjunto de características, como morfologia dos dentes, formato da arcada, presença de alterações patológicas ou terapêuticas, ausências, e anomalias numéricas, morfológicas ou posicionais. Com frequência, cadáveres encontrados na água em estágio avançado de putrefação impossibilitam a identificação papiloscópica, tornando a Odontologia Legal necessária, evitando exames mais caros e demorados, como o DNA. Os dentes e os materiais odontológicos utilizados são de grande resistência à ação do fogo e da água, e o prontuário odontológico, arquivado com o cirurgião-dentista deve conter registro de todos os procedimentos realizados no paciente em vida, bem como modelos de gesso, radiografias, fotografias e demais exames de imagem. Objetivo: O presente artigo tem como objetivo relatar o caso de um adulto afogado que teve a sua identificação confirmada através da documentação ortodôntica. Conclusão: Concluiu-se que a associação da documentação ortodôntica fornecida pelos familiares com fotos, radiografias, e pareceres, e os dados odontolegais obtidos no exame cadavérico, permitiram a confirmação da identidade do indivíduo.

Introduction: Human identification by the dental arch is considered a safe way to obtain a result, since the dental arch has uniqueness in the set of characteristics, such as morphology of the elements, arch format, presence of pathological or therapeutic alterations, absences, and numerical, morphological or positional anomalies. Often, corpses found in the water at an advanced stage of putrefaction make it impossible to identify by finger prints, making Forensic Dentistry necessary for the identification of the corpse, avoiding more expensive and time-consuming exams, such as DNA. The teeth and dental materials used are highly resistant to the action of fire and water, and the dental record, filed with the dental surgeon, contains a record of all procedures performed on the patient during life, as well as plaster models, radiographs, photographs and other image exams. Aim: This article aims to report the case of a drowned man who had his identification confirmed through orthodontic documentation. Conclusion: It was concluded that the association of orthodontic documentation provided by the family with photos, radiographs, and opinions, and the dental data obtained in the cadaveric examination allowed the confirmation of the individual's identity.

Maus-tratos infantis no currículo dos cursos de Odontologia do Rio de Janeiro / Child maltreatment in the curriculum framework of the Dentistry courses in Rio de Janeiro

Os maus-tratos infantis são vistos como um dos maiores problemas de saúde pública de acordo com a Organização Mundial da Saúde e, no âmbito odontológico, o cirurgião-dentista pode influenciar diretamente no diagnóstico e denúncia desses casos, desde que possua a percepção e as informações necessárias. O presente estudo teve por objetivo avaliar se o currículo dos cursos de Odontologia do Rio de Janeiro fornece conhecimento e preparo suficiente para os acadêmicos acerca dos maus-tratos infantis. Para tanto, foi realizada uma pesquisa de campo com coleta de dados por meio da aplicação de um questionário semiestruturado em oito cursos de Odontologia do Rio de Janeiro abrangendo 200 estudantes do último ano da graduação. Destes, 53 (26,5%) eram de instituições públicas e 147 (73,5%) de instituições particulares. Dentre os participantes, 74,5% disseram que a temática foi abordada no curso, principalmente nas disciplinas de Odontologia Legal e Odontopediatria. Todos afirmaram a importância do tema na graduação e apenas 29 (14,5%) não acreditam ser de responsabilidade do cirurgião-dentista diagnosticar esses casos. Quanto ao conhecimento do Estatuto da Criança e do Adolescente, 129 (64,5%) estudantes afirmaram conhecer, entretanto 107 (53,5%) desconhecem as implicações legais para os cirurgiões-dentistas. Hematomas, retração da criança e medo foram os sinais e sintomas mais citados pelos estudantes. Quanto à conduta, a maioria afirmou que comunicaria ao Conselho Tutelar. Conclui-se que os acadêmicos de Odontologia da amostra possuem um conhecimento regular sobre o tema maus-tratos infantis (AU).

Child maltreatment is seen as one of the major public health problems according to the World Health Organization and the dentist can directly influence the diagnosis and make a denunciation of these cases, if having the knowledge and training needed. The present study aimed to assess whether the curriculum framework of the Rio de Janeiro's Dentistry courses provides enough knowledge and preparation to the academics about child maltreatment. For that, a field survey was conducted with data collection through the application of a semi-structured questionnaire in eight dental courses in Rio de Janeiro, totalizing a sample of 200 students in the last year of graduation. Of these, 53 (26.5%) belong to public institutions and 147 (73.5%) to private institutions. Among the participants, 74.5% said that the theme was addressed in the course, mainly in the disciplines of Legal Dentistry and Pediatric Dentistry. All of them affirmed the importance of the topic at graduation and only 29 (14.5%) did not believe it was among the dentist responsibility to diagnose these cases. Regarding the knowledge of the Child and Adolescent Statute (CAS), 129 (64.5%) students stated to know, while 107 (53.5%) ignore the legal implications for dentists. Bruises, fear and retraction of the child were the most cited signs and symptoms. As for the conduct, the majority said they would report to the Guardianship Council. It was concluded that the dental students in the sample have a regular knowledge about this subject (AU).

A new approach for the analysis of facial growth and age estimation: Iris ratio.

The study of facial growth is explored in many fields of science, including anatomy, genetics, and forensics. In the field of forensics, it acts as a valuable tool for combating child pornography. The present research proposes a new method, based on relative measurements and fixed references of the human face-specifically considering measurements of the diameter of the iris (iris ratio)-for the analysis of facial growth in association with age in children and sub-adults. The experimental sample consisted of digital photographs of 1000 Brazilian subjects, aged between 6 and 22 years, distributed equally by sex and divided into five specific age groups (6, 10, 14, 18, and 22 year olds ± one month). The software package SAFF-2D® (Forensic Facial Analysis System, Brazilian Federal Police, Brazil) was used for positioning 11 landmarks on the images. Ten measurements were calculated and used as fixed references to evaluate the growth of the other measurements for each age group, as well the accumulated growth (6-22 years old). The Intraclass Correlation Coefficient (ICC) was applied for the evaluation of intra-examiner and inter-examiner reliability within a specific set of images. Pearson's Correlation Coefficient was used to assess the association between each measurement taken and the respective age groups. ANOVA and Post-hoc Tukey tests were used to search for statistical differences between the age groups. The outcomes indicated that facial structures grow with different timing in children and adolescents. Moreover, the growth allometry expressed in this study may be used to understand what structures have more or less proportional variation in function for the age ranges studied. The diameter of the iris was found to be the most stable measurement compared to the others and represented the best cephalometric measurement as a fixed reference for facial growth ratios (or indices). The method described shows promising potential for forensic applications, especially as part of the armamentarium against crimes involving child pornography and child abuse.

Violence against women: caracteristics of head and neck injuries / Violência contra a mulher: características das lesões de cabeça e pescoço

ABSTRACT Objective: This study aimed to investigate the characteristics of aggression in head and neck regions suffered by women who are victims of gender violence, and to analyze the variation in the number of cases before and after the enactment of the Maria da Penha Law. Methods: A survey was conducted on the records of examinations of personal injury made in the Department of Forensic Medicine in Vitória, in the Brazilian state of Espírito Santo. The study included women victims of bodily injury, referred as a result of domestic, family or conjugal violence, aged between 11 and 80. Results: The number of cases analyzed in this study exhibited an oscillation during the years studied. The results reveal that female victims are, in most cases, young, aged between 20 and 30, single and do not work outside the home. The victim's husband or partner was the main offender, mostly using parts of the body, like the hands and feet, as the means of aggression. The most frequent craniofacial injuries were ecchymosis and abrasions, more often in orbital, cervical and frontal regions. Conclusions: The characteristics related to violence against women obtained through this study are of great importance and should be highlighted and publicized, to encourage implementation of public policies and practical actions of acceptance and recognition of such violence, including the insertion of the Forensic Dentist on the staff of experts in all Institutes of Forensic Medicine in the country.

RESUMO Objetivo: O presente trabalho buscou levantar as características das agressões em regiões de cabeça e pescoço sofridas por mulheres vítimas de violência de gênero e analisar a variação do número de casos antes e depois da promulgação da Lei Maria da Penha. Métodos: Foi realizado um levantamento nos registros dos exames de lesão corporal realizados no Departamento Médico Legal de Vitória, Espírito Santo. Foram incluídas mulheres vítimas de lesões corporais, encaminhadas em decorrência de violência doméstica, familiar ou conjugal com idade entre 11 e 80 anos. Resultados: A quantidade de casos analisados nesse estudo exibiu uma oscilação durante os anos estudados. Os resultados revelam que a mulher vitimizada é, na maior parte dos casos, jovem, numa faixa etária entre 20 e 30 anos e solteira, e não trabalha fora de casa. O companheiro ou marido da vítima foi o principal agressor, utilizando principalmente segmentos do corpo, como mãos e pés, como meio de agressão. As lesões craniofaciais mais encontradas foram equimose e escoriação, mais frequentes nas regiões orbitária, cervical e frontal. Conclusão: As características relacionadas à violência contra a mulher obtidas pelo trabalho têm grande importância e devem ser evidenciadas e divulgadas, a fim de que políticas públicas sejam implantadas e ações práticas de acolhimento e reconhecimento desse tipo de violência sejam tomadas, incluindo a inserção do Odontolegista no quadro de peritos de todos os Institutos Médicos Legais do país.

Stature Estimate by the Upper Arch: Carrea´s Method Modified / Estimación de la Estatura por Medio del Arco Superior: Método de Carrea Modificado

The Carrea's index is an alternative to estimate the human stature. However, in cases when the jaw is affected, this technique becomes impracticable. Expanding the use of the Carrea's index, by extending it to the upper elements, would increase the chances of the method, especially in cases when only the skull is available for analysis. The aim of the study was to test a new denominator for Carrea's index, so that it could be used for the upper arch, aiming at a new feature to estimate human stature. Plaster models of the arch and the string of the upper arch of 107 dentistry students, aged between 18 and 30 years, previously submitted to anthropometric analysis, were measured with a digital caliper. The data found were inserted in software developed to find a denominator that would result in a higher number of correct answers to real statures, evaluating the left and the right hemiarch, and their average. For the right hemiarch, the denominator with more accuracy for the real stature was the interval from 2.573 to 2.583, with 58.9 %. For the left hemiarch, the best values were from 2.553 to 2.554 with 63.6 %. The average of hemiarchs had as ideal denominator values between 2.579 and 2.581, with 60.7 %. We found no significant statistical difference between denominators. It was possible to obtain a new denominator to apply Carrea's index for the upper arch. The new method had satisfactory accuracy rate and should be tested in other populations to verify its applicability.

El índice de Carrea constituye una alternativa para la estimación de la estatura humana. Sin embargo, esta técnica se torna inviable cuando la mandíbula se encuentra comprometida. Su aplicación a partir de elementos dentales superiores, resultaría de utilidad en los casos en que sólo se dispusiese del cráneo para examinar. El objetivo del estudio fue proponer un nuevo denominador para que el índice de Carrea pueda ser utilizado para el arco superior, en la búsqueda de otro recurso para estimar la estatura humana. El arco y la cuerda fueron medidos, con un calibre digital, sobre los respectivos modelos de yeso superiores de 107 estudiantes de Odontología, que tenían entre 18 y 30 años de edad y habían sido sometidos a análisis antropométricos previos. Los datos obtenidos fueron analizados matemáticamente mediante un programa desarrollado para encontrar un denominador, que proporcionase un mayor número de aciertos para las estaturas reales, evaluando el hemiarco derecho, izquierdo y la media de los hemiarcos. Para el hemiarco derecho, el denominador más apropiado para la estatura real correspondió al intervalo 2,573-2,583, con 58,9 % de acierto. Para el hemiarco izquierdo, los mejores valores quedaron comprendidos entre 2,553 y 2,554, con 63,6 % de acierto. La media de los hemiarcos determinó guarismos ideales, oscilantes entre 2,579 y 2,581, con 60,7 % de acierto. No hubo diferencia estadísticamente significativa entre los denominadores hallados. Se obtuvo un nuevo denominador, que permitió el empleo del índice de Carrea para el arco superior, con una tasa de acierto satisfactoria. No obstante, este método debe ser probado y validado para otras poblaciones, verificando su aplicabilidad.

Respect for the Donated Corpse in the View of Dentistry and Medicine Students / Respeto por el Cadáver Donado en la Visión de los Estudiantes de Odontología y Medicina

The teaching of human anatomy in universities in Brazil and around the world is accomplished mainly through the use of donated corpses. However, this methodology is threatened due to the progressive reduction of the number of corpses donated to educational institutions. This research aimed to investigate the ethical profile of undergraduate students of Medicine and Dentistry when working with the corpses during practical classes in anatomy, and to compare the students' knowledge of the law that regulates the donation and use of human cadavers as a means of learning in educational institutions. For this purpose, a sample of 106 students, 63 from the Faculty of Dentistry of Piracicaba - UNICAMP -, and 43 from the Faculty of Medicine of Jundiaí (both in the state of São Paulo, Brazil) filled a questionnaire. The data were statistically analyzed using the chi-square test, and there were virtually no statistically significant difference between the responses of the students of Dentistry and Medicine. Most students did not know the law, and 81 % (Dentistry) and 68 % (Medicine) would not donate their bodies to educational institutions. Although nearly 75 % of students have claimed that teachers emphasized the importance of respect to the donated body, 56 % of future dentists and 46 % of future physicians ensure they have heard some kind of joke about the cadaver during class, although only 4.76 % and 13.95 %, respectively, have confessed to have already presented this inappropriate behavior. Thus, it can be inferred that there is an urgent need for dissemination of the importance of body donation programs, and the teaching of ethical principles concerning to the corpse, to ensure continuity of quality of education offered in biomedical field.

La enseñanza de la anatomía humana en las universidades en Brasil y en el mundo se lleva a cabo principalmente a través del uso de partes de cadáveres. Sin embargo, esta metodología está amenazada debido a la reducción progresiva del número de cadáveres transferidos a las instituciones educativas. El objetivo de este trabajo fue investigar el perfil ético de los estudiantes de odontología y medicina sobre el cuerpo durante las lecciones prácticas de anatomía, y comparar el conocimiento de la ley que regula la donación y utilización de cadáveres humanos como un medio de aprendizaje en las instituciones educativas. Una muestra de 106 estudiantes, 63 del curso de Odontología de la Facultad de Odontología de Piracicaba - UNICAMP - y 43 estudiantes de medicina de la Facultad de Medicina de Jundiaí (ambas ubicadas en São Paulo ­ Brasil), respondió a un cuestionario. Los datos fueron sometidos a un análisis estadístico mediante la prueba de chi-cuadrado. Se observó que no había diferencia estadísticamente significativa entre las respuestas. La mayoría de los estudiantes no conocen la ley, y 81 % (Odontología) y 68 % (Medicina) no donarían su cuerpo a las instituciones educativas. Aunque aproximadamente 75 % de los estudiantes afirman que los profesores enfaticen el respeto por el cuerpo, 56 % de los futuros dentistas y 46 % de los futuros médicos aseguran que han escuchado chistes y comentarios desagradables sobre el cuerpo durante las clases, aunque sólo 4,76 % y 13,95 %, respectivamente, han confesado haber cometido tal práctica. Conclusiones: Por lo tanto, se puede inferir que hay una necesidad apremiante para la divulgación de las leyes que rigen la donación de órganos y la conciencia de los cadáveres de donación, así como la enseñanza de los principios éticos de respeto por el cuerpo, para asegurar la continuidad de la calidad de la educación que se ofrece en las ciencias biomédicas.

Correcting the planar perspective projection in geometric structures applied to forensic facial analysis.

The process of forensic facial analysis may be founded on several scientific techniques and imaging modalities, such as digital signal processing, photogrammetry and craniofacial anthropometry. However, one of the main limitations in this analysis is the comparison of images acquired with different angles of incidence. The present study aimed to explore a potential approach for the correction of the planar perspective projection (PPP) in geometric structures traced from the human face. A technique for the correction of the PPP was calibrated within photographs of two geometric structures obtained with angles of incidence distorted in 80°, 60° and 45°. The technique was performed using ImageJ® 1.46r (National Institutes of Health, Bethesda, Maryland). The corrected images were compared with photographs of the same object obtained in 90° (reference). In a second step, the technique was validated in a digital human face created using MakeHuman® 1.0.2 (Free Software Foundation, Massachusetts, EUA) and Blender® 2.75 (Blender® Foundation, Amsterdam, Nederland) software packages. The images registered with angular distortion presented a gradual decrease in height when compared to the reference. The digital technique for the correction of the PPP is a valuable tool for forensic applications using photographic imaging modalities, such as forensic facial analysis.

As informações contidas nas embalagens de anestésicos locais estão de acordo com a legislação brasileira? / The information contained in local anesthetic packaging comply with the brazilian legislation?

Objetivos: O presente estudo buscou: a) verificar se as informações contidas nas embalagens de diferentes marcas de anestésicos locais estão de acordo com a legislação vigente, e b) confrontar possíveis acidentes na clínica odontológica com informações inadequadas ou ausentes nas embalagens e respectivas bulas dos fármacos analisados. Material e Método: Foram analisadas embalagens de quatro marcas de anestésicos locais de uso odontológico (SS White ®, Cristália®, DFL® e Dentsply®), tanto as primárias (individuais) quanto as secundárias (caixa comercial do medicamento), bem como suas respectivas bulas. A pesquisa foi realizada utilizando a legislação vigente. As amostras foram coletadas em estabelecimentos dentários na cidade de Caxias do Sul/RS. Resultados: nos rótulos das embalagens primárias, somente o fabricante DFL® seguiu rigorosamente as normas. Nos rótulos de embalagens secundárias, as amostras, de um modo geral, apresentaram resultados satisfatórios no que se refere ao cumprimento da legislação. Com relação à análise das informações das bulas dos anestésicos, verificou-se vários itens presentes, porém insatisfatórios. Conclusão: constatou- -se que determinadas normas estabelecidas pela legislação foram descumpridas. Possíveis acidentes e complicações pela falta ou inadequada informação nos rótulos das embalagens poderiam ser evitados se os fabricantes seguissem as normas estabelecidas.

Objective: This study aim: a) verify if local anesthetics packaging information contained were in accordance to current legislation, and b) confront some possible accidents in the dental clinic could be caused by inadequate or lack of drugs analyzed information's on the packaging and in their inserts. Materials and Methods: Was analyzed four dental local anesthetics traits (SS White®, Cristália®, DFL® and Dentsply®) both primary (individual) and secondary (box package) as well as their respective inserts. The study was conducted using the existing drug laws standards, and the sample was obtained in City of Caxias do Sul (Brasil) dental establishments. Results: in primary packaging box, only DFL® manufacturer strictly followed the rules. In secondary packaging box, the samples, in general, had little variation in terms of legislation compliance. Inserts technical information were several present, but unsatisfactory. Conclusions: It was found that certain standards established by the legislation, regarding the necessary and mandatory information that should be included on the labels of local anesthetics packaging and their inserts were not enforced. Possible accidents and complications from missing or inadequate information on the labels could be avoided if manufacturers followed established standards.

Dental anthropology of a Brazilian sample: Frequency of nonmetric traits.

Dental elements are valuable tools in a study of ancient populations and species, and key-features for human identification; among the dental anthropology field, nonmetric traits, standardized by ASUDAS, are closely related to ancestry. This study aimed to analyze the frequency of six nonmetric traits in a sample from Southeast Brazil, composed by 130 dental casts from individuals aged between 18 and 30, without foreign parents or grandparents. A single examiner observed the presence or absence of shoveling, Carabelli's cusp, fifth cusp, 3-cusped UM2, sixth cusp, and 4-cusped LM2. The frequencies obtained were different from the ones shown by other researches to Amerindian and South American samples, and related to European and sub-Saharan frequencies, showing the influence of this groups in the current Brazilian population. Sexual dimorphism was found in the frequencies of Carabelli's cusp, 3-cusped UM2, and sixth cusp.

Valoração do dano estético odontológico utilizando três métodos: relato de caso pericial civil / Valuation of dental aesthetic damage using three methods: report of expert civil case

Objetivo: o presente trabalho tem como objetivo relatar um caso de perícia odontológica civil em queforam empregadas e comparadas três metodologias para valorar o dano estético odontológico associadoàs perdas dentais. Relato de caso: tratou-se de uma perícia civil ajuizada para ressarcimento de danos,realizada no Serviço de Assessoramento Pericial da Faculdade de Odontologia de Piracicaba daUniversidade Estadual de Campinas/Brasil. O periciado estava num caminhão que foi atingido por umapedra projetada em direção oposta à sua, pelo trabalho de um trator que se encontrava na beira doacostamento cortando grama, sendo atingindo o vidro do veículo e a face do periciado. Após atendimentono hospital local, nenhum outro tratamento foi realizado desde então. Foram empregados 3 métodos paravaloração do dano estético envolvendo perda dental: 1) dano estético dental, 2) escala de sete graus, e 3)Análise da Impressão e do Impacto do Prejuízo Estético “AIPE”. Conclusão: a utilização de diferentesformas para valorar o dano estético em casos que envolvem desdentados parciais com lesões cicatriciaismostrou a importância do perito odontólogo estar atualizado e ter conhecimento sobre as abordagensexistentes, realizar uma descrição pormenorizada e padronizada das lesões, bem como estar atento paraindicar uma visão completa da pessoa portadora de dano estético à autoridade requisitante com autilização de metodologias adequadas para valorar esse tipo de dano.

Objective: the aim of this paper is to present a case of civil expert examination in dentistry area, in whichthree methods were applied and compared for valuing aesthetic damage associated to tooth loss. Casereport: the case involved a civil expert examination requested for damage compensation, held at theAdvisory Expert Service of the Piracicaba Dental School, State University of Campinas/Brazil. Theexamined patient was wounded on the face when he was in a truck that was hit on the glass by a rock,projected from the opposite direction, by a tractor on the roadside, cutting grass. After care at the localhospital, no treatment was carried out. Three methods were used to evaluate the aesthetic damageinvolving the tooth loss: 1) dental aesthetic damage, 2) seven degrees scale, and 3) Aesthetic Perceptionof Injury Analysis or “AIPE”. Conclusion: the use of different ways to value the aesthetic damage in casesinvolving partial edentulous individuals, with cicatricial lesions showed the importance of the dental experton being updated and having knowledge on existing approaches, on performing detailed and standardizeddescription of the lesions, as well as on being alert to provide a complete vision of the aestheticallydamaged person to the requesting authority, using adequate methodologies to evaluate the injury.

Importância do cirurgião-dentista no diagnóstico de abuso sexual infantil – revisão de literatura / Importance of the dentist in the diagnosis of child sexual abuse – a review

Introdução: É dever do cirurgião-dentista ser capaz de identificar lesões provenientes de abuso sexual infantil, uma vez que grande parte das mesmas ocorrem nos campos de trabalho deste profissional. Objetivos: O presente trabalho visa, por meio de revisão da literatura, apontar o papel do dentista ao se deparar com lesões provenientes de abuso sexual infantil. Material e método: Informações provenientes de legislação e literatura especializada nacional, relativas ao tema, foram compiladas. Visto que, em suagraduação, os cirurgiões-dentistas recebem pouca ou nenhuma base referente às principais manifestações físicas e psicológicas em situações de abuso sexual, muitos acabam por não conseguirem diagnosticar e, consequentemente, não cumprem seu papel de notificar casos suspeitos, seja por medoou por desconhecer sua obrigação diante deste tipo de violência. Resultados e conclusão: É necessárioque profissionais da Odontologia sejam conscientizados durante sua graduação, para que, depois deformados, não sejam omissos. Portanto, é de extrema importância que o tema passe a compor o plano deensino de todas as instituições, especialmente nas disciplinas de Odontologia Legal e Odontopediatria.

Introduction: All dentists must be able to diagnose lesions from child sexual abuse, once many of the moccur in the working fields of this professional. Objectives: This study aims, through literature review, topoint out the role of the dentist when faced with injuries from child sexual abuse. Method: Information from legislation and national literature on the subject was compiled. Since at her graduation, dentists receivelittle or no basis concerning the main physical and psychological manifestations in sexual abuse situation,and many end up failing to diagnose and therefore do not fulfill their role to notify suspected cases, eitherby fear or by ignoring its obligation on this type of violence. Results and conclusion: Dental professionalsmust be prepared during dental school, so as not to fail after graduation. Therefore, it is of utmostimportance that the issue become part of the teaching plan of all institutions, especially in the disciplines offorensic dentistry and pediatric dentistry.

Failures in dental prosthesis: dentists perception of the involved legal aspects / Insucessos em prótese dental: percepção dos cirurgiões-dentistas quanto aos aspectos odontolegais envolvidos

This aim of this study was to verify the level of knowledge of prosthodontics specialists from the city of Porto Alegre, Rio Grande do Sul State, concerning the failures of prosthetic works, and to provide a reflection on the type of responsibility assumed by the prosthodontist during the dental treatment. This was a descriptive cross-sectional study with a non-probabilistic sample, conducted through questionnaires with closed and open questions. The data was analyzed using the Fisher's Exact Test (p value < or = 0.005). The sample consisted of 143 questionnaires. The statistical analysis evidenced that the dentists with up to 15 years of professional practice assign the responsibility of failures most often to the laboratory (p = 0.001) and to the patient (p = 0.021), but over the years this trend is reversed. The prosthodontists included in the study proved to have an adequate knowledge of issues that pervade the failures in the prosthodontics specialty. In relation to the parameters of the professional responsibility, it is necessary to consider the type of duty assumed by the prosthodontist as for the responsibility of means.

O objetivo deste estudo foi verificar o grau de conhecimento do CD especialista em prótese dentária da cidade de Porto Alegre/RS sobre aspectos relacionados aos insucessos de trabalhos protéticos, bem como propor uma reflexão sobre o tipo de obrigação assumida pelos protesistas durante o tratamento odontológico. Tratou-se de um estudo transversal descritivo, com amostra não probabilística de indivíduos realizada por meio de questionários, nos quais constavam questões fechadas e abertas. A análise dos dados foi realizada utilizando-se o Teste Exato de Fischer (sendo p < ou = 0,005). A amostra foi composta de 143 questionários. O estudo estatístico mostrou quando interpretado em relação ao tempo de exercício profissional, que até os primeiros 15 anos de formado o profissional tem o entendimento de que os erros advêm mais frequentemente do laboratório (p = 0,001) e dos pacientes (p = 0,021), invertendo esta tendência com o passar dos anos. Os protesistas componentes da amostra mostraram ter um conhecimento adequado das questões relacionadas aos aspectos que permeiam os insucessos na especialidade de prótese. Ao considerarmos os parâmetros da responsabilidade profissional, deve-se considerar o tipo de obrigação assumida pelos protesistas como responsabilidade de meio.

Sex determination from occipital condylar measurements by baudoin Index in forensic purposes / Determinación del sexo desde mediciones del cóndilo occipital mediante el Índice de baudoin con propósitos forenses

In human identification for forensic purposes the sex is one of the most important and first features to be assessed in each case. Baudoin condylar index is a sex determination method based on measurements of length and width of the occipital condyle. The aim of this research was to apply the Baudoin condylar index for sex determination, and evaluate its reliability. The sample was composed of 100 Brazilian human skulls, 50 male and 50 female from São Gonçalo cemetery, City of Cuiabá, Brazil. The measurement values were statistically analyzed in order to compare the matching rate for each sex, each side, as well as the overall average. The results showed that the overall percentage of success in applying the Baudoin index was 44.83 percent to males, and 51.93 percent to females, amounting to 47.5 percent matching. The accuracy of the Baudoin index to sex determination was quite low for this Brazilian sample, the reason why this method should be disregarded as a criterion to sexing skulls in a forensic context.

En la identificación de personas con fines forenses el sexo es una de las características más importantes y primordiales a evaluar en cada caso. El índice condilar Baudoin es un método de determinación del sexo basado en mediciones de la longitud y la anchura del cóndilo occipital. El objetivo de esta investigación fue aplicar el índice condilar de Baudoin para la determinación del sexo, y evaluar su fiabilidad. La muestra fue compuesta de 100 cráneos humanos brasileños, 50 hombres y 50 mujeres del cementerio São Gonçalo, ciudad de Cuiabá, Brasil. Los valores de medición se analizaron estadísticamente con el fin de comparar la tasa de coincidencia para cada sexo, cada lado, además de la media general. Los resultados mostraron que el porcentaje general de éxito en la aplicación del índice de Baudoin fue de 44,83 por ciento para los hombres y 51,93 por ciento para las mujeres, lo que asciende a una coincidencia del 47,5 por ciento. La precisión del índice de Baudoin para la determinación del sexo fue bastante baja para esta muestra brasileña, por lo que este método debe ser considerado como criterio para determinar el sexo de los cráneos en un contexto forense.

Prosthodontists' perception of the forensic dentistry aspects of dental records / Percepção dos protesistas sobre os aspectos odontolegais do prontuário odontológico

Objective: To verify the perception of prosthodontists regarding the forensic dentistry aspects of the rehabilitation treatment data stored in the dental records of their patients. Methods: This is a prospective study of 222 male and female dental surgeons from the city of Porto Alegre, RS, Brazil, who specialize in dental prosthesis. The study used a questionnaire with 41 structured questions and two open questions, totaling 43 questions. After descriptive analysis, the data were compared by the Fisher?s exact test. Results: A total of 143 questionnaires were answered, representing 64.4% of the existing dental surgeons at the time of the study. Most respondents (86.7%), and females more so than males (p=0.046), did follow-up or maintenance of the treatments provided. The study also found that dental surgeons 50 years old or younger follow their patients regularly but as they get older, the follow-up frequency decreases (p=0.019). Conclusion: The study experts have partial knowledge of the forensic dentistry aspects of the records of the rehabilitation treatments they provided. Their experience had a significant impact on their legal awareness and on the quality of the data they recorded regarding the procedures that suggest greater care.

Objetivo: Verificar a percepção dos protesistas sobre aspectos odontolegais envolvendo os registros relativos aos trabalhos reabilitadores no prontuário odontológico. Métodos: Trata-se de um estudo prospectivo sobre 222 cirurgiões-dentistas, em ambos os sexos, especialistas em Prótese Dentária, atuantes na Cidade de Porto Alegre, RS, Brasil. A pesquisa foi realizada por meio de um questionário com 43 questões (41 estruturadas e duas abertas) dirigido a estes profissionais. Após a análise descritiva dos resultados, os mesmos serão comparados por meio do teste Exato de Fischer. Resultados: A amostra pesquisada constituiu-se de 143 questionários respondidos (n=143), ou seja, 64,4% do número de profissionais existentes à época. Observou-se que o acompanhamento ou manutenção periódica dos trabalhos realizados mostrou um alto escore (86,7%), sendo significativamente maior para os profissionais do sexo feminino, em comparação com os profissionais do sexo masculino (p=0,046). O estudo estatístico mostrou também que o acompanhamento é constante nas faixas etárias de profissionais até os 50 anos de idade, decaindo com o passar dos anos (p=0,019). Conclusão: Existe entre os especialistas pesquisados um conhecimento parcial sobre aspectos odontolegais que permeiam os registros relativos aos trabalhos reabilitadores no prontuário odontológico, sendo que houve diferença significativa entre os grupos com diferentes tempos de experiência, no que tange a alguns procedimentos que sugerem maior cautela, bem como ao conhecimento de normas legais.

Legal analysis of the information contained in dental plaster packs

AIM: The aims of this study were: a) to verify if the instructions displayed on the packages and labels of dental plaster available for purchase in the city of Porto Alegre are in accordance with the Brazilian laws, and b) to analyze how information is available on packages and labels of dental plaster acquired by dentists. METHODS: For this study, it was used the method proposed by Silva et al. (2010) modified, according to which the information related to instructions for product use displayed on packages and labels, if present, provided by manufacturers and/or importers from each brand of plaster was reviewed: how to use, composition, price, expiration date, health risks and disposal instructions. The collected information was subsequently confronted with the requirements laid out in national legislation on trade of dental plaster. RESULTS: No product showed the price or the instructions for disposal. One brand showed no information of the package and another one showed only the composition of the product; this requirement was present in most products. The mode of use and the expiration date were present in almost all packages, except for two brands. Only two brands presented information on health risks, and yet unsatisfactory. CONCLUSIONS: The different brands and types of dental plaster analyzed presented some kind of violation of the provisions of the Brazilian legislation, most with missing or unsatisfactory information.

Accidental aspiration of a finishing bur: clinical and legal aspects / Aspiração Acidental de Broca de Acabamento: Aspectos Clínicos e Legais

O objetivo deste trabalho foi apresentar um caso clínico de aspiração de broca protética de acabamento durante o tratamento odontológico e evidenciar aspectos clínicos, éticos e legais relacionados a esse tipo de acidente. Paciente do sexo masculino, 58 anos, durante um atendimento odontológico relatou que sentiu uma sensação de “coceira” na garganta. O atendimento foi interrompido e o mesmo encaminhado para atendimento hospitalar. Após radiografia e tomografia computadorizada do tórax foi constatada a aspiração acidental de uma broca de acabamento de restauração resinosa, removida com sucesso via broncoscopia. Cabe ao cirurgião-dentista conhecer e aplicar os meios necessários para prevenir a aspiração de objetos utilizados no tratamento, como a utilização do lençol de borracha ou amarrar objetos com o fio dental, bem como abordar as complicações decorrentes desse acidente. Dessa forma estará resguardado de possíveis demandas ético-judiciais por cumprir com suas responsabilidades profissionais.

The aim of this paper is to report a clinical case of prosthetic bur aspiration during dental procedure, and to evidence clinical, ethical and legal aspects related to this kind of accident. A male pacient, 58 years-old, during a dental procedure reported a sensation of itching in the throat. The service was discontinued and the patient was taken to hospital care. After imaging exam – radiography and computed tomography– it was diagnosed accidental aspiration of a finishing bur, which was successfully removed by bronchoscopy. The analysis of this case allows concluding that the dentist must know and apply the due means to prevent aspiration of foreign bodies during dentaltreatment, as the use of rubber dam or tying small objects with dental floss, as well as inform the patient about possible complications of this accident. This way the dentist will fulfill all professional responsibilities, and will be guarded from possible ethical issues.

Sexual dimorphism in Brazilian human skulls: discriminant function analysis.

Many anthropological studies have shown that sex can be determined using the human skeleton, especially by examining the pelvis and skull. The aim of this study was to verify the presence of sexual dimorphism in the Brazilian population by craniometric analysis; to identify the most reliable measurements and to propose a discriminant function for sex determination. The selected sample was composed of 100 adult skulls, 50 male and 50 female, from Cuiabá city, Mato Grosso State, Brazil. Of all the measurements taken, only the difference between the bi-euryon distances has proven insignificant, while themost dimorphic measure was the bi-zygomatic diameter. A discriminant function was obtained by applying the bi-zygomatic and the basion-lambda measurements, with a confidence level of 72%. The authors concluded that most of the traits analyzed are sexually dimorphic and the discriminant function elaborated is reliable for sex determination in human identification for forensic purposes.

Palatal rugoscopy as a method of human identification / Rugoscopia palatina como método de identificação humana

Test the applicability of the formula in palatoscopy.Methodology: three observers examined 30 plaster models of the upper arch, obtained from dentistry students at the Universidade Federal da Paraiba (UFPB). Rugae were classified as simple and composed and as line, curve, angle, circle, sinuous and point.Results: the intra-observer examination of simple and compound rugae showed a higher coincidence percentage for composed rugae (53.3 to 56.7%), as did inter-observer examinations (43.3% to 55.0%), compared to the 5% - 23.3% obtained for simple rugae. Analysis of the main types revealed that circular rugae showed the highest coincidence percentage (95.0% to 96.7%), followed by angular (61.7% to 66.7%). The line rugae demonstrated the lowest coincidence percentage (11.7% to 45.0%). Inter-observer coincidences were highest in the circle rugae (93.3% to 96.7%) and lowest in the line rugae, with percentages between 16.7% and 15.0%. The higher percentage of composed rugae reflected its good visualization. The high observer agreement in relation to circular rugae is due to the classification of their absence, since this rugae is seldom found, in contrast to line rugae, which are mistaken for wavy rugae and vice versa, often present in the palate. It can be observed that palatal rugae as a method has a large number of classifications, but with low practicability, storage difficulties and absence of universal standards...

Testar a aplicabilidade da fórmula na rugoscopia palatina.Metodologia: três avaliadores examinaram 30 modelos em gesso do arco superior, obtidos de estudantes de Odontologia da UFPB. As rugosidades foram classificadas em simples e compostas e em reta, curva, angular, circular, sinuosa e ponto.Resultados: o exame das rugas simples e compostas, intra avaliador, demonstrou maior percentual de coincidência para as rugas compostas (53,3 a 56,7%), assim como nos exames inter avaliadores, com acertos entre 43,3% e 55,0%, confrontando com os 5,0% e 23,3% obtidos nas rugas simples. Na análise dos tipos fundamentais observa-se que as rugas circulares apresentaram maior percentual de coincidências (95,0% a 96,7%), seguida das angulares (61,7% a 66,7%). A ruga reta demonstrou menor percentual de coincidências (11,7% a 45,0%). As coincidências inter avaliadores foi maior nas rugas circulares (93,3% a 96,7%) e menor nas rugas retas, com percentual entre 16,7% e 15,0%. O maior percentual das rugas compostas demonstra a sua boa visualização. A alta concordância dos avaliadores quanto a rugas circulares ocorre em virtude da classificação de sua ausência, pois raramente se encontra esta ruga, diferente das retas, que se confundem com as sinuosas e vice-versa, frequentemente presentes no palato. Nota-se que a rugosidade palatina como método possui uma grande quantidade de classificações, porém, com praticabilidade baixa, de difícil arquivamento e ausência de padrão universal.Conclusão: a classificação das rugosidades palatinas, por meio da fórmula rugoscópica, não é aplicável devido à subjetividade do método...