Aggression Using a Knife or Other Sharp Instruments and Oral-Maxillofacial Trauma: Incidence, Risk Factors, and Epidemiologic Trends.

PURPOSE: The aim of the present study was to characterize the profile of victims of interpersonal physical violence (IPV) caused by a knife or other sharp instrument, identify the factors associated with maxillofacial trauma, and examine the incidence of maxillofacial trauma over time. PATIENTS AND METHODS: In a retrospective cohort study, we evaluated 569 medicolegal and social records of IPV victims by knife or other sharp instruments treated at a forensic medicine and dentistry center in Brazil during a 4-year consecutive period. The variables investigated were related to the sociodemographic characteristics of the victims, circumstances of the aggression, and trauma patterns. Descriptive and multivariate statistics through Poisson regression and trend analysis with the creation of polynomial regression models were used. RESULTS: The cumulative incidence of oral-maxillofacial trauma was 19.3%. The mean age of the victims was 31.29 ± 13.82 years. Cases of trauma affecting more than one region of the face prevailed (45.5%). Based on the final Poisson regression model, unemployed people were more likely to exhibit maxillofacial trauma (relative risk [RR] 1.86; 95% confidence interval [CI] 1.03-3.35; P = .039). In addition, individuals were more likely to experience maxillofacial trauma on Wednesdays (RR 1.85; 95% CI 1.01-3.37; P = .045). The trend analysis revealed a significant increase in oral-maxillofacial injuries over time (P < .05). CONCLUSIONS: The incidence of oral-maxillofacial trauma was high, and the main factors associated with trauma were the victim's employment status and day of occurrence. Future studies will focus on assessing the effect of maxillofacial trauma on the quality of life and well-being of violence victims.

Firearms, Violence-Related Injuries, and Victimization Profiles: An Approach Using Cluster Analysis.

The aim of this study was to characterize the profile of nonlethal victims of urban violence by firearms and to describe traumas suffered by victims, according to a medical-legal and forensic perspective. A cross-sectional and exploratory study was conducted at the Center of Forensic Medicine and Dentistry in northeastern Brazil. The sample consisted of 233 victims of urban violence by firearm who presented some type of trauma. Descriptive and multivariate statistics using cluster analysis (CA) were performed. The TwoStep Cluster method was chosen to characterize the profile of victims. The night shift (56.8%) and the period corresponding to Saturdays (20.0%) and Sundays (20.4%) concentrated the largest number of occurrences. Cases of trauma in more than one region of the body simultaneously prevailed (31.8%). Based on the CA results, the formation of two clusters with distinct victimization profiles was verified. Cluster 1 was mostly characterized by younger single victims who suffered violence by firearm in the urban area perpetrated by an unknown perpetrator, resulting in greater occurrence of isolated upper and lower limb traumas. In contrast, Cluster 2 consisted essentially of older, married, or stable-union victims who experienced firearm violence in the suburban area, perpetrated by a known aggressor, resulting in greater occurrence of multiple traumas, that is, affecting several regions of the body at the same time. These findings reveal different risk groups for urban violence by firearms and traumas, contributing to the planning of strategies with emphasis on health care, prevention, and promotion.

Intimate partner violence against women, circumstances of aggressions and oral-maxillofacial traumas: A medical-legal and forensic approach.

INTRODUCTION: Intimate partner violence (IPV) is a serious public health problem that frequently results in oral-maxillofacial traumas, generating high social and economic costs. The aim of this study was to describe the profile of women victims of IPV and determine the pattern of oral-maxillofacial traumas, according to a medical-legal and forensic perspective. An exploratory study of 1361 suspected cases of women victims of IPV was carried out based on database of an Institute of Legal Medicine and Forensic Dentistry of Northeastern Brazil during a period of 4 years. Medico-legal and social records of victims were searched for information related to sociodemographic data, circumstances of aggressions and trauma patterns. Descriptive and multivariate statistics and Multiple Correspondence Analysis (MCA) were performed. MAIN RESULTS: Almost half of victims exhibited some oral-maxillofacial trauma resulting from IPV (45.8%). Lesions affecting more than one third of the face (41.3%), especially in soft tissues (96.1%) were the most common. Based on the MCA results, two distinct victimization profiles (P1 and P2) have been identified. P1 was mainly characterized by women aged less than 28 years, living in the urban area, with higher education and working. They were assaulted using physical force in community settings perpetrated by former partner or ex-boyfriend during the night and weekends, resulting in oral-maxillofacial traumas. P2 was mainly composed of women aged over 28 years, living in the suburban or rural areas, with low schooling and who did not work. They were assaulted by firearm or weapon in their own home, perpetrated by their partner or boyfriend during the day and weekdays, resulting in trauma to other body parts. CONCLUSIONS: Oral and maxillofacial traumas are very common among women victims of IPV who searched for medical-legal service. In this context, forensic dentists can play a key role during the diagnostic process and should always work together with medical, biochemical and toxicological experts. The findings of this study may contribute to the formulation of evidence-based policies.