Dental Records Research Articles

The Anthropological Process of Identifying Missing Persons as a Teaching Method for Increasing Awareness in Legal and Forensic Dentistry in the Republic of Cyprus

Forensic Odontology is a critical field within forensic science, with significant importance in legal contexts and the identification of victims in mass disasters or cases of abuse. This article focuses on the efforts made by the European University Cyprus (EUC) School of Dentistry to raise awareness among dental students regarding legal and forensic dentistry practices. Through voluntary visits to the Anthropological Laboratory of the Committee on Missing Persons (CMP) in Cyprus, students gain firsthand experience and insights into anthropological analysis for identifying missing individuals. These visits provide students with practical application opportunities, emphasizing record-keeping practices, oral tissue morphology analysis, and unique aspects of restorative work during identification processes. Feedback from participating students highlights the value of experiential learning in increasing awareness about forensic odontology’s importance and relevance in real-world scenarios. The initiatives undertaken by the EUC School of Dentistry contribute to enhancing legal and forensic dentistry awareness among future dental professionals in Cyprus.

Application of Convolutional Neural Networks for Determining Gender and Age in Forensic Dentistry

Application of Convolutional Neural Networks for Determining Gender and Age in Forensic Dentistry

Missing Persons of Post-Conflict Countries: Assessing Dental Identification through a Questionnaire-based Study in Syria

Locating and identifying missing persons is crucial to protecting human rights and rebuilding war-torn countries like Syria. Biological identity primarily relies on DNA, fingerprints, or dentition. However, post-conflict countries with high deaths, limited databases, insufficient resources, and a reduced or a lack of forensic expertise make this effort more challenging. Teeth are a practical and cost-effective means to identify human remains, particularly when acceptable dental records are available. Still, the application of comparative dental analysis in conflict scenarios needs to be more explored.A survey study in Syria examined whether post-conflict countries could employ comparative dental identification of missing individuals. The attitudes and perceptions of four groups (the public and dentists, forensic odontologists, dental schools, and the Syrian Dental Association) were determined using questionnaires and analysed for the first two groups. Most respondents (>90%) indicated that addressing disappearance is crucial for post-conflict reconstruction and considered it unachievable without international support and only 20% had confidence in this support. Issues hindering human identification reported by a high percentage of dentists and forensic odontologists and included education in Forensic Odontology (92%), expertise in the field (70%), awareness (90%), the availability of antemortem records (92.3%) and political and security influence (50%). Responses from over 80% of the public, 50% of the dentists and 92% of the forensic odontologists indicated that comparative dental identification in Syria may not be feasible.The results of this study provide strong evidence of the challenges in identifying missing persons using teeth in developing nations, particularly those affected by conflicts. They include the lack of antemortem records and forensic expertise. The international community is urged to support post-conflict nations including Syria.

Association between forensic DNA and odontology in human identification during mass disaster: a systematic review

BACKGROUND: According to the literature, forensic odontology is one of the most effective and affordable scientific techniques for identifying victims of mass disasters. This research methodically reviews the role and function of forensic odontologists in several global mass disasters. Forensic DNA in odontology is associated with the importance of its application in the identification of humans of mass disasters. As the crime rate continues to rise, the field of forensic medicine has evolved significantly. Forensic dentists play a pivotal role in various areas of crime scene investigations, thereby helping solve innumerable mysteries. AIM: The study aimed to increase the body of knowledge for future research on forensic odontology by conducting a systematic review search to investigate possible forensic DNA in odontology associated with the importance of its application in the identification of humans of mass disasters. MATERIALS AND METHODS: Six databases, including Google Scholar, PubMed, Scopus, Embase, Web of Science, and ScienceDirect, were analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) quality scale. The literature search, conducted until February 2024, informed important research choices. RESULTS: A total of 16 (100%) studies related to forensic DNA of mass disasters were identified. Of these, only seven (43.75%) articles related to dental DNA were included in this review. Of the 4,808 articles obtained, 138 duplicates or irrelevant articles were eliminated. Following a full-text review, seven studies were selected based on eligibility criteria. The highest percentage of victims was identified using dental DNA. In a few studies, some samples were insufficient for complete DNA profiling due to factors such as the method of DNA extraction. CONCLUSION: Forensic odontology has played a significant role in the identification of victims of several mass disasters around the world. Although teeth are an excellent source of DNA for humans, future studies with larger sample sizes, appropriate control groups, and standardized techniques of DNA extraction need to be conducted.

Artificial intelligence in forensic odontology: A review

Artificial intelligence in forensic odontology: A review

Computer-assisted morphometric analysis of the relationship between the coronoid and condylar processes of the mandible

: The mandible is the most durable and only movable bone that constitutes the lower one-third of the face.The mandibular condyle and coronoid processes are two anatomical structures located in the superior portion of the ramus of the mandible. Morphometric understanding of these structures is key to the diagnosis of various disorders associated with the temporomandibular region. It also aids in devising a plan for the management of such disorders.: The purpose of this study is to evaluate the anatomical corelation between the condyle and coronoid of the mandible.: This retrospective study was conducted by obtaining 100 high-resolution computed tomography images from departmental archived records between 2018 and 2024. After acquisition, these images were incorporated into MIMICS Materialize software to create stereolithography models, and morphometric analysis was carried out. Out of 100 HRCT data obtained, 87 were male and 13 were female. There is a statistically significant difference in length and angulation of the coronoid and condyle on both sides. The condyle length for males was (4 ± 5.5 mm) higher than the condyle length of females on both sides. However, the coronoid length of males and females varies in a range of 0.5-2mm on both sides of the mandible. Understanding the morphological variation of mandibular condylar and coronoid processes aids in various fields of medicine like forensics, anthropology, and reconstructive maxillofacial surgery. Our study inference will aid surgeons in planning coronoid grafts for condylar reconstruction as well as other maxillofacial reconstructions. Additionally, it helps in forensic odontology to determine a person's age and gender.

Unleashing the potential of applied UNet architectures and transfer learning in teeth segmentation on panoramic radiographs

Accurate tooth segmentation in panoramic radiographs is a useful tool for dentists to diagnose and treat dental diseases. Segmenting and labeling individual teeth in panoramic radiographs helps dentists monitor the formation of caries, detect bone loss due to periodontal disease, and determine the location and orientation of damaged teeth. It can also aid in both the planning and placement of dental implants, as well as in forensic dentistry for the identification of individuals in criminal cases or human remains. With the advancement of artificial intelligence, many deep learning-based methods are being developed and improved. Although convolutional neural networks have been extensively used in medical image segmentation, the UNet and its advanced architectures stand out for their superior segmentation capacities. This study presents four semantic segmentation UNets (Classic UNet, Attention UNet, UNet3+, and Transformer UNet) for accurate tooth segmentation in panoramic radiographs using the new Tufts Dental dataset. Each model was performed using transfer learning from ImageNet-trained VGG19 and ResNet50 models. The models achieved the best results compared to the other literature models with dice coefficients (DC) and intersection over union (IoU) of 94.64% to 96.98% and 84.27% to 94.19%, respectively. This result suggests that Unet and its variants are more suitable for segmenting panoramic radiographs and could be useful for potential dental clinical applications.

Social Vulnerability Index and Dental Caries in Children: An Exploratory Study.

This retrospective cross-sectional study evaluated the association between caries outcomes in a pediatric population visiting a dental clinic and the social vulnerability index, an area-based measure capturing 4 main social determinants of health: socioeconomic status, household composition/disability, minority status/language, and housing/transportation. The Centers for Disease Control Social Vulnerability Index (SVI) and electronic dental record data of children (0 to 18 y) reporting a caries diagnosis at the Children's Hospital Colorado in 2020 were extracted for 9,201 children. Logistic regressions were used to test the association between SVI and the presence or absence of dental caries, adjusting for age, sex, ethnicity, and race. Children with a caries diagnosis had a greater mean overall SVI percentile (62.0, standard deviation [SD] = 29.1) compared with patients without a caries diagnosis (59.1, SD = 29.8; P < 0.001). With each 10-point increase in the overall SVI percentile, having a caries diagnosis visit was 2.7% more likely compared with having a visit without a caries diagnosis (odds ratio [OR] 1.027, 95% confidence interval [CI] 1.012, 1.042; P = 0.0004). Those with an overall SVI percentile between 51 and 75 were 23% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.23, 95% CI 1.07, 1.42; P = 0.003), and those with a percentile >75 were 23.6% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.236, 95% CI 1.09, 1.40; P = 0.001). Children (0 to 18 y) living in socially vulnerable environments or areas were more likely to have a caries diagnosis at their dental exam. This study showed an association between social determinants of health demonstrating social vulnerability and dental caries in children. Ultimately, understanding upstream factors for children living in socially vulnerable areas could support policymakers in creating more effective policies to support socially vulnerable populations.

Amelogenin-Based Molecular Methods for Sexual Dimorphism Identification: Protocol of a Scoping Review

Forensic dentistry and sexual dimorphism are distinct concepts. Still, they are related due to the usefulness that the first may have in the second, and this review focuses on them. A scoping review will be performed according to the Joanna Briggs Institute’s methodology. Scientific databases and grey literature will be used, and the following keywords will be applied: amelogenin, analyses, sex determination, and human identification. This scoping review will include in vitro studies concerning the goal of this review. This scoping review will deepen our knowledge concerning using teeth and amelogenin genes in sex identification in a forensic context. According to the available data, it will help implement guidelines for human remains identification. This protocol was registered with the Open Science Framework.

Augmented and Virtual Reality in Forensic Odontology: Practical Implementations

Forensic odontology’s evolution from manual to digital methods signifies a pivotal transition. Augmented Reality (AR) and Virtual Reality (VR) further this transformation by merging the physical and digital realms. This brief communication explores how AR and VR can enhance forensic odontology, offering precision, interactivity, and advanced analysis. It delves into the current landscape and envisions future possibilities, emphasizing their role in shaping precise and collaborative forensic practices. Additionally, challenges and considerations for implementing AR and VR in this field are discussed.

Charting Ethical Terrain: The Functon of Artificial Intelligence in Oral and Maxillofacial Imaging

The integration of artificial intelligence (AI) into maxillofacial imaging represents a significant advancement in diagnostics and therapy. This review explores the ethical implications of AI in this specialized area, addressing concerns such as data privacy, informed consent, and algorithmic bias. It highlights the potential benefits of AI for patient outcomes and clinical efficiency while acknowledging risks associated with reliance on automated systems. The review aims to establish a framework for ethical guidelines to ensure that AI enhances patient care. AI's application in various industries has gained momentum, with dentistry, particularly oral and maxillofacial radiology, emerging as a promising field. Recent studies have focused on convolutional neural networks for tasks such as image classification, detection, segmentation, and refinement. These AI systems support radiographic diagnosis, image analysis, forensic dentistry, and image quality enhancement. However, optimal performance requires large, well-labeled datasets, necessitating significant input from oral and maxillofacial radiologists, which can be time-intensive. For AI to be effectively integrated into clinical practice, several challenges must be overcome, including the creation of comprehensive open datasets, understanding AI judgment criteria, and addressing DICOM hacking threats. By developing solutions alongside AI advancements, the technology can significantly evolve, potentially transforming automated diagnosis, treatment planning, and tool development. Oral and maxillofacial radiologists will play a crucial role in shaping AI applications in their field, leveraging their expertise in interpreting radiographic images.

Patterns of identity: Lip prints, tongue prints and mandibular canine width as markers for gender determination—A cross-sectional study

ABSTRACT Introduction: Forensic odontology plays a pivotal role in identifying individuals in legal contexts. This study analyses the efficacy of lip prints, tongue prints and mandibular canine width in determining gender, aiming to contribute to the evolving field of forensic dentistry. Methods: A cross-sectional study was conducted involving 100 participants, analysing lip prints based on Tsuchihashi’s classification, recording tongue shapes and features through the use of alginate impressions and measuring mandibular canine width using a vernier calliper. The findings were reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Results: In lip prints, Tsuchihashi’s Type I lip print was predominantly found in females, whereas Tsuchihashi’s Type III prevailed in males. Tongue shapes revealed a predominance of pentagonal shapes in males and ovoid shapes in females. The lingual apex was blunt in males and sharp in females. Mandibular canine width was higher in males than females on both the left and right sides. Conclusion: The findings of this study support the use of lip prints, tongue prints and canine width in determining gender as ancillary and supporting methods.

Using precision periodontal health care chart (PPHCC) to improve periodontal health.

Developing a Precision Periodontal Health Care Chart (PPHCC) in the electronic dental record (EDR) system and evaluating its clinical usability and effects on clinical outcomes. A survey with ten questions based on the System Usability Scale (SUS) and six questions about assessing clinical impact was used to evaluate the satisfaction of periodontitis patients and care providers with PPHCC before and after non-surgical periodontal therapy (NSPT). The clinical outcomes, including probing depth (PD), interdental clinical attachment loss (CAL), and bleeding on probing (BOP), in patients who used PPHCC (PC) were compared to those in patients without using PPHCC (control). The associations between risk assessments included in PPHCC and clinical outcomes of NSPT were also analyzed. The mean scores of SUS questions at the initial periodontal examination were 74.26 ± 18.89 (n = 37) for patients and 88.31 ± 14.14 (n = 37) for care providers. The mean scores of SUS questions at re-evaluation were 74.84 ± 17.78 (n = 16) for patients and 89.63 ± 13.48 (n = 20) for care providers. The changes in the percentages of teeth with interdental CAL 1-2mm (p = 0.019) and CAL 3-4mm (p = 0.026) at the re-evaluation visit were significantly different between the PC and control groups, but the other parameters were not. Both patients and care providers were satisfied with using PPHCC in the clinic. However, the short-term clinical outcomes in the PC group were similar to those in the control group. PPHCC, as a tool for delivering clinical and educational information, can motivate patients to control periodontitis and assist clinicians in making a personalized treatment plan.

Analysis of non-metric dental traits for ethnicity identification in a mixed population of Uttar Pradesh

BackgroundForensic odontology involves the identification of individuals through dental records, making it a crucial tool in legal investigations. Non-metric dental traits (NMDT), which are variations in dental morphology play a key role as these traits are inherited characteristics that can help establish biological relationships or ancestry. Thus, we aim to assess the frequency and variability of NMDT in the human dentition of four ethnically mixed populations in Uttar Pradesh. This study can aid in the future by maintaining records of ethnic groups and their variability, which can be crucial for disaster victim management and forensic odontology. MethodsThe study was conducted on a total of 100 patients coming to the OPD of Oral Medicine and Oral Pathology and Microbiology of King George's Medical University from January 2022 to July 2023. Impressions of both arches were made for participants using irreversible hydrocolloid (alginate), and casts were examined under a stereomicroscope to assess 15 different morphological characteristics. ResultsNMDTs such as winging, shoveling, double-shoveling interruption groove, canine mesial ridge, hypocone, metacone, carabelli's trait, peg-shaped incisors, peg-shaped molar, premolar lingual cusp variation, deflecting wrinkle, protostylid, metaconulid, entoconulid was evaluated. The NMDTS were evaluated in four different ethnics Nordics, Mediterranean, Oriental Mediterranean, and Protoaustraloid amongst which various traits showed a statistically significant variation among the population of Uttar Pradesh. ConclusionThe sample studied presented confirmed supernumerary traits like metacone, protostylid, carabellis trait, metaconulid, premolar lingual cusp variation, and deflecting wrinkle were seen highest in Nordic, Mediterranean, Oriental Mediterranean, and Protoaustraloid ethnicity have a significant association with the Uttar Pradesh population.

Clinical Implications of Dental Injury Analysis in Forensic Odontology: A Review Article

Clinical Implications of Dental Injury Analysis in Forensic Odontology: A Review Article

Integrating Digital Imaging and AI in Forensic Odontology: Enhancing Identification Accuracy and Efficiency

Background: The integration of digital imaging and artificial intelligence (AI) in forensic odontology can significantly enhance the accuracy and efficiency of dental identification processes. These technologies provide precise and rapid analysis, which is crucial for forensic investigations. However, implementing such technologies also introduces new ethical challenges that must be addressed. Purpose: To explore the synergistic use of digital imaging and artificial intelligence (AI) in forensic odontology. This section focuses on how these technologies improve identification accuracy and efficiency while discussing the ethical considerations that arise from their implementation. Methodology: This methodology involves a comprehensive review of the existing literature on the applications of digital imaging and AI in forensic odontology. Key studies, clinical trials, and case examples are analyzed to evaluate the effectiveness of these technologies in improving forensic outcomes. The review assesses these technologies’ impact on identification accuracy and efficiency while addressing ethical concerns such as data privacy and AI biases Results: The review highlights that the combination of digital imaging and AI significantly enhances the accuracy and speed of dental identification. Advanced algorithms can process large datasets and identify subtle patterns that are often missed by human examiners, resulting in more reliable forensic outcomes. However, ethical challenges, including data privacy concerns and potential biases in AI algorithms, are critical areas that require careful consideration and regulation. Ongoing research and policy development are essential to address these issues and ensure the ethical application of AI in forensic odontology.

Dental damage: Creating 3D anatomical models to illustrate destructive effects on human teeth

Forensic odontologists often must identify human remains with damaged teeth. This damage is due to high-impact accidents, violence, or disasters. This 2-part study aimed to create two 3D digital models. They should show the destructive effects of physical and chemical agents on human teeth and popular dental materials. Researchers created an e-survey to investigate how digital models are perceived as an educational tool for Forensic Odontology. Also, a systematic review assessed experimental studies on the effects of high temperature on various prosthodontic materials. According to the results of the survey, most participants (n=69; 79%) agreed that they would find a 3D model useful for training. Participants misidentify images of burned and broken teeth under Ellis and Davey system (1970). The systematic review identified dental implant and dental crown as the most studied prosthodontic materials exposed to heat. The researchers designed dental damage model 1 to represent restored and unrestored burnt teeth, postmortem pink teeth, and traumatic injuries. The dental damage model 2 was created to demonstrate the effects of various types of damage to different prosthetic and restorative dental materials, as well as the impact of acid, water, and burial on restorative materials as additional information. Both models were edited, sculpted and painted using 3D modelling software ZBrush (2020. 1.4) and Blender (version 3.6.2). The dental damage models were uploaded and labelled on Sketchfab (Cédric Pinson, Paris, France). The study's materials could transform the teaching of complex tooth changes.

Forensic Odontology related awareness, knowledge and attitude among dentist and dental students in two Egyptian Universities: A survey-based study.

This study evaluated the awareness, knowledge, and attitude regarding forensic odontology (FO) among dental students and graduates at Beni-Suef University and Badr University in Cairo, Egypt. This cross-sectional study included 316 dentists and dental students in their final year of undergraduate study. An online self-administered questionnaire in English was used to obtain participants' responses. Less than half of the participants (47.5%) were aware of the branch of dentistry named FO. The highest percentages of correct answers in the knowledge assessment were reported in dental age estimation questions, while the lowest percentages were in items related to the use of FO in confirming sexual abuse and using palatal rugae as a marker in forensic identification. The most common source of knowledge was the internet (52.0%). Only 11.1% of the participants received FO courses in their colleges. Studying FO as a postgraduate course was interesting to 67.4% of the participants. The knowledge score was significantly associated with the participants' gender, graduation status, and educational level. This study revealed a lack of awareness of FO as a branch of dentistry among dental students and dentists in Egypt. Increasing awareness and knowledge of FO could be achieved by integrating FO into the dental curriculum at both undergraduate and postgraduate levels.

A scoping review of websites for forensic odontology training programs.

Forensic Odontology developed as a discipline in 1898 with the publication of its first textbook; however, 126 years later, a standardised core curriculum for formal training in Forensic Odontology has yet to be decided. This website scoping review aims to provide information on three main distinct categories (and 17 subcategories): Availability, Content, and Quality of Forensic Odontology education globally. The information on formal education programmes was gathered by conducting a web search using 'Google Search' in English, Arabic, Spanish, and French languages between June and July 2022. Fifty-six programmes from 18 countries met the inclusion criteria. Of the 14 master's and 42 diploma programmes, only 7.14% provided information on their websites from all the subcategories investigated. The highest numbers of master's and postgraduate diploma programmes were identified in Europe (18 programmes), South America (15), North America (11) and Asia (7). A practical aspect was included by 10 master's and 12 diploma programmes' websites. Research integration in various forms was included by 11 master's and seven diploma programmes. Programme providers and applicants must critically consider the quality of the programme being designed or applied to as there are currently no international training standards in Forensic Odontology. This study has developed an 'International Database of Forensic Odontology Programmes' (IDFOP).

Virtual dental autopsy: undertaking forensic dental identification remotely using an intra-oral video camera.

The aim of this study was to evaluate whether a forensic odontologist working remotely could accurately undertake forensic dental identifications using videos produced by non-dental forensic staff operating an intra-oral video camera (IOVC). The study's aims were to assess the accuracy and time taken to perform remote forensic dental identifications in this manner. Eight cadavers from the Centre for Anatomy and Human Identification (CAHID), University of Dundee, UK, were examined by a forensic odontologist via a traditional dental examination. Their dental condition was recorded to serve as ante-mortem records for this study. Videos of each dentition were produced using an IOVC operated by a medical student. Post-mortem records were produced for each dentition from the videos by a remote second forensic odontologist who was not present at the traditional dental examination. The ante-mortem and post-mortem records were then compared, and identification was classified as positively established, possible or excluded. Established identifications were positively made in all eight cases although there were some non-critical inconsistencies between ante-mortem and post-mortem records. Before the second opinion, 85.6% of the teeth per study subject were charted consistently. After the second opinion, the percentage of consistency increased to 97.2%. Each video on average was about 4.13 minutes in duration and the average time taken to interpret and chart the post-mortem dental examination at the first attempt was 11.63 minutes. The time taken to chart from the videos was greater than is typical of a traditional dental examination. This pilot study supports the feasibility of undertaking remote dental identification. This novel "tele-dental virtopsy" approach could be a viable alternative to a traditional post-mortem dental examination, in situations where access to forensic dental services is difficult or limited due to geographical, logistical, safety, and/or political reasons.