Felippe Bevilacqua Prado

The forensic importance of frontal sinus radiographs.

The identification of unidentified human remains through the comparison of antemortem and postmortem radiographs has found wide acceptance in recent years. Reported here is the forensic case of an unidentified adult male who had died as the result of a traffic accident, after which the body was identified by matching images of ante- and postmortem radiographs of the frontal sinus. A general discussion on identification using frontal sinus radiographs is presented, highlighting the reliability of this method, in reference to the uniqueness of the frontal sinus in humans. However, it also notes a few difficulties, especially in reference to the X-ray technique in cases where antemortem radiographs are available and a potentially larger number of anatomical, pathological or traumatic features are present. The comparison of frontal sinus outlines is recommended when it may become necessary to provide quantitative substantiation for forensic identification based on these structures.

Human identification based on cranial computed tomography scan — a case report

Today, there is increasing use of CT scanning on a clinical basis, aiding in the diagnosis of diseases or injuries. This exam also provides important information that allows identification of individuals. This paper reports the use of a CT scan on the skull, taken when the victim was alive, for the positive identification of a victim of a traffic accident in which the fingerprint analysis was impossible. The authors emphasize that the CT scan is a tool primarily used in clinical diagnosis and may contribute significantly to forensic purpose, allowing the exploration of virtual corpses before the classic autopsy. The use of CT scans might increase the quantity and quality of information involved in the death of the person examined.

Incidence of Retromolar Foramen in Human Mandibles: Ethnic and Clinical Aspects

SUMMARY: The retromolar foramen allows the passage of the neurovascular bundles that contribute to nutrition and innervation of the pulp and periodontium of the lower teeth. Knowledge of this anatomical variation may prevent complications in the anesthesia and surgical procedures in this area and serve as an anatomical landmark for ethnic identification. The aim of this study was to evaluate the impact of the retromolar foramen in human mandibles of adult Brazilians and discuss the clinical and ethnic related to the presence of this foramen. Were evaluated 222 human mandibles, dry, adults, Brazilians, independent of gender. The evaluation was performed by two examiners who standardized search from a previous anatomical study. The mandibles were analyzed: the presence of the retromolar foramen (bilateral or unilateral), the presence of the foramen on right and left sides, and the number of foramens present on each side. It was found that 59 had at least one mandible retromolar foramens resulting in an incidence of 26.58%. The retromolar foramen was present unilaterally in 41 mandibles and 18 bilaterally, with incidences of 18.47% and 12.16% respectively. On the right side, the retromolar foramen was present in incidences of 16.22% and 18.92% respectively. The analysis of the right side of the mandibles revealed that 47.46%, 21.21% and 3.03% had one, two and three foramens, respectively. The left side showed 55.93%, 16.22% and 8.11% of the 222 mandibles with one, two and three retromolar foramens, respectively. The incidence of retromolar foramen in the Brazilian population is significant and should be considered in the planning and execution of procedures in several areas of clinical practice dentistry in order to avoid complications. Moreover, it was found that the incidence of retromolar foramen contributes to differentiation of ethnic groups in the area of forensic anthropology. ˚

Morphological changes in the position of the mandibular foramen in dentate and edentate Brazilian subjects.

This study assessed the mandibular foramen (MF) position variability in dentate and edentate Brazilian mandibles. Eighty dentate and 79 edentate mandibles of unknown sex were measured bilaterally using a digital caliper (0.1‐mm precision). Horizontal linear measurements (HM) were done from the MF to the anterior border of the mandibular ramus (MF‐A) and from the MF to the posterior border of the mandibular ramus (MF‐B). Vertical linear measurements (VM) were done from the MF to the most inferior point of the mandibular notch (MF‐C) and from the MF to the inferior border of the mandibular ramus (MF‐D). Data were analyzed by two‐way ANOVA (alpha = 5%). The HM means and standard deviations (±SD) for MF‐A were, edentate right (ER): 17.5 (±3.2) mm, edentate left (EL): 17.4 (±3.4) mm, dentate right (DR): 19.2 (±3.6) mm, and dentate left (DL): 18.8 (±3.8) mm. The means (±SD) for the MF‐B measurements were, respectively, ER: 12.8 (±2.4) mm, EL: 12.9 (±2.3) mm, DR: 14.2 (±2.4) mm, and DL: 13.9 (±2.6) mm. The VM values for the MF‐C measurements were, ER: 23.4 (±3.8) mm, EL: 22.9 (±3.7) mm, DR: 23.6 (±3.1) mm, and DL: 23.1 (±3) mm, and for the MF‐D measurements, ER: 26.4 (±4.2) mm, EL: 26.4 (±4) mm, DR 28.3 (±3.9) mm, and DL 28 (±3.8) mm. Side had no influence (p>0.05) on any edentate or dentate mandible measurement. Dentate mandible measurements showed statistically significant differences compared to the edentate mandibles, except for MF‐C. The mandibular foramen position changes with loss of teeth and this variability may be responsible for occasional failure of inferior alveolar nerve block. Clin. Anat. 23:394–398, 2010.

Raloxifene enhances peri-implant bone healing in osteoporotic rats

The aim of this study was to evaluate bone healing at the bone-implant interface in rats with induced osteoporosis. The rats underwent a bilateral ovariectomy (OVX) and were fed a low calcium and phosphate diet. The OVX rats were divided into three groups: one was treated with raloxifene (OVX-RAL), one with alendronate (OVX-ALE), and one received no medication (OVX-NT). The control group rats (SHAM-DN) underwent sham surgery and were fed a normal diet. Each animal received one implant in each tibia: a machined surface implant in the right tibia and an implant with surface etching in the left tibia. All animals were euthanized after 42 days. Analysis of variance (ANOVA) and Tukey post hoc tests were applied to the biomechanics (reverse torque) and bone-implant contact (BIC) data (P<0.05). The RAL and ALE groups showed improved peri-implant bone healing. However, the ALE group showed no significant difference from the OVX-NT group. Surface treatment promoted higher corticalization at the bone-implant interface, but showed the same characteristics of mature bone and bone neoformation in concentric laminations as the machined implant. There were no statistically significant differences in reverse torque (P=0.861) or BIC (P=0.745) between the OVX-RAL and SHAM-DN groups. Therefore, the use of raloxifene resulted in good biomechanical, BIC, and histological findings in the treatment of induced osteoporosis in rats.

The mental foramen position in dentate and edentulous Brazilian's mandible

El foramen mental ha sido reportado variablemente en diferentes posiciones, segun los grupos etnicos. Repetidos errores durante el procedimiento anestesico, que involucran al foramen mental, sugieren la presencia de diferencias locales en una determinada poblacion. El objetivo del presente estudio fue determinar la posicion del foramen mental (MF) en una muestra de 170 mandibulas secas de la poblacion brasilena, siendo 79 desdentadas y 91 dentadas. La evaluacion fue hecha teniendo como referencia la base de la mandibula (BM) y la sinfisis mandibular (MS). La comparacion fue dada y llevada por generos, segun el lado de la mandibula (izquierdo o derecho) y la denticion (dentada o desdentada). El analisis estadistico fue realizado usando el test multifactorial ANOVA (alpha 5%). Mandibulas masculinas presentaron valores mayores que el grupo femenino y las mandibulas dentadas presentaron valores superiores, cuando fueron comparadas con las mandibulas desdentadas (p 0.05) entre los lados derecho e izquierdo, comparando mandibulas masculinas y femeninas. Se concluye que la posicion del foramen mental es principalmente alterada en sujetos desdentados, es considerada una estructura simetrica en la poblacion brasilera y mas comunmente localizado a lo largo del eje del segundo premolar.

Caroticoclinoid foramen in human skulls: incidence, morphometry and its clinical implications

The caroticoclinoid foramen is an inconstant structure, formed by the union of the anterior and middle clinoid processes. The aim of this study was to perform an incidence and morphometry of the caroticoclinoid foramen in Brazilian human skulls and discuss its clinical implications. Eighty dry human skulls with sex distinction were used, and 3 groups of incidence were determined: General, sex, and sides. The morphometry was performed using a manual caliper and the major diameter of the foramina was measured; the values were also divided in general, according to sex and sides. The incidence of skulls with at least one foramen was 8.5%. According to the sides, 8.5% of the skulls showed foramen on the right side and 2.5% on the left. We found 2.5% of the skulls with bilateral foramen and 6.25% with unilateral foramen. In relation to sex, the foramens were found in 5% of male skulls and 12.5% of female skulls. The major diameter of this structure presented on mean, values of 5.23 mm on general, 5.18 mm on the right side and 5.35 mm on the left, 5.30 mm in male skulls and 5.18 mm in female skulls. The anatomical characteristics of this foramen should be considered in view of its clinical implications associated with neurosurgery as clinoid process removal, and symptoms as headache due to internal carotid artery alterations in this region. In conclusion knowledge of this structure supports the diagnosis and treatment of clinical complications related to this variation.

Analysis of the fluorescence of body fluids on different surfaces and times.

The use of screening techniques, such as an alternative light source (ALS), is important for finding biological evidence at a crime scene. The objective of this study was to evaluate whether biological fluid (blood, semen, saliva, and urine) deposited on different surfaces changes as a function of the age of the sample. Stains were illuminated with a Megamaxx™ ALS System and photographed with a Canon EOS Utility™ camera. Adobe Photoshop™ was utilized to prepare photographs for analysis, and then ImageJ™ was used to record the brightness values of pixels in the images. Data were submitted to analysis of variance using a generalized linear mixed model with two fixed effects (surface and fluid). Time was treated as a random effect (through repeated measures) with a first-order autoregressive covariance structure. Means of significant effects were compared by the Tukey test. The fluorescence of the analyzed biological material varied depending on the age of the sample. Fluorescence was lower when the samples were moist. Fluorescence remained constant when the sample was dry, up to the maximum period analyzed (60 days), independent of the substrate on which the fluid was deposited, showing the novelty of this study. Therefore, the forensic expert can detect biological fluids at the crime scene using an ALS even several days after a crime has occurred.

Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians

Objectives: The aim of this study was to evaluate transversally the clinical correlation between lower incisor crowding and mandible third molar. Study Design: Three hundred healthy volunteers (134 male and 166 female), aged 20.4 (±2.4) years-old were submitted to a complete clinical examination and filled up a questionnaire about gender, age, total teeth number and presence or absence of superior and inferior third molar. After a recent panoramic radiography were evaluated. The multiple logistic regression showed that none of the studied factors influenced the mandibular incisor crowding. Results: The proportion of both molars present or both absent was higher than the other conditions (Chi-square, p<.0001). The multiple logistic regression showed that any of the studied factors, influenced (p>.05) the mandibular incisor crowding. Despite the statistical significance, wear orthodontics appliances showed a little correlation (odds ratios < 1.0) in the mandibular incisor crowding. Conclusion: Presence of maxillary and/or mandibular third molars has no relation with the lower incisor crowding. Key words:Malocclusion, third molars, lower incisor crowding, mandible.

Comparison of gunshot entrance morphologies caused by .40-caliber Smith & Wesson, .380-caliber, and 9-mm Luger bullets: a finite element analysis study.

Firearms can cause fatal wounds, which can be identified by traces on or around the body. However, there are cases where neither the bullet nor gun is found at the crime scene. Ballistic research involving finite element models can reproduce computational biomechanical conditions, without compromising bioethics, as they involve no direct tests on animals or humans. This study aims to compare the morphologies of gunshot entrance holes caused by.40-caliber Smith & Wesson (S&W), .380-caliber, and 9×19-mm Luger bullets. A fully metal-jacketed.40 S&W projectile, a fully metal-jacketed.380 projectile, and a fully metal-jacketed 9×19-mm Luger projectile were computationally fired at the glabellar region of the finite element model from a distance of 10 cm, at perpendicular incidence. The results show different morphologies in the entrance holes produced by the three bullets, using the same skull at the same shot distance. The results and traits of the entrance holes are discussed. Finite element models allow feasible computational ballistic research, which may be useful to forensic experts when comparing and analyzing data related to gunshot wounds in the forehead.