Helena Ranta

Reliability and Validity of Eight Dental Age Estimation Methods for Adults

This paper evaluates the reliability and validity of eight published dental age estimation methods for adults that may aid in victim identification. Age was calculated on 20 Caucasian teeth of known age according to the methods of Kvaal (for in situ and extracted teeth), Solheim (for in situ and sectioned teeth), Lamendin (for extracted teeth), Johanson (for sectioned teeth) and Bang (for extracted and sectioned teeth) by one independent observer. For each method, mean age error and standard error were assessed as the measures of accuracy and precision. In addition, method simplicity, requirements for tooth preparation and the equipment necessary were assessed and recommendations given for forensic use in various situations. Methods for sectioned teeth gave more reliable results when compared to methods for intact teeth.

Facultative gram-negative enteric rods in persistent periapical infections.

A bacteriological investigation has been made in two cases of persistent periapical infections. Neither of the two infections responded to root canal therapy including penicillin or penicillin and erythromycin. Samples were taken aseptically for bacteriological examination through and root canals. Chloroform-washed, sterile paper points were used for sampling. Cultivation was performed immediately at chairside on Kanamycin-Vancomycin laked blood agar (KVLB) and blood agar supplemented with menadione, cysteine and glucose for anaerobic incubation and chocolate agar for aerobic incubation. Enterobacter cloacae was only isolate in case 1; Klebsiella pneumoniae and enterococci were found in case 2. Obligately anaerobic bacteria were not found. The treatment was successful after antibiotic therapy based on susceptibility testing of the isolates. The route of infection by facultative enteric rods is discussed.

Identification of victims from the M/S Estonia

Abstract With 852 victims from 17 different countries, the sinking of the Estonia was Europe’s most severe passenger ferry disaster. The Finnish Disaster Victim Identification (DVI) team identified all 93 victims recovered from the sea within 33 days of the accident as well as victim number 94 found 18 months later. Dental identification was established in 57 cases (60%).

Isolation and characterization of undersulphated chondroitin-4-sulphate from normal human plasma

The present study was undertaken in order to characterize further the glycosaminoglycans of normal human plasma. Coagulation factor IX concentrate prepared from undiluted plasma by DEAE-Sephadex chromatography was used as the starting material. The concentrate was subjected to proteolytic treatment with papain and pronase, deproteinised with trichloroacetic acid, dialysed and passed through an AG 1 X 2 anion-exchange column. Glycosaminoglycans were eluted stepwise from the column with NaC1. The sole glycosaminoglycan obtained was an undersulphated chondroitin-4-sulphate which was identified by chemical analyses, digestibility with testicular hyaluronidase, electrophoretic behaviour and infrared spectrum. Gel-exclusion chromatography indicated a molecular weight of 17 000 for the compound. The undersulphated chondroitin-4-sulphate was calculated to represent at least 80% of the macromolecular glycosaminoglycans present in normal human plasma and to occur in a concentration of approx. 3 mg hexuronate per 1 of plasma.

Forensic osteological investigations in Kosovo

A team of Finnish forensic experts performed investigations of alleged mass graves in Kosovo under the mandate of the European Union (EU). Human skeletal remains from two locations were examined. The remains contained three almost complete skeletons, and individual bones and bone fragments, part of which were burned. Injuries, pathological changes, and findings for identification purposes were examined and documented using standard methods of forensic pathology and osteology. Gunshot injuries were found in some cases, but reliable determination of the cause and manner of death was not possible. A discrepancy arose between the number of victims reported in information received from the presiding district court, and results of the investigations. The estimation of the minimum number of victims was mostly acquired by DNA analysis.

Timing of developmental stages in permanent mandibular teeth of Finns from birth to age 25.

Objective. The aim was to provide radiographic data on postnatal development of the 8 mandibular teeth to serve as reference norms in clinical dentistry, forensic dentistry, anthropology, and research. Material and Methods. Developmental stages of teeth were assessed from a total of 2795 radiographs, mostly panoramic, of 1970 Finns (966 M and 1004 F) from birth to age 25. The grading was based on Demirjians 8 mineralization stages and the crypt stage. Results. Timing of development in individual mandibular teeth is presented in two ways: as age at attainment of each developmental stage and as age of subjects in a developmental stage. Initiation of mineralization was visible in 1st molars at 0.20 years, in central incisors at 0.22 years, lateral incisors at 0.37 years, and canines at 0.56 years of age. Timing was usually earlier in girls than in boys. Differences were greatest in canines, where females were advanced by 1.74 years at the closure of the apex. Root development in 3rd molars showed an opposite trend, where apical closure was 1.19 years earlier in men. In 3rd molars, age at apical closure in females was 21.50 years, among the highest reported. In general, the early developmental stages had the shortest duration and the last stages the longest. Conclusion. Timing of postnatal development of individual mandibular teeth in Finns resembled developmental schedules reported for other Caucasian population groups. Any differences were mostly small and inconsequential.OBJECTIVE The aim was to provide radiographic data on postnatal development of the 8 mandibular teeth to serve as reference norms in clinical dentistry, forensic dentistry, anthropology, and research. MATERIAL AND METHODS Developmental stages of teeth were assessed from a total of 2795 radiographs, mostly panoramic, of 1970 Finns (966 M and 1004 F) from birth to age 25. The grading was based on Demirjians 8 mineralization stages and the crypt stage. RESULTS Timing of development in individual mandibular teeth is presented in two ways: as age at attainment of each developmental stage and as age of subjects in a developmental stage. Initiation of mineralization was visible in 1st molars at 0.20 years, in central incisors at 0.22 years, lateral incisors at 0.37 years, and canines at 0.56 years of age. Timing was usually earlier in girls than in boys. Differences were greatest in canines, where females were advanced by 1.74 years at the closure of the apex. Root development in 3rd molars showed an opposite trend, where apical closure was 1.19 years earlier in men. In 3rd molars, age at apical closure in females was 21.50 years, among the highest reported. In general, the early developmental stages had the shortest duration and the last stages the longest. CONCLUSION Timing of postnatal development of individual mandibular teeth in Finns resembled developmental schedules reported for other Caucasian population groups. Any differences were mostly small and inconsequential.

Mitsuokella dentalis sp. nov. from Dental Root Canals

On the basis of phenetic and chemotaxonomic criteria a new nonmotile anaerobic gram-negative rod-shaped bacterium from dental root canals is described. The new species has characteristics in common with species of the genus Bacteroides, but there are also many differences. According to a detailed biochemical analysis the new species is closer to the genus Mitsuokella than to Bacteroides. We propose a new species, Mitsuokella dentalis. The type strain of M. dentalis is strain DSM 3688.

Radiology in forensic expert team operations

Radiological methods are widely used in forensic pathology. Their most common applications are in complementing human identification, particularly in investigations of mass disasters and decomposed bodies, and in searching for foreign material inside corpses. A team of Finnish forensic experts investigated human skeletal remains in Bosnia and Herzegovina (1996) and in Kosovo, the Federal Republic of Yugoslavia (1998). It also investigated more recently deceased victims in Kosovo (1999). In these investigations, the benefit of X-ray was in the detection of foreign material inside victims and their remains. For identification purposes, X-rays were mainly used to provide the best evidence possible of any pathological changes, physical characteristics, and injuries present.

Bacteriology of Odontogenic Apical Periodontitis and Effect of Penicillin Treatment

The microbiology and treatment of apical periodontitis was studied in 62 patients, followed-up for 1 year. The clinical treatment and the radiological technique were standardized. One third of the patients received no systemic antibiotics, one third received phenoxymethylpenicillin for 1 week, and one third for 3 months. On the average, 0-2 facultatively anaerobic and 4-6 anaerobic bacteria were isolated from periapical infections. The genera Bacteroides and Fusobacterium in addition to anaerobic gram-positive cocci were found most frequently. Minimum inhibitory concentrations of benzylpenicillin against 269 strains were tested. 12 strains were resistant at the concentration 2.4 micrograms/ml, including 4 strains of Fusobacterium sp. All patients were free of symptoms 1 month after the admission. Only 1 patient failed to show any progress in radiological healing. No differences between the groups in relation to penicillin therapy were found.

Prevalence and natural course of craniocervical junction anomalies during growth in patients with osteogenesis imperfecta.

Pathology in the craniocervical junction is a serious complication of osteogenesis imperfecta (OI). Our aim was to analyze the prevalence and natural course of craniocervical junction anomalies in patients with OI during growth. In a one‐center retrospective study, we analyzed lateral skull radiographs and midsagittal magnetic resonance images of 76 patients with either type I, III, or IV OI. The material included longitudinal series of 31 patients. In total, 150 patient images taken at ages 0 to 39 years were analyzed and compared with age‐matched control data. Craniocervical anomalies were observed in 37% of patients and in all OI types studied. Of the three types of anomalies, basilar invagination was seen in 13%, basilar impression in 15%, and platybasia in 29% of the patients. From those with an abnormal finding, 44% displayed more than one type of anomaly. At a group level, we found no evidence of progression of craniocervical junction pathology with age. We provide longitudinal and cross‐sectional data on craniocervical junction dimensions in growing patients with OI and, based on those, suggest a radiological management strategy for diagnosis of cranial base pathology. A higher risk of having any of the pathological conditions was associated with a lower height Z‐score. Careful follow‐up of cranial base anomalies particularly in subjects with OI and severe growth failure is warranted.