Inês Morais Caldas

The consequences of orofacial trauma resulting from violence: a study in Porto

Orofacial injuries resulting from violence are a fairly common event. In Portugal, however, the impact of these injuries remains to be elucidated. This study aims to analyze the injuries and permanent consequences of orofacial trauma (in a three-dimensional perspective: organic, functional and situational), resulting from violence. To do so, a retrospective analysis of all violence-related forensic reports performed in the North Branch of the National Institute of Legal Medicine, during 2007, was carried out (n = 513). It was found that most victims were men with a mean age of 35.4 (SD = 15.1). Most aggressions were due to punches and/or kicks. The most frequent orofacial injuries were lip injuries (57.7%), followed by extra-oral soft tissue injuries (35.9%), gingival and oral mucosa injuries (29.2%), and teeth and/or periodontal injuries (17.5%). The most frequent long-term consequences concerned the teeth and periodontal area (14.0%), followed by the lip area (7.4%), and gingival and oral mucosa tissues (3.9%). In terms of the effect on functions and life situations, it was found that chewing and embarrassment in social life events were the most prevalent (43.6% and 83.6%, respectively). These results showed that orofacial trauma from violence-related events can damage a persons quality of life, especially those concerning the teeth area, as a result of their implications in normal function and in life situations.

Morphologic Patterns of Lip Prints in a Portuguese Population: A Preliminary Analysis

Abstract:  Lip prints are thought to have the ability to distinguish individuals and, hence, have a potential use in human identification purposes. However, questions remain regarding their utility for sex determination. This study aimed to classify lip prints for different individuals in a Portuguese population and to determine whether sex differences exist. Lip prints of 25 females and 25 males were obtained using dark‐colored lipstick and cellophane tape. Lip prints were analyzed using a magnifying lens and classified according to the Suzuki and Tsuchihashi classification. A Type II pattern was found to be most common. A comparison of lip‐print patterns between males and females showed results with a statistically significant difference: Type III pattern was most common in males, and a Type II pattern in females. This study corroborates the hypothesis that lip prints are able to distinguish individuals and may be useful in sex determination.

Oral injuries in victims involving intimate partner violence

INTRODUCTION Current literature states that dental medicine can have an important role in diagnosing situations of domestic violence, namely cases of intimate partner violence, since many of the injuries that occur in this context concern the head and neck areas. The aim of this study was to characterize oral injuries in these cases in a Portuguese population, and to determine the kind of permanent consequences that they might represent. MATERIAL AND METHODS 332 forensic reports of domestic violence survivors were analysed. The reports concerned examinations performed in the North Branch of the National Institute of Legal Medicine of Portugal in 2007. Reports were assessed in order to obtain data regarding victim and offender demographic characteristics, and to characterize the nature and number of sustained injuries and their permanent consequences. MAIN RESULTS Most victims were females with a mean age of 33.7 years; the most frequent offender was the spouse; the majority of oral injuries affected soft tissues; permanent body consequences were found mainly in the teeth and periodontal tissues; permanent functional consequences were described as chewing difficulties, feeling pain or soft tissue mobility changes; permanent consequences for life activities referred mostly to social life aspects. CONCLUSIONS Oral injuries and their consequences were observed in 13.4% of intimate partner violence cases, and though being suggestive of this kind of violence, oral injuries alone are insufficient to identify this kind of abuse, and additional diagnostic criteria and evidence should be used.

Palatal rugae pattern in a Portuguese population: a preliminary analysis.

Abstract:  Palatal rugae have been related with specific racial groups and are said to be useful in sex discrimination. This work aimed to characterize the palatal rugae patterns in a Portuguese population. Fifty plaster casts were examined for first and third rugae shape evaluation; shape, frequency, and association with sex were studied. In females, the most prevalent first rugae were the straight type on the right and the curve type on the left; in males, the straight type was the most prevalent on both sides. The most frequent third rugae type was sinuous on both sides, in both sexes. No significant sexual dimorphism in rugae shape was found (p > 0.05). When comparing these results with those from other investigations, it was clear that a particular rugae pattern could be established for different ethnic groups. However, the small sample size justifies further work in larger samples to validate these findings.

Examining the socioeconomic effects on third molar maturation in a Portuguese sample of children, adolescents and young adults

IntroductionThe impact of socioeconomic status (SES) on tooth mineralization has seldom been evaluated. This is important because SES can be used as a proxy for quantifying factors in the environmental that can impact mineralization but that can be difficult to measure directly, such as nutrition.ObjectiveThe objective of this study was to examine the effects of SES on third molar mineralization, using a sample of children, adolescents and young adults from Porto, Portugal.MethodsPanoramic x-rays from 1747 patients (842 males and 904 females) were used in this study. Eight hundred and fifteen individuals were patients attending a private practice and were classified as high SES (384 males and 458 females), whereas the remaining 932 subjects (458 males and 474 females) were patients attending the dental clinic at the Faculty of Dental Medicine, University of Porto and were classified as low SES. Inclusion of individuals on the each SES group was also based on parental and own occupation. The mandibular third molar was assessed for its maturation using Demirjian’s stages. The median age of attainment of root stages was calculated for stages D to H, using logistic regression and compared between the high and low SES samples.ResultsBoys from the higher SES group show an earlier median age of attainment for stages D, E, and F. Girls from the higher SES group also show an earlier median age of attainment, but for stages D and E. Stages G and H did not show SES differences in both sexes.ConclusionsPatients from the higher SES group showed a consistent advancement in maturation of the third molar, although SES differences diminish and eventually disappear in the last stages of root maturation. An accelerated effect related to overweight and obesity is suggested as the primary explanation.

A new approach to sex estimation using the mandibular canine index

Rao et al.s mandibular canine index (MCI) is a simple odontometric method which uses the mandibular canine as the key to sex estimation. This index is defined as the ratio between the right canine mesiodistal dimension and the mandibular canine arch width. The aim of this study was to contribute to sex estimation using dental techniques by analysing the MCI efficiency, and to propose a new approach for its use. Measurements were taken from 120 plaster casts (70 females) in the 16–30 year age group. Although statistically significant sexual dimorphism was observed in both the mesiodistal dimension and the mandibular canine arch width, the MCI showed a low accuracy in sex classification (54.2% correct identifications). This accuracy was improved to 64.2% using receiver operating characteristics curve analysis. Yet, despite the better accuracy, these results reinforce the idea that the MCI may not be particularly useful in sex prediction, since it may not reflect the same degree of sexual dimorphism as its absolute measures.

Evolution and Analysis of Cultural and Cognitive Factors Related With Domestic Violence Against Women.

Despite the occurrence of encouraging political and social changes in the past few years, many beliefs about women’s role in intimate relationships persist, influencing their response to domestic violence (DV). This study aims to analyze the influence of recent policies against DV in Portugal, concerning particularly intimate partner violence against women and their perceptions about the victimization process. Two samples of women (n = 126 each) reporting an aggressive act allegedly perpetrated by the current or former male partner were interviewed with a hiatus of 5 years (before and after some most relevant policy updates). Results suggest a positive influence of the recent policies against DV. Many significant and encouraging changes were found in the more recent women sample (S2) relatively to the first sample (S1) regarding their information, awareness, perceptions, and attitudes toward DV. They seem to show less tolerance and endurance to DV, placing responsibility on the offender, as well as seem more empowered to report. In S2, there was a decrease in the acceptance of violent behaviors as normal and of reasons to explain violence; the fears, shame, and helplessness about DV; the elapsed time between the beginning of the abuse and its report; and the prevalence of more severe types of physical abuse. In S2, there was an increase on the acknowledgment of DV as a crime, the number of reports in cases without cohabitation, the report of psychological abuses, and the feeling of safety and assurance while reporting.

Study of palatal rugae pattern following orthodontic treatment

Several studies have demonstrated that palatal rugae, found on the hard palate, behave similarly to fingerprints. In fact, these structures can aid the human identification process particularly when other processes such as dental examination, dactiloscopy and forensic genetics, cannot be used. However, much remains to be explained regarding palatoscopy, and doubts persist about palatal rugae stability following dental treatment. Hence, this study evaluates the stability of palatal rugae pattern after orthodontic treatment. Forty-six casts (24 females and 22 males) were analysed and photographed using standardised techniques. Palatal rugae patterns were measured and assessed using the classification described by Basauri and Martins dos Santos. Data analyses were performed using the software Statistical Package for Social Sciences (SPSS), 22.0. Descriptive analyses were performed and differences between cases were assessed using the Wilcoxon and the chi-square tests at a 5% significance level. There was no morphological change in any rugae for both sexes. However, in females, the first right rugae had significant differences in size before and after the treatment (p = 0.039), suggesting that, in females, palatal rugae morphology is a better marker that palatal rugae length.

Human identification using dental techniques: A case report:

Dental identification of skeletal remains frequently relies on data comparison. Comparative dental identification is used to establish with a high degree of certainty that the remains of a corpse and a person represented by ante-mortem dental records are the same individual. There is no minimum number of concordant points necessary to perform a positive identification; rather, each case is unique and should be treated as such. In this paper, we present a report of a case in which positive identification was made by a paramolar tubercle in both upper first deciduous molars.

Forensic age estimation using the eruption of the second permanent mandibular molar: determining age over 14 years-old

Little is known about the role of the second molar eruption in forensic age estimation; however, in countries where the legal age is 14-years-old, it can provide important information. This study aims to analyse whether the eruption stages of the second mandibular molar can be used for forensic age estimation purposes. The eruption stage of the second left mandibular molar was assessed and correlation between age and stage of eruption was evaluated using Spearman rank order correlation. A Chi-square test was used to assess the correlation between age equal or superior to 14 and stage C or D attainment. The level of significance was defined as p<0.05. Stage C and D attainment and age 14 were significantly related in both sexes (p<0.001). Still, stage 3 was attained by 37% and 44.4% of the males and females younger than 14 years, respectively; stage 4 was attained by 14.8% and 25.6% of the males and females younger than 14 years, respectively. Second molar emergence, particularly stage D, can be used as a dental age indicator. When stage D is attained, particularly in males, there is strong suggestion of age over 14 years. However, other markers should also be used.