Rhonan Ferreira da Silva

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.

Utilização de documentação ortodôntica na identificação humana

Objective: This study describes a forensic case of incinerated remains that were identified using information found in his orthodontic records. Method: Incinerated remains of a man were found inside a car. After forensic crime scene investigation and postmortem and radiographic exams in the Forensic Department, forensic experts found that the victim had a fixed orthodontic appliance, supernumerary teeth in all quadrants, partially erupted third molars and amalgam restorations in some surfaces of several teeth. As the individual’s soft tissues were substantially destroyed, identification using fingerprints was not the ideal choice. After orthodontic records were handed in by the family, his clinical chart, radiographs, intra- and extraoral photographs and impressions were analyzed, and these data were compared with previously collected information. Results and Conclusions: Forensic dentistry examination revealed 20 concordant points in specimen examination and orthodontic records, which enabled the establishment of a positive correlation between the cadaver under examination and the missing person and eliminated the need for further analyses (DNA tests) to identify the victim.OBJECTIVE: This study describes a forensic case of incinerated remains of a man that were identified using information found in his orthodontic records. METHODS: Incinerated remains of a man were found inside a car. After forensic crime scene investigation and postmortem and radiographic exams in the Forensic Department, forensic experts found that the victim had a fixed orthodontic appliance, supernumerary teeth in all quadrants, partially erupted third molars and amalgam restorations in some surfaces of several teeth. As the individuals soft tissues were substantially destroyed, identification using fingerprints was not the ideal choice. After orthodontic records were handed in by the family, his clinical chart, radiographs, intra- and extraoral photographs and impressions were analyzed, and these data were compared with previously collected information. RESULTS AND CONCLUSIONS: Forensic dentistry examination revealed 20 concordant points in specimen examination and orthodontic records, which enabled the establishment of a positive correlation between the cadaver under examination and the missing person and eliminated the need for further analyses (DNA tests) to identify the victim.

Importance of frontal sinus radiographs for human identification

Humans beings can be identified through a series of methods, being fingerprints the most widely adopted when soft tissue is preserved. However, when the cadaver is carbonized or in skeletal form, forensic dental and anthropologic analysis may become necessary to identify the individual. Medical documentation (mainly xray images) may substantially improve the chances of identifying corpses initially deemed unrecognizable. This paper describes a forensic case in which human remains could be positively correlated to the identity of a missing person through analysis of images of the subject’s frontal sinus in skull posterior-anterior x-ray images.

Avaliação do perfil dos profissionais da área de Ortodontia quanto às condutas legais

OBJECTIVE: to evaluate the legal actions and behavior in the doctor/patient relationship, as used by Dental Surgeons practicing Orthodontics. METHODS: the population sample of the present study consisted of dental surgeons, active in the area of Orthodontics, and registered with Editora Dental Press - Maringa/PR, with a total sample size of 525 professionals. The research was conducted using a 17-question survey geared to these professionals. RESULTS AND CONCLUSIONS: the majority of participants in our study are specialized in Orthodontics; 75% of professionals use some sort of contract at the office/clinic; 73.7% of professionals periodically request maintenance x-rays; a large percentage of professionals (58.9%) keep patient records on file for life. The surveyed professionals demonstrate good knowledge of the Code of Ethics in Orthodontics, especially of Chapter XIV - on Communication.

Utilização de auxiliares odontológicos em Ortodontia: implicações éticas e legais

INTRODUCTION: the work market has been shown to be saturated with professionals working at large urban centers and, for this reason, productive strategies are indispensable. The delegation of functions to dental assistants is becoming vital and quite common for those that work with Orthodontics. AIM: to evaluate the profile of the orthodontists and the workload delegated by them to the dental assistant team. METHODS: a questionnaire was given to all specialists in Orthodontics and Dentofacial Orthopedics registered at the Regional Council of Dentistry of Goias, with practices in Goiânia and Aparecida de Goiânia. RESULTS AND CONCLUSIONS: the results demonstrated that orthodontists, in general, take advantage of the work labor of the dental assistants even surpassing the ethical-legal limits.

Human identification through the patella—Report of two cases

The human identification process is often performed by the comparison between acquired post-mortem (PM) fingerprints, dental patterns, or DNA sample with ante-mortem (AM) databases. However, in some special situations alternative sources of human identifiers reveal valuable part as forensic tools. In this context, medical records of surgical interventions and morphological bone traits are useful in the anthropological environment, specifically for the PM examination of skeletal remains. The present study reports two cases of positive human identifications by the comparative analysis between AM and PM radiographic medical records of surgically treated human patella. The present outcome highlights the importance of storing and updating medical records in order to aid human identification processes in special forensic situations.

Time of guard of orthodontic records versus legal time for their prescription.

INTRODUCTION After promulgation and wider dissemination of the Code of Consumer Protection (CCP), there was an increase in the number of legal conflicts between patients and dentists, leading these health professionals to increasingly guard themselves from possible lawsuits. As such, it becomes critical the preparation of an adequate and complete clinical record, even though the keeping time remains uncertain. OBJECTIVE To review the literature and discuss the keeping time of orthodontic records versus the legal time for their prescription, as well as to propose a model of a Term upon Completion of Dental Treatment. CONCLUSIONS It is advised to return part of the clinical records to their rightful owners by means of an itemized receipt. The Term upon Completion reflects the patients awareness and could be considered by the CCP as the initial term of the prescription time, because it implicates that the patient recognizes the quality of service provided and satisfactory results achieved.

Endoscopic removal of an endodontic file accidentally swallowed: clinical and legal approaches.

The use of a rubber dam is an essential procedure when treating root canals, and not using it may compromise the success of the treatment, as well as the patients health. This report presents a case in which a K-file was accidentally swallowed during an endodontic procedure, performed without the use of a rubber dam. Given the absence of immediate clinical complications, the subject underwent a chest radiograph. The file was located at the oesophagogastric junction and was later removed by endoscopy. In addition to the clinical repercussions, this example also illustrates the ethical-legal aspects of this type of accident.

Human identification through the analysis of smile photographs.

AbstractThe comparison between antemortem and portmortem data comprehends the basis of the dental identification process. High-tech devices allow for optimal manipulation of postmortem data. However, in especial situations, the victims do not have records of dental treatments, making necessary the search for antemortem data from personal belongings. Smile photographs are one of the most common sources of dental information detected from personal belongings. In this context, the present study reports a forensic case in which a charred body was positively identified through the application of 3 techniques for the analysis of smile photographs.

Accidental displacement of third molar into the sublingual space: a case report.

ABSTRACT Background Successful extraction of third molars depends on preoperative diagnosis and planning. Gold standard preoperative examinations are performed through computed tomography, decreasing risks and avoiding potential accidents. The present report highlights the value of preoperative examinations in face of accidentally displaced third molars. Methods An 18-years-old female patient underwent a third mandibular molar extraction with a general dentist. Accidentally, the mandibular left third molar was displaced into the sublingual space, making necessary a second surgical step. The surgery was interrupted and the patient was referred to an expert in maxillofacial surgery. Results After 21 days awaiting an asymptomatic health status, the second surgical step was successfully performed using multislice computed tomography as preoperative imaging guide. Conclusions The present case report highlights the clinical usefulness of imaging planning and informed consents in face of legal and ethic potential complaints.