Rodolfo Francisco Haltenhoff Melani

Human identification through frontal sinus 3D superimposition: Pilot study with Cone Beam Computer Tomography.

As a unique anatomical feature of the human body, the frontal sinus morphology has been used for identification of unknown bodies with many techniques, mostly using 2D postero-anterior X-rays. With the increase of the use of Cone-Beam Computer Tomography (CBCT), the availability of this exam as ante-mortem records should be considered. The purpose of this study is to establish a new technique for frontal sinus identification through direct superimposition of 3D volumetric models obtained from CBCT exam, by testing two distinct situations. First, a reproducibility test, where two observers independently rendered models of frontal sinus from a sample 20 CBCT exams and identified them on each others list. In the second situation, one observer tested the protocol and established on different exams of three individual. Using the open source DICOM viewer InVesallius(®) for rendering, Mesh Lab(®,) for positioning the models and CloudCompare for volumetric comparison, both observers matched cases with 100% accuracy and the level of coincidence in a identification situation. The uniqueness of the frontal sinus topography is remarkable and through the described technique, can be used in forensic as an identification method whenever both the sinus structure and antemortem computer tomography is available.

Responsabilidade civil do cirurgião-dentista: a importância do assistente técnico

INTRODUCTION: The dentists liability can be understood as the criminal, civil, ethical and administrative obligation that they have in their professional exercise. Thus, when producing a harmful result to the patient, due to imprudence, ineptitude or recklessness, the dentists will be liable to the foreseen penalties on the Civil Code, where the compensation will be obligatory to satisfy the damage according to the reached consequence. In these types of processes, the involved parts will be able to contract a technical assistant to supply the respective lawyers about biological, technician and professional knowledge. AIM: This paper aim to report about the technical assistants importance, in the performance of each one of the involved parts in a civil process. CONCLUSION: It is necessary a major knowledge, by dentists, about legal and ethical aspects in the professional activity.

Uso da Classificação Internacional de Doenças na análise do absenteísmo odontológico

OBJETIVO: Comparar o uso das codificacoes da classificacao de doencas e agravos em solicitacoes de afastamento do trabalho por motivo odontologico. METODOS: Foram analisadas 240 solicitacoes emitidas em um servico publico federal entre janeiro de 2008 e dezembro de 2009. O uso da Classificacao Estatistica Internacional de Doencas e Problemas Relacionados a Saude - Decima Revisao (CID-10) foi comparado ao sistema de Classificacao Internacional de Doencas em Odontologia e Estomatologia (CID-OE). Foi determinada a especificidade da codificacao nas solicitacoes de afastamento, bem como da codificacao atribuida por peritos oficiais em inspecoes indiretas, pericias e juntas odontologicas. RESULTADOS: Do total de atestados, 22,9% nao apresentaram a CID, 7,1% apresentaram a CID-9, 3,3% a CID-OE e 66,7% a CID-10. A maioria das codificacoes foi concordante (55,1%), com maior especificidade nas codificacoes atribuidas apos avaliacao dos cirurgioes-dentistas peritos oficiais. CONCLUSOES: E necessario aperfeicoar a utilizacao da CID-10 entre os profissionais de Odontologia e pericia odontologica no trabalho. Sugere-se a incorporacao do uso da CID-OE e da Classificacao Internacional de Funcionamento, Incapacidade e Saude para a analise dos afastamentos do trabalho, fornecendo dados relevantes para o monitoramento do absenteismo por motivo odontologico.OBJECTIVE To compare the use of disease and injury classification codes in workplace absences requests due to dental causes. METHODS The study analyzed 240 requests in a federal public agency between January 2008 and December 2009. The use of the International Classification of Diseases - 10th Revision (ICD-10) was compared to the Application of the International Classification of Diseases to Dentistry and Stomatology (ICD-DA). The degree of specificity was determined for the codifications on workplace justifications, as well as for codifications assigned by official dental experts in indirect inspections and expert examinations. RESULTS Of the total number of dental certificates, 22.9% did not present the ICD, 7.1% used ICD-9, 3.3% used ICD-DA and 66.7% used ICD-10. The majority of codifications were concordant (55.1%), and greater specificity was found in codifications assigned after evaluation by official dental experts. CONCLUSIONS The results indicate the need to improve use of ICD-10 among dentists and official dental experts .For analysis of work absenteeism, it is suggested the use of ICD-DA and the International Classification of Functioning, Disability and Health, which provide relevant data for monitoring absenteeism due to dental reasons.

Forensic facial reconstruction: Nasal projection in Brazilian adults

The nose has a marked cognitive influence on facial image; however, it loses its shape during cadaveric decomposition. The known methods of estimating nasal projection using Facial Reconstruction are lacking in practicality and reproducibility. We attempted to relate the points Rhinion, Pronasale and Prosthion by studying the angle formed by straight lines that connect them. Two examiners measured this angle with the help of analysis and image-processing software, Image J, directly from cephalometric radiographs. The sample consisted of 300 males, aged between 24 and 77 years, and 300 females, aged 24 to 69 years. The proposed angle ranged from 80° to 100° in both sexes and all ages. It was considered possible to use a 90° angle from projections of the Rhinion and Prosthion points in order to determine the Pronasale position, as well as to estimate the nasal projection of Brazilian adults.

An unusual method of forensic human identification: use of selfie photographs

As with other methods of identification, in forensic odontology, antemortem data are compared with postmortem findings. In the absence of dental documentation, photographs of the smile play an important role in this comparison. As yet, there are no reports of the use of the selfie photograph for identification purposes. Owing to advancements in technology, electronic devices, and social networks, this type of photograph has become increasingly common. This paper describes a case in which selfie photographs were used to identify a carbonized body, by using the smile line and image superimposition. This low-cost, rapid, and easy to analyze technique provides highly reliable results. Nevertheless, there are disadvantages, such as the limited number of teeth that are visible in a photograph, low image quality, possibility of morphological changes in the teeth after the antemortem image was taken, and difficulty of making comparisons depending on the orientation of the photo. In forensic odontology, new methods of identification must be sought to accompany technological evolution, particularly when no traditional methods of comparison, such as clinical record charts or radiographs, are available.

Dry skull positioning device for extra-oral radiology and cone-beam CT

Extra-oral radiographs of dry skulls on scientific or forensic context have head position as a critical procedure. The aims of this article are to present a multi-purposed head-positioning device, and to describe the new method of image acquirement using the device to adequately keep the head in a correct and safe position during radiological or tomographic exam. The design was created from an average-sized skull and then tested in 20 others with different morphologies, sizes, weights, and structural state of preservation. A series of digital and analog orthopantomographies followed by a cone-beam computer tomography were obtained to assure that the correct positioning standards and anatomical visualization were achievable. The developed device properly kept adult skulls in position for all extra-oral radiographic exams, providing to operators a secure and facilitated way to achieve the proper position standards. The device did not impair the visualization of the anatomical structures neither on radiographs nor in cone-beam computer tomography.

Photoanthropometric face iridial proportions for age estimation: An investigation using features selected via a joint mutual information criterion

Age assessment from images is of high interest in the forensic community because of the necessity to establish formal protocols to identify child pornography, child missing and abuses where visual evidences are the mostly admissible. Recently, photoanthropometric methods have been found useful for age estimation correlating facial proportions in image databases with samples of some age groups. Notwithstanding the advances, newer facial features and further analysis are needed to improve accuracy and establish larger applicability. In this investigation, frontal images of 1000 individuals (500 females, 500 males), equally distributed in five age groups (6, 10, 14, 18, 22 years old) were used in a 10 fold cross-validated experiment for three age thresholds classifications (<10, <14, <18 years old). A set of novel 40 features, based on a relation between landmark distances and the iris diameter, is proposed and joint mutual information is used to select the most relevant and complementary features for the classification task. In a civil image identification database with diverse ancestry, receiver operating characteristic (ROC) curves were plotted to verify accuracy, and the resultant AUCs achieved 0.971, 0.969, and 0.903 for the age classifications (<10, <14, <18 years old), respectively. These results add support to continuing research in age assessment from images using the metric approach. Still, larger samples are necessary to evaluate reliability in extensive conditions.

Use of an Alternate Light Source to Detect Tooth and Bone

The aim of this study was to identify the combination of wavelength and filter that best detects tooth and bone, and to determine which biological materials (enamel, dental root or bone) have highest fluorescence intensity when exposed to an alternate light source (ALS). Tooth and bone samples were lighted with ALS and photographed. Adobe Photoshop™ and ImageJ™ softwares were used for image analysis. Data obtained by measuring the photograph pixels were subjected to analysis of variance. The mean values of significant effects were compared by the Tukey test. In all tests, the significance level was set at p≤0.05 and the values calculated by the SAS system. The results showed that the best combination for detecting tooth and bone is an illumination wavelength of 455 nm with an orange filter. The fluorescence of dental root is greater than that of enamel, which in turn is greater than that of bone. The biological material had markedly higher fluorescence than the inert material. This knowledge can help the forensic expert to screen and detect biological materials, for example in situations where there are fragmented teeth and small bones, both at the scene and in the laboratory.

Practical Application of Anatomy of the Oral Cavity in Forensic Facial Reconstruction.

The oral cavity’s importance in defining the facial region makes it a primary feature for forensic facial reconstruction (FFR). The aim of this study is to construct a pattern of reference for dimensions and proportions of the lips and establish parameters that may help estimate the vermilion borders’ height dimensions and the mouth’s width. By means of cone beam computed tomography, divided into two samples: sample 1 (n = 322; 137 male, 185 female) verified the linear distances delimited by anatomical landmarks in soft tissue. The sample 2 (n = 108; 40 male, 68 female), verified the proportions among the height of the vermilion borders, width of the mouth, and linear distances between craniometric landmarks in hard tissues, both from a Brazilian database. The measurements were completed using OsiriX, and the results were analyzed by means of descriptive statistics at a level of significance of 5%. The height of the vermilion borders corresponded to approximately 26% of the width of the mouth. The width of the mouth increased over the course of time in men and remained stable in women. In men, a mean intercanine distance of 75% of the total mouth’s width was found; for women, it was 80%. The parameters of the relations between soft and hard tissues in the oral cavity region presented that the distance between landmarks ID-SM (Infradentale-Supramentale) corresponded to 55% of the height of the vermilion borders of the mouth for both sexes, while the distance between landmarks PM-SD (Philtrum medium-Supradentale) corresponded to 85% in men and 88% in women. Mean values of 97% of the width of the mouth in women and 93% in men were attributed to the distance between the mentonian foramina. It was not possible to estimate the height of the labial vermilion borders by the bone measurements, FIs-Fli (Foramen incisivus superius-inferius) and NS-GN (Nasospinale-Gnathion). Profound knowledge of the anatomy and morphology of the oral cavity may contribute to increasing the precision of FFRs and help with human identification.

Forensic facial approximation assessment: can application of different average facial tissue depth data facilitate recognition and establish acceptable level of resemblance?

Facial soft tissue thicknesses (FSTT) are important guidelines for modeling faces from skull. Amid so many FSTT data, Forensic artists have to make a subjective choice of a dataset that best meets their needs. This study investigated the performance of four FSTT datasets in the recognition and resemblance of Brazilian living individuals and the performance of assessors in recognizing people, according to sex and knowledge on Human Anatomy and Forensic Dentistry. Sixteen manual facial approximations (FAs) were constructed using three-dimensional (3D) prototypes of skulls (targets). The American method was chosen for the construction of the faces. One hundred and twenty participants evaluated all FAs by means of recognition and resemblance tests. This study showed higher proportions of recognition by FAs conducted with FSTT data from cadavers compared with those conducted with medical imaging data. Targets were also considered more similar to FAs conducted with FSTT data from cadavers. Nose and face shape, respectively, were considered the most similar regions to targets. The sex of assessors (male and female) and the knowledge on Human Anatomy and Forensic Dentistry did not play a determinant role to reach greater recognition rates. It was possible to conclude that FSTT data obtained from imaging may not facilitate recognition and establish acceptable level of resemblance. Grouping FSTT data by regions of the face, as proposed in this paper, may contribute to more accurate FAs.