Thiago Leite Beaini

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.

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.

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.

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.

Exposure Standards for Digital and Analogue Dry Skull Orthopantomography

Forensic or scientific practices may require producing orthopantomography of dry skulls, that lack soft tissue, therefore modifications on the usual technique should be necessary. With the objective of standardizing the postmortem digital and analogue panoramic radiography this research produced a single a digital radiography and 13 analogue panoramic images, using different exposure configurations and four different objects to try to overcome the effects of the lack of soft tissue radiation absorption on the analog radiographs. A gel based ice pack, a 20 mm dental wax block, and a 0.5 mm metallic foil were placed in different points of the device. Also a previously exposed and developed film was placed inside the cassette between the unexposed film and the intensifying screen. The images were presented to 15 dentists of several specialties, who graded and ranked the images. In conclusion, the digital panoramic was easily obtained at a 60 kV and 2 mA settings and on analog equipments the use of two films inside the cassette achieved best results with 63 kV and 06 mA exposure settings.

ÉTICA ODONTOLÓGICA: PARA ONDE DEVEMOS OLHAR EM BUSCA DE SOLUÇÕES?

O presente trabalho tem como objetivo refletir sobre o momento da etica odontologica, comportamentos observados nas midias sociais, e a influencia do mercado de consumo na Odontologia. Foi realizada uma analise em diferentes perspectivas temporais sobre a proposta de “flexibilizacao” do Codigo de Etica, o que significaria abrir normas que por principio sao fechadas, abdicando ou tirando de contexto alguns dos principios norteadores da conduta do Cirurgiao-dentista. Aditivamente, mostrou-se algumas possiveis saidas para as questoes levantadas como a discussao em foruns adequados com participacao dentre outros de especialistas da area de etica, bioetica e odontologia legal, alem da criacao de centros de pensamento (ou think tank ) da Odontologia, e ainda pela formacao continuada na area de etica profissional. Finalizando, justamente a etica foi elevada como solucao, atraves da Disciplina de Etica, Deontologia e materias correlatas tornando-se necessidade basica na formacao de profissionais cientes de suas responsabilidades para com a saude do ser humano e seu papel na sociedade.

Assessment of accuracy and recognition of three-dimensional computerized forensic craniofacial reconstruction

Facial reconstruction is a technique that aims to reproduce the individual facial characteristics based on interpretation of the skull, with the objective of recognition leading to identification. The aim of this paper was to evaluate the accuracy and recognition level of three-dimensional (3D) computerized forensic craniofacial reconstruction (CCFR) performed in a blind test on open-source software using computed tomography (CT) data from live subjects. Four CCFRs were produced by one of the researchers, who was provided with information concerning the age, sex, and ethnic group of each subject. The CCFRs were produced using Blender® with 3D models obtained from the CT data and templates from the MakeHuman® program. The evaluation of accuracy was carried out in CloudCompare, by geometric comparison of the CCFR to the subject 3D face model (obtained from the CT data). A recognition level was performed using the Picasa® recognition tool with a frontal standardized photography, images of the subject CT face model and the CCFR. Soft-tissue depth and nose, ears and mouth were based on published data, observing Brazilian facial parameters. The results were presented from all the points that form the CCFR model, with an average for each comparison between 63% and 74% with a distance -2.5 ≤ x ≤ 2.5 mm from the skin surface. The average distances were 1.66 to 0.33 mm and greater distances were observed around the eyes, cheeks, mental and zygomatic regions. Two of the four CCFRs were correctly matched by the Picasa® tool. Free software programs are capable of producing 3D CCFRs with plausible levels of accuracy and recognition and therefore indicate their value for use in forensic applications.

The Frontal Sinus Cavity Exhibits Sexual Dimorphism in 3D Cone‐beam CT Images and can be Used for Sex Determination

Few studies have assessed the use of the frontal sinus cavities for sex differentiation. In this study, a new methodology was used to assess the reliability of CBCT images of the frontal sinus cavity for determining sex based on the sexual dimorphism found in this anatomical structure. The survey sample consisted of 130 scans that were reconstructed three‐dimensionally. 3D images of the cavity volume in the frontal, lateral, and basal views were exported in TIFF. The following variables were measured in a second program: area, perimeter, bounding rectangle, ellipse fit, circularity, aspect ratio, roundness, solidity, and Ferets diameter. The methodology demonstrated the existence of sexual dimorphism with an accuracy of 80.0% in the logistic regression model. The basal view had the greatest explanatory power in the final model. This methodology may be used as an alternative way of determining a reliable biological profile during the analysis of skeletal remains.

Guidelines for reproducing geometrical aspects of intra-oral radiographs images on cone-beam computed tomography

Human identification requires comparison of individual traits of a person, depending on the availability and reproduction of antemortem (AM) records. If there is no presumed identity or AM exams are not available for comparison, the production of postmortem (PM) records is impaired. The purpose of this research is to describe and test standards to enable the comparison of antemortem periapical radiographs to images extracted from the manipulation of postmortem CBCT exams in multiple identification simulations in a randomized blind study. In a simulation, 20 CBCT images from dry skulls were used as PM records and 3 periapical radiographs (total of 60) that were randomized and blinded from the first examiner. In each case, an intentional incidence error of 10° was added in four different directions. Three points were selected in the AM radiograph, and the angle, linear measurements and proportion between these distances were collected. The AM data were used to mathematically find similar image geometry on a CBCT maximum intensity projection. Possible identification by superimposition was achieved in all cases, and statistical analysis proved the success in the reproduction of angular and length proportion using CBCT incidence manipulation. Significant reproducibility was also observed on intra- and inter-observer tests. In conclusion, the images extracted from CBCT could be compared to any periapical radiographs by superimposition, providing acceptable evidence to establish human identification. The application of this protocol is suitable for forensic practices with the high level of reproducibility and could be used as PM record when no AM records are available at the time of the exam.

Identification of a tooth-like foreign body in swine sausage.

A tooth‐like foreign body (FB) was found inside a sausage bread. Analysis aimed to investigate whether the FB was a tooth and its origin. The FB was measured, weighed, photographed, and radiographed. Macroscopic findings were suggestive of an anterior tooth. Histological slides of undecalcified cross‐sections of the FB and samples of human and swine teeth were prepared. Histological features of the FB (in light microscopy, 125× magnification) were discrepant from human tissues. Compared histological analysis displayed majority of features consistent with a hypsodont swine tooth, probably a canine. Cellularized cementum in crown region, adjacent to the enamel, and shape of the cementocytes were the main criteria excluding the possibility of human origin of the FB. Scanning electronic microscopy and energy‐dispersive spectroscopy were not performed because of fewer features to be analyzed and FB size. It was concluded that the FB may have been incorporated during meat grinding of the sausage.