Importance of Dental Radiography in Forensic Odontology: A Review

Introduction: Forensic odontology is an important and evolving branch. It has been established for critical issues like medi- colegal cases and identification of a dead person. Radiographic assisted documentation will provide objective information including the precise recording of the uniqueness of every individual where it has been used extensively in dental identification based on anatomy and by comparing maxillofacial skeletal landmarks in antemortem and post mortem records. Main body: Human Identification is mainly based on a dead body decomposition state. More likely of missing persons and the identification of individuals in conditions like criminal investigations and mass disasters. Odontological method for human identification is used commonly as it is simple by comparing with other methods, but complex in execution and requires skills and expertise. There are so many radiological techniques for forensic purposes like Computer tomography, cone-beam com- puter tomography, Orthopantomogram, 3D facial reconstruction, Radiovisiography, and Virtopsy. Objectives: This review highlights the different radiographic techniques and procedures and its application in forensic odon- tology. Source search criteria: Data were obtained and analyzed from previously published literature and electronic database search- es of relevant published literature from PubMed and Google Scholarfrom the 2001 to 2021 year. Conclusion: Imaging technologies and radiographs have become a vital component of modern medical practice and foren- sic odontology. The application of any of the mentioned techniques depends on the availability of previous images, data, or skeletal findings for Identification. So forensic radiology has a potential for crime-solving and is useful in conventional dental identification based on anatomy and by comparing maxillofacial skeletal landmarks in antemortem and post-mortem records, as they have become a crucial part of dental practice as well as in forensic odontology for diagnosis of disease, treatment plan- ning, identification of tooth structures, and age estimation.

Prevalence of incidental dental anomalies seen on pre-treatment digital panoramic radiographs of a group of Nigerian orthodontic patients: A retrospective study

Background: Radiographs are used by orthodontists in the diagnosis of malocclusion, treatment planning and monitoring. These usually reveal presence of dental anomalies that may require further assessment and management. Objective: To investigate the prevalence, types and distribution of dental anomalies seen on the orthopantomograms (OPGs) of orthodontic patients at the University of Port-Harcourt Teaching Hospital (UPTH).Methods: This was a retrospective cross-sectional radiographic study of a cohort of orthodontic patients who presented to the Department of Child Dental Health, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. The data gathered from digital orthopantomograms of the patients was analysed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows version 25.0. Results: The study comprised 249 patients with an age range of 5-44years (mean age of 14.6±7.7years) comprising 108 (43.4%) males and 141 (56.6%) females.Seventy (28.1%) [(29, 41.4% males), (41, 58.6% females)] of the patients had at least one dental anomaly. Dental anomalies were commonest (48, 68.6%) within 10-19 years age bracket followed by the 0-9 years age bracket (11, 15.7%). The most frequent dental anomaly was taurodontism (43, 61.4%), followed by congenitally missing teeth (8, 11.4%), supernumerary teeth (5, 7.1%), odontoma (4, 5.7%), peg shaped lateral incisors and transposition (2, 2.9%) respectively. Dental anomalies were more frequent in the maxilla (43, 61.4%). Conclusion: The most common dental anomaly was taurodontism. Anomalies were more frequent in female than male patients and in the maxilla than in the mandible

Mandibular Morphological Variations in Partially Edentulous Adult Patients: An Orthopantomographic Study

Objectives: This study was aimed to measure and evaluate the morphological changes of the mandible, related to age and gender in partially edentulous and completely dentate subjects using panoramic radiographs. Methods: This study included a sample of 150 partially edentulous patients and 150 completely dentate patients enrolled in the College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences between January 2015 and December 2018. Five mandibular morphological and anatomical parameters were measured using a Romexis software including; Condylar height. Gonial Angle, Ramus height, Antegonial notch depth and Ramal notch depth. Results: There was a significant difference (p=0.00) seen in the mean values of GA when comparing the partially edentulous (130.01 ± 7.79°) and completely dentate group (126.95 ± 6.64°). The mean values of GA were significantly larger among the younger age group (20-40) in both partially edentulous patients (131.58 ± 8.27°) and completely dentate group (127.17 ± 6.9°) (p<0.05). Conclusion: There was no relationship between the changes in the morphological measurements related to age and gender except for GA where younger subjects have higher GA values. Also, the mean values of GA were significantly higher in the partially edentulous group compared to completely dentate.

Frequency of Different Types of Mandibular Third Molar Impactions

Objective: Impacted third molars are a major problem in modern dentistry and the decision of whether to remove an impacted third molar is probably one of the most frequent treatment decisions faced by dentists. Impacted mandibular third molars are often associated with pericoronitis, periodontitis, cystic lesions, neoplasm, and pathological root resorption and can cause detrimental effects on the adjacent tooth. Therefore, the objective of the present study was to determine the frequency of different types of mandibular third molar impactions. Materials and Methods: This cross-sectional study was carried out in the outdoor patient Department of Oral and Maxillofacial Surgery, Multan Medical and Dental College, Multan during a period of 6 months from 15 December 2017 to 14 June 2018. After written informed consent, a total of 200 patients were recruited, diagnosed clinically and radiographically as having impacted mandibular 3rd molar. Angulation of impacted third molar was classified according to the long axis of the adjacent second molar on periapical and OPG radiographs. Statistical analysis was done through SPSS version 20. Results: Out of 200 patients, the frequency of mesioangular, vertical, distoangular, and horizontal impactions were 84 (42%), 60 (30%), 40 (20%), and 16 (8%) respectively. The depths of the impactions were 67 (33.5%) depth A, 92 (46%) depth B, and 41 (20.5%) depth C. Conclusion: Mesioangular impaction was more common followed by vertical. Depth B was the most common.

Assessing Validity of Printed Panoramic Radiographs Films for Dental Anomaly Detection

@#Introduction: The interpretations of printed panoramic radiographs film frequently depend on personal judgements analysis by observers. The findings correlations between more than two observers must consider statistical tool which can determine that sometimes the observers will agree or disagree merely by chance. Intraclass Correlation Coefficient (ICC) generally measures the degree of similarity among individuals within a cluster. Kappa statistic is the most frequently applied statistical analysis for this reason. This study aims to determine the validity of utilising printed panoramic radiographs for assessing dental anomalies and inter-examiner reliability in detecting dental anomalies observed within the panoramic radiographs. Methods: Twenty samples of printed versions of orthopantomogram (OPG) were arbitrarily selected from the AMDI Dental Clinic. Radiographic analyses were conducted twice, Trial 1 and Trial 2, with two-week intervals in between. Ten (10) printed OPG films were used in each session. During both assessments, incidence of dental anomalies was determined. All twenty OPGs were examined and analysed by the principal investigator and two independent examiners according to the inclusion and exclusion criterias. The data analysis was carried out using SPSS version 23. Results: The results of ICC for Trials 1 and 2 were 0.961 and 0.984, respectively. Conclusion: The outcomes demonstrated that the printed OPG films can be used to detect dental anomalies and inter-examiner dependability was in very good assertion for both trials, hence printed OPG films that satisfy the inclusion and exclusion criterias can be utilised for assessing dental anomalies as shown by the reliable ICC values in this study.

Evaluation of 1211 third molars positions according to the Classification of Winter, Pell & Gregory / Evaluación de posiciones de 1211 terceros molares acorde a la Clasificación de Winter, Pell & Gregory

Panoramic radiographs are important for the evaluation and classification of the third molars position, allowing the diagnosis and planning of extraction. The objective of this study is to evaluate upper and lower third molars positions in panoramic radiographs with the classification methods proposed by Pell and Gregory (1933) and Winter (1926) and the subsequent comparison of results with other authors. Panoramic radiographs of 310 patients were analyzed, 197 female and 113 male, totaling 1,211 third molars. In relation to the upper third molars, the most prevalent positions were: angle compared to the long axis of the second molar of Distoangular form (53.23 %) and the depth of impaction as Class C (48.25 %). In the lower third molars, the most prevalent positions were: angle to the long axis of the second molar in Mesioangular classification (52.96 %), the depth of impaction was B (46.54 %) and the tooth relationship with the mandibular ramus was identified as class I (55.26 %). These results provide information that can be utilized in predicting third molar development in terms of impaction or eruption, assisting dental surgeons in making decisions regarding surgical planning and treatment.

Las radiografías panorámicas son importantes para la evaluación y clasificación de la posición de los terceros molares, lo que permite el diagnóstico y la planificación de la extracción. El objetivo de este estudio fue evaluar terceros molares superiores e inferiores y posiciones en las radiografías panorámicas con los métodos de clasificación propuestas por Pell & Gregory, y Winter y la posterior comparación de los resultados con otros autores. Se analizaron las radiografías panorámicas de 310 pacientes, 197 mujeres y 113 hombres, con un total de 1.211 terceros molares. En relación con los terceros molares superiores, las posiciones más prevalentes fueron: ángulo con respecto al eje longitudinal del segundo molar de forma distoangular (53,23 %) y la profundidad de la impactación como Clase C (48,25 %). En los terceros molares inferiores, las posiciones más prevalentes fueron: ángulo con respecto al eje longitudinal del segundo molar en la clasificación mesioangular (52,96 %), la profundidad de impactación fue de B (46,54 %) y la relación de los dientes con la rama mandibular fue identificado como Clase I (55,26 %). Estos resultados proporcionan información que puede ser utilizada para predecir el desarrollo del tercer molar en términos de compactación o erupción, ayudando a los cirujanos dentistas en la toma de decisiones respecto a la planificación y el tratamiento quirúrgico.

Determination Of Gender Using Condylar Height And Coronoid Height – An Orthopantomographic Study

BACKGROUND: Identification of gender is important in forensic science and anthropology.When entire skull is not available for analysis, mandible may play a vital role in sex determination as it is the strongest bone that resists damage and disintegration. Aims and Objectives: To determine the efficacy of condylar height and coronoid height of mandible for sex determination using orthopantomographs and to compare and determine the most reliable parameter for sex determination. Materials and methods: This study was conducted using digital panoramic images of 100 each in both genders. The images captured were viewed on Kodak software and were subjected to measure the condylar and coronoid heights both on left and right side using Kodak dental imaging software. The data was entered into microsoft excel sheet and statistical analysis was done. Results: Descriptive statistics for condylar and coronoid heights on the right and left sides of mandible in both males and females were analyzed. A statistical significance of P < 0.001 has been demonstrated for all the variables. All variables showed increased measurements in males than in females. The accuracy of sex determination forcondylar height is 82.5% on right side and 78% on left side and for coronoid height it is 74% on right side and 73% on left side. Conclusion: The parameters such as condylar height and coronoid height using orthopantomographs are reliable in gender determination and the condylar height of the right side is the best parameter in gender determination.

Panoramic Radiographic Study of Mental Foramen in Selected Kashmiri Population.

Background: The aim of this study was to investigate the most common accurate position of the mental foramen in selected Kashmiri population, which helps in several clinical procedure and nerve block anesthesia. Methods: The study sample included one thousand panoramic radiographs of selected population of Kashmir that presented to postgraduate department of oral and maxillofacial surgery, Govt. dental college and hospital Srinagar from 2008 to 2015. Results: The most common Horizontal position of the mental foramen was below the root of second premolar tooth i.e. position 4 (44.77%). Conclusion: This may help the clinicians and anthropologists in identifying the mental foramen more accurately.

Caninos superiores retenidos por palatino: radiografía panorámica para evaluar ubicarlos en el arco dentario / Palatally impacted upper canines: panoramic radiography to assess their location in the dental arch

Los caninos superiores permanentes, estadísticamente, se encuentran entre las piezas dentarias que con más frecuencia quedan en retención ósea,después de los terceros molares.Sin embargo, los caninos, estética, funcionalmente, y para mantenimiento de las relaciones contactantes,a la hora de valorarlos en boca, desempeñan una función más importante que los terceros molares. Por eso la importancia de poder ubicarlos en el arco dentario. Cuando los ortodoncistas, sobre todo los menos experimentados, se enfrentan a la decisión de conservar los caninos que se encuentran en posiciones deretención ósea palatina, son muchos los interrogantes que se le plantean sobre su posible ubicación con éxito, en el arco dentario. Frecuentemente está la duda de cuál es el límite de la posición de retención para intentar su acomodamiento. Proponemos un simple trazado que se puede hacersobre la ortopantomografia panorámica, marcando dos líneas tangentes a la pared externa delas fosas nasales que se continuarán con los ejes longitudinales de los caninos retenidos de ambos lados. Si queda constituida una figura geométrica de apariencia de un rombo, significa que el extremo de la raíz se encuentra próximo a la posición que anatómicamente le pertenece (fosa canina del maxilar superior), existiendo una alta probabilidad de concluir con éxito su ubicación en el arco dentario.

Statiscally, permanent upper canines are the mostfrequently impacted teeth, after third molars.Upper canines though, have more significancethan third molars aesthetically, functionally andin maintaining contacting relations;thus the importance of bringing them inthe correct position within the dental arch.When an Orthodontist, particularly those lessexperienced, are faced with the decision ofmaintaining canines impacted in the palatal bone;many questions linger regarding the possibilitiesof successful relocation into the dental arch.Frequently, the question lays in the limitationsof moving it from its impacted positionto the correct one.We propose a simple tracing of theOrthopantomogram (OPG), marking twotangent lines to the lateral wall of the nasal cavitycontinuing on the long axis of the impactedcanines of both sides. If the result is a geometricfigure resembling a rhombus, it means thatthe radicular apex is close to the correctanatomical position (maxillary canine fossa),indicating high probabilities of successfullypositioning the impacted tooth.

Case report on unilateral segmental calcification of stylohyoid ligament.

An unusual case of a unilaterally elongated styloid process with a length of 6.8 cm was found on orthopantomogram (OPG) of male patient. The patient reported with ipsilateralotalgia presumably due to nerve compression from the elongated styloid process. The symptomatology appeared by such an anatomical variant as well as relative literature is discussed in the present case.

Incisor tooth in the nose: Anecdotal sequel to dog bite in a 3-year-old child.

A 3-year-old male child presented to the casualty with history of unprovoked dog bite over the right lateral wall of nose. He was managed conservatively with antirabies prophylaxis and dressings. He presented after 3 months with a healed wound and the right upper central incisor projecting into the nostril. The Orthopantomogram showed a rotated temporary incisor with the roots of the permanent incisor placed normally. The tooth was extracted intranasally. Among the mutilating dog bite injuries referred to a plastic surgeon, this injury though thought provoking was also comical.

Estimation of age in the living municipal employees in the age group of 25-45 years by physical and radiological examination.

Employees from government and local self-government bodies come to Departments of Forensic Medicine for age estimation for the purpose of permanent employment. According to the rules and regulations of the Municipal Corporation of Greater Mumbai (MCGM) and court orders, they are confirmed as permanent employees after a specified duration of temporary service. The age criterion is very important as regards their dates of retirement and service benefits. But because of low socioeconomic status & illiteracy, most of these employees have no documentary evidence of their birth dates. Their age, therefore, remains a mystery to be solved. The human body develops very fast in the first 20 years of life, but growth slows thereafter. There is precious little information on the estimation of age in the later years, resulting in the lack of reliable methods for this purpose. A sincere attempt to arrive at a fairly conclusive range of age with respect to changes in physical features, especially graying of hair, wrinkling of skin and radiological evaluations of fusion of components of the sternum and changes in the teeth and mandible with respect to mandibular canal seen in an oral orthopantomogram was contemplated.

Study On The Relationship Of The Inferior Alveolar Nerve Position Between Buccal And Lingual Side Using Ct And Orthpantomogram

When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar (7.1~7.4mm) and the nearest at mandibular angle area (4.4~4.8mm). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

The indexes of forensic identification for abnormal teeth with the digital orthopantomogram / 中国法医学杂志

Objective To select the indexes of forensic identification in digital orthopantomogram and formulate the full dentition pattern code.Methods To collect randomly 620 samples with dental interventions and 150 samples with dental pathological changes but without therapy.Then to observe and compare them respectively,select indexes for full dentition patterns according to the dental physiological variations,pathological changes and interventions Finally the diversity of the full dentition patterns in two groups would be evaluated by statistical analysis.Results The group with dental interventions had 619 kinds of dental pattern in 620 samples,its diversity of full dentition patterns was 99.84%.The group with dental pathological changes but without therapy had 146 kinds of dental pattern in 150 samples,thus its diversity of full dentition patterns was 97.33%.Conclusion These full dentition pattern indexes were valuable in the forensic identification of persons with abnormal teeth.

A comparative study on reliability of the root parallelism of the posterior teeth projected on the orthopantomogram with the 45 degrees oblique cephalogram / 대한치과교정학회지

At present, many orthodontists regard the root parallelism of the posterior teeth important not only in diagnosis and treatment planning but also for predicting posttreatment stability. To evaluate it, they usually refer to the orthopantomogram. At this study, 97 samples were collected from students of Yonsei University, who have well-proportioned face, Angles's class I canine & molar relationships and no crown axis deviation of the posterior teeth including canines. Reliability of the root parallelism observed from orthopantomogram was evaluated by comparison with 45degrees oblique cephalogram. The results were as follows : 1. In comparing the differences between anglular measurements in 45degrees oblique cephalogram & orthopantomogram with 5degrees, those to mandibular plane were significantly less than to occlusal plane in number of items which showed less differences than 5degrees. 2. Compared the root parallelisms in the orthopantomogram with those in 45degrees oblique cephalogram with 1% significance level, parallelism between upper canine & 1st premolar, lower canine & Ist premolar, lower 1st premolar & 2nd premolar, and lower right 2nd molar & 3rd molar showed statistically significant differences. 3. When the significance between the differences of the root parallelism between above two kinds of film and 5degrees was verified by two sided paired t-test, more or less large difference was shown between lower right 2nd molar & 3rd molar, a little larger than 5degrees between lower canine & 1st premolar, smaller at the rest of them. 4. In 45degrees oblique cephalogram, lower canine & 1st premolar showed convergent root arrangements each other, while in orthopantomogram they were divergent each other. All the others except them showed convergency on the upper, divergency on the lower in both films.