Mordida posterior a anestesia odontológica / Lip biting following dental local anesthesia

Niña de 6 años de edad, acude a la consulta odontológica24 horas después de una atención previa, mostrando una lesión en el labio inferior, blanco-amarillenta, con áreas de ulceración cubiertas por fibrina (A). La paciente relata prurito y sensación urente con hiperestesia en el área. No hay compromiso del estado general. Descartada una reacción alérgica y angioedema, el diagnóstico fue una úlcera traumática, como resultado de una mordida posterior a la anestesia del nervio alveolar inferior. El tratamiento consistió en ibuprofeno (suspensión oral, 200 mg / 5 ml, en dosis de 10mg / kg cada 8 horas por 5 días) y control clínico cada dos días (primer control, B). La resolución definitiva ocurrió 10días después de la primera atención. Con el fin de prevenir lesiones de los tejidos blandos, el odontólogo debe indicara los padres y cuidadores la importancia del monitoreo del niño por varias horas, luego de la atención odontológica que implique procedimientos con anestesia local por bloqueo troncular (nervio alveolar inferior), recordando que es más seguro para el paciente comer luego de que el efecto del anestésico desaparece (1).

Analysis of bite mark evidence.

Bite mark analysis casework strives to connect a biter to the teeth pattern present on an object linked in some way to a crime or event. The general public and some law enforcement may consider any “bite mark” case they develop to be a certainty in the quest to identify the biter. The ability of skin to register sufficient detail of a biter’s teeth is highly variable. Bite mark casework indicates that many bite marks are not well defined in detail and posses distortion due to the physical nature of skin itself. The current opinion is that bite mark can be useful in including or excluding possible suspects and ability to identify only one person as the biter. In mortal combat situations, such as the violence associated with life and death struggles between assailants and victims, the teeth are often used as a weapon. It is well known that assailants in sexual attacks, including sexual homicide, rape and child sexual abuse, often bite their victims as an expression of dominance, rage and animalistic behaviour. The teeth are a significant component of our natural arsenal.

An overview of Bite mark analysis.

Human bite mark analysis is by far the most demanding and complicated part of Forensic Dentistry. Although bite marks of an individual do have uniqueness due to specific characteristics and arrangement of the teeth, when it comes to bite mark analysis, it is complicated by numerous factors, being presented as a challenge to the Forensic Odontologists. The aim of this paper is to give a brief overview of bite mark analysis: its usefulness and limitations. The study and analysis of such injuries is challenging and complex. The correct protocol for collection, management, preservation, analysis and interpretation of this evidence should be employed if useful information is to be obtained for the courts. This article throws light on the details of evidence collection techniques and step by step method to analyse the bite mark injury. It also provides insight about the modern methods now implemented in the analysis of bite marks. Conclusions from the analysis of bite mark evidence can assist the justice system to answer crucial questions about interaction between people present at the scene of crime.

Comparison between five commonly used two-dimensional methods of human bite mark overlay production from the dental study casts.

Aim: The present study was conducted to determine the most accurate bite mark overlay fabrication technique by studying two physical characteristics, i.e., area and rotation of biting edges of anterior teeth of thirty volunteers. The objective of the study was to evaluate the reliability and efficacy of five commonly used methods of human bite mark overlays using two dimensional (2D) digital images of dental study casts as a gold standard, to rank different methods according to statistically based determination of relative accuracy of each method and to determine its feasibility in Forensic science. Materials and Methods: Overlays were produced from the biting surfaces of six upper and six lower anterior teeth of 30 volunteers using the following five methods: a) hand tracing from study casts, b) hand tracing from wax impressions, c) xerographic method, d) radiopaque impression method and e) 2D computer-based method. Area of the biting edges of the anterior teeth and relative rotation of each anterior tooth were measured and compared. Results: The xerographic method was determined to be the more accurate method with respect to tooth area and rotation. Hand tracing methods, from either wax impressions of teeth or directly from study casts, were determined to be inaccurate and subjective. Conclusions: It is recommended that forensic odontologists discontinue the use of hand tracing overlays in bite mark comparison cases as there is lot of scope for manipulation and observer bias.

Revenge by the bites.

Bite marks are important evidences, which are most often ignored by the investigating officers in India. Sometimes due to lack of this knowledge, let the culprit go Scot-free. Bite marks help to link the culprit with the crime. It is important scientific evidence, which if properly collected and analyzed can help, in successful prosecution of the case. Analysis of a case of bite marks is presented here by which culprit could be identified.

Tratamiento quirúrgico precoz en osteomielitis de mano por mordeduras humanas / Early surgical treatment in hand osteomyelitis by human bites

Hemos visto, que las mordeduras humanas poseen ciertas características particulares, que pueden interferir en su manejo; y son responsables de su morbilidad, de ahí la importancia de nuestro tema. Nuestros objetivos, consisten en la identificación del tratamiento más eficiente, en el manejo inicial de las osteomielitis de mano por mordeduras humanas y su rehabilitación; y la presentación de casos clínicos del Servicio. La metodología que utilizamos, está constituída por una revisión bibliográfica sobre el manejo de estas lesiones. De las conclusiones ha las que hemos arribamos, destacamos que la mayoría de los autores enfatizan la importancia del tratamiento temprano, con administración antibiótica enérgica y cirugía precoz. As feridas produzidas pelas mordidas dos humanos, possuem particularidades que podem intervir no seu tratamento e na evolução das suas proprias feridas, além de ser as responsavels do seus danos e complicações. Encontra-se aqui à importança do nosso tema. Os nossos objetivos são: identificar o tratamento que seja mais eficaz na precocidade do tratamento da “ostemyelitis” das mãos, pelas mordidas humanas, e a sua reabilitação aliás da apresentação de casos clínicos do nosso serviço. A metodología escolhida foi uma revisão da bibliografia sobre o tratamento de estas feridas. Concluímos que, o maior numero de autores ressaltao a importância da precocidade do tratamento, com atibióticos enèrgicos e uma cirugia precoce.

We have seen that human bites have some features which may interfere in their treatment, are responsible for their morbility and show the importance of our topic. Our objectives are discovering the best treatment for hand osteomielitys caused by human bites, its rehabilitation and showing some of our cases. Our methodology si based in a bilbliografhy revision of the treatment for this illness. From our conlusions, we spotlight that the mayority of the authors emphasize the importance of early treatment using properly antibiótics and sugery.

Bite mark analysis in child abuse.

The science of bite mark analysis is relatively new and potentially valuable. This science has been greatly used in identifying the suspects involved in crimes related to sex, child abuse, and altercations of various types. Child abuse is presenting a serious social problem with global dimensions, which is increasing at an alarming rate in all socioeconomic strata and all ethnic or racial communities. The aim of the present study was to assess these bite marks and analyze the effectiveness of a simple technique used in the department of pedodontics and preventive dentistry, College of Dental Surgery, Manipal.