Sex dimorphism according to the nasozygomatic triangle

Sex is one of the first features to be diagnosed in human identification, composing, with age, ancestry and stature, the so called "big four". Aim: The present study aimed to metrically analyze the sexual dimorphism in skulls of known age and sex from Rio Grande do Sul ­ Brazil. Methods: This was a crosssectional study of metrical analysis, which used a sample comprised of 209 human skulls (106 male and 103 female) older than 22 years old at the time of death, undamaged and without signs of trauma or abnormalities. The point nasion and the most superior points on the zygomaticotemporal sutures from each side were connected forming a triangle. This area was calculated using Heron's formula, and the results were submitted for statistical analysis. Results: All measurements showed significant values for sexual dimorphism. Through the area of the triangle, it was possible to determine sex with an accuracy of 83.97% for males and 83.50% for females. Conclusion: This simple method requires only a caliper, and still can be reliable for forensic human identification. It must be diffused and tested on other samples, and can be used as a good and inexpensive tool for experts in day-to-day practice

Identificação de vítima de afogamento por meio de documentação ortodôntica: relato de caso / Drowned victim identification through orthodontic documentation: Case report

Introdução: A identificação humana pelos arcos dentais é considerada uma forma segura para se obter um resultado, pois possuem unicidade no conjunto de características, como morfologia dos dentes, formato da arcada, presença de alterações patológicas ou terapêuticas, ausências, e anomalias numéricas, morfológicas ou posicionais. Com frequência, cadáveres encontrados na água em estágio avançado de putrefação impossibilitam a identificação papiloscópica, tornando a Odontologia Legal necessária, evitando exames mais caros e demorados, como o DNA. Os dentes e os materiais odontológicos utilizados são de grande resistência à ação do fogo e da água, e o prontuário odontológico, arquivado com o cirurgião-dentista deve conter registro de todos os procedimentos realizados no paciente em vida, bem como modelos de gesso, radiografias, fotografias e demais exames de imagem. Objetivo: O presente artigo tem como objetivo relatar o caso de um adulto afogado que teve a sua identificação confirmada através da documentação ortodôntica. Conclusão: Concluiu-se que a associação da documentação ortodôntica fornecida pelos familiares com fotos, radiografias, e pareceres, e os dados odontolegais obtidos no exame cadavérico, permitiram a confirmação da identidade do indivíduo.

Introduction: Human identification by the dental arch is considered a safe way to obtain a result, since the dental arch has uniqueness in the set of characteristics, such as morphology of the elements, arch format, presence of pathological or therapeutic alterations, absences, and numerical, morphological or positional anomalies. Often, corpses found in the water at an advanced stage of putrefaction make it impossible to identify by finger prints, making Forensic Dentistry necessary for the identification of the corpse, avoiding more expensive and time-consuming exams, such as DNA. The teeth and dental materials used are highly resistant to the action of fire and water, and the dental record, filed with the dental surgeon, contains a record of all procedures performed on the patient during life, as well as plaster models, radiographs, photographs and other image exams. Aim: This article aims to report the case of a drowned man who had his identification confirmed through orthodontic documentation. Conclusion: It was concluded that the association of orthodontic documentation provided by the family with photos, radiographs, and opinions, and the dental data obtained in the cadaveric examination allowed the confirmation of the individual's identity.

Violence against women: caracteristics of head and neck injuries / Violência contra a mulher: características das lesões de cabeça e pescoço

ABSTRACT Objective: This study aimed to investigate the characteristics of aggression in head and neck regions suffered by women who are victims of gender violence, and to analyze the variation in the number of cases before and after the enactment of the Maria da Penha Law. Methods: A survey was conducted on the records of examinations of personal injury made in the Department of Forensic Medicine in Vitória, in the Brazilian state of Espírito Santo. The study included women victims of bodily injury, referred as a result of domestic, family or conjugal violence, aged between 11 and 80. Results: The number of cases analyzed in this study exhibited an oscillation during the years studied. The results reveal that female victims are, in most cases, young, aged between 20 and 30, single and do not work outside the home. The victim's husband or partner was the main offender, mostly using parts of the body, like the hands and feet, as the means of aggression. The most frequent craniofacial injuries were ecchymosis and abrasions, more often in orbital, cervical and frontal regions. Conclusions: The characteristics related to violence against women obtained through this study are of great importance and should be highlighted and publicized, to encourage implementation of public policies and practical actions of acceptance and recognition of such violence, including the insertion of the Forensic Dentist on the staff of experts in all Institutes of Forensic Medicine in the country.

RESUMO Objetivo: O presente trabalho buscou levantar as características das agressões em regiões de cabeça e pescoço sofridas por mulheres vítimas de violência de gênero e analisar a variação do número de casos antes e depois da promulgação da Lei Maria da Penha. Métodos: Foi realizado um levantamento nos registros dos exames de lesão corporal realizados no Departamento Médico Legal de Vitória, Espírito Santo. Foram incluídas mulheres vítimas de lesões corporais, encaminhadas em decorrência de violência doméstica, familiar ou conjugal com idade entre 11 e 80 anos. Resultados: A quantidade de casos analisados nesse estudo exibiu uma oscilação durante os anos estudados. Os resultados revelam que a mulher vitimizada é, na maior parte dos casos, jovem, numa faixa etária entre 20 e 30 anos e solteira, e não trabalha fora de casa. O companheiro ou marido da vítima foi o principal agressor, utilizando principalmente segmentos do corpo, como mãos e pés, como meio de agressão. As lesões craniofaciais mais encontradas foram equimose e escoriação, mais frequentes nas regiões orbitária, cervical e frontal. Conclusão: As características relacionadas à violência contra a mulher obtidas pelo trabalho têm grande importância e devem ser evidenciadas e divulgadas, a fim de que políticas públicas sejam implantadas e ações práticas de acolhimento e reconhecimento desse tipo de violência sejam tomadas, incluindo a inserção do Odontolegista no quadro de peritos de todos os Institutos Médicos Legais do país.

Stature Estimate by the Upper Arch: Carrea´s Method Modified / Estimación de la Estatura por Medio del Arco Superior: Método de Carrea Modificado

The Carrea's index is an alternative to estimate the human stature. However, in cases when the jaw is affected, this technique becomes impracticable. Expanding the use of the Carrea's index, by extending it to the upper elements, would increase the chances of the method, especially in cases when only the skull is available for analysis. The aim of the study was to test a new denominator for Carrea's index, so that it could be used for the upper arch, aiming at a new feature to estimate human stature. Plaster models of the arch and the string of the upper arch of 107 dentistry students, aged between 18 and 30 years, previously submitted to anthropometric analysis, were measured with a digital caliper. The data found were inserted in software developed to find a denominator that would result in a higher number of correct answers to real statures, evaluating the left and the right hemiarch, and their average. For the right hemiarch, the denominator with more accuracy for the real stature was the interval from 2.573 to 2.583, with 58.9 %. For the left hemiarch, the best values were from 2.553 to 2.554 with 63.6 %. The average of hemiarchs had as ideal denominator values between 2.579 and 2.581, with 60.7 %. We found no significant statistical difference between denominators. It was possible to obtain a new denominator to apply Carrea's index for the upper arch. The new method had satisfactory accuracy rate and should be tested in other populations to verify its applicability.

El índice de Carrea constituye una alternativa para la estimación de la estatura humana. Sin embargo, esta técnica se torna inviable cuando la mandíbula se encuentra comprometida. Su aplicación a partir de elementos dentales superiores, resultaría de utilidad en los casos en que sólo se dispusiese del cráneo para examinar. El objetivo del estudio fue proponer un nuevo denominador para que el índice de Carrea pueda ser utilizado para el arco superior, en la búsqueda de otro recurso para estimar la estatura humana. El arco y la cuerda fueron medidos, con un calibre digital, sobre los respectivos modelos de yeso superiores de 107 estudiantes de Odontología, que tenían entre 18 y 30 años de edad y habían sido sometidos a análisis antropométricos previos. Los datos obtenidos fueron analizados matemáticamente mediante un programa desarrollado para encontrar un denominador, que proporcionase un mayor número de aciertos para las estaturas reales, evaluando el hemiarco derecho, izquierdo y la media de los hemiarcos. Para el hemiarco derecho, el denominador más apropiado para la estatura real correspondió al intervalo 2,573-2,583, con 58,9 % de acierto. Para el hemiarco izquierdo, los mejores valores quedaron comprendidos entre 2,553 y 2,554, con 63,6 % de acierto. La media de los hemiarcos determinó guarismos ideales, oscilantes entre 2,579 y 2,581, con 60,7 % de acierto. No hubo diferencia estadísticamente significativa entre los denominadores hallados. Se obtuvo un nuevo denominador, que permitió el empleo del índice de Carrea para el arco superior, con una tasa de acierto satisfactoria. No obstante, este método debe ser probado y validado para otras poblaciones, verificando su aplicabilidad.

Respect for the Donated Corpse in the View of Dentistry and Medicine Students / Respeto por el Cadáver Donado en la Visión de los Estudiantes de Odontología y Medicina

The teaching of human anatomy in universities in Brazil and around the world is accomplished mainly through the use of donated corpses. However, this methodology is threatened due to the progressive reduction of the number of corpses donated to educational institutions. This research aimed to investigate the ethical profile of undergraduate students of Medicine and Dentistry when working with the corpses during practical classes in anatomy, and to compare the students' knowledge of the law that regulates the donation and use of human cadavers as a means of learning in educational institutions. For this purpose, a sample of 106 students, 63 from the Faculty of Dentistry of Piracicaba - UNICAMP -, and 43 from the Faculty of Medicine of Jundiaí (both in the state of São Paulo, Brazil) filled a questionnaire. The data were statistically analyzed using the chi-square test, and there were virtually no statistically significant difference between the responses of the students of Dentistry and Medicine. Most students did not know the law, and 81 % (Dentistry) and 68 % (Medicine) would not donate their bodies to educational institutions. Although nearly 75 % of students have claimed that teachers emphasized the importance of respect to the donated body, 56 % of future dentists and 46 % of future physicians ensure they have heard some kind of joke about the cadaver during class, although only 4.76 % and 13.95 %, respectively, have confessed to have already presented this inappropriate behavior. Thus, it can be inferred that there is an urgent need for dissemination of the importance of body donation programs, and the teaching of ethical principles concerning to the corpse, to ensure continuity of quality of education offered in biomedical field.

La enseñanza de la anatomía humana en las universidades en Brasil y en el mundo se lleva a cabo principalmente a través del uso de partes de cadáveres. Sin embargo, esta metodología está amenazada debido a la reducción progresiva del número de cadáveres transferidos a las instituciones educativas. El objetivo de este trabajo fue investigar el perfil ético de los estudiantes de odontología y medicina sobre el cuerpo durante las lecciones prácticas de anatomía, y comparar el conocimiento de la ley que regula la donación y utilización de cadáveres humanos como un medio de aprendizaje en las instituciones educativas. Una muestra de 106 estudiantes, 63 del curso de Odontología de la Facultad de Odontología de Piracicaba - UNICAMP - y 43 estudiantes de medicina de la Facultad de Medicina de Jundiaí (ambas ubicadas en São Paulo ­ Brasil), respondió a un cuestionario. Los datos fueron sometidos a un análisis estadístico mediante la prueba de chi-cuadrado. Se observó que no había diferencia estadísticamente significativa entre las respuestas. La mayoría de los estudiantes no conocen la ley, y 81 % (Odontología) y 68 % (Medicina) no donarían su cuerpo a las instituciones educativas. Aunque aproximadamente 75 % de los estudiantes afirman que los profesores enfaticen el respeto por el cuerpo, 56 % de los futuros dentistas y 46 % de los futuros médicos aseguran que han escuchado chistes y comentarios desagradables sobre el cuerpo durante las clases, aunque sólo 4,76 % y 13,95 %, respectivamente, han confesado haber cometido tal práctica. Conclusiones: Por lo tanto, se puede inferir que hay una necesidad apremiante para la divulgación de las leyes que rigen la donación de órganos y la conciencia de los cadáveres de donación, así como la enseñanza de los principios éticos de respeto por el cuerpo, para asegurar la continuidad de la calidad de la educación que se ofrece en las ciencias biomédicas.

Valoração do dano estético odontológico utilizando três métodos: relato de caso pericial civil / Valuation of dental aesthetic damage using three methods: report of expert civil case

Objetivo: o presente trabalho tem como objetivo relatar um caso de perícia odontológica civil em queforam empregadas e comparadas três metodologias para valorar o dano estético odontológico associadoàs perdas dentais. Relato de caso: tratou-se de uma perícia civil ajuizada para ressarcimento de danos,realizada no Serviço de Assessoramento Pericial da Faculdade de Odontologia de Piracicaba daUniversidade Estadual de Campinas/Brasil. O periciado estava num caminhão que foi atingido por umapedra projetada em direção oposta à sua, pelo trabalho de um trator que se encontrava na beira doacostamento cortando grama, sendo atingindo o vidro do veículo e a face do periciado. Após atendimentono hospital local, nenhum outro tratamento foi realizado desde então. Foram empregados 3 métodos paravaloração do dano estético envolvendo perda dental: 1) dano estético dental, 2) escala de sete graus, e 3)Análise da Impressão e do Impacto do Prejuízo Estético “AIPE”. Conclusão: a utilização de diferentesformas para valorar o dano estético em casos que envolvem desdentados parciais com lesões cicatriciaismostrou a importância do perito odontólogo estar atualizado e ter conhecimento sobre as abordagensexistentes, realizar uma descrição pormenorizada e padronizada das lesões, bem como estar atento paraindicar uma visão completa da pessoa portadora de dano estético à autoridade requisitante com autilização de metodologias adequadas para valorar esse tipo de dano.

Objective: the aim of this paper is to present a case of civil expert examination in dentistry area, in whichthree methods were applied and compared for valuing aesthetic damage associated to tooth loss. Casereport: the case involved a civil expert examination requested for damage compensation, held at theAdvisory Expert Service of the Piracicaba Dental School, State University of Campinas/Brazil. Theexamined patient was wounded on the face when he was in a truck that was hit on the glass by a rock,projected from the opposite direction, by a tractor on the roadside, cutting grass. After care at the localhospital, no treatment was carried out. Three methods were used to evaluate the aesthetic damageinvolving the tooth loss: 1) dental aesthetic damage, 2) seven degrees scale, and 3) Aesthetic Perceptionof Injury Analysis or “AIPE”. Conclusion: the use of different ways to value the aesthetic damage in casesinvolving partial edentulous individuals, with cicatricial lesions showed the importance of the dental experton being updated and having knowledge on existing approaches, on performing detailed and standardizeddescription of the lesions, as well as on being alert to provide a complete vision of the aestheticallydamaged person to the requesting authority, using adequate methodologies to evaluate the injury.

Importância do cirurgião-dentista no diagnóstico de abuso sexual infantil – revisão de literatura / Importance of the dentist in the diagnosis of child sexual abuse – a review

Introdução: É dever do cirurgião-dentista ser capaz de identificar lesões provenientes de abuso sexual infantil, uma vez que grande parte das mesmas ocorrem nos campos de trabalho deste profissional. Objetivos: O presente trabalho visa, por meio de revisão da literatura, apontar o papel do dentista ao se deparar com lesões provenientes de abuso sexual infantil. Material e método: Informações provenientes de legislação e literatura especializada nacional, relativas ao tema, foram compiladas. Visto que, em suagraduação, os cirurgiões-dentistas recebem pouca ou nenhuma base referente às principais manifestações físicas e psicológicas em situações de abuso sexual, muitos acabam por não conseguirem diagnosticar e, consequentemente, não cumprem seu papel de notificar casos suspeitos, seja por medoou por desconhecer sua obrigação diante deste tipo de violência. Resultados e conclusão: É necessárioque profissionais da Odontologia sejam conscientizados durante sua graduação, para que, depois deformados, não sejam omissos. Portanto, é de extrema importância que o tema passe a compor o plano deensino de todas as instituições, especialmente nas disciplinas de Odontologia Legal e Odontopediatria.

Introduction: All dentists must be able to diagnose lesions from child sexual abuse, once many of the moccur in the working fields of this professional. Objectives: This study aims, through literature review, topoint out the role of the dentist when faced with injuries from child sexual abuse. Method: Information from legislation and national literature on the subject was compiled. Since at her graduation, dentists receivelittle or no basis concerning the main physical and psychological manifestations in sexual abuse situation,and many end up failing to diagnose and therefore do not fulfill their role to notify suspected cases, eitherby fear or by ignoring its obligation on this type of violence. Results and conclusion: Dental professionalsmust be prepared during dental school, so as not to fail after graduation. Therefore, it is of utmostimportance that the issue become part of the teaching plan of all institutions, especially in the disciplines offorensic dentistry and pediatric dentistry.

Sex determination from occipital condylar measurements by baudoin Index in forensic purposes / Determinación del sexo desde mediciones del cóndilo occipital mediante el Índice de baudoin con propósitos forenses

In human identification for forensic purposes the sex is one of the most important and first features to be assessed in each case. Baudoin condylar index is a sex determination method based on measurements of length and width of the occipital condyle. The aim of this research was to apply the Baudoin condylar index for sex determination, and evaluate its reliability. The sample was composed of 100 Brazilian human skulls, 50 male and 50 female from São Gonçalo cemetery, City of Cuiabá, Brazil. The measurement values were statistically analyzed in order to compare the matching rate for each sex, each side, as well as the overall average. The results showed that the overall percentage of success in applying the Baudoin index was 44.83 percent to males, and 51.93 percent to females, amounting to 47.5 percent matching. The accuracy of the Baudoin index to sex determination was quite low for this Brazilian sample, the reason why this method should be disregarded as a criterion to sexing skulls in a forensic context.

En la identificación de personas con fines forenses el sexo es una de las características más importantes y primordiales a evaluar en cada caso. El índice condilar Baudoin es un método de determinación del sexo basado en mediciones de la longitud y la anchura del cóndilo occipital. El objetivo de esta investigación fue aplicar el índice condilar de Baudoin para la determinación del sexo, y evaluar su fiabilidad. La muestra fue compuesta de 100 cráneos humanos brasileños, 50 hombres y 50 mujeres del cementerio São Gonçalo, ciudad de Cuiabá, Brasil. Los valores de medición se analizaron estadísticamente con el fin de comparar la tasa de coincidencia para cada sexo, cada lado, además de la media general. Los resultados mostraron que el porcentaje general de éxito en la aplicación del índice de Baudoin fue de 44,83 por ciento para los hombres y 51,93 por ciento para las mujeres, lo que asciende a una coincidencia del 47,5 por ciento. La precisión del índice de Baudoin para la determinación del sexo fue bastante baja para esta muestra brasileña, por lo que este método debe ser considerado como criterio para determinar el sexo de los cráneos en un contexto forense.

Legal analysis of the information contained in dental plaster packs

AIM: The aims of this study were: a) to verify if the instructions displayed on the packages and labels of dental plaster available for purchase in the city of Porto Alegre are in accordance with the Brazilian laws, and b) to analyze how information is available on packages and labels of dental plaster acquired by dentists. METHODS: For this study, it was used the method proposed by Silva et al. (2010) modified, according to which the information related to instructions for product use displayed on packages and labels, if present, provided by manufacturers and/or importers from each brand of plaster was reviewed: how to use, composition, price, expiration date, health risks and disposal instructions. The collected information was subsequently confronted with the requirements laid out in national legislation on trade of dental plaster. RESULTS: No product showed the price or the instructions for disposal. One brand showed no information of the package and another one showed only the composition of the product; this requirement was present in most products. The mode of use and the expiration date were present in almost all packages, except for two brands. Only two brands presented information on health risks, and yet unsatisfactory. CONCLUSIONS: The different brands and types of dental plaster analyzed presented some kind of violation of the provisions of the Brazilian legislation, most with missing or unsatisfactory information.

Palatal rugoscopy as a method of human identification / Rugoscopia palatina como método de identificação humana

Test the applicability of the formula in palatoscopy.Methodology: three observers examined 30 plaster models of the upper arch, obtained from dentistry students at the Universidade Federal da Paraiba (UFPB). Rugae were classified as simple and composed and as line, curve, angle, circle, sinuous and point.Results: the intra-observer examination of simple and compound rugae showed a higher coincidence percentage for composed rugae (53.3 to 56.7%), as did inter-observer examinations (43.3% to 55.0%), compared to the 5% - 23.3% obtained for simple rugae. Analysis of the main types revealed that circular rugae showed the highest coincidence percentage (95.0% to 96.7%), followed by angular (61.7% to 66.7%). The line rugae demonstrated the lowest coincidence percentage (11.7% to 45.0%). Inter-observer coincidences were highest in the circle rugae (93.3% to 96.7%) and lowest in the line rugae, with percentages between 16.7% and 15.0%. The higher percentage of composed rugae reflected its good visualization. The high observer agreement in relation to circular rugae is due to the classification of their absence, since this rugae is seldom found, in contrast to line rugae, which are mistaken for wavy rugae and vice versa, often present in the palate. It can be observed that palatal rugae as a method has a large number of classifications, but with low practicability, storage difficulties and absence of universal standards...

Testar a aplicabilidade da fórmula na rugoscopia palatina.Metodologia: três avaliadores examinaram 30 modelos em gesso do arco superior, obtidos de estudantes de Odontologia da UFPB. As rugosidades foram classificadas em simples e compostas e em reta, curva, angular, circular, sinuosa e ponto.Resultados: o exame das rugas simples e compostas, intra avaliador, demonstrou maior percentual de coincidência para as rugas compostas (53,3 a 56,7%), assim como nos exames inter avaliadores, com acertos entre 43,3% e 55,0%, confrontando com os 5,0% e 23,3% obtidos nas rugas simples. Na análise dos tipos fundamentais observa-se que as rugas circulares apresentaram maior percentual de coincidências (95,0% a 96,7%), seguida das angulares (61,7% a 66,7%). A ruga reta demonstrou menor percentual de coincidências (11,7% a 45,0%). As coincidências inter avaliadores foi maior nas rugas circulares (93,3% a 96,7%) e menor nas rugas retas, com percentual entre 16,7% e 15,0%. O maior percentual das rugas compostas demonstra a sua boa visualização. A alta concordância dos avaliadores quanto a rugas circulares ocorre em virtude da classificação de sua ausência, pois raramente se encontra esta ruga, diferente das retas, que se confundem com as sinuosas e vice-versa, frequentemente presentes no palato. Nota-se que a rugosidade palatina como método possui uma grande quantidade de classificações, porém, com praticabilidade baixa, de difícil arquivamento e ausência de padrão universal.Conclusão: a classificação das rugosidades palatinas, por meio da fórmula rugoscópica, não é aplicável devido à subjetividade do método...

Use of dental dimensions estimated from personal portraits in human identification

Many cases of human identification in which traditional methods are not applicable challenge the experts' capability and versatility. In the absence of ante-mortem records, superimposition of skull images over photographs of a possible victim arises as a possible alternative. Aim: The present study was a pilot work willing to validate a new method of sizing images of the face by the use of proportionality principles, taking as reference a few predetermined accessories: a pair of sunglasses, a hat and a necklace. Methods: Twenty-one volunteers were photographed using each one of the accessories mentioned above. Pictures of the dental arches were also taken, with millimeter scale adjacent. The images with accessories were examined by a single operator, who estimated the mesiodistal width of the upper central incisor, for later comparison with the real measures. Results: The accuracy of the method was evaluated by the Student's t-test, which showed that the estimated measures were statistically greater than the real ones. Conclusions: The analysis of the data collected showed that the use of the accessories as a dimensional scale did not generate reliable results.