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

Análise de lesões orofaciais registradas no Instituto Médico-Legal de São Luís (MA), no período de 2011-2013 / Analysis of orofacial injuries recorded in the Forensic Medicine Institute of São Luís (MA), from 2011 to 2013

Introdução: Os traumas são causas comuns de morbidades e mortalidade da população mundial. Um dos mais prevalentes é o bucomaxilofacial, pois a face é uma região muito exposta e pouco protegida.Traumas faciais podem resultar em lesões de tecidos moles e fraturas ósseas, causando graves complicações e até danos irreversíveis, e seu autor deve ser enquadrado corretamente segundo a legislação brasileira. Objetivo: Analisar o perfil das vítimas, as causas, as características das lesões orofaciais, bem como o profissional responsável pela perícia e a classificação da lesão de acordo com o artigo 129 do Código Penal Brasileiro. Método: Foram analisados laudos emitidos por médicos e odontolegistas do Instituto Médico Legal da cidade de São Luís (MA), no ano de 2011 à 2013 de vítimas acometidas por lesões orofaciais. Resultados: Os resultados demonstraram que o sexo masculino foi omais atingido (55,4%), a faixa etária mais envolvida foi 20-29 anos (40,3%), a etiologia principal foi agressão física (73,4%), a lesão mais frequente foi escoriação (25,3%) e a região mais acometida da facefoi a orbitária (26%). O profissional que mais emitiu laudos foi o médico-legista (90,8%). Das lesõesorofaciais qualificadas (39,8%), 23,0% resultaram em debilidade da função mastigatória, 4,5% emdebilidade da função mastigatória e estética e 22,3% em deformidade permanente. Conclusão: Conclui-seque é grande o número de lesões orofaciais registradas no IML de São Luís e que essas lesões foram avaliadas mais criteriosamente pelo odontolegista, ressaltando-se, com isso, a fundamental atuação desse profissional nas perícias dessa natureza.

Introduction: Traumas are common causes of morbidities and mortality in world's population. Maxillofacialtrauma is one of the most prevalent, because face is very exposed and unprotected. Facial trauma canresult in soft tissue injuries and bone fractures, causing serious complications and even permanen tdamages, making necessary the appropriate legal framework of attackers. Objective: To analyze theprofile of the victims, reason and the characteristics of orofacial lesions recorded in Forensic MedicineInstitute data, São Luís (MA), Brazil, between years of 2011 to 2013, as well as the professional responsible for expertise (doctors and dentists) and classifications in accordance with Article 129 of theBrazilian Penal Code. Methods: It were analyzed reports issued by doctors and dentistry in the period of2011 to 2013, for affected patients with orofacial injuries. Results: Results showed that male sex was themost affected (55,4%), age most involved was 20-29 years (40,3%), the main etiology was physicalaggression (73,4%), the most common injury was abrasion (25,3%) and the region most affected was theorbital (24,9%). The professional that issued more reports was the coroner (90,8%). Between the qualifiedorofacial lesions (39,8%), 23,0% resulted in weakness of masticatory function, 4,5% in weakness ofmasticatory function and aesthetics and 22,3% in permanent deformity. Conclusion: It was concluded that the number of orofacial injuries registered in the IML of São Luís data was great and these lesions wereevaluated more critically by forensics dentists, requiring their presence of this professional.

Effectiveness of dental records in human identification / Efetividade da documentação odontológica na identificação humana

Forensic dentistry, a branch of the forensic sciences, plays an important role within postmortem human identification, especially in cases of corpses that are charred, skeletonized or in an advanced state of decomposition. Identification of human remains via dental knowledge is done using a comparative technique, which is simple, inexpensive and reliable, the aim of which is to compare dental records and information recorded by dentists in clinical appointments made before an individual's death, with postmortem dental records obtained via forensic examination. In this context, the present study aims to demonstrate the importance of dental records and the effectiveness of forensic dentistry in human identification, illustrated by the report of a case that was conducted at the São Luis Coroner's Office in the Brazilian state of Maranhão. It may be concluded that dental records maintained by a dentist, when complete, properly structured and correctly archived, retain important personal information and are fundamental tools in the process of human identification.

A Odontologia Legal, ramo das Ciências Forenses, tem importante atuação nas perícias de identificação humana post-mortem, sobretudo na ocorrência de cadáveres em avançado estado de putrefação, carbonizados e esqueletizados. O processo odontológico de identificação humana é realizado por meio de técnica comparativa, o qual é simples, de baixo custo e confiável, que busca relacionar as informações e características odontológicas, registradas em prontuário clínico, antes da morte de um indivíduo, com as particularidades odontológicas encontradas no exame pericial após a morte. Neste contexto, o presente trabalho teve como objetivo demonstrar a importância da documentação odontológica e a efetividade da odontologia legal no processo de identificação humana, por meio de um relato de caso do Instituto Médico Legal de São Luís, Maranhão, Brasil. Pode-se concluir que o prontuário odontológico, elaborado pelo cirurgião-dentista na clínica diária, quando bem estruturado, completo e arquivado corretamente, armazena informações pessoais importantes, sendo ferramenta fundamental no processo de identificação humana.

Administrative and clinical denials by a large dental insurance provider

The objective of this study was to assess the prevalence and the type of claim denials (administrative, clinical or both) made by a large dental insurance plan. This was a cross-sectional, observational study, which retrospectively collected data from the claims and denial reports of a dental insurance company. The sample consisted of the payment claims submitted by network dentists, based on their procedure reports, reviewed in the third trimester of 2012. The denials were classified and grouped into ‘administrative’, ‘clinical’ or ‘both’. The data were tabulated and submitted to uni- and bivariate analyses. The confidence intervals were 95% and the level of significance was set at 5%. The overall frequency of denials was 8.2% of the total number of procedures performed. The frequency of administrative denials was 72.88%, whereas that of technical denials was 25.95% and that of both, 1.17% (p < 0.05). It was concluded that the overall prevalence of denials in the studied sample was low. Administrative denials were the most prevalent. This type of denial could be reduced if all dental insurance providers had unified clinical and administrative protocols, and if dentists submitted all of the required documentation in accordance with these protocols.