The radiographic diversity of dental patterns among 7219 young individuals-a contribution to disaster victim identification.

The diversity of dental patterns is a fundamental topic in disaster victim identification. The current scientific literature, however, is scarce of data regarding young individuals. This study aimed to assess the radiographic diversity of dental patterns, considering missing, unrestored, and filled teeth in young individuals. The sample consisted of 7219 panoramic radiographs of individuals between 12 and 22.9 years. The permanent teeth, except third molars, were coded as missing, unrestored, or filled and odds ratios (OR) were calculated based on sex, dental arch, and age. The sex-combined sample had 1.116 distinctive dental patterns. "All unrestored" teeth was the most common pattern (OR: 0.437) followed by the sequence of unrestored teeth except restored mandibular first molars (OR: 0.021). Females had more distinctive dental patterns than males (p < .001), while males had more unrestored teeth (p < .001). In the age category of 12-12.9 years, the OR for finding a distinctive dental pattern was 11%, while in the age category of 22-22.9 years it increased to 58%. On the other hand, the OR for "all unrestored" gradually decreased according to age (74% in the younger category, and 23% in the older age category). The distinctiveness of dental patterns among young individuals is affected by the predominance of unrestored teeth. However, registering a single filled tooth in a remaining unrestored dentition can reduce exponentially the probability of finding an identical pattern of missing, unrestored and filled teeth.

Forensic International Dental Database (FIDBv2) for adult age-at-death estimation in multiple forensic contexts: Strengthening the operationalization of the Lamendin criteria in a global scope model.

The aim of this study is to validate the FIDBv2 online procedure for adult age-at-death estimation using root dentine translucency (RDT) and periodontal retraction (PR) of single-rooted teeth in a worldwide sample. The sample includes 4810 teeth of 2559 individuals from 16 countries of America, Europe and Asia. Bias and inaccuracy between documented (DA) and estimated ages (EA) were calculated. Pearson and Intraclass Correlation Coefficients were computed to assess the strength of agreement between pairs of data, while Kolmogorov-Smirnov Z was used to evaluate the statistical significance of the differences. The percentages of correctly estimated cases within different age ranges were obtained to find trends in the reliability of the results. Most of the biases (-4.61-1.31 years) and inaccuracies (4.81-9.72 years) are low. The dispersion of EA increases with age and almost all the DA-EA correlations are above 0.75. DA-RDT and DA-PR correlations are positive, most of the former being high (0.74-0.91), and the latter being low (0.11-0.54). The highest percentages of correct estimations are identified for the ±7.5 and ±10 years ranges, and most comparisons of bias and inaccuracy between countries are non-significant. The high correlations between DA and EA suggest that the method is robust and reliable for a global application. Mean errors are low, with the best results found in the 30-69-year-old cohort. This research supports that the method is effective and accurate for age estimation in forensic contexts worldwide, thus reaffirming it is a generalizable procedure locally and internationally.

The Brazilian (FRANCO) method for dental age estimation: Willems' model revisited.

OBJECTIVES: This study aimed (I) to test the Willems' dental age estimation method in different geographic samples of the Brazilian population, and (II) to propose a new model combining the geographic samples in a single reference table of Brazilian maturity scores. MATERIALS AND METHODS: The sample consisted of 5017 panoramic radiographs of Brazilian males (n = 2443) and females (n = 2574) between 6 and 15.99 years (mean age = 10.99 ± 2.76 years). The radiographs were collected from the Southeastern (SE) (n = 2920), Central-Western (CW) (n = 1176), and Southern (SO) (n = 921) geographic regions. Demirjian's technique was applied followed by Willems' method and the proposed Brazilian model. RESULTS: Willems' method led to mean absolute errors (MAE) of 0.79 and 0.81 years for males and females, respectively. Root mean squared errors (RMSE) were 1.01 and 1.03 years, respectively. The Brazilian model led to MAE of 0.72 and 0.74 years for males and females, respectively, and RMSE of 0.93 years for both sexes. The MAE was reduced in 70% of the age categories. Differences between regions were statistically (p < 0.05) but not clinically significant. CONCLUSION: The new model based on a combined population had an enhanced performance compared to Willems' model and led to reference outcomes for Brazilians. CLINICAL RELEVANCE: Assessing patients' biological development by means of dental analysis is relevant to plan orthopedic treatments and follow up. Having a combined-region statistic model for dental age estimation of Brazilian children contributes to optimal age estimation practices.

Positive identification through comparative dental analysis in mass disaster: a systematic review and meta-analysis.

PURPOSE: The study aimed to assess the probability of achieving positive identification through comparative dental analysis (CDA) and to determine the factors that influence its success rate in mass disaster scenarios. METHODS: An electronic literature search was conducted across six databases for observational studies that reported both the total number of mass disaster victims and the count of victims identified through CDA alone. A random-effect meta-analysis, using the proportion of victims identified with CDA as the effect size, was conducted alongside subgroup analyses based on the type of disaster (natural or non-natural), the disaster classification (open or closed), and the geographical region (i.e., Europe, Asia). RESULTS: The search yielded 3133 entries, out of which 32 studies were deemed eligible. Most of the studies (96.8%) presented a low risk of bias. The meta-analysis revealed a mean weighted-proportion probability of 0.32, indicating that forensic odontology could identify about one-third of the victims in a mass disaster. The probability of comparative dental identification was three times higher in closed mass disasters compared to open disasters (p < 0.05) and was higher in mass disasters occurring in North America and Europe compared to other regions (p < 0.05). CONCLUSION: The current result suggested that CDA can identify approximately 32% of a victim in a hypothetical scenario, emphasizing the integral role of teeth and forensic odontology in victim identification framework.

How reliable is stature estimation by dental means? Systematic review and meta-analysis.

Dental measurements have been proposed as parameters for stature estimation for at least 85 years. The scientific literature on the topic, however, is controversial regarding the performance of the method. This systematic literature review of observational cross-sectional studies aimed to compile evidence to support decisions in the forensic practice regarding the use of dental measurements for stature estimation. Embase, LILACS, MedLine (via PubMed), SciELO, Scopus, Web of Science, DansEasy and Open Access Thesis and Dissertations (OATD) were searched. Data regarding the rate of correct stature classifications were extracted. A meta-analysis with a Random Intercept Logistic Regression model and a Logit Transformation was conducted. The search led to 10.803 entries, out of which 15 were considered eligible (n = 1486 individuals). The studies were published between 1990 and 2020 and were authored by South American (n = 7) and Asian (n = 8) research teams. Dental measurements were predominantly (93.34 %) performed on dental casts or via intraoral inspection. The overall rate of correct classifications based on stature was 68 %. Excluding outliers, the overall accuracy of the method decreased to 64 % (95 %CI: 54-73 %). Significant heterogeneity was detected (I² = 72.4 %, τ2 = 0.24, H = 1.91, p < 0.001). Egger's test (p = 0.94) and the funnel plot did not reveal publication bias. Dental measurements are not reliable for stature estimation in the forensic field.

On the forensic value of tattoos for human identification ­ a literature review / Da importância forense das tatuagens para identificação humana ­ uma revisão da literatura

Disaster victim identification is structured according to international recommendations on the attempt to optimize forensic logistics. The International Criminal Police Organization (INTERPOL) establishes primary and secondary methods for human identification. This study aimed to revisit the existing literature to address the forensic importance of tattoos. The scientific literature has shown advances in the forensic analyses of tattoos specially when it comes to the application of especial imaging techniques, namely photography with infrared light to visualize latent tattoo inks and cover-up tattoos, as well as the use of biochemical processing to distinguish components of the tattoo inks. Other relevant aspect is the fields dedicated to tattoo descriptions in software used worldwide for disaster victim identification, namely PlassData. Coding systems have been proposed as well to facilitate communication in the human identification process. The future of forensic analyses of tattoos is promising considering the increase of research in recent years. Forensic practice might benefit from it with more scientific evidence to support the utilization of tattoo analyses in casework

A identificação de vítimas de desastres em massa é estruturada de acordo com recomendações internacionais na tentativa de otimizar a logística forense. A INTERPOL (International Criminal Police Organization) estabelece métodos primários e secundários para identificação humana. Este estudo teve como objetivo revisitar a literatura existente para abordar a importância forense das tatuagens. A literatura científica tem mostrado avanços nas análises forenses de tatuagens, especialmente no que diz respeito à aplicação de técnicas especiais de imaginologia, como a fotografia com luz infravermelha para visualizar tintas latentes de tatuagens e tatuagens de cobertura, bem como a utilização de processamento bioquímico para distinguir componentes das tintas de tatuagem. Outro aspecto relevante são os campos dedicados à descrição de tatuagens em softwares utilizados mundialmente para identificação de vítimas de desastres em massa, como o PlassData. Sistemas de codificação também foram propostos para facilitar a comunicação no processo de identificação humana. O futuro das análises forenses de tatuagens é promissor considerando o aumento das pesquisas nos últimos anos. A prática forense pode beneficiar-se com mais evidências científicas para apoiar a utilização de análises de tatuagens na condução de casos periciais

Black male, 19: Brazilian "criminal commando" and the breach of human rights / Homem negro, 19 anos: o "comando criminoso" brasileiro e a violação dos direitos humanos

Dental age estimation is a technical procedure performed to support Court decisions in cases of legal liability, clandestine migration, sexual abuse, and several other applications. This study reports a case of an undocumented individuals that was originally identified by the criminal legal system (without a previous civil identity). In his identity records, a name was given: "Black male, 19" ­ indicating his population affinity (African), sex (male) and age (19 years). His body was found decapitated and referred to the medicolegal institute. The dental examination highlighted the presence of a third molar in the very early stage (») of root formation. Age was estimated using five methods based on dental development (the methods of Schour and Massler [1941], Moorrees et al. [1963], Anderson et al. [1976], London Atlas [2010], and Blenkin and Taylor [2012]). All the methods indicated that the individual was a minor, within the range between 14.5 and 15.5 years. This study highlights the importance of assigning adequate personnel to technical tasks in the police/forensic routine in order to safeguard human rights

A estimativa da idade dentária é um procedimento técnico realizado para apoiar decisões judiciais em casos de responsabilidade legal, migração clandestina, abuso sexual e diversas outras aplicações. Este estudo relata o caso de um indivíduo indocumentado que foi originalmente identificado pelo sistema penal (sem identidade civil prévia). Nos seus registos de identidade foi atribuído um nome: "Homem negro, 19 anos" ­ indicando a sua afinidade populacional (africana), sexo (masculino) e idade (19 anos). Seu corpo foi encontrado decapitado e encaminhado a um Instituto Médico-legal. O exame odontológico evidenciou a presença de um terceiro molar em fase muito inicial (») de formação radicular. A idade foi estimada usando cinco métodos baseados no desenvolvimento dentário (os métodos de Schour e Massler [1941], Moorrees et al. [1963], Anderson et al. [1976], London Atlas [2010] e Blenkin e Taylor [2012]). Todos os métodos indicaram que o indivíduo era menor de idade, na faixa entre 14,5 e 15,5 anos. Este estudo destaca a importância de designar pessoal adequado para tarefas técnicas na rotina policial/forense, a fim de salvaguardar os direitos humanos

Identificação odontológica de corpo íntegro utilizando tomografia computadorizada pós-morte - relato de caso pericial / Dental identification of intact body through postmortem computed tomography - forensic case report

Há muito, os conhecimentos odontológicos têm se apresentado como uma ferramenta primordial na determinação da identidade de vítimas de morte violenta, especialmente quando estas se apresentam carbonizadas, putrefeitas, mutiladas ou esqueletizadas, mas também em casos atípicos, como em cadáveres "frescos". Nesse contexto, o presente trabalho tem o objetivo de relatar o primeiro caso de identificação odontológica utilizando-se o equipamento de tomografia computadorizada do Instituto Médico Legal (IML) de Goiânia-GO para obtenção das informações post-mortem (PM) de um cadáver íntegro, que foram confrontadas com os dados da radiografia panorâmica antemortem (AM). Relato de Caso: Um indivíduo vítima de projéteis de arma de fogo foi removido para o IML de Goiânia para os exames de praxe depois de vir a óbito em unidade hospitalar. Apesar de o corpo se apresentar "fresco", a coleta (tomada) de impressões digitais revelou um registro cuja qualidade não permitia a demarcação dos pontos necessários para um confronto papiloscópico. Os supostos familiares, então, apresentaram radiografia panorâmica AM, fato que motivou a equipe pericial a utilizar o recém instalado equipamento de tomografia computadorizada para a obtenção de imagem PM, possibilitando o devido processo de reconciliação (AM x PM), onde foram identificadas diversas similaridades de natureza anatômica e terapêutica que remeteram a uma identificação positiva da vítima. Conclusão: A adoção de abordagens tecnológicas e a alocação de recursos humanos especializados para a identificação humana devem ser prioridades nos serviços de Medicina e Odontologia Legal, visando aumentar a eficiência e precisão no processamento das demandas usuais, bem como para solucionar eventuais desafios técnicos

For a long time, dental knowledge has proven to be a fundamental tool in determining the identity of victims of violent death, especially when they are charred, putrefied, mutilated or skeletonized, but also in atypical cases, such as fresh corpses. In this context, the present work aims to report the first case of odontological identification using the computerized tomography equipment of the Forensic Medical Institute (IML) of Goiânia-GO to obtain post-mortem (PM) information from an intact corpse, which was compared with antemortem (AM) panoramic radiograph data. Case Report: An individual victim of gunshot wounds was taken to the IML of Goiânia for routine examinations after dying in a hospital unit. Although the body was "fresh," fingerprint collection revealed a record whose quality did not allow the necessary points for a papilloscopic confrontation to be marked. The supposed relatives then presented antemortem panoramic radiography, which motivated the forensic team to use the newly installed computerized tomography equipment to obtain PM images, enabling the proper reconciliation process (AM x PM), where several anatomical and therapeutic similarities were identified leading to a positive identification of the victim. Conclusion: The adoption of technological approaches and the allocation of specialized human resources for human identification should be priorities in Forensic Medicine and Odontology services, aiming to increase efficiency and accuracy in processing usual demands, as well as to solve any technical challenges that may arise

Three-dimensional replica of the temporal bone in the teaching of human anatomy.

PURPOSE: The current study proposes the comparison of the visualization and identification of anatomical details between natural human temporal bone, its respective copy from three-dimensional printing, and the virtual model obtained from CBCT. METHODS: The sample consisted of undergraduate students in Dentistry (Group UE, n = 22), Postgraduate students in Radiology and Imaging (Group P-RI, n = 20), and Postgraduate students in Forensic Odontology (Group P-FO, n = 24). All participants attended a theoretical class on specialized anatomy of the temporal bone and subsequently performed the markings of 10 determined structures. RESULTS: The number of correct identifications was similar in natural bone and printed three-dimensional models in all groups (p > 0.05). The virtual model showed a significantly lower number of correct structures (p < 0.05) in the 3 groups. In general, there were significantly higher percentages of accurate answers among postgraduate students compared to undergraduate students. Most graduate students believed that the printed three-dimensional model could be used to teach anatomy in place of natural bone, while undergraduate students disagreed or were unsure (p < 0.05). Regarding the virtual tomographic image, in all groups, students disagreed or were not sure that its use would be beneficial in replacing natural bone. CONCLUSION: Three-dimensional and virtual models can be used as auxiliary tools in teaching anatomy, complementing practical learning with natural bones.

Atlas of Dental Near-Infrared Transillumination Images.

Technological improvements have introduced significant innovations in dentistry and broadened the array of tools and techniques in dental care. One technological development that has been widely researched over the past 20 years is the use of Near-Infrared Transillumination (NIRT) imaging for the diagnosis of dental caries. This paper aims to introduce a comprehensive collection of NIRT images, intended as a reference tool for routine dental examinations, dental research, pedagogical activities, and forensic odontology. The collection presents pairwise clinical and NIRT images categorized as follows: (a) healthy teeth, (b) carious teeth, (c) restored teeth, (d) enamel defects, and (e) diverse findings. This atlas could be a valuable tool for the dental community as it is designed as an identification guide of NIRT illustrated dental features.

Accuracy of the London Atlas to estimate the age of legal majority in a sample of the Amazon Regio.

Background: Estimating the age of majority is a challenging task in forensic odontology, especially because the third molars are usually the only developing teeth between the ages of 16 and 21 years. The London Atlas emerged as an alternative to estimate age using dental development, eruption and deciduous root resorption as parameters. The method has performed well in young age categories, while its performance for age estimation via third molars has been disputed. The present study tested the performance of the London Atlas to estimate the age of legal majority in a sample of individuals from the Amazon Region. Material and Methods: The sample consisted of 1.256 panoramic radiographs of women (n = 694) and men (n = 562) between 16 and 22.9 years. The method was applied to the maxillary (#28) and mandibular (#38) left third molars. For comparative purposes, the sample was divided into seven age groups: 16├ 16.99; 17├ 17.99; 18├ 18.99; 19├ 19.99; 20├ 20.99; 21├ 21.99; and 22├ 22.99 years. Chronological and estimated ages were compared descriptively by means of mean absolute errors (MAE) and root mean squared errors (RMSE), as well as through Receiver Operating Characteristic (ROC) curves and their area under the curve (AUC). Results: The MAE of the age estimates using tooth #28 was 1.76 years for females and 1.52 years for males. When the tooth #38 was used, the MAE for the females and males were 1.68 and 1.51 years, respectively. The MAE and RMSE increased in ascending order between age categories. Tooth #28 led to 74% of correct classifications around the age of legal majority, while tooth #38 reached 77%. The area under the curve was 0.75 for tooth #28 and 0.73 for tooth #38. Conclusions: The London Atlas should be used carefully to estimate the age of legal majority and not as a single method when the age threshold is 18 years. Key words:Age determination by teeth, forensic dentistry, forensic science, third molar.

On the forensic relevance of tattoos: distinguishing black inks with energy dispersive spectroscopy and backscattered scanning electron microscopy.

PURPOSE: This study aimed to analyze black tattoo inks by means of energy dispersive spectroscopy and backscattered scanning electron microscopy. METHODS: The sample consisted of five types of commercial tattoo pigments of the black colour (Easy Glow™, Electric Ink™, Iron Works™, Master Ink™, and Viper™). An Energy Dispersive Spectroscopy (EDS) detector (Silicon Drift Detector - SDD - type) attached to a Scanning Electron Microscope (SEM) device (Tescan Vega3 LMU, Libusina, Czech Republic) was used. X-ray characteristic signs were detected for each tattoo ink in an interval between 0 and 2.5 keV. The electron acceleration potential in the microscope was 15 keV. Two regions were analyzed for each sample (n = 10). On each region, a micrography of backscattered electrons (BSE) was obtained. Means and standard deviations (SD) of the weight percentages (Wt%) were calculated. RESULTS: C and O were predominant, with a mean O/C ratio between 2.69 and 2.74 Wt%. Electric Ink and Master Ink were the most similar pigments, while Easy Glow was the most distinctive - with agglomerates of Al that had a concentration 25 × higher than other specimens. Other compounds detected in the sample were Cl and Cu. CONCLUSION: EDS and SEM were efficient to distinguish black tattoo inks. These are our preliminary outcomes on the use of EDS and SEM to analyze black tattoo inks. Thus, careful interpretation is necessary to avoid rash applications in human identification practice.

Binary decisions of artificial intelligence to classify third molar development around the legal age thresholds of 14, 16 and 18 years.

Third molar development is used for dental age estimation when all the other teeth are fully mature. In most medicolegal facilities, dental age estimation is an operator-dependent procedure. During the examination of unaccompanied and undocumented minors, this procedure may lead to binary decisions around age thresholds of legal interest, namely the ages of 14, 16 and 18 years. This study aimed to test the performance of artificial intelligence to classify individuals below and above the legal age thresholds of 14, 16 and 18 years using third molar development. The sample consisted of 11,640 panoramic radiographs (9680 used for training and 1960 used for validation) of males (n = 5400) and females (n = 6240) between 6 and 22.9 years. Computer-based image annotation was performed with V7 software (V7labs, London, UK). The region of interest was the mandibular left third molar (T38) outlined with a semi-automated contour. DenseNet121 was the Convolutional Neural Network (CNN) of choice and was used with Transfer Learning. After Receiver-operating characteristic curves, the area under the curve (AUC) was 0.87 and 0.86 to classify males and females below and above the age of 14, respectively. For the age threshold of 16, the AUC values were 0.88 (males) and 0.83 (females), while for the age of 18, AUC were 0.94 (males) and 0.83 (females). Specificity rates were always between 0.80 and 0.92. Artificial intelligence was able to classify male and females below and above the legal age thresholds of 14, 16 and 18 years with high accuracy.

Influence of surgeon experience on implant placement in guided surgeries: A systematic review and meta-analysis of randomized clinical trials.

STATEMENT OF PROBLEM: Guided surgical techniques in implant dentistry use virtual planning to accurately position implants. Understanding the effect of a surgeon's experience on guided surgery is essential to ensure successful outcomes. PURPOSE: The purpose of this systematic review and meta-analysis of randomized clinical trials was to evaluate the influence of a surgeon's experience on the accuracy of implant positioning in guided surgery for completely or partially edentulous patients. MATERIAL AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, searches were conducted in the PubMed, Scopus, Web of Science, EMBASE, Cochrane Library, SciELO, and nonpeer-reviewed literature databases. Studies that met the population, intervention, control, and outcome (PICO) strategy were included: a completely or partially edentulous maxilla or mandible, guided surgery performed by experienced and inexperienced surgeons, and assessing implant positioning accuracy. A random-effects meta-analysis with a 95% confidence interval was conducted using Stata 15.1. The risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials (RoB2), and evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022302288). RESULTS: Three articles from 2017 to 2020 encompassing 43 participants (22 men and 21 women) with a mean age of 61.2 years and a total of 150 implants were included. No significant difference was found between experienced and inexperienced surgeons in terms of angular, cervical, or apical deviations of the implants (95% confidence interval, P<.05). The difference between surgeons regarding positioning accuracy was less than 0.01 degrees for angular deviation, 0.35 mm for apical deviation, and 0.16 mm for cervical deviation. Low heterogeneity was observed for angular deviations (Q P=.021, I2=34%, and t2<.001) and cervical deviations (Q P=.18, I2=45%, and t2=.064). High heterogeneity was observed for apical deviations (Q P<.001, I2=87% and t2=.522). The overall bias risk was moderate, with the evidence certainty ranging from low to moderate. CONCLUSIONS: In guided surgery, the surgeon's experience did not significantly impact the occurrence of deviations in implant positioning.

Influence of CBCT-derived panoramic curve variability in the measurements for dental implant planning.

OBJECTIVE: To investigate whether the curve markings performed prior to panoramic and cross-sectional reconstructions can influence the planning of oral implants. METHODS: Twenty oral radiologists landmarked the reference panoramic curves in 25 CBCT scans of the mandible. Bone height was measured on the resulting cross-sectional slices in the edentulous region of the lower first molar. The following data were recorded: (1) number of landmarks used to build each reference curve; (2) shape of the reference curve (inverted "U", inverted "V" or "horseshoe"); and (3) measurement in the first molar region. The data were assessed for variability based on the number of landmarks, the shape of the reference curve, and the measurements obtained. RESULTS: The number of landmarks used to guide the panoramic reconstruction varied among radiologists (p < 0.05), but most of them draw curves in inverted "U" shape (68-100%). The reproducibility of the measurements taken in the edentulous mandibular first molar region was excellent (84.7%). The number of landmarks and the shape of the curve did not have a significant influence on the reproducibility of the measurements (p > 0.05). CONCLUSION: Variations of the operator-dependent steps during the panoramic reconstructions occur but do not play a significant part changing the measurements taken for oral implant planning.

Biological profiling using the human mandible.

BACKGROUND: In the absence of soft tissue, skeletal remains are analyzed to identify the deceased. This assessment involves establishing the biological profile that aids medicolegal investigations and fulfils the right of the dead to be identified. Since the mandible is the strongest bone in the skull and easily identifiable, even when fragmented, this study aimed to systematically review its value in constructing the biological profile in the published literature. We searched PubMed, ScienceDirect, Scopus, and Latin American and Caribbean Health Sciences Literature and collected cross-sectional studies published in English before 2021. A risk of bias assessment was completed based on Joanna Briggs Institute's critical appraisal tools. The data are presented descriptively and were analyzed using Microsoft Office Excel 365. HIGHLIGHT: Of the 104 eligible articles, 94 examined the sexual dimorphism of the mandible, while 25 attempted to estimate age. Ancestry and stature were the least explored biological characteristics (five and one articles, respectively). A metric analysis was the most common approach (n = 80), followed by morphological analysis and combined morphologic and metric techniques (n = 18 and n = 6, respectively). The results showed no statistically significant correlation between an individual's mandible and stature. Orthopantomogram radiography continues to be the most common radiographic technique for assessing the mandible. CONCLUSION: The mandible is reliable when used for sex estimation; however, caution should be exercised in relying solely on it for morphological assessments. This review provides guidance on estimating age, sex, and ancestry directly from mandibular specimens or radiographs.

Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review.

BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

An integrative literature review of the potential technical challenges in Forensic Odontology practice ­ an exploratory study / Uma revisão integrativa da literatura sobre os potenciais desafios técnicos na prática da Odontologia Forense ­ um estudo exploratório

Forensic Odontology deals with the presentation of dental evidence in a court of law. An academic exploration revealed instances of technical challenges within the field. This study endeavours to delve into the spheres where these challenges occur, with the core objective of enhancing the quality of practice. An integrative literature review was conducted using the online platforms SCOPUS and Web of Science. Based on the selection criteria, 29 pertinent papers dated 2000-2023 were included. Quantitative analysis of the categories of selected articles was performed using Microsoft Excel 2019 (Microsoft Corp., Redmond, WA, USA). Technical concerns were reported in all facets of Forensic Odontology with the general role of expert witnesses being reported the most (n=8; 27.58%). Within the different facets of the field, age estimation was the most prominent area of concern (n=8; 27.58%) and child abuse and neglect (n=1; 3.57%) represented the least reported category. Findings indicate that there is a need to prioritize avenues to enhance the quality of practice in the general role of expert witnesses and the specific area of dental age estimation. To this end, increased support for researchers must be provided to help validate methodologies. It is advisable to institute mandatory formal training and proficiency testing within the field. Inadequate knowledge of dentists regarding child abuse and neglect has been noted, demonstrating the need for more dedicated quality training. Recommendations for Forensic Odontologists have been curated combining this study's results and the codes of ethics of various forensic organisations

A Odontologia Legal trata da apresentação de provas odontológicas em juízo. Uma exploração acadêmica revelou exemplos de desafios técnicos na área. Este estudo procura aprofundar as esferas onde estes desafios ocorrem, com o objetivo central de melhorar a qualidade da prática. Foi realizada uma revisão integrativa da literatura utilizando as plataformas online SCOPUS e Web of Science. Com base nos critérios de seleção, foram incluídos 29 artigos pertinentes datados de 2000-2023. A análise quantitativa das categorias dos artigos selecionados foi realizada no Microsoft Excel 2019 (Microsoft Corp., Redmond, WA, EUA). Preocupações técnicas foram relatadas em todas as áreas da Odontologia Legal, sendo o papel geral dos peritos o mais relatado (n=8; 27,58%). Dentro das diferentes áreas de atuação, a estimativa da idade foi a área de preocupação mais proeminente (n=8; 27,58%), e o abuso infantil e a negligência (n=1; 3,57%) representaram a categoria menos relatada. Os resultados indicam que há uma necessidade de priorizar caminhos para melhorar a qualidade da prática no papel geral dos peritos e na área específica da estimativa da idade dental. Para este efeito, deve ser prestado maior apoio aos investigadores para ajudar a validar metodologias. É aconselhável instituir treinamento formal obrigatório e testes de proficiência na área. Foi observado um conhecimento inadequado dos dentistas sobre abuso e negligência infantil, demonstrando a necessidade de uma formação mais dedicada e de qualidade. As recomendações para Dentistas Forenses foram selecionadas combinando os resultados deste estudo e os códigos de ética de várias organizações forenses.

Panoramic Radiography vs. CBCT in the Evaluation of the Maxillary Third Molar Roots.

Background and Objectives: A comprehensive understanding of the position of third molar roots and adjacent structures, such as the maxillary sinus (MS), is essential for safe extractions. Diagnostic imaging plays a fundamental role in achieving accurate treatment planning. This study aimed to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the evaluation of maxillary third molar roots and their relationship with the MS. Materials and Methods: Two trained radiologists evaluated third molar images. The number of roots, morphology (fused/conical, divergent, dilacerated, or atypical), and their relationship with the MS in PR and CBCT were registered. Descriptive and inferential statistics were performed using the weighted Kappa test. Results: Regarding the number and morphology of the roots, Kappa values showed moderate (κ = 0.42) and fair agreement (κ = 0.38), respectively. Regarding the proximity with the MS, most of the roots showed close contact (30.6%), or 1/3 of root superimposition (35%), in PR evaluation, while in CBCT, the third molars were in contact with the MS floor (32%), and with alveolar domes (27.2%). Conclusions: PR is a moderately reliable image technique to identify the number of roots and root morphology of maxillary third molars. PR, however, does not provide any radiographic signs that clearly indicate the anatomical relationship between the maxillary third molar roots and the maxillary sinus detected in CBCT images.