A história da odontologia legal no Brasil. Parte 2: origem enquanto disciplina e especialidade / The history of forensic dentistry in Brazil. Part 2: the origin as discipline and specialty

Em seus primórdios, a Odontologia Legal se destacou, principalmente, por viabilizar a investigação da identidade no âmbito forense. Gradativamente, novas técnicas foram incorporadas e aceitas dentre o rol de atividades desempenhadas nesta seara. Extrapolando as barreiras do empirismo, esta "arte dentária" percorreu caminhos desafiadores até ser aceita e reconhecida como ciência. Ao passo em que Odontologia Legal era consolidada enquanto técnica e ciência, a justiça era munida de ferramentas periciais para a elucidação de casos com significante impacto social. Contudo, apesar de aceita perante a justiça e sociedade, esta ciência pouco se desenvolveria fora dos limites acadêmicos. Restando-se necessária sua inserção neste contexto, a Odontologia Legal passou a ser considerada como importante componente da educação superior no Brasil. Foi na década de 30 que esta ciência integrou legalmente a formação dos Cirurgiões-dentistas, e dela fez parte até os dias atuais. A partir desta data, esta ciência se disseminou de maneira mais abrangente uma vez que figurou entre as disciplinarias obrigatórias requeridas em território nacional. Consideravelmente distinta das demais áreas da Odontologia, a Odontologia Legal veio a ser reconhecida como especialidade aproximadamente 40 depois do seu surgimento nos cursos de graduação. Neste ínterim, somam-se 677 Cirurgiões-dentistas registrados nesta especialidade. Sua origem e inserção como disciplina e especialidade possibilitaram um desenvolvimento exponencial por meio do ensino, pesquisa e extensão, assim como da educação continuada respectivamente. Compilando informações literárias científicas e não científicas, o presente trabalho resgata importante peça histórica da Odontologia Legal e contribui para o enriquecimento da literatura odontológica nacional.

In the early times, Forensic Dentistry was known for having potential application in human identification cases. Gradually, new techniques were included and accepted among those performed by the Forensic Dentist. Along the challenging paths to extrapolate the barriers of empiricism, the "dental art" evolved into science. While in one hand Forensic Dentistry consolidated as technique and science, on the other hand justice improved with tools to elucidate cases of significant social impact. Despite accepted by justice and society, Forensic Dentistry could not develop more out of the academic limits. Over the next years, Forensic Dentistry was discussed and considered as an important part to be included in the undergraduation courses in Brazil. In the 30's this science was legally implemented in the higher education and remained up to the present date. From that moment, Forensic Dentistry was disseminated broadly and became mandatory in dental trainings. Considerably distinct from the other fields in Dentistry, Forensic Dentistry was formally recognized as specialization nearly 40 years after implemented in the undergraduation courses. Currently, the Brazilian Federal Council of Dentistry accounts 677 professionals registered as Forensic Dentists. The origin and acceptance of Forensic Dentistry as subject in undergraduation and graduation allowed a stronger development mainly through research and teaching. The present study compiles the literature to retrieve important information from the history of Forensic Dentistry in Brazil and contributes to the improvement of the scarce scientific literature in the field.

Computational Approach to Identify Different Injuries by Firearms.

Complications arise in the analysis of gunshot wounds to the maxillofacial region, when neither the projectile nor the gun is found at the crime scene. We simulated 5- and 15-cm firing distances at a human mandible to investigate the external morphology of entrance wounds based on fire range. The ammunition models, .40-caliber S&W, .380-caliber, and 9 × 19-mm Luger, were constructed with free-form NURBS surfaces. In a dynamic simulation, projectiles were fired against mandibular body 3D model at 5 and 15 cm. All entrance wounds presented oval aspect. Maximum diameter and von Mises stress values were 16.5 mm and 50.8 MPa, both for .40-caliber S&W fired at 5 cm. The maximum energy loss was 138.4 J for .40 S&W fired at 15 cm. In conclusion, the mandible was most affected by .40-caliber S&W and morphological differences were observable in holes caused by different incoming projectile calibers fired at different distances.

Finite-element analysis of 3 situations of trauma in the human edentulous mandible.

PURPOSE: Maxillofacial trauma resulting from falls in elderly patients is a major social and health care concern. Most of these traumatic events involve mandibular fractures. The aim of this study was to analyze stress distributions from traumatic loads applied on the symphyseal, parasymphyseal, and mandibular body regions in the elderly edentulous mandible using finite-element analysis (FEA). MATERIALS AND METHODS: Computerized tomographic analysis of an edentulous macerated human mandible of a patient approximately 65 years old was performed. The bone structure was converted into a 3-dimensional stereolithographic model, which was used to construct the computer-aided design (CAD) geometry for FEA. The mechanical properties of cortical and cancellous bone were characterized as isotropic and elastic structures, respectively, in the CAD model. The condyles were constrained to prevent free movement in the x-, y-, and z-axes during simulation. This enabled the simulation to include the presence of masticatory muscles during trauma. Three different simulations were performed. Loads of 700 N were applied perpendicular to the surface of the cortical bone in the symphyseal, parasymphyseal, and mandibular body regions. The simulation results were evaluated according to equivalent von Mises stress distributions. RESULTS: Traumatic load at the symphyseal region generated low stress levels in the mental region and high stress levels in the mandibular neck. Traumatic load at the parasymphyseal region concentrated the resulting stress close to the mental foramen. Traumatic load in the mandibular body generated extensive stress in the mandibular body, angle, and ramus. CONCLUSIONS: FEA enabled precise mapping of the stress distribution in a human elderly edentulous mandible (neck and mandibular angle) in response to 3 different traumatic load conditions. This knowledge can help guide emergency responders as they evaluate patients after a traumatic event.

Comparison of gunshot entrance morphologies caused by .40-caliber Smith & Wesson, .380-caliber, and 9-mm Luger bullets: a finite element analysis study.

Firearms can cause fatal wounds, which can be identified by traces on or around the body. However, there are cases where neither the bullet nor gun is found at the crime scene. Ballistic research involving finite element models can reproduce computational biomechanical conditions, without compromising bioethics, as they involve no direct tests on animals or humans. This study aims to compare the morphologies of gunshot entrance holes caused by.40-caliber Smith & Wesson (S&W), .380-caliber, and 9×19-mm Luger bullets. A fully metal-jacketed.40 S&W projectile, a fully metal-jacketed.380 projectile, and a fully metal-jacketed 9×19-mm Luger projectile were computationally fired at the glabellar region of the finite element model from a distance of 10 cm, at perpendicular incidence. The results show different morphologies in the entrance holes produced by the three bullets, using the same skull at the same shot distance. The results and traits of the entrance holes are discussed. Finite element models allow feasible computational ballistic research, which may be useful to forensic experts when comparing and analyzing data related to gunshot wounds in the forehead.

Positive identification of a burned body using an implanted orthopedic plate.

Human identification is usually obtained by comparing fingerprints, antemortem and postmortem radiographs, dental records and also by DNA profiling. Sometimes forensic investigators come across some medical appliances such as orthopedic devices. These medical devices may be useful to achieve positive human identification. This paper aims to present a positive identification of a burned human body by tracking batch numbers engraved in an implanted orthopedic device found in the decedent's left ulna bone. The examiners also collected and analyzed other valuable hints related to the case. Forensic examination can provide reliable positive human identification, even if few, but precise information can be obtained from antemortem and postmortem records. The present report illustrates a set of valuable techniques and how identifying numbers in orthopedic devices are helpful to determine positive human identification in cases of carbonization. As seen in this case, the forensic experts used low-cost identification procedures with accurate results, avoiding DNA profiling method that would be of higher cost and time consuming. Considering social and legal aspects, it is quite important that physicians and dentists understand that correct and accurate records of surgeries they perform, such as fixation of orthopedic devices and dental implants, are utterly relevant and helpful in cases of human identification.

O odonto-legista e um corpo não-identificado / The forensic dentist and an unknown body

Um adulto jovem desapareceu e oito dias após esse evento foi encontrado um corpo em estado avançado de putrefação com característica corporal similar e com as mesmas vestimentas. O reconhecimento e a leitura papiloscópica estavam impossibilitados devido ao estado em que fora encontrado o corpo. Os cadáveres em estado avançado de putrefação, os quais se tornam impossíveis constatar a identidade pelos meios convencionais, têm a possibilidade de serem identificados por meio dos elementos dentários. Para isso, é mister ter à mão dados produzidos em vida, principalmente os registros realizados após um tratamento odontológico. Este relato teve o objetivo de demonstrar a importância do registro dos procedimentos odontológicos realizados nos pacientes os quais eventualmente servirão de subsídios em identificações cadavéricas de corpos não identificados, assim como também apresentar o trabalho desenvolvido pelo cirurgião-dentista atuando como odonto-legista. O cirurgião-dentista deve utilizar qualquer recurso no intuito de registrar suas atividades diárias, pois por mais simples que sejam podem elucidar um desaparecimento e minorar a angústia de uma família angustiada.

A young adult disappeared and eight days later a similar body with the same clothes was found in advanced state of decomposition. It was not possible to recognize the body or to take fingerprints because of its state. Cadavers in advanced states of decomposition can be identified by dental elements when the conventional means of identification are not possible. For this purpose, it is essential to have access to data that were produced while the person was still alive, especially the dental records after a dental treatment. The objective of this paper is to show the importance of recording dental procedures which may eventually be used to identify cadavers and to present the work developed by a dental surgeon working as a forensic dentist. The dental surgeon must use any resource available to record his or her daily activities, since no matter how simple they are, they can elucidate a disappearance and alleviate the anguish of a family in distress.