A systematic review and meta-analysis of oral and maxillofacial trauma
Cristiana Palmela Pereira, Rui Santos, Adriana Santos, Catarina Gonçalves, Diana Augusto, Ana Rodrigues, Francisco Salvado, Fátima Brilhante
Objective of work: The aim of this study was to determine the most frequent injuries and their relationship with gender, age and aetiology.
Materials and Methods: An Epidemiologic Systematic Review was carried out, in the databases PUBMED and Scopus, between 2010-2020. We used Joanna Briggs Institute Checklist to access the Risk of Bias and Grading of recommendations, assessment, development, and the evaluations (GRADE) method was applied to assess the quality of the evidence of the 78 included articles.
Results and Conclusions: Out of the 78 articles included, 14 were classified as moderate-risk bias and 58 as low risk. Only 20.5% had a prospective design and the male/female ratio ranged from 0.299 to 11.83. The majority of the studies described fractures (67) and only 26 reported dental injuries. The studies were distributed into five regions of countries: Asia, Africa, Latin America, Europe and Muslin regions.
The results showed that road traffic accidents (55.37%) were the most frequent type of trauma, followed by assault (17.56%) and falls (10.21%). Fractures were the most prevalent injuries (84.3%). It was possible to establish an association between road traffic accidents and Asian countries. Assaults were more frequent in Africa, predominantly males, whilst falls increased with age, amongst women, in European countries. Fractures were usually observed in Muslin regions.
(J Forensic Odontostomatol 2022, 40; 3-2:21)
Poornima Parvathala, Narendra R. Chittamuru, Nageswara R. Kakumanu, Lucky Yadav, Sidrah Hamid Ali, Sabha Ali, Sana Hamid Ali, Jyothi Tadakamadla, Santosh K. Tadakamadla8, Sudheer B. Balla
Prediction of the attainment of legal age thresholds, especially in children and young adults, is a common task in medico-legal practice. In many countries, 21 years has medico-legal importance. In the present study, we assessed and compared the accuracy of the third molar maturity index (I3M) and the stages of radiographic visibility of the root pulp (RPV) in predicting the age threshold of 21 years. A sample of 910 digital panoramic radiographs (455 males and 455 females) of adolescents and young adults aged between 16 and 30 of south Indian origin were evaluated. The authors examined the performance of different I3M cut-off values and RPV stages. I3M cut-off value of 0.02 has resulted in better discrimination with an accuracy of 76.92% and 80.44%, specificity of 48.28% and 56.16% in males and females, a sensitivity of 100%, and post-test probability of 65.9% in both sexes. The accuracy and sensitivity of RPV stage 2 were 84.76% and 84.55%, 78.17%, and 78.97% in males and females, while the specificity and post-test probability were 100% in both sexes.
In conclusion, the I3M method resulted in a more significant percentage of false positives and cannot be used to state the attainment of 21 years. However, the presence of RPV stage 2 could say that the subject had already attained the age of 21 years. Further studies are warranted to address the usefulness of these methods.
(J Forensic Odontostomatol 2022, 40; 3–22:33)
Pooja Chakraborty, Astha Pandey, Srikant Natarajan, Samarika Dahal
Forensic odontology is a young area in India. However, it has been used as an integral component in a various medicolegal cases in India. However, the involvement of a dentist in mass disasters still needs to be well recognized. The role of the dentists in any unforeseen circumstances is to contribute as an adjunct hand in Disaster Victim Identification (DVI) which is in an emergent stage in India. This study aimed to assess an Indian dental professional’s knowledge and awareness of their role in DVI. A pre-tested, self-administered anonymous questionnaire consisting of 6 open-ended and 14 close-ended questions was mailed to the participants. A total of 441 responses were recorded. The study indicated adequate knowledge and awareness among dental practitioners. Conversely, only a handful of people had first-hand autopsy experience. Thus, to supplement the skills needed to work at ground zero, it is recommended to develop hands-on training programs for dentists in each state of India. Also, creating a pool of experts in each state of India can strengthen the task force.
(J Forensic Odontostomatol 2022, 40; 3–34:44)
Andrea Baz, Suzana Mantovani, Bianca Santos, Leandro Grecco, Giuliano Gonçalves, Marianna Arakelyan, Jeidson Marques, Ademir Franco
Background: Estimating the age at death is a common procedure in the fields of forensic human identification and anthropological/archaeological investigations. Root translucency and periodontosis are regressive parameters used to estimate the age of adults, more specifically in Lamendin’s method – established in 1992 in a French population. This study aimed to test the applicability and validity of Lamendin’s method in a Brazilian osteological collection.
Methods: The sample consisted of 74 single-rooted teeth obtained from 50 skeletal remains (mean age: 53.20 ± 16.17 years) from Southeast Brazil. Lamendin’s method was applied to enable a comparison between chronological (CA) and estimated ages (EA). A new population-specific equation was designed for the studied sample and the outcomes were compared with those obtained with Lamendin’s original equation.
Results: The original methods led to a general underestimation of 11.32 years (8.83 years in males and 15.91 years in females). The method had a better performance among individuals between 40 and 59 years (mean differences between CA and EA: 4.8 years). The population-specific equation led to a mean overestimation of -2.04 years in males, and a mean underestimation of 3.77 years in females. Underestimations were considerably higher in other age groups.
Conclusion: Despite the apparent improvements, both the original and the population-specific equations revealed coefficients of concordance that were constantly low between CA and EA. These outcomes suggest restrictions to the application of Lamendin’s method in the forensic field, especially for human identification. The method, however, seems to be applicable for anthropological/archaeological applications.
(J Forensic Odontostomatol 2022, 40; 3-45:51)
Histo-morphologic and gravimetric changes of teeth exposed to high temperatures – An in-vitro study
Nisha Sam, Sivakumar Trivandrum Thanappan, Anna. P. Joseph, Varun Baby Amma Raghavan Pillai, Vinod Mony
Background: Fire intelligence is the multidisciplinary basis of reconnaissance, which includes determining the origin, cause, and identification of fire victims. Fire is a destructive force capable of inflicting significant damage. Destruction of soft tissue in fire disasters makes victim identification nearly impossible. Teeth are hard and resilient and withstand such conditions. Analyzing the precise morphological, stereomicroscopic, histological, and gravimetric findings can extract valuable information from dental evidence in forensic investigations.
Materials and Methods: Thirty-six mandibular premolar teeth extracted for therapeutic purposes were exposed to high-temperature gradients. Macroscopic, stereomicroscopic, histological, and dry weight analyses were performed at each temperature gradient.
Results: The colour of teeth changed from yellowish orange to metallic black bronze to chalky white. Stereomicroscopy showed intact teeth at 100°C, gradual micro-cracks at 500°C, and a fully fractured crown at 900°C. Decalcified sections revealed dilatation of dentinal tubular pattern at 300°C. Dentinal tubules showed appearance of vapour bubbles at 400°C, resulting in loss of typical architecture. In the ground sections, alterations in scalloping nature of dentino-enamel junction, coalescing radicular dentinal tubules, and sand cracking appearance of teeth were noted at 100°C, 300°C, and 900°C, respectively. Significant reductions in the weight of the teeth samples were observed with higher temperatures.
Conclusion: From the morphological, histological, and gravimetric changes in a tooth caused by fire, it might be possible to determine the temperature and duration of fire exposure, and the cause of the fire.
(J Forensic Odontostomatol 2022, 40; 3–52:61)