Forensic Odontology is defined as that branch of dentistry which, in the interest of justice, deals with the proper handling and examination of dental evidence with proper evaluation and presentation of dental findings.

1. FORENSIC ODONTOLOGY Part - I
Presenter – Dr. Ruchika Garg

2. References
 Textbook of Oral Pathology by Shafer – 6th Edition
 Oral and maxillofacial pathology by Neville, Damm, Allen, Bouquot – 3rd Edition
 Essentials of Oral and Maxillofacial Radiology 2nd ed. - Freny Karjodkar
 I A Pretty and Sweet. A look at forensic dentistry - The role of teeth in the determination of
human identity. British Dental Journal, volume 190, no. 7, April 14 2001.
 Shamindra Sengupta et al. Forensic odontology as a victim identification tool in mass disasters: A
feasibility study in the Indian scenario. Journal of Forensic Dental Sciences ; January-April 2014 ;
Vol 6 ; Issue 1.
 Ashith B. Acharya et al. Forensic Dental Age Estimation by Measuring Root Dentin Translucency
Area Using a New Digital Technique. J Forensic Sci. May 2014;Vol. 59, No. 3. doi: 10.1111/1556-
4029.12385.
 Thomas J et al. Dentures in Forensic Identification. - A Review of Methods & Benefits. J Adv Med
Dent Scie 2014;2(1):85-94.

3. Contents
Part - I
Introduction
History
Need of forensics
Various methods of identification
Role of forensic odontologist
Basis of dental identification
Identification in disasters
Identification from DNA

4. Contents
 Identification from Palatal rugae
 Dental profiling
 Sex differentiation
Part - II
 Age estimation
 Bite mark analysis
 Lip prints
 Forensics and medico legal aspects
 Conclusion

5. Introduction
• Forensic derived from latin word
• Forensis - before the forum.
• Odontology – study of teeth
Definition - FDI
• Forensic Odontology is defined as that branch of dentistry which, in the interest of justice,
deals with the proper handling and examination of dental evidence with proper
evaluation and presentation of dental findings.
“ DEAD MAN DO TELL TALES ”

6. Field of activity of
Forensic Odontology
Civil Criminal Research

7. History
• 49 A.D - Agrippina, wife of Claudius - Roman emperor, identified the body of her husbands divorcee
Lollia Paulisa
• 66 A.D - Sabina, Nero’s mistress killed Nero’s wife
• India 1199 AD - Rahtor Raja of Conouj, Jai Chandra was recognized by his false anterior teeth, after
he was killed in a battle
• Dental evidence played a vital role in historical case of identification of Adolf Hitler
Dr. Oscar Amoedo, who was Professor at a dental school in Paris is considered as
"Father of Forensic Odontology".

8. Role of Forensic Odontologist
Identifying unknown remains through dental records
Assisting in identification in a mass disaster
Assisting the Archeologist in determining the ethnicity, gender of the skeletal
remains.
Age estimation of the living and dead individuals.
Recognition and Analysis of bitemarks
Presenting evidence in court as an expert witness.

9. Need for Personal Identification
Legal purposes
Settlement of property dispute
Remarriages
Cremation or burial of the body according to relevant religious
and cultural customs.

10. Methods of Identification
Visual Identification
Fingerprints
DNA
Dental records

11. Basis for Dental Identification
• Dentition is unique ( Keiser – Nielsen )
• Morphology and arrangement of teeth vary from person to person
Dental Identification Procedures
COMPARATIVE
RECONSTRUCTIVE

12. Comparative Identification
Oral Autopsy
Obtaining Dental Records
Comparing Ante-mortem and Post-mortem dental records
Writing a report and drawing conclusions

13. Oral Autopsy
Before the autopsy is carried out, photographs, radiographs, fingerprints, fingernail scrapping and
hair samples are taken.
Examination of the external features of the body.
Forensic dentist should have adequate knowledge about
- Rigor mortis
- Algor mortis
Burned / Incinerated teeth - Stabilized using cyanoacrylic cement, Poly vinyl acetate or clear acrylic
spray paint.

14. Digital Autopsy
• Rapid
• Non destructive documentation process
• More precise
• Any new 2-d views can be reconstructed ; used for visualization
• Reconstruct 3-d views to visualize soft tissue
Advantages
• Intravenous contrast agents not possible
Disadvantages
Multisliced computed tomography (MSCT)

15. Obtaining Dental Records
• Records may be in the form of
dental charts, photographs, casts, or
radiographs.
• Modified Interpol Ante-mortem
Odontograph

16. Comparing Post and Antemortem Dental Data
Once post - mortem and ante - mortem data is available, they can be compared.
Features evaluated – Tooth morphology and associated bony structures pathology and
restorations.

17. Writing a Report and Drawing Conclusions
Positive identification
Probable identification
Possible identification
Insufficient information
Excludes identification

18. Identification in Disasters
Natural
Man-made

19. Amount of data in a disaster is far greater and so the process is complicated
In addition - human remains may be fragmented, incinerated or commingled.
Involves examining and comparing hundreds or thousands of ante & post
mortem data

20. Dental Section
Postmortem unit
Antemortem unit
Comparison and
identification unit

21. Postmortem Unit
Location at which body is recovered is noted
Preliminary examination of mouth is made to evaluate the oral condition.
The dental examination is carried out in the temporary mortuary.
A portable dental radiography apparatus may be required

22. Antemortem Unit
Collection of as much information as possible within a short period of time.
Dental records should be located after communication with the relatives and
dentists of the victim.
All information obtained is then transferred onto the standard Interpol Ante -
mortem composite chart.

23. Comparison and Identification Unit
 Comparison and confirmation of identification
The ante-mortem data are taken individually and compared to the post-
mortem data
IDENTIFY, ODONTID, CAPMI and IDIS
Final identification should always be done by dentist manually

24. Identification from Dental DNA
If the dental records are not available
Dental DNA is extracted from teeth and compared with the DNA of the
victim’s siblings or parents.
“ EVERY CONTACT LEAVES A TRACE ”

25. Types of DNA
Genomic or
Nuclear DNA
Mitochondrial
DNA

26. Mitochondrial DNA Typing
Maternally derived
DNA profile can be developed from highly degraded sample
Many copies of mtDNA may be present ; whereas only 1 - 2 copies of nuclear
DNA

27. Extraction of Dental DNA
Pulpal tissue best source of
DNA
Cryogenic grinding for
extracting DNA
Conventional endodontic
access

28. Application
9/11 attacks
• There were more than 20,000 specimens of human remains recovered after the 9/11 attacks.
• Only about half of the victims were identified by 2005 and the rest were considered unidentifiable.
• But in 2007, the process of identification was restarted using an advanced STR-based technology
became available and even tiny and degraded samples of teeth and bones became adequate for
identification.
The Indian Army has initiated DNA profiling of all its soldiers in 2011. This database will be valuable to
identify soldiers for purposes of record, as well as to present the remains to their families.
Muruganandhan J, Sivakumar G. Practical aspects of DNA-based forensic studies in dentistry. Journal of Forensic Dental Sciences.
2011;3(1):38-45. doi:10.4103/0975-1475.85295.

29. Application
• A very interesting case was presented by Sweet and Sweet (1995) in which a victim was incinerated
and her body was completely carbonized and DNA extraction by usual method was not possible.
• However, her body was identified after an unerupted third molar enabled extraction of DNA.
• The Indian Ocean tsunami of 26 December 2004 created major challenges for forensic identification
of dead bodies.
• DNA profiling were useful in identification of those bodies where other dental methods were not
successful.
Girish K, Rahman FS, Tippu SR. Dental DNA fingerprinting in identification of human remains. Journal of Forensic Dental
Sciences. 2010;2(2):63-68. doi:10.4103/0975-1475.81284.

30. Palatal Rugae in Identification
Useful in edentulous persons
Rugae patterns like teeth are considered unique to an individual
Limson and Julian have developed a computer software program which makes use of the principle commonly employed in
fingerprint analysis.
The plotted points are assessed by the software program and the information stored sequentially, corresponding to the
pixel position.

31. Classification of Palatal Rugae
Primary rugae (>5mm)
Secondary rugae(3-5mm)
Fragmentary rugae (2-3mm)
Rugae <2mm is not taken in to
consideration
Lysell measured rugae in a straight line from medial to lateral and categorized as

32. Branched,
Unified,
Cross-linked,
Annular, and
Papillary.

33. Analysis of Rugae Pattern
Thomas and Van Wyk have manually traced rugae pattern from ante and postmortem dentures and
superimposed tracings on photographs of plaster model
Study conducted
 A recent study by Nayak et al. suggested that ruga patterns are useful in identifying an individual’s race or ethnicity.
In particular, they examined straight, curved, wavy, and circular ruga shapes in populations originating from southern
and western India, and found significant differences between them.
While straight rugae were more frequently found among southern Indians, curved rugae had a greater incidence
among western Indians.
Based on ruga shape, they were able to correctly identify an individual’s origin in 70% of cases.
Anoop Jain et al. Palatal rugae and their role in forensic odontology. Journal of Investigative and Clinical Dentistry (2013), 4,
1–8.

34. Use of Ameloglyphics in Personal Identification
• Tooth prints are the pattern formed by the enamel rod ends at the crown surface of the tooth.
• Manjunath and coworkers recorded the enamel rod end pattern using acetate peel technique.
• Based on their recent study that examined 60 subjects and 120 teeth, they have categorized tooth
prints into eight different patterns and demonstrated that no two teeth have similar pattern and
coined the term Ameloglyphics.

35. Dentures in Forensic Identification
Rationale of forensic dentures
• Labeled dental prostheses are critical in identification purposes after major mass disasters.
• Also avoids the confusion of mixing of dentures in geriatric and mental institutions and in cases of
hospitalized unconscious patients where dentures are maintained by care takers.
• Also useful to find out the correct mold and shade of teeth for the replacement of broken denture
teeth by incorporating those details in the denture.

36. Classification for different types of denture labeling
systems
• Marking with embossed letters
• Engraving the denture
• Writing on the denture surface
Surface
marking
method
• Metal identification bands
• Computer-printed denture microlabeling system
• Lead paper label and radiograph
• Denture Bar coding
• Laser etching
• Radiofrequency identification tags (RFID)
Inclusion
method

37. Engraving the denture
• This is the simplest way of marking dentures
• The two letters are engraved with a small round dental bur on the fitting surface
of the maxillary complete denture.
• The first letter is the initial letter of the name ; and
• The second letter (X) is the initial letter of the surname.

38. Marking with embossed letters
• Embossed letters are made by scratching or engraving on the model before processing.
• Initial letters are written on the buccal surface of the disto-buccal flange.
• Identification letters are typed on embossing tape with a manual label - maker and
attached to the appropriate position on the framework wax pattern and casting is finished.
• The marked plate will be visible through tissue-colored acrylic

39. Writing on the denture surface
• Disposable blade used to cut the patient’s name in straight lines on buccal surface of the
distobuccal flange
• Then lead pencil or ink pen is rubbed over fine grooves to make them more evident.
• Requires frequent remarking, possibly every 3 to 4 weeks
Heath et al (1988) mentioned a technique in which the roughened surface
of a finished denture could be temporarily marked with a fiber-tip pen &
these marks could be protected against abrasion with layers of sealant

40. Metal identification bands
• Dentures have been marked in Sweden with a stainless steel metal band incorporated into
the acrylic containing the personal ID of the patient and incorporated to denture pre or post
fabrication.
• Metallic markers have been found to be the most durable form of marker in cases of severe
damage.

41. Computer - printed denture micro labeling system
• Berry et al (1995) suggested a post- fabrication technique for identification of prosthetic devices.
• The identification label bearing the patient’s details is computer generated and placed in slot in the
denture followed by saturated clear resin polymer applier to seal it & cured in a pressure pot.
• Similarly Ling (1998) suggested a computer - printer denture microlabelling system in which patient’s
details are computer printed & then photocopied onto a transparency sheet in 50% reduced size.
• After treating with cyanoacrylate acid esters adhesive solution the microlabel is incorporated into the
denture during the packing stage.

42. Lead paper label and radiograph
• Mona Sayed et al (2009) explained using a lead foil paper found in the intra-oral x-ray film to type the
patient's data with any manual ribbon typewriter.
• During the trial closure stage, flask is re-openned
• Identification label is incorporated
• Alternatively, the label can be incorporated after the denture is processed by cutting a depression
and then covering with light cured acrylic resin of the same color.
• When a periapical radiograph is taken of the denture, the patient's details would appear clearly in it.

43. Denture bar coding
• A bar code applicable to dentures consist of a machine readable code of a series of bars and spaces
printed in defined ratios.
• A machine forces the paint through the silk, when heated to 860°C for 30 min in an industrial
porcelain oven.
• The barcode is then read with a reader, and incorporated on to the denture, sealed with acrylic resin
and could be used for crowns also.
• Barcoding is technique sensitive but it provides exact information.
Rajendran et al in 2012 devised a comparatively simple 2-D bar-code technique with patient’s details
such as name, and social security number using a code generator.
• The 2-D bar code label is printed and laminated
• Bar code is then incorporated in the denture with clear acrylic resin.

44. Laser etching
• A copper vapor laser (CVL) is available that can etch a patient’s identification into the
metal surface of a partial denture easily and legibly
• Font size of the data is reduced by a CVL beam focused and
• Then it is delivered to the material surface by the two axis scanner mounted with mirrors
• A personal computer controls the movement of the scanner and the firing of the CVL.
• As the method requires specialized equipment it is very expensive and require
experienced technicians to perform.

45. Radiofrequency identification tags (RFID)
• The inclusion of radio-frequency identification (RFID)- tags within dentures is a cosmetic, effective
labeling method
• Preferred because of their small size (8.5×2.2 mm) and the large amount of denture user data that can
be stored in them.
• Consists of a data carrier, or tag, and an electronic handheld reader that energizes the transponder by
means of an electromagnetic field emitted via the reader’s antenna.
• It then receives the coded signal returned by the transponder and converts it into readable data.
• The chip remains intact and readable in sub-zero temperature as well as after burning for 1 hr at
1500°C.

46. Dental Profiling
Dental profiling includes identifying different parameters pertaining to the unknown
individual.
These include parameters like ethnic origin / race, age and gender.

47. Identifying ethnic origin from teeth
Human race can be characterized either according to their races (Caucasians,
Mongoloids and Negroids) or by their geographic origin.

48. Genetic and environmental influences on teeth
Dental feature have a complex mode of inheritance and are a
combination of hereditary factors and environmental effects to which a
person is exposed.
Different populations show considerable diversity in their dentition.
Dental features can be classified into
1. Metric : Based on measurements
2. Non-metric: Based on shape

49. Non - metric dental features
Shovelling
Carabelli’s Trait
Three-cusped maxillary second
molar
Mandibular molar groove pattern
Four cusped mandibular molars

50. Sex Differentiation
Sex can be determined based on data from morphology of skull and
mandible, tooth measurements and by DNA analyses of teeth.

51. Craniofacial Morphology and Dimensions
1. Architecture Rugged Smooth
2. Frontal eminence Small Large
3. Forehead Sloping Vertical
4. Supra-orbital ridges Well-developed Slightly-developed
5. Mastoid process Large Small
6.Palate Large, U-shaped Small, Parabolic
7.Occipital area Large Small
MALE FEMALESKULL

52. MANDIBLE Larger, thicker and
broader ramus
Smaller, thinner and
narrower Ramus
Condyles Larger Smaller
Chin Shape Squarish
Rounded/pointed
Gonial Angle Less obtuse More obtuse
MALE FEMALE

53. Dental Index
• Tooth proportions may also be used in differentiating in between genders
Using Mandibular Canines:
Using the mesio-distal dimension of mandibular canines a formula was obtained
MCI = Mesio-Distal crown width of mand. crown
Mand. Inter canine arch width
Standard MCI = (Mean female MCI – SD) + (Mean female MCI + SD)
2
Mesio-distal dimension of mandibular canines in females is less than males.

54. Sex determination by DNA analysis
• Amelogenin – secreted by ameloblasts
• AMEL gene –

55. Sex determination from dental pulp
• Basis of fluorescence of distal end of a long arm of Y-chromosome in dental pulp
• Unreliable – due to putrefaction
• Acetin-orcin stain – Y-chromosome
• 0.5% Quinacrine HCL staining
• Toluidene blue staining – detecting female x-chromatin (Barr bodies)
Case reported
• Among the several cases described in the literature with DNA isolation from teeth, a very important report was published by
Sweet and Sweet (1995).
• This paper presents a case of human remains identification in which a victim of murder was incinerated and had her body
almost completely carbonized, reduced to approximately 25% of its original size, which then precluded DNA analysis by the
usual methods.
• However, a preserved unerupted third molar enabled DNA extraction from the dental pulp (1.35 µg), which was an excellent
source of high molecular weight genomic DNA.
Sweet D, Sweet CHW. DNA analysis of dental pulp to link incinerated remains of homicide victim to crime scene. J Forensic
Sci. 1995;40:310-4.