Dental Identification Through Endodontic Radiographic Records: a Case Report

Abstract

Objective of work

The present study aims to report a case of successful human identification based on the comparison of ante-mortem and post-mortem records of endodontic treatment. Based on these, the legal value of storing and updating clinical records is highlighted throughout the text.

Case report

An unknown body was recovered from a traffic accident site. Forensic examination was conducted in order to establish the identity of the victim. Based on the absence of ante-mortem fingerprint registration in the national database, the search for AM data was performed using periapical radiographic records from private dental clinics. A positive dental identification was achieved analyzing evidence of endodontic treatment.

Conclusion

Dental radiographs play a valuable role as legal tools supporting the criminal demands on the daily forensic practice. Specifically in endodontics, periapical radiographs are essential for a proper treatment. In forensics, these radiographs represent a solid source of ante-mortem data for human identifications.

Introduction

Currently, an increased trend of lawsuits is observed worldwide. Consequently, the correct registration of clinical procedures becomes more important over time (1). In odontology a detailed description of the treatment plan, practical steps and post-treatment outcomes is essential to support the dentist against potential legal and ethical complaints (2). Moreover, the registration of dental treatment also allows for further comparative techniques in human identification cases (3, 4). To sum up, the registered clinical data play an important part both in the civil and criminal areas of the forensic environment.

In this context, endodontics is a specific branch of odontology, which essentially depends on imaging exams (5). Dental radiographs are the most common source of ante-mortem (AM) evidence for human identification (6). Once the AM data is obtained, the comparison with post-mortem (PM) data is enabled (7, 8). The comparative human identification is usually based on forensic evidence, such as dental treatments and unique morphology (5).

Based on that, the present study reports a case of human identification through the comparison between AM and PM endodontic findings, highlighting the relevance of endodontics as an essential adjuvant to the forensic sciences.

Case report

In 2005, an unknown body, recovered from a traffic accident site, was referred to the Medico-Legal Institute of Goiania, Brazil. The body awaited in the institute for 30 days allowing the relatives to claim it. The relatives did not come forward, and the body was buried as an unknown person. Nevertheless, the PM data of the victim was properly registered for possible human identification needs.

In 2006, six months after the burial, potential relatives of the victim claimed the body, and the exhumation and human identification were performed. The fingerprint identification was not feasible due to the absence of AM fingerprint data, making necessary the search for personal data from previous medical and dental treatments of the victim. The relatives provided dental AM data collected from a private dental clinic. The data consisted of periapical radiographs, dated from 2001 and 2004, related to the endodontic treatment of the maxillary right second pre-molar (#15) (Figure 1); and the maxillary left lateral incisor (#22) (Figure 2). Moreover, the periapical radiographs revealed bilateral pneumatization of the maxillary sinuses in the molar region, and the absence of the maxillary right first molar (#16). Based on that, the PM data was obtained performing periapical radiographs of teeth highlighted AM. The same forensic evidence was detected both AM and PM, resulting in a positive dental identification.

Figure 1.

– Comparison of ante-mortem (A: 2001, B: 2004 and C: 2004) and post-mortem (D: 2006) periapical radiographs, highlighting the endodontic treatment of the maxillary right second pre-molar (#15); the pneumatization of the right maxillary sinus in the molar region; and the missing maxillary right first molar (#16).

Figure 2.

– Comparison of ante-mortem (A: 2001 and B: 2004) and post-mortem (C: 2006) periapical radiographs, highlighting the endodontic treatment of the maxillary left lateral incisor (#22).

Discussion

Dental radiographs are considered the most reliable source of AM data in the human identification field (6). Specifically, dental radiographs allow for a close PM duplication of AM evidence, consequently enabling an optimal comparative procedure. Additionally, root canal treatments are less modified in the clinical routine if compared to dental interventions performed on the dental crown. Thus, endodontic identifiers are maintained for a longer period as forensic tools (6).

In special situations, such as major fire disasters, the dental structures become fragile (9). However, endodontic filling materials remain preserved up to 1100° Celsius, allowing for human identification processes (10). Accordingly, Bonavilla et al (11), 2008, confirmed the preservation of microscopic structural patterns of root sealers and gutta percha exposed to high temperatures.

The practical usefulness of endodontic evidence for human identification was already described by Spyropoulos and Liakakoy (12) in 1990. The authors achieved a positive dental identification based on the endodontic treatment and morphologic outline of a single maxillary right second premolar. In 1996, Weisman (13) corroborated the reliability of AM endodontic records as a forensic tool performing a successful dental human identification. Nowadays, the present study highlights the legal importance of storing and updating clinical records which allow for a positive dental identification based on endodontic treatment. Endodontists must be aware of the proper techniques for optimal radiographic dental assessment, making feasible a PM radiographic duplication for the comparative human identification process.

Conclusion

Despite the constant enhancement of dental techniques, materials and facilities, the conventional radiographs, routinely performed in the clinical practice, are still the most common source of forensic AM data for the human identification process. In this context, endodontics becomes a valuable specialty in the forensic scope, once periapical radiographs are often performed. The present case report illustrates the relevance of properly recording clinical interventions, through dental radiographs, providing a successful case of positive dental human identification based on endodontic findings.