The Dentists’ Understandings on Dental Medical Records in East Java, Indonesia

Introduction: A dental medical record is a systematic documentation of a patient, provided by the dentists. Various information including the patient data, diagnoses, treatments, and odontogram are recorded in the dental medical records. In Indonesia, the guideline of dental medical records has been established by the Ministry of Health. However, the preliminary study by the Department of Forensic Odontology, Faculty of Dental Medicine Universitas Airlangga, showed that many dentists documented the medical records, not following the Medical Record Guidelines from the Ministry of Health. Purpose: This study aims to determine the dentists’ understandings of the completeness of dental medical records according to the Dental Medical Record Guidelines by the Ministry of Health of Indonesia. Methods: A total of 358 dentists in East Java participated in this study by fulfilling an online questionnaire. Results: The results showed that approximately 27.4% of the respondents are conducting dental medical records following Dental Medical Record Guidelines. Conclusion: The results of this study are expected to be considered as a reference for the implementation of socialization on the Dental Medical Record Guidelines and the formulation of policies that regulate the use of dental medical records following national standards.

AMELOGLYPHICS-AN UPDATED REVIEW

In this modern era equipped with technologies, the crime rates are increasing exponentially. This requires newer methodologies to identify a person who is a victim as well as the perpetruator. Automated biometric systems helps in identifying the individuals by the stored information in the database which are unique for each individual. Some of the important methods are ngerprint biometrics and iris scanning.As these methods involves soft tissues they cant be relied upon during mass disasters like burn accidents and gas leakage accidents. Hence, a biometric system using the hard tissue is required for better identication of the individuals. Thus, Ameloglyphics is introduced to aid in identication of individuals died during mass disasters and it plays a vital role in forensic odontology. This review highlights this technology in detail.

Denture marking as a forensic tool- Case series

Forensic odontology is the branch that comes under forensic science which deals with proper handling, examination and evaluation of dental evidences. This manuscript describes various techniques that can be adopted for denture identification. The labeling method followed here is inclusion method where photographic sheet was used to mark dentures as this sheet is solvent resistant. The area selected for denture marking is palatal area on maxillary denture and distolingual flange of mandibular area as these areas have sufficient space for inclusion of details and there are not esthetically compromising areas. By this method denture labeling could be done in existing prosthetic devices or could be incorporated in newly constructed prosthesis. The American Board of Forensic Odontology guidelines indicate that most dental identifications are based on restorations, caries, missing teeth and/or prosthetic devices.

Dentist’s Role and Responsible in Identification and Investigation

Background: A dentist is responsible for promoting oral health and disease prevention to make the world a better place in terms of oral health. Besides, the dentist also plays an important role in the forensic field and law enforcement. Forensic odontology is an area of dentistry that deals with the proper management and investigation of dental evidence, which aids in identifying people and the presentation of dental evidence in the interest of justice. Purpose: This article discussed the role and responsibilities of dentists in human identification. Review: The world continues to deteriorate as time passes with much criminality and disasters that cannot be prevented. In many cases, the identification process can be done through the unique characteristics of dentition. Various information such as age, sex, and ethnicity are recorded in the tooth. Forensic dentists are responsible to manage and evaluate tooth evidence. Conclusion: Forensic odontology plays an essential role in determining individual identity. The unique features of dentition provide accurate results in identification if all procedures are correctly employed. With the advancement of science and technology, dentistry may now assist in the identification and investigation of forensic cases.

Digitalised exercise material in forensic odontology

Introduction This paper presents digital educational material in forensic odontology, including dental identification after multiple fatalities and dental age estimation from different age groups. Material and method Electronic patient records consisting of intraoral scans of the dentition, digital radiographs, photographs and written dental records were collected. Exercises in age estimations contained digital radiographs and photographs of ground tooth sections, with digital measuring tools and tables according to age groups. The teaching material was organised as a module in an electronic Learning Management System with external links to all relevant teaching material. Results For the identification exercises, intraoral scans and the latest digital radiographs simulated the postmortem examination of the deceased. For comparison, all other radiographs, photographs and dental records were available as antemortem material. The exercise was to match postmortem findings with the antemortem records using the Interpol standard and reconciliation. Age assessment of children used designated tables to grade tooth development on digital radiographs. For adults, non-destructive methods, digital radiographs, photographs and measuring tools were used. Discussion The teaching concept was hybrid, but it can easily be adapted as a fully digital exercise. The instructions and written material can be translated into different languages. The level of difficulty in the exercises can be adjusted according to the participant’s level of knowledge. Conclusion The educational material embraces the new possibilities for digitalisation and intraoral scanning. This might be a valuable tool for motivating and engaging the students in their participation and understanding of the subject.

Orthodontists in forensic facial approximation (FFA): current inter-disciplinary perspective

Forensic odontology has contributed significantly in forensic investigations and involves various branches of dentistry including orthodontics. The current communication presents evidence-based perspective highlighting synergistic union of different specialties for Forensic Facial Approximation (FFA). It brings forth commonality in principles of anthropology, forensic science, anthropometry, anatomy, paleontology, forensic odontology, with orthodontics, used in FFA. Various attributes and skills of orthodontists’ aid in dental and skull profiling and the corresponding sex, age, and ethnicity-based soft tissue assessments for facial soft tissue thickness (FSTT), may aid a life-like appearance. They can assist hard tissue profiling by their expertise in growth of skeletal and soft tissue, along with the evolutionary trends in occlusion, and diet formulations. Their knowledge in identifying teeth patterns, dental/skeletal jaw relationships, cranial/facial indices, vertical/horizontal facial proportions, can help prepare skull for orientation and reconstruction. The dental, photographic, and radiographic records maintained by orthodontists and general dentists are instrumental in data retrieval, used in various software, clinical, or research areas. These can provide normative values for comparative analysis or facial recreation. The orthodontists can also assist anthropologists and forensic specialists in the virtual reconstructions due to their ease in using latest digital technologies including three-dimensional (3D) facial scan, stereo-photogrammetry, 3D printing, automated soft-tissue landmarks, growth, and age predictions. Thus, the current study established the commonality in concepts of various forensic disciplines with orthodontics, which can strengthen both forensic on-field facial approximations and hard/soft tissue research to further enhance the accuracy of contemporary digital software used in FFA.

Comparison of maxillary sinus on radiograph among males and females

Background: An obstacle in forensic odontology is an incomplete body caused by post-mortem damage. The problem can be solved by using lateral cephalometric radiographs for victim identification. Sex determination can be performed on the maxillary sinus, which is the largest among the paranasal sinuses. Purpose: This study aims to analyse the maxillary sinuses’ width and height on lateral cephalometric radiographs among male and female subjects. Methods: The study samples were 60 lateral cephalometric radiographs (30 males and 30 females) between the ages of 20 and 40, with complete permanent dentition (or third molar absence). The height and the width of maxillary sinus measurement were performed using measurement tools of EzDent-i Vatech Software. Results: The average width of the maxillary sinus on males was 40.60 ± 1.56 mm, and the height was 35.02 ± 2.09 mm, while the width and the height on females were 36.93 ± 1.30 mm and 29.72 ± 1.76 mm, respectively. The independent t-test reveals a significant difference (p<0.05) between males and females, both in the maxillary sinus’s width and height on the lateral cephalometric radiograph. Conclusion: The maxillary sinus in males is larger than in females, it opening up possibilities for disaster victim identification.

Secondary Dentin as an Aid in Gender Predilection: A Forensic Study

Background Forensic odontology deals with age, sex, and race determination of the deceased at crime scenes, disasters, or natural calamities. Studies regarding the role of secondary dentin in age estimation have been documented on a several occasions in the literature but use of secondary dentin in gender predilection has not yet been documented. So, the present study was aimed at using the secondary dentin as a diagnostic tool in gender predilection. Materials and Methods The study included a total of 20 samples (10 males and 10 females). Extracted teeth were collected and placed in 10% neutral buffered formalin solution. The sections were ground on Arkansas stone until the appropriate thickness of the ground sections was achieved. The freshly prepared ground section was mounted on a slide using DPX mounting media. Ground sections were visualized under a microscope and the thickness of secondary dentine was measured using the image analysis software. Results The data were collected and subjected to group statistics. The secondary dentin thickness of all the samples, males and females, was measured. It was observed in our study that the mean thickness of secondary dentin was more in male samples (0.2970) with the standard deviation of 0.01494, as compared with that of females where the mean thickness was found to be 0.1970 with the standard deviation of 0.02058. Conclusion This study has shown that variation in secondary dentin thickness does exist between male and female groups. This criterion can be considered as an aid for gender determination in the future.

INDIGENCE OF FORENSIC ODONTOLOGY IN LEGAL PRACTICE OF PAKISTAN

Objective: To assess and interpret the utility and need of forensic dentistry in current judicial system of Pakistan. Study Design: Cross sectional study. Place and Duration of Study: Twin cities of Rawalpindi and Islamabad, in the month of Jun, 2020. Methodology: This questionnaire based cross-sectional study was conducted in a 1-month time frame, and a sample of 100 lawyers was recruited using snowball sampling technique and only criminal lawyers were included which had a minimum of 5 years of experience. Data was analyzed using SPSS-24. Results: The results were quite significant, 81% (81 lawyers) of the population recognized the relationship of forensic dentistry with criminal litigation (p-value=0.006). Furthermore 86% (86 lawyers) believed that there are a limited number of practicing forensic dentists and a massive 96% (96 lawyers) of the population was not able to acquire the expertise of a forensic dentist. Conclusion: There is a major lack of trained forensic odontologists and training institutes in Pakistan, which has a significant effect on the legal practices of Pakistan. Furthermore, it defines the lack of specialization trend in forensic odontology.