dental radiographic in

forensic identification
Department of Forensic Odontology
Faculty of Dental Medicine Universitas Airlangga

AROFI KURNIAWAN, DRG., PH.D

introduction
purpose & scope

▪ Regardless of whether human remains are visually identifiable,

decomposed, incinerated, or skeletal, dental evidence is
routinely acquired through photographs, radiographs, and
dental charting

▪ In the identification task, the forensic odontologist relies most

frequently on information regarding the dentition and its
supporting structures 3
▪ dental records and radiographs are evaluated forensically to
identify missing and unknown individuals and victims of a
multiple fatality incident

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▪ additionally, since recording errors can occur during charting,
dental radiographs are often the most objective evidence of the
actual dental characteristics

▪ Biometric comparable patterns related to the teeth and their

associated restorative and anatomical configurations remain
the principal means of radiographic assessment in the dental
identification process. 5
 Accurate PM dental
record

needs

dental charting +
variety of
radiographic images

root canal Impacted Osseous Foreign

Retained root 6
treatment teeth pathology bodies
Application of forensic radiography

▪ Dental profiling

▪ Age estimation

▪ Sex determination

▪ Cranio-facial reconstruction

▪ Injury analysis

▪ Determining the cause of death 7

Common problems in dental radiography

▪ Forensic dentist may encounter technical errors related to

exposure and processing of radiographs

▪ Images may be blurred, distorted, or contain insufficient

information to differentiate among teeth, osseous structure,
sinuses, and associated soft tissue

▪ Additional problems are commonly encountered when

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comparing edentulous radiographs.
radiographic in dental
identification
dental radiograph

Intraoral radiograph
▪ Periapical ─ includes a radiographic series of the dentition and
supporting structures that can range from 14 to 21 images for
entire dental arches.
▪ Bitewings ─ an image that depicts the maxillary and
mandibular crowns of the teeth, providing a clear image of the
interproximal surfaces of the teeth and allowing for detection
of interproximal caries. 10
dental radiograph

▪ Occlusal ─ used routinely to outline the maxillary and

mandibular dental arch forms in the axial plane. Additionally,
this view is helpful in assessing the floor of the mouth or
palate for significant extradental radiographic abnormalities.

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occlusal radiograph bitewing radiograph

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periapical radiograph
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Handheld x-ray
postmortem periapical radiograph

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15
dental radiograph
Extraoral radiograph
▪ Panoramic ─ this large image shows most of the lower face
including the inferior areas of the orbits, sinus and nasal
cavities, maxilla, temporomandibular joints (TMJ), mandible,
and hyoid bone and cervical spine
▪ Cone Beam Computed Tomography (CBCT) ─ With the
development of this 3D dental imaging technique, this
stipulation has become less problematic since intraoral and
panoramic projections needed for comparison may be 16

replicated from CBCT slices of whole volume images

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Panoramic device for death body

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panoramic
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CBCT scan

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AM & PM dental radiographic comparison

Antemortem and postmortem radiographs are compared noting

similarities and differences. The most current films are examined
first because they will show the greatest similarity to the
postmortem status of the teeth and jaws

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AM & PM dental radiographic comparison

Comparison is done on
▪ Number and arrangement of teeth (missing teeth, rotated teeth,
spacing, extra teeth, impacted teeth)
▪ Caries and periodontal bone loss
▪ Coronal restorations
▪ Hidden restorations (posts, implants, root canal fillings)
▪ Bony pathology
▪ Dental anatomy
▪ Frontal & maxillary sinus and nasal aperture 22
radiographic features
in dental identification
Classification of tooth-related radiographic features

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Coronal, pulpal, & root anomalies

▪ Dens in Dente is a tooth anomaly resulting from invagination

of the dental papilla during tooth development and appears as
a “tooth within a tooth”
▪ dilacerated root ─ The root shape of an affected deciduous or
permanent tooth may appear curved or angled

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Coronal, pulpal, & root anomalies

▪ Extra roots (supernumerary roots) most commonly affect the

mandibular canines, premolars, and third molars
▪ Pulp stones are relatively common opaque findings formed
within the coronal pulp, these may be free or attached and
most often arise after tooth development

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Coronal, pulpal, & root anomalies

▪ Shovel-shaped incisors may indicate certain categories of the

race of the victim. Maxillary incisors are most commonly
affected
▪ Iatrogenesis is an unplanned adverse effect or complication
resulting from the treatment or advice of a healthcare provider.
Dental radiographs may reveal such iatrogenic findings as
tooth perforations, retention of broken instruments,
postsurgical retained fractured roots, and antral 27

communications
conclusion
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IN TWO OR THREE COLUMNS

Dental radiographic findings beyond those related to dental restorations

alone can be essential in determining definitive dental identifications. Also,
emerging radiological technologies provide the twenty-first century forensic
dentist with the additional ability of evaluating 3D image information
related to structures in the head and neck.

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CBCT technology is becoming more widely used as a component of the
dental diagnostic evaluation of patients whose treatment requires oral
surgical, orthodontic, TMJ, and dental implant procedures. Thus, in the
future, it is likely that these images will become more commonly available
to the forensic dentist who requests dental records for comparison.

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improve our competencies

Therefore, the forensic dentist should

attain a level of competency in the
interpretation and comparison of
radiographic patterns generated by a
growing variety of imaging techniques in
order to facilitate a successful dental
identification through radiographic
evaluation
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THANKS! 32