Maximizing postmortem oral-facial data to assist identification following severe incineration

ReviewPURPOSE: This paper reviews the literature for methods of maximizing the postmortem oral-facial information available for a comparison to be made for identification following an incident resulting in incineration. METHOD: A search was initially instigated utilizing PubMed, Scopus, and Google Scholar, with further library searches and correspondences among peers around the world leading to a comprehensive review of the literature. CONCLUSION: Maximizing postmortem dental evidence in a severe incineration event requires correct recognition and recording of dental data. Odontologists should attend the scene to facilitate this recognition. The information should be documented, photographed, and stabilized before retrieval. Wrapping, padding, and further support of the remains during transportation to the examination mortuary will aid this process. Examination at the mortuary requires further photography, complete charting, and radiographic examination of any dental material available, as well as awareness of other possible medical evidence, to enable identification of the human remains.John W. Berket

Stabilisation of dental structures of severely incinerated victims at disaster scenes to facilitate human identification

Abstract not availableJohn Berketa, Denice Higgin

Survival of batch numbers within dental implants following incineration as an aid to identification

Dental implants have become a popular choice of treatment in replacing individual lost teeth or entire dentitions. The physical properties of high corrosion resistance, high structural strength and high melting point, suggest the retention of intact implants following most physical assaults. As the implants are machine made, they lack the individualisation required for their use as identifiers of the deceased, however the Straumann™ Company (Waldenburg, Switzerland) has recently released information that within the chamber of their implants they have laser etched batch numbers. The number of implants with the same batch number varies from 24 to 2400. The purpose of this study was to ascertain if the batch number was still identifiable following intense heat exposure in a furnace. A Straumann™ Standard Plus 3.3 x 8 mm implant, with no healing cap nor abutment attached was incinerated to 1125 degrees Celsius. Another Straumann™ Standard Plus 3.3 x 8 mm implant was also incinerated in the same way as the first implant but with an abutment attached. The results indicated that the first implant had totally oxidised within the internal chamber whilst the second implant following the removal of the abutment revealed an intact identifiable batch number. If the companies constructing implants were to place individual serial numbers rather than batch numbers on these implants then the potential exists for a new approach to be established for the identification of the deceased.J. Berketa, H. James, V. Marinohttp://www.ncbi.nlm.nih.gov/pubmed/2123985

A pilot study in the recovery and recognition of non-osseointegrated dental implants following cremation

Minimal dimensional changes in free standing dental implants when incinerated in a kiln to a temperature of 1125°C have been reported previously. However, in the same study colour changes were observed between commercially pure titanium and titanium alloy type of implants, with speculation that this change may be a useful distinguishing tool in cases requiring forensic identification. The present study was instigated to determine what changes occur following cremation to bone-supported dental implants placed within mandibles of sheep. A selection of dental implants was photographed and radiographed. They were then surgically placed in sheep mandibles and the entire sheep heads cremated in a commercial cremator. There was detachment of the dental implants from the mandible, which could have implications for scene recovery. Following retrieval and re-irradiating of the implants, image subtraction evaluation of the radiographs was recorded using Adobe® Photoshop.® As with the previous study there was slight oxidation of the implant surfaces leading to minor alteration of the images. There was, however, no gold crust colour change in the commercially pure titanium. Photography within the retrieved implants revealed the batch number within the Straumannä implant was still visible, which could significantly add weight to the identification of deceased persons.J. Berketa, H. James, V. Marin

Dental implant changes following incineration

Non-visual identification of victims utilizes DNA, fingerprint and dental comparison as primary scientific identifiers. In incidents where a victim has been incinerated, there may be loss of fingerprint detail and denaturing of DNA. Although extremely durable, tooth loss will also occur with extreme temperatures and the characteristics of recovered dental implants, if any, may be the only physical identifying data available. Currently, there are no experimental investigations to determine what changes occur to dental implants following high temperature exposure. A selection of dental implants was radiographed, utilizing purpose built apparatus to allow standard methodology. They were then heated in an INFI-TROL™ kiln to a maximum temperature of 1125 °C and the radiographic procedure repeated. Image subtraction evaluation of the radiographs was recorded using Adobe® Photoshop®. Both commercially pure titanium and titanium alloy dental implants survived the incineration and there was oxidation of the surface leading to minor alteration of the image. There was, however, no detectable sagging of the implants. The results of this research suggest that dental implants are still recognizable following incineration. In scenarios commonly seen by forensic odontologists, heat will destroy both teeth and conventional dental restorative materials. Implants, however, will resist these conditions and will also retain the features necessary to identify the type of implant.J. Berketa, H. James, V. Marin

Cochlear implants in the forensic identification process

Purpose: Decedents who are severely decomposed, skeletonized or incinerated present challenges for identification. Cochlear implants aid hearing and bear unique serial numbers that can be used to assist with identification of bodies that are not visually identifiable. The purpose of this paper was to highlight companies that have or had manufactured cochlear type implants and demonstrate the appearance of the implants to assist crime scene investigators, pathologists, anthropologists and odontologists. Method: Investigation of cochlear implants was conducted on the internet and companies were contacted for information regarding their implants. Results: The functional appearance of a cochlear implant is explained, brands of implants are tabulated and pre and post-incineration images are presented. Conclusion: The prevalence of cochlear implants is predicted to increase, thus they are likely to become relevant to the identification process. Company brand and serial markings can be retrieved from post-incineration implants making them a valuable aid in identification when other identifiers that may be present are not useful because they are heat-sensitive.John Berketa, Helen James, Neil Langlois, Lindsay Richard

Radiographic recognition of dental implants as an aid to identifying the deceased

This study was undertaken to determine if dental implants can be radiographically differentiated by company type to aid forensic identification of the deceased. Recognition of dental implants on intraoral radiographic images was assessed in a blind study using a radiographic examination guide to highlight differences between dental implants. Inter- and intra-examiner comparisons were conducted and a computer program (Implant Recognition System) was evaluated to see whether it improved the accuracy of implant recognition. The study found that dental implants could be radiographically differentiated by company type. The Implant Recognition System in its current form was of little benefit for radiographic assessment of dental implants for forensic odontologists. Prior knowledge of implant types, with a McNemar's statistical value of 92.9, proved to be most significant in identification.John W. Berketa, Robert S. Hirsch, Denice Higgins, and Helen Jame

The utilization of a commercial gloss spray in stabilization of incinerated dental structures

Abstract not available.John Berketa, Ahmad Fauzi, Helen James, Anthony Lake, Neil Langloi

Use of a non-volatile agent to stabilize severely incinerated dental remains

PURPOSE: The aim of this study was to identify volatile-free products that would be suitable for stabilizing incinerated dental remains at the scene of an incident, and that would not compromise any postmortem examination. METHODS: The anterior mandibles of sheep were incinerated, sprayed unilaterally with stabilizing agents, vibrated for 30 s, and assessed. The effect of the stabilizing solutions on radiographic examination was also recorded. Tests for volatility and the effect on human mandibles were also conducted. RESULTS: A flour/water mixture of one part flour to two parts water, and a paste mixture of one part Clag™ glue to one part water both produced significant stabilization results. The flour mixture left an opaque layer on the samples that it was applied to, which still allowed dental examination, but the glue paste mixture resulted in a clearer layer. Both solutions allowed radiographic examination and were free of volatiles. CONCLUSION: Diluted Clag™ paste, when sprayed on to incinerated remains, assists in their stabilization for transportation. When Clag™ paste is unavailable a mixture of two parts water to one part plain flour could be utilized for stabilization.John Berketa, Helen James, Neil Langlois, Lindsay Richards, Paul Pigo

The utilization of incinerated hip and knee prostheses for identification

PURPOSE: The aim of this study was to test various methods of retrieving number data from hip and knee implants from cremated human remains and to validate our findings by cross referencing our results with the national joint replacement registry. METHOD: Implants were collected from the remains of individuals who had donated their bodies to science following routine planned cremation. A number of different chemical and physical methods to expose the implant numbers on cremated implants to the point that they were legible were tested. The retrieved data on the implants was referred to the Australian Orthopaedic Association National Joint Replacement Registry to identify the individuals, and the names were cross-referenced from the original list of donors. RESULTS: It was possible to retrieve sufficient data from cremated implants to track the name of the recipient of implants if they were placed following the formation of the registry. Both wet and dry paper (1200 size and without moisture), and fine grade steel wool (used in antique restoration), were successful in removing the oxidized layer from implants. With hip implants, it was discovered that the best area to retrieve clear readable information is inside the ball head or at the end of the neck as this area is protected from oxidation during incineration. CONCLUSION: Incinerated or cremated hip and knee implants may be used to assist in the identification of a decedent following careful treatment, in conjunction with national joint revision registries and company data.John William Berketa, Ellie Simpson, Stephen Graves, Grace O, Donohue, Yen-Liang Li