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 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 4  |  Issue : 1  |  Page : 43-46

Identification of the deceased in disaster by barcode: Aadhaar-linked complete denture


Department of Prosthodontics and Crown and Bridge, Bapuji Dental College, Davangere, Karnataka, India

Date of Web Publication29-May-2019

Correspondence Address:
Dr. Disha Patel
Department of Prosthodontics and Crown and Bridge, Bapuji Dental College, Davangere, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijfo.ijfo_36_18

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  Abstract 


Personal identification is an indispensable requirement for forensic and medicolegal investigations, war, crimes, and civil unrest, natural, and mass disasters, postmortem, accident, loss of memory, states of unconsciousness, and being inadvertently misplaced on admission to a hospital. Positive identification through labeled dentures plays a key role in the abovementioned scenario. The importance of denture identification has long been accredited by the dental profession. Various denture identification systems have been reported in the literature. This clinical report describes various methods involved in labeling dentures and suggests unique method of labeling dentures linked with Aadhaar ID card in India.

Keywords: Aadhaar card ID, barcode denture identification marking, denture labeling, human identification


How to cite this article:
Patel D, Datta A, Bhise G, Chethan M D, Nandeeshwar D B. Identification of the deceased in disaster by barcode: Aadhaar-linked complete denture. Int J Forensic Odontol 2019;4:43-6

How to cite this URL:
Patel D, Datta A, Bhise G, Chethan M D, Nandeeshwar D B. Identification of the deceased in disaster by barcode: Aadhaar-linked complete denture. Int J Forensic Odontol [serial online] 2019 [cited 2019 Jun 26];4:43-6. Available from: http://www.ijofo.org/text.asp?2019/4/1/43/259271




  Introduction Top


Identification of deceased is essential in casualties associated with natural calamities or man-made accidents such as fire, aircraft accident, explosions, and other mass disasters such as Tsunami, earthquakes, and landslides. Without a valid identity, one must consider the ensuing problems of death certification, the disposable of deceased property and the considerable time before the relatives can claim the accrued money on insurance policies or make claim for compensation.[1],[2]

Identification of mutilated remains or decomposed bodies is difficult especially when other parameters (such as facial features, scars, tattoos, deformities, peculiarities, and personal belongings) fail as in cases of 100% burns or putrefaction.

Forensic odontology is the branch of dentistry which deals with the proper handling and examination of dental evidence and the proper evaluation and presentation of dental findings in the interest of justice.[3] In identification of human remains, forensic odontology plays a very important part. Most dental identifications are based on restorations, caries, missing teeth, and/or prosthetic devices, such as partial and full removal prostheses, which may be readily documented in the record or might have been existing.[4] Fortunately, some dentures are marked and can be traced to a particular owner. Denture marking is accepted as a means of identifying dentures and persons in geriatric institutions or postmortem during war, crimes, civil unrest, natural, and mass disasters.[5]

Due to the lack of a comprehensive fingerprint database in our country, dental identification is growing as an essential part of forensic investigation. Prosthodontics is a branch of dentistry concerned with the design, manufacture, and fitting of artificial replacements for teeth and other parts of the mouth. Prosthodontists are playing very important role in forensic dentistry as they are concerned with fabrication of various prostheses which can serve as an important tool for identification.

The denture marking is important for the following reasons:

  1. For identification of unknown denture wearer in cases of calamities such as fire explosion, floods, earthquake, plane crash, or war
  2. In patients who have lost their memory owing to personal health issues such as Alzheimer's disease, amnesia or senility, psychiatric cases, homicide, and suicide, denture labeling can provide personal identity
  3. The denture can be returned to the owner in cases of lost and found
  4. A rapid and accurate method other than fingerprinting is essential for identification of the individuals
  5. In the laboratory, the dental technicians will find it easy to identify a denture, especially at the deflasking stage, if it is marked/labeled
  6. To ensure the correct denture delivery to the respective patient.


The standard requirements for denture labeling are as follows:

  1. They should be biologically inert when incorporated into the denture
  2. Inexpensive
  3. Easy and quick application
  4. Easy retrievability after an accident
  5. Resistant to chemicals
  6. Should not deform at high temperature
  7. Marking must also be cosmetically acceptable
  8. Visible/readable
  9. Durable without jeopardizing the strength of the prosthesis
  10. Permanent marking
  11. Resistant to everyday cleansing and disinfecting agents.


The recommended areas for labeling is along the posterior lingual flange, under the teeth for the mandibular dentures and posterior buccal surface to tuberosity region and palate area in a maxillary denture.[6]

These areas are accessible to reader; there is often sufficient thickness of resin to incorporate without any technical difficulties without affecting the esthetics of the denture.[7] Various methods of denture labeling have been reported in the literature.[8] However, two main methods in labeling dentures are the surface method and inclusion method.

Surface methods

  1. Scribing or engraving method
  2. Embossing method.


Inclusion methods

  1. Denture barcoding
  2. Lenticular card method
  3. ID band method
  4. Paper strip method
  5. T-bar method
  6. Laser etching
  7. Electronic microchips
  8. Photographic method
  9. Radiofrequency identification tags
  10. 2D barcode.


We suggest linking of denture marking system with Aadhaar card, a citizen's unique identification card in India. This is ideally advised to do so after patient's informed consent is obtained.

Rationale and goals of Aadhaar card:

  1. Provide an individual identity
  2. Provide social security benefits
  3. Financial inclusion
  4. Aadhaar-enabled service delivery
  5. Aadhaar-direct benefit transfer
  6. E-governance
  7. Prevention of corruption
  8. Prevention of identity fraud
  9. Ghost employees
  10. Forensic odontology (suggested in this article).


Information in Aadhaar card system: unique identification authority of India issues Aadhaar card having information stored in their digital library.[9]

  1. Face photo
  2. Fingerprint
  3. Iris scans
  4. Body identification mark
  5. Demographics such as name, age, gender, and address
  6. Barcode
  7. 2D barcode
  8. 12-digit number.



  Case Report Top


A 56-year-old male patient reported to the department with a chief complaint of difficulty in chewing food. Medical history was not contributory. Intraoral examination revealed a completely edentulous maxillary and mandibular arch. Treatment plan was to fabricate a conventional complete denture with the incorporation of Aadhaar card number and code as identity of the patient for future identification in case of any mishap to aid in forensic study. Before the start of procedure, informed consent of the patient was obtained.

The procedures were as follows:

  1. Following try-in, wax-up of the trial dentures, flasking, and dewaxing were done
  2. Aadhaar card number and code were printed separately; excess was cut and coated completely with cello tape [Figure 1]
  3. Separating medium was applied on the maxillary and mandibular part of flask
  4. Aadhaar card number and code was stuck on the posterior area of the palate for the maxillary part and lingual border of the mandibular part of flask with the help of glue [Figure 2]
  5. A small amount of heat cure pink acrylic resin (DPI, Mumbai) was mixed and placed over the area covered by acrylic teeth [Figure 3]. Later on, sufficient amount of heat cure clear acrylic resin (DPI, Mumbai, Maharashtra, India) was mixed and packed over the remaining part [Figure 4]
  6. A wet cellophane sheet was positioned, and trial closure was done. This prevented the shifting of the cello tape covered Labelle during the final closure
  7. The flask was reopened, flash trimmed away, and cellophane sheet removed
  8. After curing and bench curing, the dentures were retrieved
  9. Finishing, polishing, and occlusal corrections were done before denture delivery [Figure 5].
Figure 1: Aadhaar card number and code embedded in cello tape

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Figure 2: Denture label stabilized on the maxillary and mandibular part of the flask

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Figure 3: Heat cure acrylic resin packed

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Figure 4: Heat cure clear acrylic resin packed

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Figure 5: Finished and polished esthetic denture with Aadhaar card and barcode labeling

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  Discussion Top


Among the techniques discussed, the surface method seemed easy to apply and relatively inexpensive, but unhygienic. The inclusion methods are definitely more permanent and provided a good result, but it weakens the denture structure and creates porosity. Some of them are more expensive and trained personnel in well-equipped dental laboratories are needed. At times, the only identifiable remains are victims' marked partial and complete dentures when all other methods fail to do so. This is the reason enough to justify the implementation of ID marking of dentures. The dentist should always inform the patient clearly the benefits of denture labeling and motivate the patient for the same. In India, denture ID metal band linked to unique Aadhaar card can set an ideal example in front of the entire world in denture labeling system if made mandatory by legislation.[10]

It is obvious that only marked dentures can reveal the positive identity of a person when all other methods rendered absolutely dud.[11] The dentist should always inform the patient clearly the benefits of denture labeling and motivate the patient for the same. However, the patient has right to refuse. Some of the procedures for denture labeling may be too expensive or unesthetic for the patient. Because there is international consensus about methods of denture marking, we suggest newer methods for the same. Five requirements of marking dentures were suggested by Kruger–Monson.[12] They were as follows:

  1. The strength of the prosthesis must not be jeopardized
  2. It must be easy and inexpensive to achieve
  3. The identification system must be efficient
  4. The marking must be durable and visible
  5. The marking must withstand fire and humidity.



  Conclusion Top


This article describes an easy and cost-effective technique with readily available armamentarium in any dental office or institution for denture identification. The label demonstrates no sign of deterioration, withstands high temperature, and is esthetic. It is biologically acceptable and fulfills all the forensic requirements of a suitable prosthesis. Denture ID linked to unique Aadhaar card system of labeling dentures can be beneficial to both patients and dentists. Government of India make mandatory of linking Aadhaar card in various schemes which include, linking of Aadhaar card to liquid petroleum gas cylinder distribution system. Similarly, there is a need to implement this strategy by government also in the field of dental sciences in labeling prosthesis. Dental Council of India can suggest Government of India to make necessary legislations regarding compulsory denture labeling system in India.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Montelius K, Lindblom B. DNA analysis in disaster victim identification. Forensic Sci Med Pathol 2012;8:140-7.  Back to cited text no. 1
    
2.
Wang N, Shen CD. Improved application of bomb carbon in teeth for forensic investigation. J Radiocarbon 2010;52:706-16.  Back to cited text no. 2
    
3.
Caldas IM, Magalhães T, Afonso A. Establishing identity using cheiloscopy and palatoscopy. Forensic Sci Int 2007;165:1-9.  Back to cited text no. 3
    
4.
Blumenfeld J. racial identification in the skull and teeth. Univ West Ont J Anthropol 2000;8:20-36.  Back to cited text no. 4
    
5.
Halcrow SH, Nancy T, Buckley HR. Age estimation of children from prehistoric Southeast Asia: Are the dental formation methods used appropriate? J Archaeol Sci 2007;34:1158-68.  Back to cited text no. 5
    
6.
Bali SK. Denture Identification methods: A review. Int J Health Sci Res 2013;3:100-4.  Back to cited text no. 6
    
7.
Berry FA, Logan GI, Plata R, Riegel R. A postfabrication technique for identification of prosthetic devices. J Prosthet Dent 1995;73:341-3.  Back to cited text no. 7
    
8.
Alexander PM, Taylor JA, Szuster FS, Brown KA. An assessment of attitudes to, and extent of, the practice of denture marking in South Australia. Aust Dent J 1998;43:337-41.  Back to cited text no. 8
    
9.
Wilson HJ, Mansfield MA, Heath JR, Spence D. Dental Technology and Materials for Students. 8th ed. London: Blackwell Scientific Publications; 1987. p. 397-401.  Back to cited text no. 9
    
10.
Agüloǧlu S, Zortuk M, Beydemir K. Denture barcoding: A new horizon. Br Dent J 2009;206:589-90.  Back to cited text no. 10
    
11.
Colvenkar SS. Lenticular card: A new method for denture identification. Indian J Dent Res 2010;21:112-4.  Back to cited text no. 11
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12.
Stavrianos CH, Petalotis N, Metska M, Stavrianou I, Papadopoulos CH. The value of identification marking on dentures. Balkan J Stomatol 2007;11:212-6.  Back to cited text no. 12
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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