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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 4  |  Issue : 2  |  Page : 77-81

Tooth size: Third eye in forensic odontology


1 Malabar Dental College and Research Centre, Edappal, Malappuram, Kerala, India
2 Department Of Orthodontics, RVS Dental College, Coimbatore, Tamil Nadu, India

Date of Submission31-Aug-2019
Date of Acceptance22-Oct-2019
Date of Web Publication26-Dec-2019

Correspondence Address:
Dr. Ajmal Khan S Kattak
Malabar Dental College and Research Centre, Edappal, Malappuram, Kerala, India
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijfo.ijfo_14_19

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  Abstract 


Background: The role of the forensic odontologist is to establish a person's identity. Teeth, with their physiologic variations, pathoses, and effects of therapy, record information that remains throughout life and beyond. The comparison of the facial profile from dental morphometrics has been a subject of great interest in forensic odontology. H. Pound's formula and Berry's formula are few methods used to determine the size of maxillary central incisors.
Objective: The aim of this study is to suggest a novel approach in identifying a potential suspect or victim by determining the facial parameters (bizygomatic width and facial length) using the mesiodistal dimensions of maxillary central incisors.
Materials and Methods: This study included sample size n = 200 participants, of which 100 participants were male and 100 were female. The width of maxillary central incisors of all the participants was measured. The values were incorporated in the Berry's biometric index and Pound's formula to determine the bizygomatic width and facial length (estimated values) Bizygomatic width and facial length of all the participants were also measured in actual values. These values were then compared.
Results: The difference between actual and estimated values in regard to bizygomatic width was 0.01 in males and 0.02 in females, whereas the difference in facial length values was 0.03 in males and 0.02 in females.
Conclusion: Logistic regression was used (instead of made write used) to predict the probability of the parameters most likely to be reproduced in the creation of the facial profile based on tooth morphometrics. The results indicated a definite correlation between the facial and the tooth parameters and the role of formulas in facial parameter construction. Thus, this method can be developed as a new tool and can be applied in future disaster victim identification operation.

Keywords: Dental morphometrics, facial reconstruction, forensic odontology, permanent maxillary central incisor


How to cite this article:
Prabu P S, Kattak AK, Prabu N, Menon S, Beenu V, Pattath VS. Tooth size: Third eye in forensic odontology. Int J Forensic Odontol 2019;4:77-81

How to cite this URL:
Prabu P S, Kattak AK, Prabu N, Menon S, Beenu V, Pattath VS. Tooth size: Third eye in forensic odontology. Int J Forensic Odontol [serial online] 2019 [cited 2020 Jul 2];4:77-81. Available from: http://www.ijofo.org/text.asp?2019/4/2/77/274046




  Introduction Top


Dr. Oscar Amoedo is known as “The Father of Forensic Odontology.” Harvey defined forensic dentistry as that branch of forensic medicine which in the interest of justice deals with the proper handling and examination of dental evidence with the proper evaluation and presentation of dental findings.[1],[2] This discipline plays a significant role in the identification of human remains in incidents such as tsunamis, earthquakes, landslides, bomb blasts, and terrorist attacks, airplane crashes, train, and road accidents where highly mutilated and dismembered dead bodies are recovered which are beyond recognition[3],[4] This process of identification of the disaster victims is known as disaster victim identification. Teeth are the strongest part of the human body, which can withstand high explosion and are not damaged by such incidents.[5],[6]

Dental morphometrics is a quantitative analysis to form a concept that encompasses the size and shape of teeth. Estimation of the facial profile from dental morphometrics has been a subject of great interest in forensic odontology. Various studies have been attempted in the determination of facial dimension using permanent tooth morphometrics in the past. The parameters used were tooth length, crown length (CL), mesiodistal width, and tooth labiolingual width, and correlation with the facial measurements has been attempted in the past.

In the field of prosthodontics, the selection of anterior teeth is an important criterion. Usually, the methods followed are Pound's formula, Berry's biometric method, anthropometric cephalic index, and dentogenic concept.[7],[8]

Berry's formula:[9]





Pound's formula:[10]



These formulae have been proven reliable in determining the dimensions of anterior teeth.[7],[11] Moreover, in forensics, the determination of facial parameters is an integral part of the identification of an individual. Facial reconstruction relies on the relationships between the facial features, subcutaneous soft tissues, and underlying bony structure of the skull. If there is no clue for potential identity because of impossibility to compare questioned remains with possible familiar material, in such cases, one of the last chances is to recreate antemortem appearance by face reconstruction.[12]

The present study aims to establish a relation, if any, between the CL of the permanent maxillary central incisor tooth and the facial height, l.

The current literature reveals minimal research in the field of forensic odontology with regard to the mathematical relationship between the width of the face and the width of the central incisor.[13] Consequently, this study has been conducted with the aim to illustrate a novel approach done by applying Pound's formula, Berry's Biometric Index, in the field of forensic odontology to aid in the determination of the facial parameters (bizygomatic width and facial length) of a potential suspect or victim using the mesiodistal dimensions of maxillary central incisor.


  Materials and Methods Top


The present study was conducted in the Department of Prosthodontics, and Crown and Bridge, Malabar Dental College and Research Center, Malappuram, Kerala, India. The study was conducted among 200 patients between the ages of 18 and 30 who visited the College. The procedure of the study and the purpose was explained to every participant, and then consent was obtained from the participants. The study was continued further with the approval from the Ethical Committee of the Institute. The selection of the individuals was based on the following criteria that the study subject should have.

Inclusion criteria

The inclusion criteria were as follows:

  • Both permanent maxillary central incisor should be present
  • No history of orthodontic treatment no interdental spacing or crowding
  • They should not have more than one full or one three-fourth crown in maxillary central incisor
  • They should be above 18 years of age, so facial growth was complete
  • No severe attrition and caries cases
  • No restorations in incisors.


Exclusion criteria

The exclusion criteria were as follows:

  1. The apparent loss of tooth structure due to caries, fracture, attrition or restorations
  2. Teeth restored to correct interdental spacing or malformations
  3. Evidence of any dental irregularities such as crowding, malformed teeth, microdontia, or macrodontia
  4. The asymmetric face, especially any surgical correction of orbital structures.


Materials used for this study include as follows: [Figure 1], [Figure 2], [Figure 3]:

  1. Vernier caliper [Figure 1]
  2. Face bow [Figure 2]
  3. Millimeter tape [Figure 3].


Intraoral and extraoral values (actual measurement in cm)

Intraoral measurement

The mesiodistal dimension of the maxillary central incisor (MDCI) is measured between interproximal contact points with the help of a Vernier caliper [Figure 4].
Figure 1: Vernier caliper

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Figure 2: Face bow

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Figure 3: Millimeter tape

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{Figure 1}{Figure 2}{Figure 3}
Figure 4: The mesiodistal dimension of the maxillary central incisor (MDCI) is measured between interproximal contact points with the help of a Vernier caliper

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Extraoral measurements

The greatest bizygomatic width of each participant was taken as the most lateral points on the external surface of the zygomatic arch and was measured using a facebow and a millimeter ruler [Figure 5].
Figure 5: The greatest bizygomatic width of each participant was taken as the most lateral points on the external surface of the zygomatic arch and was measured using a facebow and a millimeter ruler

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The facial length was determined with a measuring tape [Figure 6].
Figure 6: The facial length was determined with a measuring tape

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Each reading was taken five times, and the average of three values was obtained to minimize the intraobserver errors.

Derived values/estimated value

The mesiodistal width of the central incisor was substituted in the formulas, the bizygomatic width and facial length values were estimated.

These actual measurements were compared and analyzed with the estimated values.


  Statistical Methods and Results Top


Collected data were entered into Microsoft® Excel 2007 software and converted into Data was analyzed using the statistical package SPSS 22.0 (SPSS Inc., Chicago, IL).

Based on these values, the mean and standard deviation were calculated. The P = 0.05 or less was considered statistically significant.

For inferential statistics, Pearson's correlation coefficient was applied to find out significant correlations between the groups.

These actual measurements were compared and analyzed with the estimated values.

The actual mean of the bizygomatic distance in males was 13.35 ± 5.082, and in females, it was 12.16 ± 2.56. The actual measured facial height showed mean values of 19.37 ± 0.5709 in males and 18.04 ± 0.5095 in females [Table 1]. It was found that the calculated length/estimated length was obtained by substituting the mesiodistal width of central incisor in the formulas of that estimated bizygomatic mean was 13.34 in males and 12.14 in females. The estimated actual measured facial height showed mean values of 19.34 in males and 18.02 in females [Table 1] and [Table 2].
Table 1: Actual facial measurements

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{Table 1}
Table 2: Estimated facial measurements (formula method)

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Therefore, the difference in values of calculated length and estimated length of bizygomatic width was 0.01 in males and 0.02 in females, whereas the difference in facial length was 0.03 in male and 0.02.

Pearson's correlation coefficient [Table 3]

Actual and estimated bizygomatic width in females and males (females r = 0.998 and males r = 0.995) and statistical correlation could be detected in facial height (females r = 0.995 and males r = 0.998).
Table 3: Pearson's correlation coefficient

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  Discussion Top


Following a mass disaster, identification of individual victims by dental means is one of the most reliable methods. In severe burn situations and/or following severe disintegration, visual recognition of facial features and fingerprints is often impossible due to extensive soft-tissue destruction; this situation often necessitates the use of hard (calcified) tissue such as human dentition and jawbones for human identification.[14]

Forensic facial approximation or forensic facial reconstruction is a three-dimensional recreation of the face of an entity from skull remains which adequately resembles a deceased person to allow identification of an individual.[15] In severely damaged bodies, when all other means of identification fail or when it is desirable to obtain additional confirmation of an identity that the dental criteria is used.

The identification of a person from dental records by a qualified forensic dentist has been established and accepted by the court of law. It is a challenging task to identify the unrecognizable bodies of the missing individuals in mass disasters. In 1453, the first case identified by dental identification was of The Earl of Shrewsbury, who fell in the battle of Castillon. In 1897, 126 Parisian socialites were burned to death in a few minutes in the “heute da la charite.” At the request of the council, who knew many of victims, Dr. Oscar Amoedo aided by two French dentists examined and identified many of the bodies. This incident was published as the first text in forensic dentistry on mass disasters.[16]

Berry's biometric ratio method was first introduced in 1906.[17] He discovered that the proportions of the upper central incisor tooth had a definite proportional ratio to face proportions. Similar is the H pound's formula.[11] Over the years, it has been employed to ascertain the dimensions for the selection of teeth as dictated by specific facial proportions, that is the bizygomatic width,[18] length of the face, respectively. Although it has proved itself valuable in the field of prosthodontics, its application as a tool for identification purposes is yet to be fully explored.[11],[17]

The above study has been conducted with the aim to illustrate a novel approach done by applying Pound's formula, Berry's Biometric Index, in the field of forensic odontology to aid in the determination of the facial parameters (bizygomatic width and facial length) of a potential suspect or victim using the mesiodistal dimensions of maxillary central incisor.

In the above study, the actual facial measurements which were measured manually were compared to the estimated facial measurement (calculated by the formula). There was a statistically significant statistical correlation between the values (P < 0.05). Thus, it proves formula method is an appropriate method in estimating the facial dimensions from teeth and bite marks. Moreover, hence these facial parametric values can be included in facial reconstruction.


  Conclusion Top


Within the limitations of the present study, the following conclusions were drawn:

Within the limitations of the present study, it can be concluded that there exists a definite method of finding out facial parameters from teeth size using the existing formula methods (Pound's formula and Berry's formula), in a major accidents, crime, burial, mass disaster as teeth are the hardest and robust tissues of the human body.

However, these are preliminary findings, and further studies on a larger crosssection of the population are definitely suggested to further authenticate these results.

India is far behind both in the theoretical and practical aspects of forensic dentistry. Recently, the Dental Council of India has formulated regulations in which provision regarding teaching of forensic dentistry has been made in the final year of Bachelor of Dental Surgery curriculum.

Forensic in developing countries such as India, forensic dentistry is not developed up to the mark and services of forensic dentists are not being utilized. Dental surgeons should maintain the dental records and debris of tooth material in case of restorations of the patients treated by dental surgeons. Hence, the preserved material may be used in the identification of deceased individuals.[19] The results of the study show a promising way forward in forensic dentistry.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Keiser-Nielsen S. Forensic odontology. Int Dent J 1968;18:668-83.  Back to cited text no. 1
    
2.
Harvey W. Dental Identification and Forensic Odontology. London: Henry Kimpton Publisher; 1976. p. 88-140.  Back to cited text no. 2
    
3.
Krogman WM, Iscan MY. The Human Skeleton in Forensic Medicine. 2nd ed. Springfield, Illinois: Charles Thomas Publisher; 1986. p. 189-243.  Back to cited text no. 3
    
4.
Hinchliffe J. Forensic odontology, part 2. Major disasters. Br Dent J 2011;210:269-74.  Back to cited text no. 4
    
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Hinchliffe J. Forensic odontology, part 1. Dental identification. Br Dent J 2011;210:219-24.  Back to cited text no. 5
    
6.
Pretty IA, Sweet D. A look at forensic dentistry part 1: The role of teeth in the determination of human identity. Br Dent J 2001;190:359-66.  Back to cited text no. 6
    
7.
Abdullah MA. Inner canthal distance and geometric progression as a predictor of maxillary central incisor width. J Prosthet Dent 2002;88:16-20.  Back to cited text no. 7
    
8.
Gomes VL, Gonçalves LC, do Prado CJ, Junior IL, de Lima Lucas B. Correlation between facial measurements and the mesiodistal width of the maxillary anterior teeth. J Esthet Restor Dent 2006;18:196-205.  Back to cited text no. 8
    
9.
Berry FH. Study of prosthetic art. Dent Mag 1905;1:405.  Back to cited text no. 9
    
10.
Sellen PN, Jagger DC, Harrison A. Methods used to select artificial anterior teeth for the edentulous patient: A historical overview. Int J Prosthodont 1999;12:51-8.  Back to cited text no. 10
    
11.
Salim NB, Jain AR, Varma A. Reliability of H. pound's formula for anterior teeth selection. Biomed Pharmacol J 2017;10:1003-7.  Back to cited text no. 11
    
12.
Ramesh G, Nagarajappa R, Sreedhar G, Sumalatha MN. Facial soft tissue thickness in forensic facial reconstruction: Is it enough if norms set? J Forensic Res 2015;6:5.  Back to cited text no. 12
    
13.
Kramer RS, Jones AL, Ward R. A lack of sexual dimorphism in width-to-height ratio in white European faces using 2D photographs, 3D scans, and anthropometry. PLoS One 2012;7:e42705.  Back to cited text no. 13
    
14.
Kolude B, Adeyemi BF, Taiwo JO, Sigbeku OF, Eze UO. The role of forensic dentist following mass disaster. Ann Ib Postgrad Med 2010;8:111-7.  Back to cited text no. 14
    
15.
Chowdhry A, Kapoor P, Popli DB, Sircar K. Inclusion of forensic odontologist in team of forensic facial approximation: A proposal and technical note. J Clin Diagn Res 2018;12:HM01-4.  Back to cited text no. 15
    
16.
Sharma G, Yadav M, Singh H, Aggarwal AD, Sandhu R. Forensic odontology: Role in mass disaster. JIAFM 2006;28:971-3.  Back to cited text no. 16
    
17.
Esposito SJ. Esthetics for denture patients. J Prosthet Dent 1980;44:608-15.  Back to cited text no. 17
    
18.
Hasanreisoglu U, Berksun S, Aras K, Arslan I. An analysis of maxillary anterior teeth: Facial and dental proportions. J Prosthet Dent 2005;94:530-8.  Back to cited text no. 18
    
19.
Verma AK, Kumar S, Rathore S, Pandey A. Role of dental expert in forensic odontology. Natl J Maxillofac Surg 2014;5:2-5.  Back to cited text no. 19
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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