Analysis of time‑dependent changes in Bitemarks on Styrofoam sheets

Djeapragassam Parimala, Mariappan Jonathan Daniel, Subramanian Vasudevan Srinivasan, Jimsha Vannathan Kumaran

Abstract
Context: The scope of Bitemarks in forensic dentistry is widening as they help the forensic expert in identifying the perpetuator in
medicolegal cases. The greatest challenge in Bitemarks analysis is the time‑dependent changes produced in Bitemark patterns on
various substrates at the scene of the crime. Aims: To analyze the time‑dependent changes in Bitemarks on Styrofoam sheets.
Settings and Design: Single centered prospective study. Materials and Methods: Twenty‑five subjects were randomly chosen,
and dental casts prepared. Then test bites were registered on Styrofoam sheets, overlays prepared from these test bites on
subsequent days (day 1, 2, 3, 4) and checked for matching accuracy. Statistical Analysis Used: The data were analyzed using
Kruskal–Wallis ANOVA to compare the overlays from dental stone cast with test bites on Styrofoam sheets on subsequent days.
Results: The P value was found to be 1 which is statistically not significant implying that there were no significant time‑dependent
changes in the pattern of Bitemarks. Conclusions: There were no time‑dependent changes in the pattern of Bitemarks on Styrofoam
sheets hence they serve as better materials than Bitemarks on human skin or food substrates obtained from the scene of the crime.

Key words: Bitemarks, forensic dentistry, overlays, Styrofoam, test bites

Introduction impressions of both the dental arches were made and

the corresponding casts were prepared. Test bites were
Bitemarks are physical alterations in a medium caused by the registered from these individuals by making them bite on
contact of teeth.[1] These Bitemarks are frequently found on Styrofoam sheets obtained from the common disposable
food substances in crime scenes[2‑6] and play a pivotal role Styrofoam plates that are commonly referred as thermocol
in identifying the offenders. However, these are prone to plates [Figure 1a]. The thickness of the sheets we used was
distortion because of their perishable nature. 0.2 cm and the sheets were custom made from Styrofoam
plates of 9 inches diameter.
The ABFO has suggested test bite registration media like
wax sheet, Styrofoam, clay and human skin of volunteers.[1] These sheets were folded and placed in the mouth such
Through this study, we analyzed the time‑dependent changes that the extension of the sheet was from canine to canine.
in Styrofoam as to check its reliability without distortion The folded end of the Styrofoam sheets were placed
if found in a crime scene and its durability as a test bite inside the mouth and the free end of the sheets extending
registration material. outside the mouth. Then the subjects were instructed to bite
on the sheets [Figure 1b]. The sheets were removed from the
Materials and Methods mouth [Figure 1c] and unfolded so that the bite pattern was
obtained in the same plane as the typical horseshoe shaped
Twenty‑five healthy subjects above 15 years of age were pattern facing each other as shown below [Figure 1d]. The
randomly chosen and after obtaining informed consent sheets were washed in running tap water and then dried by
placing against absorbent tissue paper. Then it was gently
Department of Oral Medicine and Radiology, Mahatma Gandhi
wiped off with cotton soaked in surgical spirit to disinfect
Postgraduate Institute of Dental Sciences, Puducherry, India
the surface and air dried.

Correspondence: Dr. Djeapragassam Parimala, The Bitemarks thus obtained formed the base from which
Department of Oral Medicine and Radiology, Mahatma Gandhi overlays were generated by tracing the pattern of Bitemarks
Postgraduate Institute of Dental Sciences, Puducherry, India. on transparent sheets with a marker [Figure 2a]. The sheets
E‑mail: [email protected] were numbered on the back side for easy recognition on the
subsequent days. The sheets were left at a dry place in normal
Access this article online room temperature, no special preservation techniques
Quick Response Code: or protocols were followed. The Bitemark patterns were
Website: analyzed for time‑dependent changes [Figure 3]. Overlays
www.contempclindent.org
were generated on four subsequent days from these sheets
to analyze the alteration in the pattern of Bitemarks with time
DOI: elapse [Figure 2b]. A reference overlay was generated for each
10.4103/0976-237X.152948 subject from the dental casts by tracing the incisal edges of
anterior teeth with marker on a transparent sheet [Figure 2c].
S77 Contemporary Clinical Dentistry | March 2015 | Vol 6 | Supplement 1
 Parimala, et al.: Analysis of time‑dependent changes in Bitemarks on Styrofoam sheets

The overlays thus generated on the subsequent days

(day 1, 2, 3, 4) were superimposed on the reference overlay
obtained from the dental cast and checked for matching
accuracy [Figure 2d]. Then appropriate matching scores were
assigned as 0 ‑ no match, 1 ‑ mild match, 2 ‑ moderate match
and 3 ‑ excellent match.
a b
Results

The data obtained by checking the matching accuracy were

tabulated and analyzed statistically. It was found that 16% of
the cases showed moderate matching (i.e. 4 out of 25 samples
had a matching accuracy score 2) and 84% showed excellent
matching with the reference overlays generated from the
c d dental casts (i.e. 21 out of 25 samples had a matching accuracy
Figure 1: (a) Styrofoam sheet (b) test bite registration score 3). However, when comparing within the Styrofoam
(c) resultant bite pattern (d) unfolded Styrofoam sheet showing sheets, the matching accuracy remained the same on the
maxillary and mandibular bite pattern on the same plane four subsequent days.

Kruskal–Wallis ANOVA test was used to analyze the

time‑dependent changes by comparing the overlays from
dental stone cast with test bites registered on Styrofoam
sheets on subsequent days [Table 1]. The P value was found
to be 1 which is statistically not significant implying that
there were no significant changes in the pattern of Bitemarks
a b with time elapse.

Discussion

Bitemarks if analyzed properly not only can prove the

participation of a particular person or persons in crime but
also help in exoneration of the innocent.[7] In the majority
of cases, qualitative evaluation of the Bitemarks is usually
c d easier with bitten foodstuffs than human skin although it
must be emphasized that certain foods make poor media
Figure 2: (a) Bite pattern traced (b) resultant overlay from
Styrofoam sheet (c) overlay being traced from dental stone for Bitemark registration.[8] Skin is a poor medium to capture
cast (d) superimposed overlay for checking matching accuracy marks left in it by various tools, weapons and teeth. From the
time the mark is made until the case data are obtained, the
skin continues to change. If the victim is alive, bruising may
appear. If deceased, then post‑mortem changes may occur.[9]

Among the ABFO recommended materials Styrofoam readily

serves as a bite registration material. Wax sheets might
need softening while clay may be tacky and needs proper
manipulation. Skin known for its elastic nature make the
Bitemarks fleeting. The use of skin on human volunteers,
porcine skin and cadaver skin for test bite registration have
also been reported in the literature. However, these materials
may be disagreeable to register Bitemarks from our test
subjects. Considering these ethical issues, we attempted to
register Bitemarks on an inanimate material. So, in our study
we used Styrofoam sheets.[3,10,11]

Rothwell et  al. (2001) conducted a study to analyze the

Figure 3: Bitemark patterns on Styrofoam sheet with elapse distortion in preserved Bitemark skin and stated that
in time on four consequent days (day 1, 2, 3, 4) although some samples were dimensionally stable, there

Contemporary Clinical Dentistry | March 2015 | Vol 6 | Supplement 1 S78

 Parimala, et al.: Analysis of time‑dependent changes in Bitemarks on Styrofoam sheets

Table 1: Kruskal–Wallis ANOVA comparing overlays for recording both class and individual characteristics. Coffee/
time‑dependent changes cold drink cups are the most common form of Styrofoam
Kruskal–Wallis ANOVA result bitten object. Dorion (1989) reported the use of Styrofoam as
Day n Sum of Kruskal–Wallis an impression media for registering and analyzing a suspect
P level LS
ranks test H dentition.[3,13,14]
1 25 1262.5 0.0000 1.0000 NS
2 25 1262.5
Wax and Styrofoam behave quite differently from human
skin, as they undergo permanent plastic deformation under
3 25 1262.5
stress, unlike skin that has visco‑elastic properties.[15] The
4 25 1262.5
problem with this method is that wax and skin are very
P value 1 not significant implies that there is no changes with time elapse. different in consistency and require different amounts
LS: Level of significance; NS: Not significant; ANOVA: Analysis of variance
of pressure to produce a mark, and if too much force
is used the wax Bitemark will most likely produce an
was both contraction and expansion of Bitemark specimens,
overlay that does not reflect the real situation.[16] The use
even within individual skin samples. He concluded that even
of disposable plates and cups have increased these days,
standard techniques for storage and preservation of Bitemark
and so it is possible that one may find these at the scene
samples will not produce reliable dimensional accuracy.[10] In
of the crime more interestingly with a Bitemark. In our
our study, with Styrofoam we found that 16% of the cases
study, Kruskal–Wallis ANOVA test was used to analyze the
showed moderate matching with the dental casts (i.e. 4 out
time‑dependent changes by comparing the overlays from
of 25 samples had a matching accuracy score 2) and 84%
dental stone cast with test bites registered on Styrofoam
showed excellent matching (i.e. 21 out of 25 samples had a
sheets on subsequent days and the P value was found to be
matching accuracy score 3). This discrepancy occurred when
1 which is statistically not significant implying that there
there existed crowding in the dental arches with one or two
were no significant changes in the pattern of Bitemarks
teeth well above or below the incisal plane. This is suggestive
of the superiority of Styrofoam over dental casts because with time elapse. This is possibly because of the permanent
the pattern registered on Styrofoam sheets are the result of plastic deformation these sheets undergo with the biting
the biting force applied which is probably the more accurate pressure. Styrofoam forms part of the hard group of
reproduction of the dynamic process of biting; whereas the materials called thermoplastic elastomers. An elastomer
reference overlay is merely traced from the static dental will undergo an immediate, linear and reversible response
model. to high strain to an applied force. This response has a
mechanical analogy with a spring according to Hooke’s Law.
Avon et al. (2005) studied the ageing of human Bitemarks on Nonlinear, time‑dependent irreversible response is a viscous
in‑vivo models of porcine skin and stated that porcine skin response according to a dashpot model.[17] Research is
exhibited similar changes like human skin. He concluded that needed in assessing the physical properties and biomaterial
the passage of time will result in loss of tooth depressions in perspective of Styrofoam sheets and further studies with
human or porcine skin. The status of the tissue at the time prolonged time duration is needed.
of biting; the time elapsed between the biting and when the
analysis was made; condition of the skin injured; the clarity of Through our study, we would like to suggest the possibility
the marks and the site of the wound; must all be considered of the use of Styrofoam as a test bite registration material
in determining the evidentiary value of any Bitemark.[11] as an alternative to the dental casts. Bitemarks may
be offensive or defensive in nature and for this reason
In this study, we have analyzed the time‑dependent changes Bitemark evidence is collected from both the victim and
in Styrofoam and we found that the inter canine distance and suspect.[18] In certain cases wherein the victim is severely
mesio‑distal width of the incisal edges obtained in the test injured and with restricted mouth opening Styrofoam can
bites on the Styrofoam sheets remained the same suggesting be used as an alternative. Identification of individuals
that there was no alteration in the pattern of Bitemark with is not always straightforward and easy especially in
time elapse. Stavrianos et al. (2011) in their study of Bitemarks medicolegal cases where the individuals are either unable
on bitten apple to compare accuracy of two methods in to give accurate answers or are purposefully misleading.
Bitemark analysis have stated that they had refrigerated the Living individuals for whom identification is required
apple; which could possibly be to overcome the shrinkage are criminals attempting to elude custody, amnesia
with time elapse.[12] In the case of fruits the water content victims, comatose victims, victims of disfiguring trauma
of fruits influence the Bitemarks; the more juicy the fruit the or persons requiring identity confirmation following
less prominent the Bitemark. identity theft. [19] Impression making may be difficult
in special situations like in young children, mentally
Styrofoam comes in many thicknesses, shapes and colors. challenged individuals, emotionally disturbed victims of
Teeth will usually imprint fairly accurately in Styrofoam, rape, child abuse, individuals with gagging, bed ridden

S79 Contemporary Clinical Dentistry | March 2015 | Vol 6 | Supplement 1

 Parimala, et al.: Analysis of time‑dependent changes in Bitemarks on Styrofoam sheets

individuals (who could not be positioned upright as needed References

for impression making), individuals with soft tissue injuries
like lacerations intra orally, individuals with TMJ disorders 1. American Board of Forensic Odontology. Diplomates Reference
Manual. 2013. Available from: www.abfo.org/wp.../ABFO-
and restricted mouth opening due to any other reason.
Reference-Manual-1-22-2013-revision.pdf. [Last access on 2013
In these conditions, Styrofoam can be used as a better Dec 15].
alternative method in obtaining the pattern of Bitemarks 2. Whittaker DK, MacDonald DG. A Color Atlas of Forensic Dentistry.
as the thickness of the sheet is 2 mm only. London: Wolfe Medical Publications; 1989.
3. Dorion RB. Bitemark Evidence. 1st ed. New York: Marcel Dekker;
2005.
Styrofoam test bite registration is advantageous over 4. Bernitz H, Piper SE, Solheim T, Van Niekerk PJ, Swart TJ.
the conventional dental casts because they are handy, Comparison of bitemarks left in foodstuffs with models of the
easily available, does not require any dental materials, suspects’ dentitions as a means of identifying a perpetrator.
J Forensic Odontostomatol 2000;18:27‑31.
economical and less time consuming in overlay generation. 5. McKenna CJ, Haron MI, Brown KA, Jones AJ. Bitemarks in
The dental stone casts prepared are also brittle and needs chocolate: A case report. J Forensic Odontostomatol 2000;18:10‑4.
special precautions during transportation, the procedural 6. Gorea RK, Jasuja OP. Identification from bitemarks on Nakh (pear).
difficulties and need for a laboratory setting, impression J Indo Pac Acad Forensic Odontol 2010;1:30‑3.
7. Kaur S, Krishan K, Chatterjee PM, Kanchan T. Analysis and
trays, impression materials, delay due to transportation of identification of Bitemarks in forensic casework. Oral Health Dent
impression to laboratory and time for setting of cast are all Manag 2013;12:127‑31.
eliminated with the use of Styrofoam sheets. However, it is 8. Nambiar P, Carson G, Taylor JA, Brown KA. Identification from a
reported that in Styrofoam sheets larger the cell size more bitemark in a wad of chewing gum. J Forensic Odontostomatol
2001;19:5‑8.
inaccurate the representation of teeth being recorded[20] 9. Bowers CM, Bell GL, editors. Manual of Forensic Odontology.
which can be overcome by the use of Styrofoam plates 3rd ed. Ontario: Manticore; 1997. p. 184‑90.
rather than the Styrofoam sheets as the cells are more 10. Rothwell BR, Thien AV. Analysis of distortion in preserved Bitemark
skin. J Forensic Sci 2001;46:573‑6.
closely packed in these plates. The limitation of using
11. Avon SL, Wood RE. Porcine skin as an in‑vivo model for ageing
Styrofoam is that it may be charred when near direct of human Bitemarks. J Forensic Odontostomatol 2005;23:30‑9.
flame hence care must be taken while transportation. 12. Stavrianos C, Vasiliadis L, Emmanouil J, Papadopoulos C. In
Another limitation is the uniformity in color of the sheets vivo evaluation of the accuracy of two methods for the Bitemark
analysis in food stuff. Res J Med Sci 2011;5:25‑31.
that makes computer‑assisted overlays and a photocopy 13. Dorion RB. Styrofoam as an Impression Material. Proceedings
method of overlay generation out of scope. However, of the 41st Annual Meeting of the American Academy of Forensic
we can overcome this limitation with a careful contrast Sciences; 1989 Feb 13‑18; Las Vegas, NV, Colorado Springs,
painting. We suggest painting the Styrofoam with a CO: American Academy of Forensic Sciences; 1989.
14. Dorion RB. Bitemark Project 2000 – Objectivity. Proceedings of
contrast dark colored, flat tipped permanent marker (to the 53rd Annual Meeting of the American Academy of Forensic
and fro strokes like in shading a coin pattern on a plain Sciences; 2001 Feb 19‑24; Seattle, WA, Colorado Springs, CO:
paper) to make the incisal outlines of teeth in the test American Academy of Forensic Sciences; 2001.
bite more prominent (and stay distinct as they are three 15. Bush MA, Miller RG, Bush PJ, Dorion RB. Biomechanical factors
in human dermal bitemarks in a cadaver model. J Forensic Sci
dimensional registrations lying at a depth from the plane 2009;54:167‑76.
of the sheet) before preparing the overlays. 16. Kouble RF, Craig GT. A comparison between direct and indirect
methods available for human Bitemark analysis. J Forensic Sci
2004;49:111‑8.
Conclusion 17. ElSonbati AZ. Thermoplastic Elastomers. Ch. 8. Croatia: InTech
Publishers: 2012. p. 8. Available from: http://www.intechopen.
The forensic expert plays a vital role in medico legal cases com/books/thermoplastic‑elastomers/thermoplastic‑elastomers.
where his judgment decides the fate of the individual; such [Last accessed on 2015 Feb 24].
18. Bhargava K, Bhargava D, Rastogi P, Paul M, Paul R, Jagadeesh HG,
an important decision should not be deceiving due to the et al. Review research paper an overview of Bitemark analysis.
time‑dependent alterations in Bitemarks. So through our study, J Indian Acad Forensic Med 2012;34:61‑6.
we conclude that Styrofoam serve as better substrates than 19. Kanaparthy A, Kanaparthy R. The dental role in forensic medicine.
human skin or food substances if obtained from a scene of IOSR J Pharm 2013;3:14‑7.
20. Wright FD, Dailey JC. Human Bitemarks in forensic dentistry. Dent
crime as there were no time‑dependent changes in the pattern Clin North Am 2001;45:365‑97.
of Bitemarks on Styrofoam. We envision the widespread use
of Styrofoam as a test bite material in the near future as an How to cite this article: Parimala D, Daniel MJ, Srinivasan SV,
alternative to dental casts in special conditions like trismus, Kumaran JV. Analysis of time-dependent changes in Bitemarks on
bed ridden individuals etc., were no alternative methods have Styrofoam sheets. Contemp Clin Dent 2015;6:S77-80.

been suggested till date. Source of Support: Nil. Conflict of Interest: None declared.

Contemporary Clinical Dentistry | March 2015 | Vol 6 | Supplement 1 S80

Copyright of Contemporary Clinical Dentistry is the property of Medknow Publications &
Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a
listserv without the copyright holder's express written permission. However, users may print,
download, or email articles for individual use.