Journal of Forensic Radiology and Imaging 1 (2013) 201–206

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Journal of Forensic Radiology and Imaging

journal homepage: www.elsevier.com/locate/jofri

Case report

Interrelationship between forensic radiology and forensic

odontology—A case report of identified skeletal remains
R.F. Silva a,n, A. Franco b, P.E.M. Dias c, A.S. Gonçalves d, L.R. Paranhos e
a
Forensic Odontology, Scientific Police of Goias, Federal University of Goias, Av. Universitaria, Esquina com 1ª Avenida s/n, Setor Universitario,
74605-220 Goiania, Goias, Brazil
b
Forensic Odontology, Katholieke Universiteit Leuven, Belgium
c
Morphology and Forensic Anthropology, Masaryk University, Czech Republic
d
Federal University of Goias, Brazil
e
Bioethics, Sacred Heart University, Brazil

ar t ic l e i nf o a b s t r a c t

Article history: Objectives: To report a forensic case of positive human identification using radiographic and anthro-
Received 1 June 2013 pological techniques.
Received in revised form Material and methods: Unknown human skeletal remains were received, under the legal request for
11 June 2013
identification. Anthropological exams consisting in the analysis of teeth, long bones, and cranial features
Accepted 26 June 2013
Available online 16 August 2013
were performed to estimate the age, stature and gender of the victim. Post-mortem (PM) periapical
radiograph of the teeth, and posteroanterior radiograph of the skull, were obtained and compared to
Keywords: ante-mortem (AM) recorded lateral and posteroanterior radiographs of a missing person.
Human identification Results: Positive matching was obtained by comparing mandibular molars between periapical (PM) and
Forensic anthropology
lateral radiographs (AM) and frontal sinuses between posteroanterior radiographs.
Forensic odontology
Conclusion: In this context, the present case illustrates the usefulness of anthropological reconstructive
Forensic radiology
Forensic medicine procedures for identification narrowing the search for AM data. Further on, forensic radiographs of
skeletal remains proved to be an important tool reproducing PM forensic records for comparative human
identification.
& 2013 Elsevier Ltd. All rights reserved.

1. Introduction are compared to each other. A positive identification can be

obtained considering the high level of similarity between the data,
In the forensic sciences, forensic radiology is a useful tool both or considering a potential matching between unique traits of the
for investigations around the cause death and human identifica- victim, such as supernumerary teeth. In this context, the present
tions, respectively enhancing performances in forensic medicine study aims to report a case in which human skeletal remains were
and odontology. Specifically in reconstructive human identifica- identified based on forensic radiology evidences through recon-
tions, in which ante-mortem (AM) data is absent [1], post-mortem structive and comparative identification.
(PM) anthropological analysis through radiographic modalities
allows for accurate age estimation procedures narrowing the
search for potential victims. On the other hand, in comparative 2. Material and methods
human identifications, in which AM and PM data are matched [2],
radiographic registration of unique traits of the victim, such as In 2009, unknown skeletal remains were found near to a forest
morphological features, is the most common available forensic area in the central region of Brazil. After the crime scene
evidence. investigation, anthropological analysis for human identification
In special occasions, both reconstructive and comparative was carried out aiming to build an evidence-based post-mortem
human identifications must be performed for accurate outcomes. (PM) profile of the victim.
In these situations AM data are lately found, hampering immediate Thus, skeletal age estimation was performed through the exam
identification by directly comparing with PM data. Thus, initially, of long bones, according to McKern and Stwart [6], considering the
the victim's age [3], gender [4] and stature [5] can be predicted to percentage of bone fusion in the proximal humeral and tibial, and
guide further AM search. Once AM and PM data are collected, they distal radial and femoral, epiphyses (Fig. 1). In addition, dental age
estimation was performed according to the techniques of Ander-
son et al. [7]; Solari and Abramovich [8]; Nicodemo et al. [9]; and
n
Corresponding author. Tel.: +55 62 3209 6051. Gunst et al. [10], considering the developmental stages [11] of
E-mail address: [email protected] (R.F. Silva). third molars in PM periapical radiographs (Fig. 2). Further on,

2212-4780/$ - see front matter & 2013 Elsevier Ltd. All rights reserved.
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202 R.F. Silva et al. / Journal of Forensic Radiology and Imaging 1 (2013) 201–206

Fig. 1. Skeletal age parameters represented by the fusion of Humerus, Tibia, Radius, and Femur epiphysis. (A) Humerus proximal epiphysis; (B) Tibia proximal epiphysis; (C)
Radius distal epiphysis and (D) Femur distal epiphysis. The arrows indicate the bone fusion area.

anthropological gender differentiation was performed by quanti- #45, were missing PM; the tooth #38 was missing AM; the teeth
tatively analyzing sexual skeletal indicators, such as pelvic and #12, #13, #14, #15, #16, #17, #24, #25, #28, #37, #43, #46 and
cranial morphological features. Finally, the estimation of the #47 were present and totally erupted; the teeth #18 and #48 were
skeletal stature was also performed according to Dupertuis and partially bone erupted; the teeth #22 and #31 were present but
Hadden's [12], 1951. fractured, and the tooth #36 presented only a remain mesial root.
Based on the obtained reconstructive PM forensic profile, the In addition, metallic dental restorations were observed on the
search for AM data was accurately carried, narrowing the potential occlusal surface of the tooth #46 (Fig. 3).
victims. Further on, a 17-year-old girl, missing since December 2008,
was indicated as the main potential victim among related missing
persons. The girl's relatives provided a posteroanterior and a
lateral radiograph of the skull, both dating from 2007
3. Results (Figs. 4 and 5). The posteroanterior radiograph allowed for
the morphological analysis of the frontal sinuses, as well for
The estimated skeletal age ranged between 18 and 24 years old the detection of dental restorations. In the lateral radiograph, the
(Table 1). The estimated dental age ranged between 14.7 and 20.6 position and shape of two radiopaque dental restorations on
years old (Table 2). The assessed morphological features were the occlusal surface of the tooth #46 were observed, as well as
compatible with a female individual. The victim was between the incomplete root formation of third molars.
160 cm and 168 cm in height. In order to correctly compare the detected AM dental evidences
In detail, the PM dental exam enabled to observe that: the teeth with PM data, a periapical radiograph of the teeth #46 and #47,
#11, #21, #23, #25, #27, #32, #33, #34, #35, #41, #42, #44 and and a posteroanterior radiograph of the skull (Fig. 6), were
 R.F. Silva et al. / Journal of Forensic Radiology and Imaging 1 (2013) 201–206 203

Fig. 2. PM periapical radiographs of third molars. (A), (B), and (C): Teeth #18, #28, and #48 (indicated by the arrows) partially developed, respectively; (D): Absence of tooth
#38.

Table 1
Ranges of skeletal age, expressed in years, considering the percentage of bone fusion according to McKern and Stwart [6].

Bone (region) % of bone fusion Age range

Humerus (proximal epiphysis) 20–100 18–24

Radius (distal epiphysis) 30–100 18–23
Femur (distal epiphysis) 60–100 18–22
Tibia (proximal epiphysis) 65–100 18–23

Table 2
Age ranges, reported in years, according to third molars development, considering the techniques of Anderson et al. [7]; Solari and
Abramovich [8]; Nicodemo et al. [9]; and Gunst et al. [10].

Tooth Anderson et al. [7] Solari and Abramovich Nicodemo et al. [9] Gunst et al. [10]
(10th Stage) [8] (Stage “F”) (Roots 2/3 developed) (6th Stage)

#18 14.7–17.5 15.0–18.5 16.0–19.5 17.4–20.6

#28 14.7–17.5 15.0–18.5 16.0–19.5
#48 15.0–17.5 14.7–20.0 16.0–19.5

Fig. 3. Maxilla and mandible revealing dental identifiers. (A) Maxilla and (B) Mandible.

performed. The forensic comparison revealed similar dental mor- In the AM and PM PA radiographs, the frontal sinuses presented
phology of the teeth #46 and #47 between AM and PM radio- a unique shape, consisting of a single lobe for each side separated
graphic data (Fig. 7). In addition, the tooth #48 presented the same by a median septa tilted to the right side (Fig. 8). In this context,
position both AM and PM. the reconstructive identification of skeletal remains enabled
204 R.F. Silva et al. / Journal of Forensic Radiology and Imaging 1 (2013) 201–206

Fig. 4. AM lateral radiograph of the skull.

Fig. 6. PM PA radiograph of the skull.

dead, such as for forensic anthropology, craniofacial reconstruc-

tions, virtual autopsies, and human identification cases [13].
Specifically, in comparative human identifications conventional
radiographs or high-tech imaging can be performed in the search
for unique dentomaxillofacial structures [14,15].
In this context, the medical literature reports that forensic
odontology is a powerful tool for the human identification process,
especially in cases of carbonized, decomposed, putrefied, and
skeletonized bodies [16]. In addition, its efficiency is improved
under the feasibility of comparison between unique AM and PM
data, such as the unique-shaped frontal sinuses [17].
The present case illustrates a situation in which two radio-
graphs, provided by the victim's parents, were used as reliable AM
data. Moreover, unique dental traits were clearly observed in the
dentomaxillofacial area, such as dental restorations, dental mor-
phology and development, providing higher credibility for further
forensic investigations [18–20]. In accordance to previous positive
identifications founded on dental uniqueness [18,21], the two
dental restorations observed on the occlusal surface of the tooth
#46, played a great comparative role due to its unique shape,
Fig. 5. AM PA radiograph of the skull. position and dimensions. In this context, is relevant to note that
the PA radiograph was analyzed to confirm the correct side of the
a comparative procedure based on solid and unique forensic dental restorations on the tooth #46, because in the lateral
evidences, leading to an accurate positive human identification. radiograph the side differentiation is hampered by several anato-
mical superimpositions.
In addition, in order to estimate the victim's age through the
4. Discussion third molars development, PM periapical radiographs were
obtained. The dental age estimation outcomes were strongly
Forensic radiology applications can be useful both for specific related to the victim's age at the time she was missing (17.5 years).
investigations in the living, such as for age estimations, and in the In opposite, the skeletal age investigation revealed discrete
 R.F. Silva et al. / Journal of Forensic Radiology and Imaging 1 (2013) 201–206 205

Fig. 7. Comparison between the AM lateral radiograph of the skull and the PM periapical radiograph of the lower right molars. (A) Partial view of the AM lateral radiograph
of the skull showing distinct dental restorations on the tooth #46; (B) PM periapical radiograph of the same area showing the compatible dental restorations on the
tooth #46.

Fig. 8. Comparison between the AM and PM PA radiograph of the skull considering the position of the median septa. (A) Partial view of the AM PA radiograph of the skull;
(B) Partial view of the PM PA radiograph of the skull. The unique position of both AM and PM median septa is indicated by the arrows.

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