Indian Journal of Forensic Odontology

Dentinogenesis imperfecta (DI) is a genetic disorder affecting the developmental integrity of the dentin which results in weakened dentin. It is inherited as an autosomal dominant trait. The affected teeth, generally the posterior teeth will have to be extracted due to severity in wear and thereby possible fracture. This commonlyresults in loss of posterior occlusion and reduced vertical dimension. Apart from wear and fracture, anterior teeth may have an unesthetic appearance because of discoloration. Early diagnosis and treatment of DI is recommended, as it may prevent or intercept deterioration of the teeth and its occlusion. This article presents a case report of Prosthodontic Management of a patient diagnosed with Dentinogenesis Imperfecta.
 

Prosthodontics, the dental specialty focused on creating artificial replacements for teeth and oral structures, is governed by a complex medicolegal framework essential for ensuring patient safety and professional integrity. In prosthodontics, medicolegal aspects primarily deal with ensuring the standard of care, maintaining patient rights and avoiding malpractice. This review highlights key medicolegal aspects, including informed consent, negligence, and the ethical responsibilities of prosthodontists. It shows the importance of thorough documentation, effective communication, ethical issues and adherence to standards of care to mitigate malpractice risks.
 

Background: Gender determination is a crucial aspect of forensic anthropology, playing a vital role in the identification process of unknown human remains. Recent advancements in imaging technologies, particularly Cone Beam Computed Tomography (CBCT), have the way for more accurate and non-invasive methods of gender estimation through morphometric analysis.1 The maxillary sinus, orbital index, and foramen magnum are anatomical structures that exhibit sexual dimorphism, meaning their dimensions differ between males and females.1 The maxillary sinus, located within the maxillary bone, shows distinct variations in size and shape based on gender. Similarly, the orbital index, which is the ratio of the orbital height to its width, varies significantly between the gender.2 The foramen magnum, a crucial structure at the base of the skull, also presents measurable differences in size and shape between males and females.3 This retrospective study aims to evaluate the efficacy of using CBCT to determine gender through the morphometric analysis of these anatomical structures.  Aim and Objectives: Aim of the study is to determine gender using morphometric analysis of maxillary sinus, orbital index &foramen magnum using CBCT. Objectives of the study is to evaluate the morphometric analysis of maxillary sinus of height, width and depth, morphometric analysis of orbital index of height and width and to evaluate the morphometric analysis of foramen magnum of length width and shape. Methodology: 90 CBCT images of patients were taken from the department database. The DICOM data will be imported to ROMEXIS 6.1.0 software. The age group selected between 13 and above. Maxillary Sinus: Axial view: a) The width was the longest distance perpendicular from the medial wall of the sinus to the most lateral wall of the lateral process of maxillary sinus in axial view. b) The depth was defined as the longest distance from the most anterior point to the most posterior point of the medial wall in the axial view. In coronal view a) The height was measured away from the inner surface of the anterior border of maxillary sinus and was defined as the longest distance from the lowest point of the sinus floor to the highest point of sinus roof in the coronal view. Orbital Index: In coronal view a) Orbital height: Highest distance between the superior and inferior  orbital margin. b) Orbital width: Maximum lateral curved distance between the medial margin and lateral margin of the orbit. Foramen Magnum: a) In axial view the anteroposterior dimension and transverse dimension are measured from the most prominent point. b) The shape of the foramen magnum determined based on the Richards and Jabbour classification. c) Shape of the magnum was found to be circle, semicircle, wide oval, heart, bipointed, birounded, venterally rounded and dorsally convergent. Results: There were about 48.8% of males and 51.2% of females in the study. there is a significant difference in length, height and width of maxillary sinus between males and females and hence, maxillary sinus can be used as an effective parameter in gender determination. The length of orbital index was more in males than females and width of orbital index was less in males than females the mean differences between the gender was found to be statistically nonsignificant. The mean length and width of foramen magnum was more in males than females. This mean difference was found to be statistically significant (p-value=0.01), indicating foramen magnum’s length, width and area can be used as an effective parameter in sex determination. Conclusion: CBCT-based morphometric analysis of the maxillary sinus, orbital index, and foramen magnum is a reliable method for gender determination. This approach shows great potential for enhancing forensic anthropological practices and assisting in the identification of human remains. Future research should focus on validating these findings across larger and more diverse populations and exploring additional cranial landmarks to further improve the robustness of gender determination methods. 

Introduction: Teeth, which are known for their durability, even under extreme conditions, have long been a key tool in forensic investigations. Among the various indicators, dental wear is frequently used for age estimation when other biological markers are unavailable. In this study, we aimed to assess the effectiveness of dental wear for age estimation in the modern Indian population by applying Brothwell’s method. The total wear score was translated into an estimated age range based on the established correlation between dental wear and age as defined by the Brothwell chart. Materials and Methods: This cross-sectional observational study was conducted on a sample of 104 participants whose chronological ages were known, allowing for a comparison between their actual age and that estimated from dental wear. The participants were selected according to specific inclusion criteria. Archived occlusal surface photographs of the maxillary and mandibular molars were examined. Dental wear assessment was conducted using Brothwell’s 1981 chart as a standard reference. Statistical analysis was performed to determine the correlation between the estimated age from dental wear and the participants' chronological age as well as the accuracy of this method. Results: The mean chronological age of male participants was 35.11 years (±10.64), while for female participants, it was 34.96 years (±10.81). Males had a mean Brothwell score of 4.19 (±2.07), which was slightly lower than that of females with a mean score of 4.32 (±2.23). A strong association was found between the estimated Brothwell age group and chronological age group, as demonstrated by a statistically significant chi-square value (0.001*) and Cohen’s kappa of 0.64. Spearman's correlation analysis revealed a strong relationship between chronological age and Brothwell score, with a value of 0.97. The Mann-Whitney U test comparing dental wear scores between vegetarian and non-vegetarian participants revealed no significant differences. Conclusion: This study confirms the usefulness of Brothwell’s dental-wear method in forensic
age estimation, although it underscores the need for modifications when applied to modern populations. The moderate agreement between estimated and actual ages suggests that dental wear remains a valuable indicator, but factors such as modern dietary habits and dental care practices should be considered.
 

Aims & objectives: This study's objective was to assess understanding, and attitude/ practices of forensic odontology among students of dentistry. Material & methods: An institution based cross sectional survey, was carried out among 309 students of Narayana Dental College Nellore, AP, India, belonging to III, IV BDS, Internship & post-graduation, from Feb to May 2023. Questionnaire forms which included 22 open & closed end questions on knowledge & awareness (19 questions) & attitude/practice (03 questions) towards forensic odontology, were distributed and were collected with their answers. These were further analyzed statistically based on percentages and association with age, gender and year of the study. Results: Our study showed that 94.5% students knew about Forensic odontology as a specialty and 69.3% were aware about its recognition as a subject. 60-70% of students agreed upon the having the knowledge that bite marks, lip prints, rugae patterns, dental radiographs etc. are helpful in the age & gender determination, and which in turn could also aid in the detection of crimes. Only 49% of participants knew about training programs in forensic odontology & 76% were interested in joining the same. More than 90% agreed that maintaining dental records could help forensic experts in their investigations. In our study, all the participants had adequate knowledge/awareness. Interns displayed more knowledge & awareness when compared to undergraduates and even to postgraduates in few instances. Conclusion: With increasing knowledge & awareness about forensic odontology and students showing keen interest in pursuing the subject more opportunities should be made available. This can be made possible by recognizing this subject as a separate specialty and establishing well equipped training centers. Thus, the scope of forensic odontology in various fields and especially in that of crime investigation & individual identification in different situations gets boosted.