Sources for Antemortem Data

Antemortem data may include as dental radiographs, written records, models and photographs. Original radiographs should be obtained if possible. The discovery and collection of antemortem records is ordinarily the responsibility of the investigative agency who has access to missing persons reports at the local, state or national level. However, the forensic odontologist may recognize additional characteristics (e.g., prior orthodontic treatment) which could be helpful in establishing a potential ID. This section lists a variety of resource agencies and/or individuals that might provide assistance in locating records.

1. Local Agencies:
• Hospitals, Other Health Care Facilities.
• Dental Schools.
• Health Care Providers.
• Employer Dental Insurance Carrier.
• Public Aid Insurance Administrator.

2. State Agencies:
Contact state or local agencies for dental record assistance.

3. Federal Agencies:

FBI National Crime Information Center (NCIC)

Council on Dental Affairs and the Federal Dental Service
1111 14th Avenue, NW, #1200
Washington, DC 20005

Military Records Depository
900 Page Blvd.
St. Louis, MO

4. Insurance Carriers


5. Other Sources
• Family/Friends/Coworkers.
• Public aid insurance administrator.
• Employer dental insurance carrier.
• Prior military service.
• Prior judicial detention in county.
• State or Federal institutions.
• Prior hospitalizations (e.g. chest films, skull films).
• Oral surgeons in the area.
• Veterans administration hospitals.
• Any previous areas of residence.
• Chiropractic x-rays.
• If evidence of ortho treatment, orthodontists in the area.

Comparison Of Antemortem & Postmortem Evidence

This section deals with factors which may be present in both the antemortem and postmortem dental evidence and can be useful for comparison purposes. Most dental identifications are based on restorations, caries, missing teeth and/or prosthetic devices which may be readily documented in the records. It should be noted, however, that the precipitous decrease in caries incidence in recent years will dictate greater reliance on other dental findings in the future. It is emphasized that, given adequate records, a nearly infinite number of objective factors have identification value (see Section IV). Thus, objective findings, particularly those which are unique to the individual, provide the basis for concordance or exclusion.
Concomitantly, apparent discrepancies between the antemortem and postmortem evidence (e.g. errors in recording, dental treatment subsequent to the available antemortem record) must be resolved.
The following subsections provide examples of objective findings in the teeth, periodontium, and/or jaws, which may be demonstrable in both antemortem and postmortem records. While the factors listed are by no means comprehensive, they may serve as a checklist and demonstrate the range of objective findings that may be applicable in difficult identification cases.

Dental Features Useful in Identification

Teeth
• Teeth present.
• Erupted.
• Unerupted/impacted.
• Missing teeth.
•Congenitally missing.
• Lost antemortem.
• Lost perimortem/postmortem.
• Tooth Type
• Permanent.
• Mixed dentition.
• Retained primary teeth.
• Supernumerary teeth.
• Tooth Position
• Malpositions: facial/linguoversion, rotations, supra/infra positions, diastemas, other occlusal discrepancies.
• Crown Morphology
• Size and shape of crowns.
• Enamel thickness.
• Location of contact points, cemento-enamel junction.
• Racial variations: e.g. shovel-shaped incisors, Carabelli cusp, etc.
• Crown Pathology
• Caries.
• Attrition/abrasion/erosion.
• Atypical variations: e.g. peg laterals, fusion/gemination, enamel pearl, multiple cusps.
• Dens in dente.
• Dentigerous cyst.
• Root Morphology
• Size, shape, number, dilaceration, divergence of roots.
• Root Pathology
• Root fracture.
• Hypercementosis.
• External root resorption.
• Root hemisections.
• Pulp Chamber and Root Canal Morphology
• Size, shape, number.
• Secondary dentin.
• Pulp stones, dystrophic calcification..
• Root canal therapy: e.g. gutta percha, silver points, endo paste and retrofill proce - dures.
• Internal resorption.
• Periapical Pathology.
• Periapical abscess/granuloma/cyst.
• Cementoma.
• Condensing osteitis.
• Dental Restorations
• Metallic restorations: amalgams, gold or nonprecious metal crowns/inlays, endo- • posts, pins, fixed prostheses, implants.
• Nonmetallic restorations: acrylics, silicates, composites, porcelain, etc.
• Partial and full removal prostheses.
• Periodontium
• Gingiva: Morphology/Pathology.
• Contour: gingival recession, focal/ diffuse enlargements, interproximal craters.
• Color: inflammatory changes, physiologic or pathologic pigmentations.
• Plaque and concretions oral hygiene status, stains, calculus.
• Periodontal Ligament: Morphology/Pathology
• Thickness.
• Widening (e.g. scleroderma).
• Lateral periodontal cyst.
• Alveolar Process and Lamina Dura
• Height/contour/density of crestal bone.
• Thickness of inter-radicular alveolar bone.
• Exostoses, tori.
• Pattern of lamina dura (loss, increased density).
• Periodontal bone loss.
• Trabecular bone pattern osteoporosis, radio-densities.
• Residual root fragments, metallic fragments.

Maxilla and Mandible
• Maxillary sinuses: Size, shape, retention cyst, antrolith, foreign bodies, oral-antral fistula, relation ship to adjacent teeth.
• Anterior nasal spine, incisive canal, median palatal suture, incisive canal:Size, shape, cyst.
• Pterygoid hamulus: Size, shape, fracture.
• Mandibular canal/mental foramen: Diameter, anomalous (bifurcated), canal, relation ship to adjacent teeth.
• Coronoid and condylar process: Size and shape.
• Temporomandibular joint:
Size, shape, hypertrophy/atrophy, ankylosis, fracture, arthritic changes.
• Other pathologic processes/jaw bones:
Developmental/fissural cysts, hemorrhagic (traumatic) bone cyst, salivary gland depression, reactive/neoplastic lesions, metabolic bone disease, other disorders inducing focal or diffuse radiolucencies or radiopacities, evidence of orthognathic surgery, or prior evidence of trauma (e.g. wire sutures, surgical pins, etc).

Categories & Terminology for Body Identification

Positive Identification:
The antemortem and postmortem data match in sufficient detail to establish that they are from the same individual. In addition, there are no irreconcilable discrepancies.

Possible Identification:
The antemortem and postmortem data have consistent features, but, due to the quality of either the postmortem remains or the antemortem evidence, it is not possible to positively establish dental identification.

Insufficient Evidence:
The available information is insufficient to form the basis for a conclusion.

Exclusion:
The antemortem and postmortem data are clearly inconsistent. However, it should be understood that identification by exclusion is a valid technique in certain circumstances.

NOTE: The forensic dentist is not ordinarily in a position to verify that the antemortem records are correct as to name, date, etc.; therefore, the report should state that the conclusions are based on records which are purported to represent a particular individual.

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