Forensic dental identification in complicated fractured skull conditions: case report with adapted algorithm for image comparison

Abstract

Objective. To report a case of successful forensic dental identification in complicated fractured conditions of the skull using available ante-mortem and post-mortem radiographical data sets of different origin. Materials and Methods. Ante-mortem orthopantomogram and post-mortem peri-apical X-ray images were converted in *.jpeg format with their further import into GIMP 2.10 software (The GIMP Development Team). Segmentation of OPG-image was provided in topographical projections of jaws segments obtained directly from the victim. Comparison of analyzed image segments was provided manually within GIMP 2.10 software using function of “Layers” and “Opacity” by the proposed algorithm. Results. Considering that overall 20 positive concordant dental identificators were verified during comparison of AM and PM X-ray datasets, we can resume that odontological identity was established. All of above mentioned discrepancies could be classified as explainable. Inter-agreement rate between two investigators considering correspondence between AM and PM datasets reached Cohen’s kappa level equal of 0,97, while positive 100% agreement was reached considering 21 out of 24 analyzed characteristics. Conclusion. Available AM and PM radiographical data sets represent sufficient amount of information for effective forensic dental identification, even if such were obtained by different roentgenological techniques (orthopantomography and peri-apical radiography). Modern approaches of graphical superimposition expand the possibilities for person’s identification by dental status and could be effectively implemented in forensic dental practice especially under the condition of deficiency or total absence of dental and medical records.