Dental Path (Lecture 1 &2)

STARRED TERMS

antemortem material

each method has its advantages and shortcomings, but without exception, all are dependent on the existence of

DNA identification

dependable and accurate if properly applies, can be denatured by pH, temp, severe decomposition, and time (IS EXPENSIVE)

odontology

the science dealing with teeth, their structure and development, and their diseases

dental identification

the comparison of a missing person’s dental records, models, and radiographs with the dental evidence from unknown remains, has long been recognized as one of the most reliable means of positive scientific identification

identification purposes

the province of forensic dentistry in court proceedings does not encompass the determination of guilt or innocence, nor does the dentist, in the role of expert witness, have the prerogative to encroach upon any areas of legality, it is strictly for

similar manner

teeth follow a semi-standardized pattern, the quantitative measurements help establish relative age of a person as every human body ages in a . . .

enamel

the strongest material in the human body that withstands decomposition

1200F

household fire in which dentition can withstand destruction

closure

in cases involving a death, little progress will be made without first establishing the true identity of the decease, the timely identification of unknown human remains is important as it provides . . .

shovel shaped incisors

ethnic forensic anthropology finding in asian/native american demographic

cusp of carabelli

ethnic forensic anthropology finding in european demographic

yes

can you identify a head if the teeth are pulled out?

consistencies, explainable inconsistencies, unexplainable inconsistencies

When evaluating dental x-rays, the commonly accepted method used by forensic dentists is to look for three possible results from the comparisons:

explainable inconsistencies

things that, while not similar from one x-ray to another, can be reasonably explained if the person had dental treatment in between the time the earlier and later x-rays were made

unexplainable inconsistencies

are those things that are not similar between one x-ray and another, and cannot be explained away reasonably, even if the person did have dental treatment in between the earlier and later x-rays. just ONE of these can rule out a positive victim ID

one direction

when there is an alteration in an individual’s dental condition, that change is in. . .

individual characreristics

evidence that can be associated to a common source with an extremely high degree of probability is said to possess . . .

class characteristics

evidence associated only with a group is said to have. . .

incisors

will display class pattern of c

canines

will display class pattern of triangles with some variations

premolars

will display class pattern of single or dual triangles, diamonds, with some variations

molars

will rarely display marks, but when present reflect the shape of marking area

No

Are people’s bite marks unique?

possible identification

ABFO degree of certainty → consistent with no unexplained discrepancies poor quality of remains or antemortem evidence

ABFO degree of certainty

within reasonable medical certainty = positive identification

agonal or perimortem bite marks

create a bruising pattern that is well defined

postmortem bite marks

has well defined dentition but no bruising

diagnostic casts

permit inspection from perspectives that are impossible to obtain when looking in the patient’s mouth, permit extended observations and comparisons far beyond the patient’s endurance for holding their mouth open an are available for study during patient’s absence

gypsum products

used extensively in dentistry and are supplied in three forms: dental plaster, dental stone, die stone

dental plaster

weakest material a.k.a plaster of paris, is white in color

dental stone

high strength plaster used for pouring most casts, yellow in color

die stone

the strongest material, brown in color

alginate impression material

supplied in powder form and mixed with water, flexible gel resembling rubber when set, it’s important characteristic is its ability to rebound from stresses

classification of alginate

irreversible hydrocolloid, consists of particles of a gelatinous (colloid) state in water (hydro) and irreversible because it cannot return to liquid solution once jelled

composition of alginate

salts of alginic acid (product of marine kelp), an activator (usually calcium sulfate), a retarder (sodium phosphate), an inert filler, flavoring

primary

deciduous, 20 teeth, charted as “A”-”T”, nor premolars or third molars

permanent

adult, 32 teeth, charted as 1-32, premolars present

maxillary

upper teeth

mandibular

lower teeth

third molars

wisdom teeth, if not clinically evident have been extracted or have not erupted

Sir William Osler’s theory

early signs of many of the common degenerative diseases, nutritional deficiencies, and disease of metabolism are seen intraorally before they are physically apparent elsewhere

lower central incisors

first teeth to come in, around the same time the upper central incisors come in (~6 months)

0-3 years

primary teeth erupt

3 - 6.5 years

20 primary teeth in function

6.5 - 12.5 years

mixed dentition (primary shedding as permanent erupt)

12.5 - 17 years

28/32 permanent teeth in function

17 - 21 years

3rd molars erupt if present and if they can be accommodated

hypodontia

some teeth are missing

oligodontia

6+ teeth are missing

anodontia

rare, complete absence of all primary or permanent teeth

third molars > lateral incisors > second premolars

most commonly missing are the last teeth in each series

supernumerary teeth

additional tooth buds, can resemble a tooth of the normal series or as a failed eruption, more common in permanent teeth in males

cleidocranial dysotosis

rare congenital disorder of bone characterized by abnormalities of the clavicles, skull, and jaws as well as by occasional stunting of long bones, multiple supernumerary teeth is characteristic of

gardener’s syndrome

condition characterized by occurrence of multiple, impacted supernumerary teeth familial colorectal polyposis

parulus

gum boil

caries

tooth decay caused by plaque, sugar, and streptococci mutans must be present, most prevalent human disease in the world

AI

heritable enamel defect, enamel hypo mineralization

DI

heritable dentin defect, pearl-gray coloration of teeth

plaque

yellowish sticky pasta that accumulates on unbrushed teeth, not just food debris, thick mucous film created by bacteria

calculus

tartar, hardened plaque

ANUG

acute necrotizing ulcerative gingivitis, punched out papilla, caused from smoking, cortico-steroids, stress, poor oral hygiene

spirochetes and bacteroids

ANUG ‘bugs’

apthous

canker sore, most common oral ulceration

apthous

painful superficial ulcers of unknown etiology that are often triggered by stress , possible hormonal relation

HSV

virus that causes cold sores and fever blisters

HSV-1 herpes virus

usually establishes latency in the trigeminal ganglion, a collection of nerve cells near the ear. From there, it tends to recur on the lower lip or face.

HPV 6 and 11

low oncogenic risk, associated with benign lesions of the anogenital areas, oral papillomas, etc.

HPV

most common STD, upcoming research on rise of cancers of the tonsils and base of the tongue

HPV 13 thorugh 18

high oncogenic potential

HPV 16

70% of cervical cancers, 50% of oropharynx cancers

parotid, sublingual, submandibular

three major pairs of salivary glands

mucocele

occurs when there is an injury to the minor salivary glands, which are scattered throughout the oral cavity

ranula

results from injury to the ducts in the floor of the mouth that involves the sublingual gland duct

malignant melanoma

fatal, occuring anywhere other than the mouth is generally fairly treatable but due to anatomy of head and neck oral is most often fatal