Figure 10-10. - Dental registrar.
Postmortem dental radiology plays a critical role in the process of identifying unknown human remains. The procedures used are basically identical to those that would be performed on a living patient, with certain adaptations necessary to each specific situation. The actual exposure of postmortem radiographs poses some special problems that must be recognized and considered to ensure the production of adequate, useful radiographs for comparison with the antemortem dental records. These problems will vary depending on the number of remains to be identified, the condition of those remains, the completeness of the dental structures recovered, and the availability of antemortem dental records. In general, the smaller the total number of remains to be processed, the fewer problems with postmortem radiology. As the number of remains increases, the problems encountered in performing postmortem radiology will increase both in total number and complexity.
Access to dental structures for placement and exposing of the radiographs is entirely determined by the condition of the remains. Normally no problems are associated with skeletalized remains. The lack of soft tissue allows easy visualization for placement of film and angulation. Positioning of the tubehead can also be readily determined and adjusted as needed. The same is true for fragmented remains, which are easily positioned against the X-ray film on a flat surface, as shown in figure 10-12. Problems with access to dental structures arise most commonly with intact full body remains. This is particularly true if it is a recent death and rigor mortis (stiffing of a dead body) is still present. Opening the jaws more than just a few millimeters can be exceedingly difficult in the presence of rigor mortis. Problems with access are also routinely encountered in individuals killed by fire, because of the loss of flexibility of the muscle fibers as they are cooked in the extreme heat. Drowning victims will also present problems with access to the dentition. If the individual remained in the water for a prolonged period of time, the soft tissues around the teeth begin to swell with fluid and thereby obstruct accurate film placement. When access to the dentition for postmortem dental radiology is a problem, the dental officer will be able to assist you with proper access.Continue Reading