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.