ANTEMORTEM DENTAL EXAMINATION

Another major section in forensic dentistry involves the antemortem dental record examination. Dentists, hygienists, and Dental Technicians can effectively operate this section. The task of this section will always be the most difficult in the entire forensic dentistry arena. They will be required to determine who was involved in the disaster, locate and procure all military or civilian dental records and radiographs, arrange for the delivery of these materials, and undertake the process of developing a composite antemortem record for each victim for the evidence supplied. You may not have all existing antemortem dental records for the victim from outside sources. This may lead to discrepancies in the antemortem record and postmortem record comparison. The quality, quantity, and variety of dental record documentation of this antemortem evidence present the major obstacles in this section. Clearly, all antemortem evidence must be compiled

to a single antemortem dental record form as shown in figure 10-16, to provide a composite antemortem picture. The latter (computer/description codes column) may be easily compared to the postmortem findings recorded on a postmortem dental record of similar format. Comparing dental records sent directly from dental offices with a postmortem record is a near impossible task. At least two members of the antemortem dental record staff should review each composite antemortem dental record as a quality control mechanism. Figure 10-17 shows a dental staff reviewing antemortem dental records. The completed antemortem composite form should also be quality checked against antemortem dental radiographs.

COMPUTER SUPPORT

In this day of data management and word processing, computers can now play a major role in forensic dental ID. The software we use is called the Computer Assisted Postmortem Identification (CAPMI) referenced in figure 10-18.

The basic principle is one in which antemortem and postmortem databases are built using the information charted on the antemortem and postmortem forms. These two databases are run against each other and the possibilities of matches are ranked to produce a most likely identities list. This list is then used by the forensic team to assist in the final ID process. The list does not make an ID, but merely minimizes the number of records that must be

compared manually by the team. The advantage is that, instead of having to look at every record to make a comparison, the dental officer or dentist who is reviewing the record is initially guided to the most likely match. This is tremendously efficient and offers a significant savings in time. CAPMI may be installed either on a portable or desktop computer. Your command can obtain copies of CAPMI software and instructions free of charge by writing to the following address:

The Director

Armed Forces Institute of Pathology

Attn: AFIP-AMS

14th & Alaska Ave, NW

Washington, DC 30306-6000

ANTEMORTEM/POSTMORTEM RECORDS COMPARISON

The last section in the dental forensic ID process compares the antemortem and postmortem records. Here the results of all previous work are seen. Armed with the antemortem record and radiographs, postmortem record and radiographs, CAPMI printout (if used), and a summary sheet, the forensic team starts the process of comparing records and films. The size of the section is dependent on the number of fatalities, since there is a requirement to place all postmortem dental records face-up on tables in numerical order for a comparison with the antemortem composite dental records, as shown in figure 10-19. After all postmortem dental records have been placed as described, the staff can systematically compare- the antemortem dental composite records as they are received with the postmortem dental records placed on the table. This is done by hand carrying the composite antemortem record and walking alongside the tables viewing the postmortem dental records looking for a significant point of comparison, such as a crown on tooth #30. Once significant points of comparison are noted between the antemortem and postmortem dental record forms, the radiographs of the respective records can be reviewed and a possible match established. Figure 10-20 shows dental team members reviewing radiographs.

If it is possible to determine the gender of the disaster victims, it is possible to reduce the manual comparison task by placing the postmortem records in 10-18