168 Forensic dentistry
In situations involving specimens that are not readily identifiable as
human facial structure, dental remains can be located with the assistance
of large-format radiographs. This radiograph facilitates locating radiopaque
structures that can assist in locating dental structures within the speci-
men or body bag. Once these items are identified on this large radiograph,
the examiner can use this image to assist in locating structures of interest,
including teeth, dental prosthetic items, and bony structures of the mandible
or maxilla.
Once all available dental material is found, forensic odontologists should
take dental radiographs in an effort to reproduce similar exposures and
angulations anticipated in the antemortem dental record. Since the source
and type of radiographs may be unknown at this point in the process, it is
recommended that a full series of radiographs be obtained. This series of
films should include posterior and anterior periapical radiographs and bite-
wing radiographs. If the specimen is fragmented, the radiographer should
consider the necessary film placement and tube head angulations to repli-
cate those normally obtained in a clinical setting. For convenience in image
capturing the examiner may also find it helpful to radiograph the maxillary
and mandibular teeth separately in bitewing radiograph projections. If the
examiner is taking images of fragmented remains, care should be taken to
ensure that consistent projection geometry is maintained by placing the
film or digital sensor on the lingual aspect of the specimen. Again, care-
fully following protocol is important, as the examiner may not have a second
chance to complete the radiographic examination. Attention to detail is nec-
essary, and any images that are not adequate should be retaken so complete
radiographic information is available for comparison to antemortem data.
If digital radiography is available, the examiner will find the retake of images
to be straightforward since the need to process films is eliminated and the
image is instantly viewable. Additional details concerning forensic dental
radiography techniques can be found in Chapter 10.
The postmortem record, whether digital or paper, should be recorded in
a form that will assist in the comparison process. It should be a format that
records and displays the relevant features of the dentition to demonstrate
missing teeth and the restored surfaces (Table 9.1).
9.4.2 Antemortem Examination
When an investigating agency determines that a dental identification may
be required, the agency attempts to locate and obtain the dental record. This
action, securing antemortem dental records, is a crucial step in dental iden-
tification, and the quality of these records is totally dependent on practicing
dentists keeping accurate records of the dental status of their patients. Most