Research Doctorate - Doctor of Philosophy (PhD) / Identification of the victims of a mass fatality incident is considered a basic human right.Forensic odontology frequently makes a significant contribution to the identification process following major disasters, and is considered a primary identifier in the Interpol Disaster Victim Identification (DVI) Guidelines. Many authors have indicated that to achieve identification with dignity and respect requires practical guidelines and standard operating procedures. No internationally accepted guidelines currently exist for the practice of forensic odontology in DVI situations. This report documents the development of a comprehensive practice guide for use by Australian forensic odontologists in a mass fatality incident. To understand the value of this document in a professional context the project also looked at the development and application of forensic odontology in multiple fatality incidents in Australia. This evolution has seen forensic odontology grow from a spasmodically used ad-hoc service to the consistent professional service delivered by practitioners today. The research question addressed in this project was “Is the Delphi technique is an appropriate tool to assist the Australian Society of Forensic Odontology to develop a set of guidelines and Standard Operating Procedures for Disaster Victim Identification practices”? Thirty one members of the Australian Society of Forensic Odontology and four members of various Australian police services and the private disaster management sector participated in the project. The participants set the level of consensus against which they wished to work and took 4 rounds to reach agreement on the contents of the document. The resultant document, the “Disaster Victim Identification Forensic Odontology Guide” is comprehensive in coverage, meets many of the criteria established to define quality and places the Australian Society of Forensic Odontology at the vanguard of professionalism in the forensic odontology community, and confirms the Delphi technique was an appropriate tool to assist in the development of a set of guidelines and Standard Operating Procedures for Disaster Victim Identification practices.

Research Doctorate - Doctor of Philosophy (PhD) / Identification of the victims of a mass fatality incident is considered a basic human right.Forensic odontology frequently makes a significant contribution to the identification process following major disasters, and is considered a primary identifier in the Interpol Disaster Victim Identification (DVI) Guidelines. Many authors have indicated that to achieve identification with dignity and respect requires practical guidelines and standard operating procedures. No internationally accepted guidelines currently exist for the practice of forensic odontology in DVI situations. This report documents the development of a comprehensive practice guide for use by Australian forensic odontologists in a mass fatality incident. To understand the value of this document in a professional context the project also looked at the development and application of forensic odontology in multiple fatality incidents in Australia. This evolution has seen forensic odontology grow from a spasmodically used ad-hoc service to the consistent professional service delivered by practitioners today. The research question addressed in this project was “Is the Delphi technique is an appropriate tool to assist the Australian Society of Forensic Odontology to develop a set of guidelines and Standard Operating Procedures for Disaster Victim Identification practices”? Thirty one members of the Australian Society of Forensic Odontology and four members of various Australian police services and the private disaster management sector participated in the project. The participants set the level of consensus against which they wished to work and took 4 rounds to reach agreement on the contents of the document. The resultant document, the “Disaster Victim Identification Forensic Odontology Guide” is comprehensive in coverage, meets many of the criteria established to define quality and places the Australian Society of Forensic Odontology at the vanguard of professionalism in the forensic odontology community, and confirms the Delphi technique was an appropriate tool to assist in the development of a set of guidelines and Standard Operating Procedures for Disaster Victim Identification practices.

A documentação odontológica é utilizada como ferramenta indispensável para identificação humana uma vez que possibilita a comparação entre registros ante mortem (AM) e post mortem (PM), levando a resultados objetivos e confiáveis. A constante evolução tecnológica ocasionou grande avanço na qualidade dos exames por imagens, auxiliando o processo de identificação por arco dentário. Nesse contexto, as imagens radiográficas digitais ganharam espaço frente às convencionais e as tomografias computadorizadas (TC) passaram a ser comumente utilizadas na Odontologia, devido à multiplicidade dos detalhes oferecidos pelas imagens tridimensionais. Estudos recentes revelam as tentativas de se reproduzir imagens semelhantes às intraorais por meio de TC. No entanto, ainda não há estudos efetivos no campo das ciências forenses, utilizando tomografias computadorizadas de feixe cônico (TCFC) com o propósito de identificação. O presente estudo teve como objetivo desenvolver uma metodologia para simulação de imagens radiográficas intraorais em tomografias computadorizadas de feixe cônico, visando repetir a incidência e geometria da radiografia de origem, contemplando os possíveis erros de angulação, além de verificar a eficácia e confiabilidade desse princípio entre os examinadores. Para isso, foi realizada a aquisição de vinte TCFC de crânios secos e os dados do seu odontograma inseridos nas fichas PM do WinID. Para cada crânio, um segundo observador realizou três radiografias periapicais digitais, simulando as AM, uma delas contendo alteração de posicionamento. As 60 radiografias foram randomizadas, três pontos foram selecionados, suas distâncias lineares e angulação mensurados no Photoshop e catalogados em planilha do Microsoft Excel. Os dados odontológicos das radiografias foram incluídos como fichas AM do WinID. O software indicou similaridade ao confrontar os elementos AM com os PM. e os valores tabulados das radiografias conduziram as análises do primeiro, sem o conhecimento prévio dos erros. As regiões de interesse (ROI) das imagens radiográficas foram localizadas nas TCFC e a geometria de incidência simulada, mediante a manipulação dos planos espaciais e ferramentas disponíveis no software Osirix, buscando valores semelhantes aos originais. Por fim, a sobreposição de imagens foi realizada utilizando artifícios do Photoshop, comprovando a similaridade entre as imagens originais e as replicadas na tomografia. Os resultados mostraram que foi possível replicar a geometria das imagens radiográficas nas TCFC em 100% da amostra. Testes estatísticos como o coeficiente de variação, diferenças de médias e coeficiente de Pearson evidenciaram forte correlação para todas as variáveis estudadas e todos os valores foram estatisticamente significantes (p<0.05). O protocolo desenvolvido possibilitou a reprodução da geometria e incidência das radiografias convencionais em TCFC, inclusive na presença de alterações na angulação. As imagens produzidas puderam ser comparadas às originais, assegurando o resultado por sobreposição. Em todas elas ficou comprovada a viabilidade do uso do protocolo para fins de identificação humana e sua aplicação, portanto, foi considerada confiável e segura, visto que a concordância entre os observadores ficou demonstrada pelos testes estatísticos. / Dental Records are used as a necessary tool for human identification, as it enables the comparison of Antemortem (AM) and Postmortem (PM) data, leading to objective and reliable results. The constant evolution of technology brought advances in the quality of images, aiding the dental arch identification process. In this context, the digital radiographic images gained ground among conventional radiographs and Computed Tomography (CT) became usual in dentistry, due to the multiple details available in the tridimensional images. Recent studies shown attempts of reproducing intraoral images from CT. But there was no effective studies in the forensic science field using Cone-Beam Computed Tomography (CBCT) with identification purposes. The present study aims on developing a methodology that could simulate intra-oral images in CBCT exams, in order to repeat the incidence and image geometry of the original radiography, covering possible angulation errors and testing the reliability of the process. To do so, 20 CBCT were acquired from dry skulls and their dental charts were registered in WinID. In each cranium, a second observer made three periapical radiographs, simulating the AM records in WinID, and one should contain and incidence error. The 60 radiographs were randomized and in each three points were selected with linear distances and angle between them were measured in photoshop and recorded in a MS Excel chart. The data from the radiographs were included in WinId as AM records. The Sotware indicated similarities of the records by matching AM and PM, and the values from the radiographs directed the analysis made by the first examiner, with no knowledge of the previous errors and the AM data registered in WinID. The Region of Interest (ROI) in the radiographs were located in the CBCT and the geometry and incidence were simulated using the manipulation of the orientation planes and tools of the software Osirix, in search of similar to the original values. Finally, the superimposition of images was made in Photoshop, to prove the achievement of similarity between the original images and those extracted from the CBCT. The results showed a possible repeatability of image geometry in 100% of the sample. Statistic test of the variance coefficient, average difference and Pearson coefficient highlighted the strong correlation of all variables and significance of all tested values (p<0.05). The developed protocol enabled the reproduction of conventional radiographs geometry and incidence in CBCT exams, including in the presence of incidence errors. The produced images could be compared to the original, assuring a result by superimposition. In every analysis, the use of this protocol has been confirmed as viable for human identification purposes, and its usage was considered reliable and secure, as the concordance between examiners was demonstrated by the statistic analysis.

A documentação odontológica é utilizada como ferramenta indispensável para identificação humana uma vez que possibilita a comparação entre registros ante mortem (AM) e post mortem (PM), levando a resultados objetivos e confiáveis. A constante evolução tecnológica ocasionou grande avanço na qualidade dos exames por imagens, auxiliando o processo de identificação por arco dentário. Nesse contexto, as imagens radiográficas digitais ganharam espaço frente às convencionais e as tomografias computadorizadas (TC) passaram a ser comumente utilizadas na Odontologia, devido à multiplicidade dos detalhes oferecidos pelas imagens tridimensionais. Estudos recentes revelam as tentativas de se reproduzir imagens semelhantes às intraorais por meio de TC. No entanto, ainda não há estudos efetivos no campo das ciências forenses, utilizando tomografias computadorizadas de feixe cônico (TCFC) com o propósito de identificação. O presente estudo teve como objetivo desenvolver uma metodologia para simulação de imagens radiográficas intraorais em tomografias computadorizadas de feixe cônico, visando repetir a incidência e geometria da radiografia de origem, contemplando os possíveis erros de angulação, além de verificar a eficácia e confiabilidade desse princípio entre os examinadores. Para isso, foi realizada a aquisição de vinte TCFC de crânios secos e os dados do seu odontograma inseridos nas fichas PM do WinID. Para cada crânio, um segundo observador realizou três radiografias periapicais digitais, simulando as AM, uma delas contendo alteração de posicionamento. As 60 radiografias foram randomizadas, três pontos foram selecionados, suas distâncias lineares e angulação mensurados no Photoshop e catalogados em planilha do Microsoft Excel. Os dados odontológicos das radiografias foram incluídos como fichas AM do WinID. O software indicou similaridade ao confrontar os elementos AM com os PM. e os valores tabulados das radiografias conduziram as análises do primeiro, sem o conhecimento prévio dos erros. As regiões de interesse (ROI) das imagens radiográficas foram localizadas nas TCFC e a geometria de incidência simulada, mediante a manipulação dos planos espaciais e ferramentas disponíveis no software Osirix, buscando valores semelhantes aos originais. Por fim, a sobreposição de imagens foi realizada utilizando artifícios do Photoshop, comprovando a similaridade entre as imagens originais e as replicadas na tomografia. Os resultados mostraram que foi possível replicar a geometria das imagens radiográficas nas TCFC em 100% da amostra. Testes estatísticos como o coeficiente de variação, diferenças de médias e coeficiente de Pearson evidenciaram forte correlação para todas as variáveis estudadas e todos os valores foram estatisticamente significantes (p<0.05). O protocolo desenvolvido possibilitou a reprodução da geometria e incidência das radiografias convencionais em TCFC, inclusive na presença de alterações na angulação. As imagens produzidas puderam ser comparadas às originais, assegurando o resultado por sobreposição. Em todas elas ficou comprovada a viabilidade do uso do protocolo para fins de identificação humana e sua aplicação, portanto, foi considerada confiável e segura, visto que a concordância entre os observadores ficou demonstrada pelos testes estatísticos. / Dental Records are used as a necessary tool for human identification, as it enables the comparison of Antemortem (AM) and Postmortem (PM) data, leading to objective and reliable results. The constant evolution of technology brought advances in the quality of images, aiding the dental arch identification process. In this context, the digital radiographic images gained ground among conventional radiographs and Computed Tomography (CT) became usual in dentistry, due to the multiple details available in the tridimensional images. Recent studies shown attempts of reproducing intraoral images from CT. But there was no effective studies in the forensic science field using Cone-Beam Computed Tomography (CBCT) with identification purposes. The present study aims on developing a methodology that could simulate intra-oral images in CBCT exams, in order to repeat the incidence and image geometry of the original radiography, covering possible angulation errors and testing the reliability of the process. To do so, 20 CBCT were acquired from dry skulls and their dental charts were registered in WinID. In each cranium, a second observer made three periapical radiographs, simulating the AM records in WinID, and one should contain and incidence error. The 60 radiographs were randomized and in each three points were selected with linear distances and angle between them were measured in photoshop and recorded in a MS Excel chart. The data from the radiographs were included in WinId as AM records. The Sotware indicated similarities of the records by matching AM and PM, and the values from the radiographs directed the analysis made by the first examiner, with no knowledge of the previous errors and the AM data registered in WinID. The Region of Interest (ROI) in the radiographs were located in the CBCT and the geometry and incidence were simulated using the manipulation of the orientation planes and tools of the software Osirix, in search of similar to the original values. Finally, the superimposition of images was made in Photoshop, to prove the achievement of similarity between the original images and those extracted from the CBCT. The results showed a possible repeatability of image geometry in 100% of the sample. Statistic test of the variance coefficient, average difference and Pearson coefficient highlighted the strong correlation of all variables and significance of all tested values (p<0.05). The developed protocol enabled the reproduction of conventional radiographs geometry and incidence in CBCT exams, including in the presence of incidence errors. The produced images could be compared to the original, assuring a result by superimposition. In every analysis, the use of this protocol has been confirmed as viable for human identification purposes, and its usage was considered reliable and secure, as the concordance between examiners was demonstrated by the statistic analysis.