Forensic dental identification using two-dimensional photographs of a smile and three-dimensional dental models: A 2D-3D superimposition method.

Photographs of a person smiling may provide valuable information about their anterior dentition. These images can be an alternative ante-mortem (AM) dental source in cases with no dental records, which gives the forensic odontologist a significant opportunity for comparative dental analysis. There are no reported studies that have investigated the reliability of a superimposition technique using 2D photographs of a smile and 3D dental models in dental identification. The aim of this study was to explore novel odontological methods by combining 2D photographs with 3D dental models, simulating a dental identification scenario. The objective was to increase the accuracy of dental identification using an AM photograph with the aid of 3D imaging as an alternative to post-mortem (PM) photographs. The study comprised of 31 3D dental models (simulating PM information) and 35 digital photographs (simulating AM information). The data was analysed in two phases: Phase I- Visual Comparison of 2D-3D images and Phase II- 2D-3D superimposition after a wash out period. Both methods were analysed by the principal investigator. Further, one-third (ten) of the sample was evaluated by six raters (three experienced forensic odontologists and three forensic odontology MSc. students). The inter-rater agreement was assessed using intra-class correlation (ICC 2, 1, absolute). The results of the study suggest that the inter-rater and intra-rater reliability using 3D superimposition was highest (ICC ≈ 1.0). In summary, there was an increase in match rates and higher certainty among the opinions reached when using the 2D-3D superimposition method. The procedure attempted to reduce the limitations of previously existing 2D methods and is intended to assist forensic experts with an alternative method in dental identification when expressing conclusions on a case using photographs.