Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland.
Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.
Int J Legal Med. 2024 Jan;138(1):85-96. doi: 10.1007/s00414-022-02869-z. Epub 2022 Aug 10.
The use of tooth-colored composite resin materials in dentistry is increasing. As composite restorations appear similar to the natural tooth structure, their detection is becoming more challenging. The aim of this study was to compare five diagnostic methods for detection of dental restorations and to create reliable postmortem dental records for forensic purposes. A conventional examination method without a direct light source (CONV), with a dental loupe light (DL), Galilean loupes with a direct light source (GDL), a fluorescence-inducing device (FIT), and intraoral radiographs (RX) were compared. Dentists specializing in conservative dentistry or oral surgery and dentistry students participated. Regarding sensitivity, specificity, positive predictive value, and negative predictive value, FIT and RX showed significantly higher results than CONV, DL, and GDL. RX and FIT showed comparable results in identifying composite restorations but depending on their location. The combination of both methods may lead to even better results. In conclusion fluorescence-inducing devices show good results in identifying composite restorations and therefore should be considered as a standard tool in forensic examinations. Another advantage is their small size, low cost, and mobility. Good illumination and magnification devices are recommended to enhance performance during conventional examinations. Involving dentists specialized in conservative dentistry could contribute to dental identification.
牙科中使用牙色复合树脂材料的情况越来越多。由于复合修复体看起来与天然牙结构相似，因此它们的检测变得更加具有挑战性。本研究的目的是比较五种诊断方法检测牙科修复体的效果，并为法医目的创建可靠的死后牙科记录。本研究比较了传统无直接光源检查法（CONV）、带牙科放大镜的光源检查法（DL）、带直接光源的伽利略放大镜检查法（GDL）、荧光诱导装置检查法（FIT）和口腔内射线照相检查法（RX）。参与研究的人员包括专门从事保守性牙科或口腔外科及牙科的牙医和牙科技师。在敏感性、特异性、阳性预测值和阴性预测值方面，FIT 和 RX 比 CONV、DL 和 GDL 的结果明显更高。RX 和 FIT 在识别复合修复体方面的结果相当，但取决于其位置。两种方法的结合可能会带来更好的效果。总之，荧光诱导装置在识别复合修复体方面显示出良好的效果，因此应被视为法医检查的标准工具。此外，其还有体积小、成本低和移动性好等优点。建议使用良好的照明和放大设备来提高传统检查的性能。涉及专门从事保守性牙科的牙医可以有助于牙科鉴定。
