While the phenomenon of pink teeth has been known since 1829, when it was first described by Bell, its application in forensic medicine has been limited. Recently, however, attention was again focused on pink teeth in legal cases. The medico-legal implication was the use of pink teeth as a possible means of evaluating the cause of death. Pink teeth can occur during life and postmortem. Except for very few and poorly documented exceptions, they develop earliest after 1 to 2 weeks postmortem. Their chemical analogy is seepage of hemoglobin or it's derivates into the dentinal tubules. Prerequisites are hyperemia/congestion and erythrocyte extravasation of the pulp capillaries, furthermore autolysis and a humid milieu. Therefore, they are most often associated with water immersion. The intensity of characteristics varies between different cases and also between different teeth in an individual case. Since the ante-mortem prerequisites are non-specific and can be replaced by certain postmortem conditions, there exist until now no specific correlation to the cause of death. The phenomenon is very often seen in victims of drowning where the head usually lies in a head-down position. From this it can be assumed that pink teeth even if not identical to postmortem lividity can, at least to some extent, be considered as analogous. Since, there is no obvious connection between the occurrence of pink teeth and the cause of death, it may be concluded that pink teeth are not pathognomonic for a specific cause of death and this is therefore an unspecific phenomenon.
Ante-mortem orthopantomograms may be of great value in the identification of human remains. This x-ray technique provides an overall view of the teeth and jaws and thus of numerous individual structural characteristics within a short time. Standardised post-mortem orthopantomography has previously not been feasible in the forensic practice. The present study shows how orthopantomography can be applied to identification procedures. The reproduction of ante-mortem x-ray conditions is implemented here in the production of post-mortem x-rays, using a purpose-designed radiographic tripod. For the first time, account is taken not only of the size and structure but also of the nature of the soft tissue covering of exhibits. For post-mortem preparation of these radiographs, appropriate positioning aids, a spinal column substitute and a soft tissue filter were constructed. Individual macerated jaws as well as the complete cranium can now be positioned correctly in the upright orthopantomograph (OPG). The method presented expands the spectrum of forensic radiology for the individual case and in our opinion also offers a reliable aid for victim identification in the wake of mass disasters, aircraft crashes and terrorist attacks, where a large number of bodies have to be identified under great pressure.
: The autopsy rates in Germany are frighteningly low compared to other European countries. Considering the dramatic decline of clinico-pathological autopsy rates the role of the post-mortem examination as a control of clinical medicine and death statistics cannot be fulfilled properly. The low medicolegal autopsy rate is responsible for the high number of undetected non-natural or violent deaths.
A 37-year-old female showed signs of hyperthyroidism 2 weeks before death after a partial thyroidectomy was carried out 15 years previously. An examination 3 days before death revealed a normal blood cell count, an increased level of thyroidal hormones, sinus tachycardia and a high blood pressure of 170/90 mm Hg. A hyperthyroidism was diagnosed and therapy with carbimazol (2 x 10 mg) was started but 2 days later fever and chill occurred and before death short phases of unconsciousness and dyspnoea. The autopsy findings showed an interstitial inflammation of the AV-node, the His-bundle and its branches which can correlate with typical ECG changes in hyperthyroidism.
Maxillofacial traumas are common and often associated with other injuries. From a forensic point of view, it is often necessary to relate the traumatic event to the subsequent injuries. The aim of this study was to explore the etiology of maxillofacial injuries due to objective signs and the anamnestic history of patients. In a prospective study over a 1-year period, all patients presenting with mandibular and midface fractures seeking treatment at the University Medical Center in Münster. Germany, were investigated. Demographic data, patient history, and pattern and etiology of injury were recorded, along with evaluations of the patients' descriptions. Thorough clinical and radiological investigation was performed and photographic records were taken. In our study, 122 patients, with a male to female ratio of 2:1 were included. The mean age was 30.7 +/- 13.4 years. Assault was the most common etiology (40%), followed by traffic accidents (29%) and falls (17%). Alcohol was reported to play a role in 40% of all injuries. There was no difference in the number of patients with mandibular or midface fractures. In 75%, maxillofacial fractures were associated with other injuries. The patients' descriptions of the orofacial traumas seemed to be highly. For age, anatomical location, concomitant injuries, and other signs of trauma, we found no statistical association with the underlying etiology.
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