Forensic odontology is one of three primary identifiers designated by Interpol to identify victims of mass casualty events. Forensic odontology is involved in all five phases-Scene, Postmortem, Antemortem, Reconciliation and Debrief. Forward planning, adequate funding, international cooperation and standardization are essential to guarantee an effective response. A Standard Operation Procedure should be utilized to maximize quality, facilitate occupation and health issues, maintain security and form a structure to the relief program. Issues that must be considered in the management of the forensic odontology component of disaster victim identification are given in "Appendix 1". Each stage of the disaster, from initial notification to debrief, is analyzed and a comprehensive checklist of actions suggested.

This study was undertaken to determine if dental implants can be radiographically differentiated by company type to aid forensic identification of the deceased. Recognition of dental implants on intraoral radiographic images was assessed in a blind study using a radiographic examination guide to highlight differences between dental implants. Inter- and intra-examiner comparisons were conducted and a computer program (Implant Recognition System) was evaluated to see whether it improved the accuracy of implant recognition. The study found that dental implants could be radiographically differentiated by company type. The Implant Recognition System in its current form was of little benefit for radiographic assessment of dental implants for forensic odontologists. Prior knowledge of implant types, with a McNemar's statistical value of 92.9, proved to be most significant in identification.

Background: The comparison of dental morphology and restorative work for human identification has been well documented. This case study involved documentation of osseointegrated and clinically restored dental implants following cremation. Methods: The mandible and the maxilla were excised from a head containing implants and cremated. The remains were retrieved, digital and radiographic images were taken and elemental analysis undertaken. The brand of implants was identified utilizing web based search engines. A prosthodontist, known to commonly use this implant system, was approached to ascertain possibilities that matched the data given. Results: Following cremation the implants were identified and a prosthodontist was able to identify the deceased. Two implants in the maxilla had dehiscences on their buccal surfaces, which could not be detected by periapical radiographs. Conclusions: Dental implants osseointegrated and restored with a prosthetic superstructure were recognizable following severe incineration. It was possible to trace back the identity of the unknown victim to a prosthodontist. Bone dehiscences discovered in this study highlighted how two-dimensional radiographs may not reveal lack of bone support.

The desired outcome of the victim identification component of a mass fatality event is correct identification of deceased persons in a timely manner allowing legal and social closure for relatives of the victims. Quality Management across all aspects of the Disaster Victim Identification (DVI) structure facilitates this process. Quality Management in forensic odontology is the understanding and implementation of a methodology that ensures collection, collation and preservation of the maximum amount of available dental data and the appropriate interpretation of that data to achieve outcomes to a standard expected by the DVI instructing authority, impacted parties and the forensic odontology specialist community. Managerial pre-event planning responsibility, via an odontology coordinator, includes setting a chain of command, developing and reviewing standard operating procedures (SOP), ensuring use of current scientific methodologies and staff training. During a DVI managerial responsibility includes tailoring SOP to the specific situation, ensuring member accreditation, encouraging inter-disciplinary cooperation and ensuring security of odontology data and work site. Individual responsibilities include the ability to work within a team, accept peer review, and share individual members' skill sets to achieve the best outcome. These responsibilities also include adherence to chain of command and the SOP, maintenance of currency of knowledge and recognition of professional boundaries of expertise. This article highlights issues of Quality Management pertaining particularly to forensic odontology but can also be extrapolated to all DVI actions.

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The transfer of materials between victim and perpetrator was first reported by Locard in the nineteenth century. While in recent years DNA testing has been very successful in matching biological material from crime scenes to perpetrators, the following cases demonstrate that other more time-honored methods remain useful. Two cases of lethal assault are reported where the victims had bitten their assailants resulting in fragments of the perpetrators' skin being wedged between their teeth which were discovered during post mortem oral examinations. As the fragments were able to be matched to injuries in the perpetrators, identification was established prior to confirmatory DNA testing. In case 1 a criminal conviction for manslaughter resulted, and in case 2 the identity of the assailant was confirmed. Examination of a properly exposed and illuminated oral cavity may provide useful evidence in assault cases. These cases represent an unusual dental variant of Locard's principle.

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Maximizing postmortem dental evidence in a severe incineration event requires correct recognition and recording of dental data. Odontologists should attend the scene to facilitate this recognition. The information should be documented, photographed, and stabilized before retrieval. Wrapping, padding, and further support of the remains during transportation to the examination mortuary will aid this process. Examination at the mortuary requires further photography, complete charting, and radiographic examination of any dental material available, as well as awareness of other possible medical evidence, to enable identification of the human remains.