Evaluation of five methods to identify composite restorations in human teeth on a forensic purpose—an ex vivo comparative study

Abstract

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.

The Dentist’s Ability to Detect Different Restorative Procedures on Periapical Radiographs—Results from a Reliability Study

“…With respect to the lack of comparable studies, the discussion of the data is subject to restrictions. In a forensic dental study [21], dentists specialized in conservative dentistry reached a high CK value for restoration detection (0.83), followed by dentists specialized in oral surgery (0.64) and dental students in their final semester (0.57). The data support the assumption that there were significant differences between beginners and more experienced practitioners, which were not documented in our study (Tables 1 and 5).…”