Identification II

Topics: 1. Age determination of fetus . 2. MLI of age. 3. Forensic odontology (examination of teeth). 4. Anthropometry.

Age determination of feotus

Rule of HAASE

This is a rough method of calculating the age of fetus. The length of fetus is measured from crown to heel in cm. During 1st five months of pregnancy, age= length of fetus e.g. fetus of 16 cm is of 4 months During last 5 months, age=length of fetus/5

Terms

Term DEVELOPING OVUM is used for 1st 710 days after conception i.e. until implantation occurs. Term EMBRYO is used from 1 week to end of 2nd month. After 2nd month, it is called FETUS. The age of fetus can be determined by taking into account appearance of different characters at different time.

At the end of 1st month

Length-1 cm, weight-2.5g Eyes are seen as two dark spots. Umbilical vessels present. Mouth is seen as cleft. Limbs appear as bud like processes.

At the end of 2nd month

Length-4 cm, wt-10 g Mouth & nose separated. Hands & feet are webbed. Umbilical vessels disappeared. Placenta begins to form. Anus is seen as dark spot.

1st ossification centre in a fetus appears in clavicle(4-5 wk), followed by maxilla(6 wk).

At the end of 3rd month

Length-9 cm, wt-30g Eyes closed & pupillary membrane appears. Nails appear in the form of thin membrane on fingers & toes. Sex is not yet differentiated. Placenta formed & differentiated.

At the end of 4th month

Length-16 cm, wt-120g Sex can be recognized. Lanugo hair is seen on the body. Convolution begin to develop in the brain. Meconium is found in the duodenum. ( meconium is a mixture of bile, mucus & shed off mucosa.)

At the end of 5th month

Length-25 cm, wt-225-450g Midpoint at xipoid. Nails distinct & soft. Light hair appears on head. Eyelids closed, eyebrow & eyelash absent. Skin is wrinkled & covered with VERNIX CASEOSA. ( vernix caseosa protects fetal skin from amniotic fluid)

Umbilicus recedes upwards. Testes present on psoas. Centre for calcaneum present.

At the end of 6th month

length-30 cm, wt-450-900g Hair appear on head. Eyebrows & eyelashes are beginning to form. Eyelids are adherent & pupillary membrane is still present. Cerebral hemisphere cover cerebellum. Skin is red, vernix caseosa present. Nails are distinct.

Testicles lie close to kidneys & scrotum is empty. Meconium is seen in upper part of large intestine. Centre for manubrium & 1st segment of mesosternum present.

At the end of 7th month

Length-35 cm, wt-1350-1800g Skin is dusky red, thick & fibrous. Subcutaneous fat begins to be deposited. Nails are thick but do not extend to the tips of fingers & toes. Eyebrow & eyelash distinct & eyelids are open. Scalp hair is 0.75 cm. Gall bladder contains bile & caecum is seen in right iliac fossa.

Pupillary membrane has almost disappered. Testicle may be found in external inguinal ring. Meconium is seen in whole of small intestine. Centre of ossification of talus appeared.

At the end of 8th month

Length-40 cm, wt-1.5 kg Placenta weighs 500g. Scalp hair thicker. Skin is red but not wrinkled & covered with soft hair. Lanugo has disappeared from face. Nails nearly reach the end of fingers & toes.

At the end of 9th month

Length-45 cm, wt-2250-3250g Scalp is covered with dark hair of 4 cm length. Lanugo is seen only on shoulders. Vernix caseosa is present over the flexures of joints & neck folds. Placenta weighs 500g. Nails have grown over the tips of fingers & toes.

Both the testicles have descended to the scrotum. Meconium is seen at the end of large intestine. Ossification centre appears at the lower end of femur.

At the end of full term fetus

Appearance of full term mature child: Length-45-50cm, wt-3-3.5kg Head is about 28 cm in circumference & well covered with hair which is 3.5 cm long & dark. Head of male weighs 100g more than female. Head is 1/4th of whole body length. Lanugo is seen only on shoulders. Skin is covered with vernix caseosa which is readily seen in the flexure of joints & neck folds.

Vernix caseosa is white cheesy substance made up of sebaceous secretion & epithelial cells. Being sticky, it can not be easily removed. It protects fetal skin against maceration while in liquor amnii. Pupillary membrane is absent. Nails project beyond finger tips & to the end of toes. Umbilicus is situated midway between pubis & ensiform cartilage. Umbilical cord is fleshy with a normal spiral twist & a glistening surface of about 45-50 cm in length.

Age in months length Weight Nails Hairs

3 9cm 30-35 gm ---

4 16cm 120-130 gm -Lanugo hairs differenti able --

5 25cm 400 gm Tip of finger Scalp hairs ---

6 30cm 700gm ---

7 35cm 1kg -Scalp hair 1cm ---

8 40cm 1.5kg -1.5cm

9 45cm 2-2.5 kg Beyond the tip 2cm

Sex Eyelids

---

Well differentiable Adherent

-Well formed, open -I.C. --

---

Intestine Testes Center for ossification

----

Meconiu m in s.i ---

A.C. -calca nium

T.C. ---

D.C. I.I.R. Talus

rectum scrotum Cubiod

Cartilage of nose & ear present. Both testicles have descended into scrotum. Vulva is closed & labia minora is covered by fully developed labia majora. Meconium is present in rectum. It is generally expelled in a day or two after delivery. Centre of ossification is present in femur, cuboid & upper end of tibia. Placenta is about 22 cm in diameter & about 700g in weight. Six frontanelles are present. Anterior frontanelle is 4x2.5cm.

DEATH OF FETUS IN UTERO

Fetal movements disappear. Fetal heart sounds can not be heard. Uterus dose not corresponds to estimated age of fetus or may regress in size. Amniotic fluid turbid & brown. Immunological test becomes negative.

Radiological signs are: 1. SPALDINGS SIGN: Bones of cranial vault show loss of alignment & are overlapping. 2.Collapse of spinal column due to absence of muscle tone. 3. Presence of gas in heart & great vessels.

SPALDINGS SIGN

EXAMINATION OF ABORTED MATERIAL

When a substance alleged to have been expelled from uterus as a product of conception is sent to a medical man, he should wash it in water to determine if it is a fetus or merely a blood clot, a shred of the dysmenorrheal memb.,a polypus or a fibroid tumor. Small portion is cut off & mounted on microscope.

In early months of pregnancy, if embryo is not found, presence of chorionic villi found under low power of a microscope will decide the fact of miscarriage. During 1st 3 months of pregnancy, fetus is expelled en masse, after this fetus is born 1st & then after a time placenta is detached & expelled, a portion of which may remain adherent to uterus. Placenta sent along with fetus should be examined to ascertain if it is entire or torn at any place.

Old age changes

Baldness Hyper trichosis Graying of hairs Arcus senilis Cataract

Baldness

Development of cataract

Arcus senilis

Medico-legal importance of age

1)

Criminal Responsibility:A child above 5 yrs is liable for punishment for any unlawful act under Indian railways act 1890 S.118. Any act which is done by a child under 7 yrs is not an offence S.82 of IPC A child b/w age 7 -12 yrs, is presumed to be capable of committing an offence if attained sufficient maturity to judge the nature n consequences of his conduct S.83 of IPC

A child under 12yrs cannot give valid consent to suffer any harm which may occur from an act done in good faith & for its benefit (sec. 89 I.P.C) A person above 18 yrs can give the valid consent to suffer any harm which may result from an act not intended to cause death & grievous hurt (sec.87 I.P.C.)

2)Judicial Punishment

Acc. to Juvenile Justice Act 2000,juvenile or boy mean a person who has not completed 18th year of age. Juvenile Justice Boards exercise powers in relation to juveniles in conflict with law. The board may advice or order the juvenile to participate in group counseling or perform social service or sent to a special home until he becomes adult. No juvenile in conflict with law shall b sentenced to death or life imprisonment.

3)Rape

Sexual intercourse by a man with a girl under 15 yrs even if she is his own wife, or with any other girl under 16 yrs even with her consent is rape

4)Kidnapping

Kidnapping means taking away a person by illegal means It is an offence :To kidnap a child with the intention of taking dishonestly any movable property(sec.369,I.P.C.) To kidnap a minor from lawful guardianship if the age of a boy is under 16 & that of girl is under 18yrs(sec.361,I.P.C) To kidnap a minor for purposes of begging(363A)

To procure a girl for prostitution if her age is under 18 yrs (sec.366-A,I.P.C) To import into India from a foreign country a female for purposes of illicit intercourse , if her age is less than 21 yrs (366-B,I.P.C)

5)Employment

A child below 14 yrs cannot be employed to work in any factory or mine or in any other risky employment.

A person completing 15 yrs is allowed to work in a factory as an adult if a fitness certificate is issued by the certifying surgeon.

6)Attainment Of Majority

A person attain majority at the age of 18 yrs, but when a person is under the guardianship of Court of Wards, or is under a guardian appointed by the court, he attains majority on the completion of 21yrs(sec.3 Ind. Majority Act,1875)

7)Evidence

Competency for giving evidence depends on understanding , not on age A child of any age can give evidence if the court is satisfied that the child is truthful(sec.118,I.E.A)

8)Marriage Contract

A female under 18 yrs & a male under 21 yrs cannot contract marriage (Child Marriage Restraint Act,1978)

9)Infanticide

The charge of infanticide cannot be supported , if the infant can be proved under the age of 7 months of i.u.l.

Forensic odontology

Permanent teeth

Forensic odontology deals with science of dentistry to aid in the administration of justice. Dental identification depends mainly upon comparison between records of the missing persons & findings in the bodies in relation to : (1)Restorative work. (2) Unusual features. (3)Comparison of ante mortem with post mortem x-rays.

1. 2.

3.

4.
5. 6.

Particulars should be noted: Nos. , spacing & situation of teeth present with special note of un erupted & deciduous teeth, permanent teeth, decayed teeth, undersized teeth. No. & situation of absent teeth. General condition of teeth: like erosion, cleanliness, conservation, filings & cavities, color, periodontosis Peculiarities of arrangement: like prominence, ectopic teeth, overlapping, malposition, deformities, rotation ,Supernumerary teeth.

MEDICOLEGAL IMPORTANCE

Dental identification is most sophisticated method of comparative identification. Dental findings establish identification of single individuals after accidental death or homicide Identification of large no. of people after mass disaster like explosions, house fires, earthquakes. Estimation of age of an individual. Determination of sex & blood group. Poisons can be detected. Criminals can be identified by bite marks.

BITE MARKS

Human bites are usually semicircular or crescentic. Teeth may cause separate marks or intermittently broken lines. Bite marks may be abrasions, contusions, lacerations, or combination of three. In forcible bite appearance is of two bows. Rarely, bite mark may be linear in pattern. Teeth marks becomes visible when examined under U.V. rays in dark.

Human bite marks

In sexual bites, teeth are used to grip during sucking. Love bites seen usually on breast, neck, cheek, abdomen. Swabs of bite mark should be taken immediately . If there is delay in sending swab to lab. , they should be kept in freezer. In child abuse, bite marks can be seen anywhere on the body. So, bite marks are useful in identification

Methods of charting of teeth

1.

There are more than 150 different methods of identifying, numbering, and charting of the teeth. The most widely used systems are: UNIVERSAL SYSTEM: Teeth are numbered 1 to 16 from upper right to upper left, and 17 to 32 from lower left to lower right.

Right 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Left

17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

2. Palmers notation

Rt. 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 Lt. 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

3 . Haderup system

It is similar to palmers notation except that it uses a plus sign(+) to designate the upper teeth, and a minus sign(-) for the lower.

Rt.

+ 2 +1
-2 -1

+ 1+2
-1 -2

Lt.

4 . FDI (Federation Dentaire International) two digit system:

It bears a slight resemblance to palmers system in that both utilize the same number, but the F.D.I. System substitutes a number for the quadrant side and that number is placed before the tooth number. RT 1 4 2 3 LT

Diagrammatic or anatomical chart

In this each root is represented by a pictorial symbol that gives the same number of the teeth surface as those on the same teeth in the mouth. The positions of the crowns, caries, fillings, or the other abnormalities are marked on the diagrams.

Animal bites

Rodents gnaw away tissue over fairly limited areas. Bites by the dogs which attacks suddenly are usually clear cut, showing narrow squarish arch.

as the animal bites to hold on to the attacked person. Cat bite shows small rounded arch with punctured marks made by canines, and are usually associated with scratch marks from claws.

Occupation, habits and social position

1.

2.

3.

Cobblers, carpenters, seamstresses, electricians, dressmakers, etc have central notches in the incisor edge of front teeth, due to the holding of the thread, needle, nails, etc. Musicians have localized attrition of there teeth. Some of them have wide defects on the front of the teeth, while others have defects on incisal edge. In pipe smokers and cigarette smokers who use holders, there is a visible loss of material on the incisal edges of the teeth, mostly at angle of the mouth.

Teeth Lower central incisors Upper central incisors Upper lateral incisors Lower lateral incisors Canines First premolars Second premolars First molars Second molars Third molars

Age of eruption of Temporary teeth 5th/6th month 6th/7th month 7th/8th month 8th/9th month II months XX XX 1 year 20 - 30th month XX

Age of eruption of permanent teeth 7th/8th year __________ 8th/9th year __________ 11th/12th year 9th/10th year 10th /11th year 6th/7th year 12th-14th 17th-25th year or more

Differences between Temporary and Permanent Teeth

FEATURES
Size weight

TEMPORARY
Smaller in all dimensions and lighter in weight China white Vertical More constricted

PERMANENT
Larger in dimensions and heavier in weight. Ivory white Slightly projected forward Less constricted

Colour Incisors Neck

Ridge
Roots of molars Replacement Total number Difference in types of teeth

Present in between neck & body No ridge present

More divergent but smaller Replaced by permanent teeth 20 No premolars, 8 molars Less divergent but larger Not replaced by any 32 (sometimes 28 - 31) 8 premolars and 12 molars

MIXED DENTITION

Period of MIXED DENTITION - Starting from the day of eruption of one permanent 1st molar till before the day of eruption of last permanent canine, there will be both temporary and permanent teeth in the jaws. This period, when both permanent and temporary teeth are present in the jaws, is known as the period of mixed dentition. It is about 6-13 years

Dental anatomy

Estimation of Age from Teeth in Elderly Subjects

In elderly subjects, age can be ascertained by application of Gustafson's formula (based on the ageing and decaying changes of teeth). Most of the criteria or changes (except attrition and periodontosis) used in this formula are useful only while examining a dead subject or skeleton because, for examination of those changes, teeth have to be extracted from their sockets. After 18 - 20 years of age the following changes progressively occur in teeth:

Gustafsons method

1) ATTRITION
This change occurs on the opposing mastication surfaces of the teeth of upper and lower gums due to continuous friction. Four degrees are attributed to this change: 1. AO or '0' degree : N'o attrition 2. Al or 1st degree - When attrition is limited within the thickness of the enamel 3. A2 or 2nd degree - When attrition is limited within the dentine tissue. 4. 3 or 3rd degree - When attrition has exposed the soft pulp of the tooth.

Attrition

2)PERIODONTOSIS When maintenance of teeth and gum is bad, there may be loosening of teeth According to the length of exposure of the root, periodontosis has also been awarded four degrees. The rating of periodontosis is done as follows : 1. Po or '0' degree - No periodontosis or no exposure of root. 2. PI or 1st degree - Exposure of less than 1 /3rd of the part of the root next to crown. 3. P2 or 2nd degree - Extension of periodontosis or exposure is more than 1/3rd but less than 2/3rd of the root from near the crown. 4. P3 or 3rd degree - Periodontosis extends beyond 2/3rd of the length of the root from near the crown.

Periodontosis

3. SECONDARY DENTINE With advance in age, there is deposition of secondary dentine tissue in the pulp cavity. The process progresses till replacement of almost whole of the pulp. It starts from above in case of mandibular teeth and from below in case of maxillary. This change has also been given 4 ratings: 1. So or '0' degree - When there has been no deposition of secondary dentine tissue in the pulp cavity. 2. SI or 1st degree - When secondary dentine tissue start to deposit at the upper part (in case of lower ja wand reverse in case of upper jaw) of the cavity. 3. S2 or 2nd degree - When about half of the pulp cavity from 'above' is occupied by secondary dentine tissue. 4. S3or 3rd degree - When almost whole of the cavity is filled up by the dentine tissue

4) ROOT RESORPTION
- is another decaying change. It is classified into.4 gradations: 1. Ro or '0' degree - No resorption at any place of the root. 2. RI or 1st degree - Resorption is noticed only in some spots. 3. R2 or 2nd degree - Resorption is conspicuous over a larger area. 4. R3 or 3rd degree - Resorption of more extensive area, involving both cementum and dentine tissue.

5) CEMENTUM APPOSITION:
is another ageing change counted for estimation of age. This occurs on the surface of the root. There are 4 grades: 1. Co or '0' degree - Only a normal layer of cementum is noticed. 2. CI or 1st degree - When cementum apposition is slightly greater than normal. 3. C2or2nddegree - When a thick layer of cementum apposition has occurred. 4. C3 or 3rd degree - When a heavy layer of cementum is present

6. TRANSPARENCY OF ROOT
This occurs in the root, from below upwards in lower jaw and from above downwards in upper jaw teeth due to rarefication of the dentine tissue. 4 grades are used to record the degree of transparency: 1. Ro or '0' degree - No transparency noticed anywhere. 2. RI or 1st degree - When transparency is just noticeable, mostly over the apical region. 3. R2 or 2nd degree - When upto 1/3rd from the apical region. becomes transparent. 4. R3 or 3rd degree - When transparency extends upto 2/3rd length of the root, from the apex. Of all the above criteria, transparency of root alone is the single most important one (see below). Rating of cementum apposition is most difficult to assess

Anthropometry

1st attempt at a personal identification system

Introduced

by French police expert Alhonse Bertillon in 1883 Called Bertillon system Relied on a detailed description (portrait parle) of the subject Precise body measurement (anthropometry)

Anthropometry

Based on the principle that the dimensions of the human bone system remained fixed from the age of 20 until death It was thought that no 2 skeletons could have the same measurements 11 measurements of the human anatomy was recommended
Height,

width of head, length of left foot etc .

Various measurements

A Bertillon "booking" Card