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Determinação médico-legal da identidade de cadáveres não documentados: análise radiográfica de ortopantomografias e telerradiografias por sobreposição dos seios nasais, frontais e maxilares numa população portuguesa
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Objetivo: Validar o método de análise radiográfica de ortopantomografias e telerradiografias por sobreposição dos seios nasais, frontais e maxilares numa População Portuguesa, no âmbito determinação médico-legal da identidade de cadáveres não documentados. Metodologias: A amostra populacional consistiu em 104 ortopantomografias e 96 telerradiografias pré e pós tratamento ortodôntico, obtidos no departamento de ortodontia da Faculdade de Medicina Dentária da Universidade de Lisboa, entre Setembro de 2016 e Maio de 2017, com 27 indivíduos do género masculino e 25 do género feminino com idades compreendidas entre os 11 e os 52 anos. Realizou-se a sobreposição entre todos os exames imagiológicos com recurso aos programas de manipulação de imagens Microsoft 2017® e Adobe Photoshop CC 2015®, com prévio delineamento dos limites. Todos os dados foram tratados estatisticamente no programa SPSS versão 24. Resultados: Foi analisada uma distribuição homogénea por género, com afinidade populacional maioritariamente caucasiana e com idade média de 22 anos. A validação intra-observador apresentou valores de concordância entre excelente e razoável. As estruturas analisadas obtiveram sempre valores acima dos 50% de casos de sobreposição negativa, com maior significado no género masculino, e com aumento com o intervalo de tempo de tratamento mais alargado. Discussão/Conclusão: Com base nos resultados obtidos, verificou-se que as estruturas analisadas apresentam diferenças estatisticamente significativas entre o período ante mortem e post mortem simulados com as ortopantomografias e telerradiografias, justificável com a reduzida amostra e inexperiência do observador. Assim não é possível tirar conclusões válidas quando à aplicabilidade deste método estudado. São necessários mais estudos com amostras maiores e intervalos etários mais alargados, de forma a aumentar a evidência científica e contribuir para o progresso na área da Medicina Dentária Forense.
Objective: To validate the method of radiographic analysis of orthopantomographies and cephalograms by overlapping of the nasal, frontal and maxillary sinuses in a Portuguese population, within the medical-legal determination of the identity of undocumented cadavers. Methodologies: The population sample consisted of 104 orthopantomographies and 96 pre and post-orthodontic teleradiographies obtained at the Orthodontics Department of the Dental Faculty from University of Lisbon between September 2016 and May 2017, with 27 individuals of the masculine gender and 25 of the feminine gender between the ages of 11 and 52 years. Overlapping of all imaging tests was performed using the Microsoft 2017® and Adobe Photoshop CC 2015® image manipulation programs, with prior boundary delineation. All data were statistically treated in the SPSS version 24. Results: A homogeneous distribution was analyzed by gender, with a predominantly caucasian population affinity and with a mean age of 22 years. The intra-observer validation presented agreement values between excellent and reasonable. The analyzed structures always obtained values above 50% of cases of negative overlap, with greater significance in the male gender, and with increase with the longer treatment time interval. Discussion /Conclusion: Based on the obtained results, it was verified that according to the analyzed structures they present statistically significant differences between the ante-mortem and post-mortem period simulated with orthopantomographies and cephalograms, justifiable with the reduced sample and inexperience of the observer. Thus, it is not possible to draw valid conclusions about the applicability of this method. Further studies with larger samples and wider age ranges are needed to increase scientific evidence and contribute to progress in the field of Forensic Dentistry.
Objective: To validate the method of radiographic analysis of orthopantomographies and cephalograms by overlapping of the nasal, frontal and maxillary sinuses in a Portuguese population, within the medical-legal determination of the identity of undocumented cadavers. Methodologies: The population sample consisted of 104 orthopantomographies and 96 pre and post-orthodontic teleradiographies obtained at the Orthodontics Department of the Dental Faculty from University of Lisbon between September 2016 and May 2017, with 27 individuals of the masculine gender and 25 of the feminine gender between the ages of 11 and 52 years. Overlapping of all imaging tests was performed using the Microsoft 2017® and Adobe Photoshop CC 2015® image manipulation programs, with prior boundary delineation. All data were statistically treated in the SPSS version 24. Results: A homogeneous distribution was analyzed by gender, with a predominantly caucasian population affinity and with a mean age of 22 years. The intra-observer validation presented agreement values between excellent and reasonable. The analyzed structures always obtained values above 50% of cases of negative overlap, with greater significance in the male gender, and with increase with the longer treatment time interval. Discussion /Conclusion: Based on the obtained results, it was verified that according to the analyzed structures they present statistically significant differences between the ante-mortem and post-mortem period simulated with orthopantomographies and cephalograms, justifiable with the reduced sample and inexperience of the observer. Thus, it is not possible to draw valid conclusions about the applicability of this method. Further studies with larger samples and wider age ranges are needed to increase scientific evidence and contribute to progress in the field of Forensic Dentistry.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2017
Palavras-chave
Medicina Dentária Forense Radiografia dentária Identificação humana Teses de mestrado - 2017