Pathology and Abnormalities of the Teeth as a Biographical Profile in

Uncovering the Identity of Unknown Skeletal Remains

Eko Prastyo

, Ledy Ana Zulfatunnadiroh

, Rachmadita Yoga Pratiwi

, and Myrtati Dyah Artaria

Forensic Science Study Program, Post Graduate Studies, Universitas Airlangga, Surabaya

The Department of Anthropology, FISIP, Universitas Airlangga, Jl. Airlangga 4-6 Surabaya 60286, Indonesia

Keywords: Individualization, pathology, skeletal remains, dental uniqueness, dentition

Abstract: Proper identification of personal identity is essential in the investigation because mistakes can be fatal in the

judicial process. Identification is based on the peculiar characteristics of the person. The possibility of

positive identification will be increased when considering individualization factors as biographical profile

material. The purpose of this paper is to describe the pathological conditions and abnormalities of teeth and

jaws that can be utilized to increase the completeness of the biographical profile of a person. We use

collections of human skeletons remains in Universitas Airlangga. For this preliminary study, we used 5

crania for observations. The assessment was based on macroscopic observational methods on the teeth and

the alveolar bone. The results show that there are several pathological conditions and disorders that along

with other peculiar characteristics of the individual will add to the individualization of the cranium. Several

dental diseases that are found and can be used for positive identifications are periodontitis, dental caries,

tooth fracture, dental impaction, excessive teeth, malposition and malrotation; and dental stain. Those

characteristics altogether give the uniqueness of the individual. The characteristics should be compared to

images of the person during his living years, and to his known habit-such as smoking and or drinking

coffee/tea. Individualization is needed to enrich biographical profile data in identifying unknown human

skeletal remains, through disease detection and projection of lifelong habit.

1 INTRODUCTION

Proper identification of personal identity is very

important in the investigation because mistakes can

be fatal in the judicial process. Identification is the

determination of the identity of the living or the

dead, based on the typical characteristics of the

person. If any bones and adult skulls are found, there

will be identification of several things. First, race

determination, gender determination, age

identification, height measurement, and facial

reconstruction of the skull also can be done (Byers,

2010).

Dental anthropology is part of the natural

sciences, because this science is part of physical

anthropology. In the process of personal

identification using the tooth many things can be

used as a guide. Each individual has a different

shape or morphology in his teeth. In addition, the

condition of the pathology and abnormalities of teeth

and jaws in each individual is different and can be a

special feature for personal identification (Artaria,

2009).

In this paper the author to describe and explain

the pathological and abnormalities of the teeth and

jaws that can be utilized to increase the

completeness of the biographical profile of a person.

There are not many identification processes that

consider individualization factors as biographical

profile material in terms of uncovering identities of

unidentified skeletal remains. Therefore, the authors

are interested to make a paper that discusses about it.

2 MATERIAL AND METHOD

Materials for this writing is a collection of remaining

human skeletons in Universitas Airlangga. For this

preliminary study, we used 5 cranes for observation.

This assessment is based on macroscopic

observational methods on the teeth and alveolar

bone.

426

Prastyo, E., Zulfatunnadiroh, L., Pratiwi, R. and Artaria, M.

Pathology and Abnormalities of the Teeth as a Biographical Proﬁle in Uncovering the Identity of Unknown Skeletal Remains.

DOI: 10.5220/0007544304260430

In Proceedings of the 2nd International Conference Postgraduate School (ICPS 2018), pages 426-430

ISBN: 978-989-758-348-3

Figure 1: One of the pathological cranium from the rest of

the human skeleton as an object of observation.

3 RESULT AND DISCUSSION

The results show that there are several pathological

groups that signalled dental diseases and disorders in

a person, as well as a person's habit during his

lifetime.

Pathological groups found in cranium, ie;

Periodontitis, Dental caries, Enamel hypoplasia,

Excision. Dental abnormalities found in cranium

include; Fractures on the incisal edge (upper central

incisors), Suspect dental agenesis or impaction of

the upper left canine teeth, Supernumerary teeth or

excess teeth (Parapremolar), Malposition and

malrotation of the supernumerary teeth. Typical

features of specific habits found in cranium are;

Tooth discoloration or tooth staining because of the

bad habit of smoking.

By knowing a pathological state and

abnormalities in the teeth seen in the rest of the

human skeleton we can provide more information as

an attempt to complete the data in order to identify a

person. Moreover, with the discovery of

pathological state and abnormalities in our teeth we

can describe a person's lifetime condition, especially

if the skeletal remains are found in large quantities

and have the same pathological features (Byers,

2010).

3.1 Periodontitis

Periodontitis is a multifactorial disease that causes

infections and inflammation of dental support

tissues, usually resulting in loss of bone and

periodontal ligaments and usually is the cause of

adult tooth loss and edentulousness (Newman et al.,

2018; Ireland, 2006).

Periodontal inflammation has many causes (eg,

bacteria, trauma). However, most of periodontitis

cases are resulted from the accumulation of

microorganisms on the teeth. Risk factors in chronic

periodontitis include the presence of certain

subgingival bacteria, tobacco use, diabetes, age, and

sex. In addition, there is evidence that other factors

may contribute to the pathogenesis of periodontal

disease: environmental, genetic, and systemic (eg,

diabetes) (Gafan et al., 2004; Ireland, 2006).

Figure 2: Alveolar bone resorption and exposed tooth root

that can be seen on the rest of the skeleton, indicating the

occurrence of periodontitis. Alveolar bone resorption is

thorough in all alveolar bone supporting tooth.

3.2 Dental Caries

Caries is the destruction of the crown derived from

bacterial infection. Bacterial metabolic activity

causes acid products that damage the enamel (tooth

enamel). Dental crown caries is caused by aerobic

bacteria. Meanwhile, caries in tooth root is caused

by anaerobic bacteria (Artaria, 2009).

In the remaining skeleton, it can be seen the

presence of caries on the surface of the occlusal, pit

and fissure.

Pathology and Abnormalities of the Teeth as a Biographical Proﬁle in Uncovering the Identity of Unknown Skeletal Remains

427

Figure 3: Dental caries can be found on the rest of the

frame. Occurs on occlusal surfaces, pits and tooth fissures.

3.3 Enamel Hypoplasia

Hypoplasia is a dental development disorder that can

occur as a result of trauma or infection prior to

dental eruption in the oral cavity. It is usually

characterized by disturbances on the formation of

enamel matrices. If Turners of hypoplasia is found in

the anterior region of the tooth, the most likely cause

is trauma to the tooth bud. The clinical

characteristics of enamel hypoplasia are highly

unfavorable for aesthetic, dentin sensitivity become

higher, it may lead to malocclusion and dental caries

(Nayak et al., 2016).

Figure 4: Clinical features of enamel hypoplasia are seen

on the labial surfaces of the central incisors.

3.4 Excision

Tooth excision is a physiological change seen in the

morphology of the occlusal anatomy and incisal

tooth due to dental function. Such morphological

changes are characterized by loss of incisal mamelon

or crown cusp on posterior teeth. Tooth excision

occurs because it is widely used for mastication and

Bruxism. The existence of bad habits such as eating

hard foods, eating grains and grinding teeth can also

cause morphological changes in the teeth (attrition)

(Tamril, 2014).

Figure 5: Visible the entire occlusal surface of the

posterior tooth experienced attrition.

3.5 Fracture

Tooth fracture is one of the main causes of tooth

decay after caries and periodontal tissue disease.

Tooth fracture is a condition of the teeth showing the

loss or fragmentation of the fragment of a complete

tooth. This condition is usually caused by trauma to

the face or teeth such as sports that make physical

contact or engage in car accidents (da Silva

Mendonca DH et al., 2012; DiAngelis AJ et al.,

2012).

Figure 6: Fractures on the incisal edge found on the

remaining skeleton.

ICPS 2018 - 2nd International Conference Postgraduate School

428

3.6 Dental Agenesis and Impaction

Dental agenesis on one or more of the tooth

elements is the most common anomaly found in

human teeth. Every tooth, either permanent or

deciduous teeth, has the possibility of having an

agenesis. In the permanent tooth, the third molar is

the most common tooth of the agenesis, followed by

the incisors of both the maxilla and the mandibular

second premolar. Other teeth that are also often

having an agenesis are the mandibular first incisors

and the maxillary second premolar teeth (Jimenez et

al., 2005). A permanent dental agenesis is the

absence of development of one or more permanent

dental elements because they are not formed or may

be due to the non-growth of permanent dental seed

(Vastardis, 2000).

Etiology of impaction teeth can be caused by

local obstruction of hard tissue, local pathology,

impairment of normal development of incisors, and

genetic or hereditary factors. With the exception of

the third molar teeth, the maxillary permanent

canine is the common tooth impaction. Recent

research on maxillary canine impaction frequency

shows a prevalence of 0.27% to 2.4% where women

are more often than men (Becker and Chaushu,

2015).

3.7 Supernumerary Teeth

(Parapremolar)

Supernumerary teeth or extra teeth is a disorder in

which the number of teeth is more than normal.

These additional teeth usually have an abnormal

morphology and shape. Supernumerary teeth that

resemble normal teeth are called supplemental teeth,

whereas more teeth that do not resemble normal

teeth are called accessory. Supernumerary teeth can

be single, multiple, and unilateral or bilateral

eruptions and may be present in one or both jaws.

Supernumerary teeth are more common in the upper

jaw than in the lower jaw. These excess teeth can

also formed in different parts of the jaw, ie in the

area of the upper incisive incisor (also called

mesiodens), next to the molar teeth (also called

paramolars), at the very back of the last molar teeth

(also called disto-molars) or next to premolar teeth

(also called parapremolars). The most common

supernumerary teeth are mesiodens. This disorder is

more common in permanent teeth than in deciduous

teeth (Parolia et al., 2011).

Figure 7: There are excess teeth (Parapremolar) on the rest

of the skeleton. Excessive teeth experience malposition

and malrotation.

3.8 Malposition and Malrotation of

Supernumerary Teeth

Malposition could be teeth crowed, teeth

overlapping, tilted, shifted, and rarely. Malrotation

could be a tooth rotation. The malposition and

malrotation state are often not recorded on the daily

examination (antemortem), so to overcome the

malposition and malrotation conditions, it can be

examined the postmortem data from the mold model

or from roentgen photographs (Harty and Ogston,

1993).

3.9 Tooth Discoloration or Tooth

Staining

Tooth stains can be caused by smoking. Smoking is

an easy thing to meet everyday in the community.

The number of cigarettes greatly affects the rapid

progress of the formation of dental stains. Duration

of smoking can cause thickening of tooth staining

(Sinaga et al., 2014).

Nicotine with decomposition products especially

pyridine is a substance in producing dental stains

which can often be seen in teeth of smokers. This

element will form pigmented deposits attached to the

surface of the teeth and range the colour in brown to

black. Thickened stain deposits can make tooth

surface become rough which will lead to plaque

build up to irritate nearby gums (Sinaga et al., 2014).

Pathology and Abnormalities of the Teeth as a Biographical Proﬁle in Uncovering the Identity of Unknown Skeletal Remains

429

The use and consumption of tobacco and coffee

can cause tooth stains. The use of tea, certain

mouthwashes and pigments in the diet can also

cause the formation of tooth stains and tobacco also

usually cause stains on the enamel surface. Tooth

stains can enter the tooth layer in people who smoke

during their lifetime and are difficult to remove

(Sinaga et al., 2014).

Figure 8: Stains on the tooth surface due to smoking can

be found on the remaining skeleton.

4 CONCLUSIONS

Individualization is needed to enrich biographical

profile data in identifying unknown human skeletal

remains. It should be considered that identification

of pathological conditions and abnormalities in teeth

cannot be determined arbitrarily because

macroscopic determination alone is not sufficient. In

addition to disease detection, individualization can

project lifestyle habits in the form of stress markers,

as in the object of this writing is likely to have a

lifetime smoking habit as clearly visible the typical

features found on the surface of teeth, smoking can

also be a predisposing factor in periodontitis disease

as well as age.

ACKNOWLEDGEMENTS

We thank the Department of anatomy and histology,

physical anthropology section in Universitas

Airlangga for supporting the observation of skeletal

remains. We would like to Acknowledge Prof.

Myrtati Dyah Artaria for support & Co-operation in

preparing this paper.

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