ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Comparison of Computed Tomography (CT) and Odontogram in Forensic Identification
Clinical Question For an unidentified person, will computed tomography be as accurate as the analysis of written and graphic dental records in forensic dental identification?
Clinical Bottom Line Results of the study were inconclusive and no decision about computed tomography can be determined from this study. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18679703Kirchoff/2008Ten whole skulls collected from the Institute of Forensic MedicineLaboratory Study
Key resultsComputed tomography, when compared to odonotogram, resulted in a sensitivity of 88.2%, specificity 97.1%, positive predictive value 88.7%, and negative predictive value 97%.
Evidence Search "Forensic Dentistry"[Mesh] "Tomography, X-Ray Computed"[Mesh] ...view in PubMed
Comments on
The Evidence
The Gold Standard that was applied in this study was incorrectly identified as the comparison of dental odontograms. The true Gold Standard for forensic identification is the comparison of ante-mortem and postmortem radiographs. This study was also not blind to the target test. The Gold Standard was used in all patients. There were no competing interests.
Applicability The choice to conduct a CT scan is not always a feasible option due to the lack of ante-mortem availability, precision, and accuracy. Even though CT was found to produce many errors in this research, it is important to note that this study was conducted in 2008 and that better technology has been developed since that time. This study fails to demonstrate the potential of CT use in forensic identification. CT comparisons warrant further research using current and rapidly improving technology.
Specialty/Discipline (Basic Science)
Keywords Forensic odontology, computed tomography
ID# 813
Date of submission: 04/05/2011spacer
E-mail womackj@livemail.uthscsa.edu
Author James Womack
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author David Senn, DDS
Faculty mentor/Co-author e-mail SENN@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Lilley Gharavi, Michael Morchat, Scott Makins (San Antonio, TX) on 10/09/2014
A PubMed search on dental computed tomography compared to an odontogram was performed on October 2014. No updated evidence is available for this comparison, however, as the author of the this CAT states, the odontogram was used incorrectly as the gold standard in the study by Kirchoff. The gold standard for dental forensics involves premortem and antemortem radiographs. In a more recent publication: Murphy 2012 PubMed 22390716, this retrospective study on 30 individuals showed that CT units with flat panel detectors and CBCT are capable of producing images which can be favorably compared to antemortem images (panoramic radiographs) for identification and age determination purposes.
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