Role of endodontic treatment related signs for the forensic odontology practice considering real-life quality of comparable radiographs

Abstract

Background. Real life quality of periapical radiographic images widely varies, while also periapical radiographs not always have been taken at the same angulation, especially in multirooted tooth cases, which in turn potentially may limit the value of obtained information received during endodontic treatment for the further comparative dental identification. Objective. To objectify possibility of using real-life quality periapical radiographs obtained during endodontic treatment for the comparative dental identification. Materials and Methods. Research was organized in the form of cross-sectional hospital-based study. Copies of ten pairs of selected radiographs were distributed for the Set 1 (simulation of ante-mortem images), which contained 10 radiographs of before root canal treatment, and Set 2 (simulation of post-mortem images), which contained 10 radiographs of after endodontic interventions. Set 1 and Set 2 images were randomized, and structured via Google Form, and five teaching assistants from the Department of Restorative Dentistry were asked to match the images through provided Google Form. Results. The range of 50-80% correct pre- and post-treatment images matching levels were registered among five operators. The mean correct matching level reached 68.0 ± 7.2%. Experience within endodontics seems to be valuable regressor regarding outcome performance (p < 0.05), while additional Radiology specialization did not significantly improved performance level for matching pre- and post-treatment images (p > 0.05). Operator graded 5 out of 10 images pair as relatively easy to match, 2 images – as moderately difficult to match, and 3 images – as hard to match (Fig. 3), while their agreement on the obtained above-mentioned scores reached 0.8. Conclusion. Significance of endodontics within forensic odontology field in most cases dictated by using the results of periapical radiology as evidences of ante-mortem origin, while also considering the fact of root canal morphology uniqueness and individualized endodontic treatment pattern consistency both ante- and post-mortem even under the influence of various disturbing factors. On the other hand identification role of endodontic signs may be diminished within the absence of proper quality radiographs, or when such were provided at critically different angulations, while also when endodontic-related evidences could not be supported by dental records.