International Journal of Dental and Health Sciences Review Article Volume 02,Issue 06 VIRTOPSY: NEW PHASE IN FORENSIC ODONTOLOGY Yogish.P 1, Asha Yogish 2 1.Assisstant Professor in Department of Oral Pathology and Microbiology, Sharavathi Dental College and Hospital, Shivamogga. 2.Postgraduate student in Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences, Virajpet. ABSTRACT: Nowadays, technological advances are becoming more and more important in forensic sciences. Yet autopsy is still one of the very traditional methods. This also applies for dental autopsies, in which visual, photographic and radiological evidences are collected. Virtual Autopsy appears as a helpful and complementary tool for dental and medical cadaveric examination. Using high-tech radiological approaches, Virtual Autopsy may provide, through images, an efficient and more accurate view on the individual case. This critical review aims to update on the origin, applications of virtopsy and also the role of dentists in this field. Keywords: Autopsy; Radiology; Forensic Odontology INTRODUCTION: Death is an inevitable part of life and at psychiatry and behavioural science, few occasions scientific examination of questioned documents, toxicology and bodies after death becomes mandatory. physical anthropology. Modern day investigations have reached a point of sophistication interconnecting Forensic pathology is a discipline of the involvement of many different Forensic science which deals with disciplines to serve problems including pathologic and physiologic changes of a establishing reasons for death. The body before and after death wherein contribution of Forensic science in autopsy plays a significant role which achieving this is noteworthy. deals with establishing the circumstance leading to death by scientific Forensic Science is an area of examination of the whole surface of the specialization that can be used in a body as well as body cavities.[1] judicial setting and involves principles and procedures for the systematic The main aim of this review article is to application of knowledge involving update on the origin, applications of collection of data through observation virtopsy and also the role of dentists in and experimentation thus leading to this field. recognition and formulation of a HISTORY OF AUTOPSY problem. It involves 10 disciplines which Greek physicians Erasistratus and include Crimanilistics, engineering Herophilus dissected cadavers to study science, general, jurisprudence, the working of organs and nerves.[2] It odontology, pathology/biology, was in 1700 when Giovanni Morgagni – *Corresponding Author Address: Dr Yogish.P Email: [email protected] Yogish.P et al, Int J Dent Health Sci 2015; 2(6):1548-1555 the founder of today's autopsy wrote a legal purposes was seen in the forensic book on “The seats and causes of practice since 1896.[7] Disease" investigated by anatomy and published it in 1761 in which he Martin and Arroio showed the described 700 autopsies that he applicability of post-mortem performed. Susequently Matthew Baillie, radiographic techniques in order to in 1793 wrote a textbook on Morbid identify bodies through comparative [8] Anatomy of the Human Body and its analysis of the cranial sinuses. Besides, accompanying atlas, 6 years later.[2] In numerous cases were reported in which 1800, William Osler who taught liver, heart, brain and bone injuries were medicine placed autopsy at the centre investigated radio graphically revealing of the medical education.[3] the possible death cause. Furthermore, X-ray examinations were valuable to AUTOPSY VS VIRTOPSY perform guided autopsies based on the acquired skeletal information. More The etymology of “autopsy” refers to the specific in detecting(healing) bone doctor examining a body, and the union fractures, which in many cases are of the terms “autos” and “psia” meaning indistinguishable during traditional [4] “own” and “view” respectively. The autopsy.[8] A new autopsy technique traditional internal autopsy procedure consists of the internal examination of consists of body mutilating techniques. death bodies using computed Due to the emotional aspects of the tomography (CT) and magnetic victim’s relatives, their knowledge of resonance imaging (MRI), without these mutilation forms the major opening the body or body parts. Besides, [5] objection against autopsies. The it allows the reconstruction of a 3D view arguments justifying the autopsy, of the analyzed cadaver. This procedure namely the need to know the cause of was called “Virtopsy.[9] death or the identity of an unknown deceased individual overrules this The term Virtopsy coined by Thali M.. et emotional involvement. Therefore, the al is created from the terms Virtual and families and relatives of the victim often Autopsy where Virtual is derived from remain in a conflicting situation with the the latin word “Virtus” which means forensic examiners.[6] Parallel to that, „useful, efficient and good‟ and some religious and cultural aspects elimination of autos ie, self thus leading represent relevant objections for the to the scientific umbrella Virtopsy. autopsy procedure. Based on these Virtopsy is a transdisciplinary technology objections, and in an attempt to that combines Forensic medicine, ameliorate the autopsy results, pathology, radiology, image processing, alternative aids in diagnosing the cause physics and biomechanics.[10] Because of death were developed. One of these is the dentition contains multiple radiological imaging. Its use for medico- identifiers teeth often play a major role 1549 Yogish.P et al, Int J Dent Health Sci 2015; 2(6):1548-1555 in human identification processes. analysis concluded that the effective These processes allow for dental relative to the use of placebo was about identification: 2.1 (95% confidence interval 1.5-3.0) [5]. The basic effect of bupropion is to The comparison between post mortem elevate the levels of dopamine in the (PM) and ante-mortem (AM) data, the brain. Increase in the levels of dopamine development of dental PM victim are associated with the use of nicotine, profiles and the dental DNA so the use of bupropion mimics the use [11] techniques. of nicotine. This mechanism helps to quit tobacco faster relatively then other The collection of all PM dental data is drugs. Also it helps in maintaining the indispensable for dental identification. diet and weight of the patient. Some These are obtained by direct visual studies have also suggested that the observation and related recording of the conjugation of bupropion and nicotine available evidence. Additional patch is more effective than either of information is collected after them being used alone [6]. photographic and radiographic imaging of the dentition and the oral cavity. In Another important drug very commonly certain cases the PM photographic and used in the treatment of tobacco abuse radiological exam is difficult because the is Clonidine. Clonidine has been widely access to the oral cavity is hindered (e.g. used in opium and alcohol withdrawal bodies in rigor mortis condition).In but recent studies suggest its efficacy in contrast to the classical dental autopsy tobacco withdrawal as well [7]. Also drug the virtual autopsy process allows dental named nortriptyline can also be used in identification in an accurate and quick the tobacco cessation therapy but only way without damaging the body to as a second line therapy. access the available dental data. Dental age estimation methods based on tooth Imaging techniques was supported by development can be applied during the the creation of organizations like the virtual autopsy, allowing the examiner to Institute of Forensic Medicine include or exclude individuals based on (Denmark), the Victorian Institute of age related victim lists.[12] Pathology (Australia), the Society of Imaginological Autopsy (Japan) and the ORIGIN AND MECHANISMS Headquarters of Medical Examinations of the Armed Forces of the United States Drugs Aiding in Cessation: The most of America.[13] In the nineties, the common line of drugs indicated to be Institute of Forensic Medicine of the aiding in tobacco cessation are the anti- University of Bern, Switzerland, began to depressants. Amongst the majority, the document on the characteristics of the basic drug used is Bupropion human body in a concrete, objective and Hydrochloride. A placebo trial of non-invasive way. This resulted in the bupropion was conducted and the 1550 Yogish.P et al, Int J Dent Health Sci 2015; 2(6):1548-1555 creation of a new discipline, denoted as is performed using the GOM “Virtopsy”, a virtual project of TRITOP/ATOSIII® system (GOM®, autopsy.[14] In this context, the concept Braunschweig, Germany).[15] The TRITOP of the objective and noninvasive portion is based on photogammetry, documentation of the body consists in therefore digital images are taken by a the observation of the anatomical Nikon D2X® camera (Nikon Corp.®, structures through computed Tokyo, Japan) and submitted wirelessly tomography (CT), magnetic resonance to the main system.[15] Through these (MRI) and micro radiology devices. images the photogammetry calculates Specific software (e.g. Tera Recon the position of the body and the texture Aquarius NET®, Foster City, California, of the surface model. The surface United States of America) allowed for 3D scanning is performed by the ATOS reconstructions of the computed component, and it is based on the tomography images from the observed principle of triangulation. The sensor