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I A Pretty

Publications and source records attributed to I A Pretty.

36 records · Page 2Linked to original sources

The intra- and inter-examiner reliability of quantitative light-induced fluorescence (QLF) analyses.

OBJECTIVE: To assess the reliability of the analysis stage of quantitative light-induced fluorescence (QLF). The QLF analysis involves subjective input from the user and this study examines the influence of this on the reproducibility of the QLF data. METHOD: QLF images were taken of 20 human molar teeth that had been previously subjected to a demineralizing solution (phosphoric acid 37%) to create artificial white spot lesions on their buccal surfaces. Following examination of the images, 16 were chosen to represent a range of lesion size and severity. Three copies were made of the images and each was allocated a different filename. 10 examiners in three centres were asked to analyse each of the 16 images on three occasions, with at least seven days between each attempt. Simple instructions describing the analysis procedure were supplied and examiners were asked to adhere to these directions. Examiners were asked to rate each of the 16 teeth on their first attempt both quantitatively (5 point scale) and qualitatively in terms of difficulty of analysis. Data reported were the delta Q at 5% threshold for each tooth on each of three attempts. RESULTS: Using ANOVA and paired t-tests to detect statistical differences, the three attempts of each examiner were used to determine intra-examiner reliability. Only one examiner (a novice at the technique) demonstrated differences between all three attempts and two demonstrated difference between one attempt. When the mean scores were compared to determine the inter-examiner reliability, only one examiner's results were statistically different when compared with two others. CONCLUSION: This study has demonstrated that the analysis stage of QLF is reliable between examiners and within multiple attempts by the same examiner, when analysing in vitro lesions. Novices at the technique should be trained before analysing experimental data.

Analysis of Variance↗

Determination of the sensitivity and specificity of sibship calculations using AmpF lSTR Profiler Plus.

In circumstances where a known DNA reference sample from the deceased's belongings or biological parents is not available, more complex kinship analyses are possible. The purpose of the work reported here is to determine the sensitivity and specificity of the sibship analysis utilising multiple STR loci. Using all nine Profiler Plus loci, likelihood ratios for biologically-related siblings ranged from slightly less than 1 to over 45,000. When allelic dropout was mimicked, likelihood ratios ranged from less than 1 to over 1,000. Thus, the results of this study have a direct application to forensic laboratories faced with identifications involving sibling comparisons.

British Columbia↗

Detection of in vitro demineralization of primary teeth using quantitative light-induced fluorescence (QLF).

INTRODUCTION: With the advent of remineralizing therapies and the new, conservative approach to restoration placement, interest in detecting and monitoring subclinical, precavitated lesions has increased. The increased understanding of clinicians about the processes of primary and secondary prevention and the detection of lesions to which these therapies may be applied, is one of the current goals in caries management. Quantitative light-induced fluorescence (QLF) is a new method for the detection of very early caries. OBJECTIVES: To determine the ability of QLF to detect and longitudinally monitor in vitro enamel demineralization. To present the device to the paediatric community and present future in vivo uses of the device. DESIGN: An in vitro study with combined in vivo pilot. SAMPLE AND METHODS: Twelve previously extracted, caries free, primary molars were selected and prepared. Two teeth were randomly selected as controls. Teeth were prepared by gentle pumicing and coating in an acid-resistant nail-varnish, except for an exposed window on the buccal surface. QLF baseline images were taken and the teeth then exposed to a demineralizing solution. Teeth were removed at regular intervals (24, 48, 72, 96, 120, and 144 h), air-dried and QLF images taken. QLF images were analysed by a single, blinded examiner (to control, to length of exposure). Mineral loss, as measured by DeltaQ, was recorded. RESULTS: Demineralization was noted in all experimental teeth by 48 h, and within 24 h in six teeth. The QLF successfully monitored the increase in mineral loss over time (P < 0.05). The detected lesions were not visible clinically until 144 h and then in only the most severe lesions. No demineralization was detected by QLF in control teeth. The device was user- and patient-friendly in vivo, detecting subclinical lesions. CONCLUSION: Detection of very early mineral loss and subsequent monitoring of this loss is possible in primary teeth using QLF. The device is well suited to use in paediatric dentistry and offers applications for both clinicians and researchers. The determination of the status of carious lesions (active/inactive) will be possible with readings taken at recall appointments.

Analysis of Variance↗

The effect of ambient light on QLF analyses.

The use of optical methods in the diagnosis of early caries is developing rapidly. The introduction of the quantitative light-induced fluorescence (QLF) device has promised the use of a quantifiable technique in vivo. This study describes the effect that ambient light has upon the reliability of QLF analyses. Using human teeth and simulated lesions the study examined the effect of 15 different light levels on three severities of carious lesions. The study found that a light level of 88 lux could be employed in areas where QLF is to be used without significantly affecting the reported value, DeltaQ. This study impacts upon the health and safety issues surrounding QLF usage as well as ethical issues relating to working in dark environments.

Analysis of Variance↗

Results of the 4th ABFO Bitemark Workshop--1999.

Thirty-two certified diplomates of the American Board of Forensic odontology (ABFO) participated in a study of the accuracy of bitemark analysis. Examiner experience as board-certified odontologists ranged from 2 to 22 years. Examiners were given sets of photographs (a cast in 1 case) of 4 bitemark cases and asked to report their certainty that each case was truly a bitemark and the apparent value of the case as forensic evidence. Participants also received 7 occluding sets of dental casts, 1 correct dentition for each case and three unrelated to any of the cases, and asked to rate how certain they were that each set of teeth had made each bitemark. Receiver operating characteristic (ROC) analysis resulted in an accuracy score of 0.86 (95% CI=0.82-0.91). Youden's index was used to determine a cutoff point for determining an accuracy score for each case. Accuracy scores were significantly correlated with bitemark certainty and forensic value (P<0.001 in both cases) but not with examiner experience (P=0.958). The use of individual ROC analysis with weighted Youden's index to calibrate individual accuracy was also demonstrated.

Bites, Human↗

The use of QLF to quantify in vitro whitening in a product testing model.

BACKGROUND: Professional and consumer interest in whitening products continues to increase against a background of both increased oral health awareness and demand for cosmetic procedures. In the current legal climate, few dentists are providing 'in-office' whitening treatments, and thus many patients turn to home-use products. The most common of these are the whitening toothpastes. Researchers are keen to quantify the effectiveness of such products through clinically relevant trials. AIM: Previous studies examining whitening products have employed a variety of stained substrates to monitor stain removal. This study aimed to quantify the removal of stain from human enamel using a new device, quantitative light-induced fluorescence (QLF). The experimental design follows that of a product-testing model. MATERIALS AND METHODS: A total of 11 previously extracted molar teeth were coated with transparent nail varnish leaving an exposed window of enamel. The sound, exposed enamel was subject to a staining regime of human saliva, chlorhexidine and tea. Each of the eleven teeth was subjected to serial exposures of a positive control (Bocasan), a negative control (water) and a test product (Yotuel toothpaste). Following each two-minute exposure QLF images of the teeth were taken (a total of 5 applications). Following completion of one test solution, the teeth were cleaned, re-stained and the procedure repeated with the next solution. QLF images were stored on a PC and analysed by a blinded single examiner. The deltaQ value at 5% threshold was reported. ANOVA and paired t-tests were used to analyse the data. RESULTS: The study confirmed the ability of QLF to longitudinally quantify stain reduction from human enamel. The reliability of the technique in relation to positive and negative test controls was proven. The positive control had a significantly (alpha = 0.05) higher stain removal efficacy than water (p = 0.023) and Yotuel (p = 0.046). Yotuel was more effective than water (p = 0.023). CONCLUSION: The research community, the practicing clinician and the consumer all require sound product evaluation data. The use of human enamel specimens may offer more relevant clinical data. QLF has been designed as an in vivo device. Further development of the technique should permit in vivo clinical whitening trials.

Analysis of Variance↗

A look at forensic dentistry--Part 2: teeth as weapons of violence--identification of bitemark perpetrators.

Teeth are often used as weapons when one person attacks another or when a victim tries to ward off an assailant. It is relatively simple to record the evidence from the injury and the teeth for comparison of the shapes, sizes and pattern that are present. However, this comparative analysis is often very difficult, especially since human skin is curved, elastic, distortable and undergoing oedema. In many cases, though, conclusions can be reached about any role a suspect may have played in a crime. Additionally, traces of saliva deposited during biting can be recovered to acquire DNA evidence and this can be analyzed to determine who contributed this biological evidence. If dentists are aware of the various methods to collect and preserve bitemark evidence from victims and suspects it may be possible for them to assist the justice system to identify and prosecute violent offenders. This paper reviews the recognition and recovery of this evidence and provides insight into modern methods used to investigate bitemark evidence from heinous crimes.

Bites, Human↗

A look at forensic dentistry--Part 1: The role of teeth in the determination of human identity.

Forensic dentistry can be defined in many ways. One of the more elegant definitions is simply that forensic dentistry represents the overlap between the dental and the legal professions. This two-part series presents the field of forensic dentistry by outlining two of the major aspects of the profession: human identification and bite marks. This first paper examines the use of the human dentition and surrounding structures to enable the identification of found human remains. Conventional and novel techniques are presented.

DNA Fingerprinting↗

The design and assessment of mock mass disasters for dental personnel.

Mass disasters represent a significant challenge for dental personnel who are frequently called upon to provide identifications. Recently-published materials have highlighted the need to prepare such groups for the disaster challenge and to report inadequacies in existing preparation methods with an emphasis on team integration, organization, and the psychological and emotional effects of such work. Many studies have retrospectively reported errors that have been made in disaster situations, but few have addressed the issues proactively. In an effort to provide a prepared team of dental members, a mock disaster exercise (Operation: DENT-ID) is conducted annually in Vancouver, Canada. The present study analyzes the effectiveness of this exercise in relation to team organization, assessment of preparedness, and the emotional and psychological issues. An index of preparedness is developed and described. This index, in the form of a questionnaire, can be given to participants in mock disasters to assess the effectiveness of such exercises. While the focus of this paper is on the assessment of dental personnel, the indices and methods used can be applied to any group working within the disaster team. Results indicate that the increase in preparedness as a result of the exercise was highly significant.

Adaptation, Psychological↗

Adherence of forensic odontologists to the ABFO bite mark guidelines for suspect evidence collection.

Boards and associations within forensic science have long been accepted as vehicles for the development and dissemination of protocols and recommendations for practice. Recent controversies surrounding bite mark analyses have brought the methods and practices of forensic dentists to the attention of both the courts and the media. In the mid-eighties the American Board of Forensic Odontology developed guidelines for bite mark analysis in response to unfavorable commentaries on the discipline by legal observers. The purpose of this study is to examine the adherence of board certified and noncertified forensic dentists to the guidelines for collection of evidence from bite mark suspects. A questionnaire was employed during an American Academy of Forensic Sciences meeting. Results showed that, in general, when the odontologists collected evidence they did adhere to the guidelines, although collection of salivary samples was not common. Of concern is the large number of odontologists who do not collect their own evidence from suspects. Police officers or other individuals often perform this task and therefore the guidelines must be disseminated to these groups to ensure that the maximum yield is obtained from bite mark evidence. A review of the materials used to collect evidence is also included with details of applications in forensic science.

Bites, Human↗

Digital bite mark overlays--an analysis of effectiveness.

U.S. courts have stated that witnesses must be able to identify published works that define operational parameters of any tests or procedures that form the basis of scientific conclusions. Such works do not exist within the field of bite mark analysis. As the most commonly employed analytical technique in bite injury assessment. this study defines quantifiable variables for transparent digital overlays. A series of ten simulated, postmortem bites were created on pigskin and, with accompanying overlays, assembled into cases. Using two separate studies with four examiner groups, the study defined values of intra- and inter-examiner reliability, accuracy. sensitivity, specificity, and error rates for transparent overlays. Methods and statistical treatments from medical decision-making and diagnostic test evaluation were employed. Forced decision models and receiver operating characteristic analyses were utilized. Sensitivity and specificity values are described. and the results are consistent with other dental diagnostic systems. It was concluded that the weak inter-examiner reliability values explain the divergence of odontologists' opinions regarding bite mark identifications often stated in court. The effect of training and experience of the examiners was found to have little effect on the effective use of overlays within this study. The authors conclude that further research is required so that the results of the current study can be placed into context, but this represents a significant first step in establishing the scientific basis for this aspect of forensic dentistry.

Animals↗

Lack of dental uniqueness between two bite mark suspects.

The central dogma of bite mark analysis is based upon two assumptions. The first is that human teeth are unique, and the second is that sufficient detail of the uniqueness is rendered during the biting process to enable identification. Both of these assumptions have been challenged over recent years, and a healthy scientific skepticism surrounding bite mark analysis has developed. The case presented features two suspects whose dental arrangement was similar and, when compared to the bite mark, both demonstrated consistent features. Within a closed population of possible biters, one of the two suspects was responsible for the injury. The case is illustrated with photographic and overlay detail of the suspect's teeth and demonstrates the complexity of such cases. The authors call for greater caution when drawing conclusions from such cases and highlight the need for further research into the replication of dental features on human skin.

Bites, Human↗

Anatomical location of bitemarks and associated findings in 101 cases from the United States.

The purpose of this paper is to update and confirm previous studies that examined the anatomical location of human bitemarks. This information is useful to forensic odontologists and pathologists, physicians, and coroners who must be familiar with the most likely locations of bitemarks. The data are also useful for those involved in bitemark research. Using the legal database "Lexis," 101 bitemark cases were identified from the United States Courts of Appeal. Cases were included in the study if they provided details concerning the bitemark, such as anatomical location, number of injuries, and information concerning the victim. Information on 148 bites was collated. These data are presented in tabular and graphical form to allow comparisons between males and females, victims and perpetrators, adults and children, and the crime types associated with human bites.

Adolescent↗

Human bites and the risk of human immunodeficiency virus transmission.

The risk of human immunodeficiency virus (HIV) transmission following a bite injury is important to many groups of people. The first are those who are likely to be bitten as an occupational risk, such as police officers and institutional staff. Another group are represented by the victims and perpetrators of crimes involving biting, both in attack and defense situations. The possibility of these bites transmitting a potentially fatal disease is of interest to the physicians who treat such patients and the legal system which may have to deal with the repercussions of such a transmission. Bite injuries represent 1% of all emergency department admissions in the United States, and human bites are the third most common following those of dogs and cats. The worldwide epidemic of HIV and acquired immunodeficiency syndrome (AIDS) continues, with >5 million new cases last year and affecting 1 in 100 sexually active adults. A review of the literature concerning human bites, HIV and AIDS, HIV in saliva, and case examples was performed to examine the current opinion regarding the transmission of HIV via this route. A bite from an HIV-seropositive individual that breaks the skin or is associated with a previous injury carries a risk of infection for the bitten individual.

Adult↗

The scientific basis for human bitemark analyses--a critical review.

This article presents a discussion of the scientific basis for human bitemark analyses. Using a review of the literature, the major areas of contention within the field are assessed: including the accuracy of bitemarks on skin, the uniqueness of the human dentition, and analytical techniques. The review revealed a lack of valid evidence to support many of the assumptions made by forensic dentists during bitemark comparisons. The new level of judicial scrutiny of such scientific evidence is likely to emphasise this lack of knowledge upon which bitemark analysis relies. The authors call for a more scientific and evidence-based approach to forensic dental research.

Bites, Human↗

Associated postmortem dental findings as an aid to personal identification.

The use of the unique features of the human dentition to aid in personal identification is well accepted within the forensic field. Indeed, despite advances in DNA and other identification methodologies, comparative dental identifications still play a major role in identifying the victims of violence, disaster or other misfortune. The classic comparative dental identification employs the use of postmortem and antemortem dental records (principally written notes and radiographs) to determine similarities and exclude discrepancies. In many cases the tentative identification of the individual is unknown and therefore antemortem records cannot be located. In such a situation a dental profile of the individual is developed to aid the search for the individual's identity. With such a profile a forensic odontologist can identify and report indicators for age at time of death, race (within the four major ethnic groups) and sex. In addition to these parameters the forensic dentist may be able to give more insight into the individual. This paper outlines, for the non-expert, some of the additional personal information that can be derived from the teeth of the deceased, and which may assist in their ultimate identification.

Forensic Dentistry↗

The effect of video repositioning on the reliability of light-induced fluorescence imaging: an in vivo study.

The ability to monitor longitudinally the development, arrest or resolution of early demineralised lesions is one strength of quantitative light-induced fluorescence (QLF). When taking sequential images of an individual's teeth for monitoring it has been suggested that the subsequent images should be taken from the same position the baseline image. To assist in this process, video repositioning software is available that enables automatic capture of images once the system identifies that they are similar enough to the baseline comparator. The purpose of this study was to determine if the use of such software-assisted capture improves the reliability of subsequent QLF analysis. 20 subjects had 34 surfaces (buccal and occlusal) imaged by 2 examiners at baseline, and again 1 week later using both manual and software-assisted (VidRep) systems. Analysis of the three key reportable values for QLF (DeltaF, lesion area, DeltaQ) suggested that there is no significant improvement in reliability using VidRep although VidRep demonstrates additional advantages above and beyond image geometry, relating to the speed of subsequent image analysis.

Child↗